Robust reusable reliable models for health care optimization

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Canadians spend more than $142 billion on health care (CIHI, 2005).  Despite spending a record 10.4% of GDP in 2005 on health care, demand for services is increasing.  Ensuring timely access to care at all levels of acute care is a pressing concern and has been the subject of much debate recently, particularly with respect to access to elective procedures.Hospitals and health care processes are usually thought of as a network of queues with mulitple types of customers and complicated priority schemes.  Simulation, accordingly, is an ideal tool for modelling and analyzing patient flows.The application of simulation to particular instances of patient flow is well studied and documented in the literature (see Jun, Jacobson and Swisher, 1999 or Preater, 2002 for excellent reviews).  However, one of the more interesting aspects of the operational research literature on patient flow is the number of "one-off" studies that appear in the literature.  The overhead in terms of time, effort, and expense have limited the penetration of simulation methodologies into the health care arena, despite their obvious benefits.We propose the development of a tool to evaluate wait time issues at the local, regional, and provincial level.  We hypothesize that, despite variations in the organization of care delivery, a common framework can be developed to describe patient flow instances.  Once identified, the framework can be used to develop functional specifications for composable simulation elements that can be used to model patient flow processes.  Ultimately, we believe that it is possible to create a simulation-based environment for decision making that can be used by non-experts to make informed patient flow process decisions.