This study details the creation of two Simulat1on models for a cardiac surgery
specialty in a Midlands hospital The models were designed to help the
specialty meet waiting time targets set out by the Government in their NHS
The first model is a spreadsheet data Simulation that gives a general prediction
of patients waiting for surgery by time band for up to a year in the future based
on previous data.
The study uses the qualitative analysis of Interviews and documents to
generate the second model The first part of this model is a qualitative causal
loop diagram of the cardiac surgery system A quantitative 'Stock & Flow'
model is drawn from this qualitative model which gives detailed predict1ons of
waiting lists and times and other system variables for the cardiac surgery specialty
The system dynamics model is validated it can estimate the maximum number
of new outpatient attendances the system can support whilst keeping inpatient
waiting times below three months for various configurations of theatre time and
Cardiac lntensive Care Unit (CICU) beds The study concludes that CICU beds
are a bigger constraint on inpatient waiting times in the cardiac surgery
specialty at the hospital than theatre time. Measures to improve waiting times
and shorten lists should therefore concentrate on improving patient flow
through the CICU, for example more beds in the unit would enable more
patients to be treated The model can also demonstrate the use of the theory of
constraints in managing waiting lists, which is the method used by the NHS
Modernisation Agency in their guidance on wait1ng list management.
A Doctoral Thesis. Submitted in partial fulfilment of the requirements for the award of Doctor of Philosophy of Loughborough University.