Modelling and simulation as planning tools for improvement of the quality of health care environments : towards a conceptual model of a care process

Planning for and designing new health care environments that meet the standards of contemporary and future health care are complex tasks. Understanding the nature of the health care environment and the care process is essential for a successful design process. Building and health care administrators, as well as professionals such as nurses and physicians should be engaged in discussions of what takes place within the environment. In this process, simulation and modeling may be a support for building future scenarios. The aim of the present thesis was to explore simulation as a planning tool for the process of designing new health care environments. The literature in the field was scrutinized and a first step towards a conceptual model of a care process was developed. The model is based on important concepts in health care and results from an observational study. Simulation has been used in industry for many years. Health care has adopted industrial models and it has proven to be useful for analyzing and solving problems of limited scope e.g. waiting lists and waiting times. However, health care involves issues beyond those of waiting lists, waiting times and ways of optimising processes with the aim of increasing production. A simulation model for health care should focus on how professionals' work together, how they communicate with each other and with the patient, and how they plan care with and for the patient. The conclusion of present study is that there is need for models with comprehensive scope that can handle questions from a process-oriented view. The care process should be modelled from a patient – centered perspective. Key words: simulation and modeling, health care services, health care process, design proces