Optimising complex care pathways for inflammatory rheumatic disease using a practical simulation tool

Norfolk and Norwich University Hospitals NHS Foundation Trust

This project is under way, and will run until November 2020.

  • Run by Norfolk and Norwich University Hospitals NHS Foundation Trust, in partnership with the University of East Anglia.
  • Project aimed at improving understanding of where improvements can be made to care pathways for people with musculoskeletal conditions, and what changes are effective.
  • A user-friendly, web-based simulation tool will be developed that combines epidemiological data with local care pathway information to model the effect of system changes.

Musculoskeletal conditions affect one in four adults in the UK, and have a significant impact on quality of life. Caring for people with musculoskeletal conditions accounts for 5% of the NHS budget.

There is considerable variation in the management of, and outcomes for, people with these conditions across the UK, and understanding of how best to standardise and improve quality of care is complex.

This Advancing Applied Analytics project involves developing a user-friendly simulation tool that synthesises complex epidemiological data on inflammatory rheumatic disease into a simulation of a Trust’s long-term care pathway. The project will extend and refine an existing national-level model of rheumatoid arthritis and ankylosing spondylitis by including detailed local information of organisational structures, clinical activities and prescribing.

The tool will utilise ‘agent based simulation’ – computer models that simulate a whole system by capturing the behaviour of individuals and the way in which they interact.

The tool will help service mangers and clinicians to identify areas for improvement and monitor change, empowering them to use health care data to predict long-term consequences of local decisions on cost and patient outcomes. For example, decision-makers will be able to study the impact of changes on utilisation patterns, disease outcomes and staffing levels.

Users will not require statistical skills, only knowledge of their local care pathways. The tool will present information that is easily understandable in relation to the local system.

If implemented successfully, it is envisaged that the approach could be extended to a number of healthcare settings and scenarios.

Contact information

For more information about this project, please contact Professor Alexander MacGregor, Consultant Rheumatologist Epidemiologist, Norfolk and Norwich University Hospitals NHS Foundation Trust.

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