Using soft systems methodology as a precursor for an emergency department simulation model

With patient flow simulation models it is not only important to identify visible resources obvious for inclusion in the model, but before this, it is important to fully understand and structure the problem situation, grounding it in the reality of working lives and organizational structure, strategies and professional cultures. In this project we have used soft systems methodology (SSM) at the emergency department (ED) at Akershus University Hospital. The purpose of the study is to identify and structure the problems in the ED for their own sake, and to identify factors that should, and should not be included when building the simulation model. Problem areas which should be considered when building the simulation model are physical infrastructure, staffing, communication between staff, physical working conditions, patient waiting times and bed logistics. This article shows that SSM is a successful precursor for building patient flow simulation models. OR Insight (2011) 24, 168–189. doi:10.1057/ori.2011.8; published online 15 June 2011