Assessment of a 7-day turn-around for the reporting of cervical smear results using discrete event simulation

Abstract

A discrete event simulation (DES) model has been used to analyse options with the potential to facilitate a 7-day turn-around of cervical screening results in England, with the aim of reducing the anxiety experienced by the participants. Detailed information regarding the cervical screening process collected from the NHS Cancer Screening Programme, research papers, current national guidelines and five cytology laboratories in England was used to inform a DES model representing a typical laboratory. A number of options for change were evaluated. The simulation model suggested that it would be feasible to improve the result turn-around times from 95% within 11 weeks to 95% within 2 weeks; and from an average current result turn-around time of around 6 weeks, to over 50% within 7 days. Moreover, the options for change should be cost saving in the long term.

Keywords:

• simulation
• decision analysis
• health service
• cervical screening

Acknowledgements

Acknowledgements are due to the many cytologists and other specialists who input to this project by responding to questionnaires or via other correspondence. In addition, thanks go to Julietta Patnick and Richard Winder of the NHS Cancer Screening Programme.