The DH Accident and Emergency Department model: a national generic model used locally

Abstract

The Department of Health (DH) Accident and Emergency (A&E) simulation model was developed by Operational Research analysts within DH to inform the national policy team of significant barriers to the national target, for England, that 98% of all A&E attendances are to be completed (discharged, transferred or admitted) within 4 hours of arrival by December 2004. This paper discusses why the model was developed, the structure of the model, and the impact when used to inform national policy development. The model was then used as a consultancy tool to aid struggling hospital trusts to improve their A&E departments. The paper discusses these experiences with particular reference to the challenges of using a ‘generic’ national model for ‘specific’ local use.

Keywords:

• health service
• hospitals
• emergency departments
• simulation

Acknowledgements

Members of the DH emergency care policy team—particularly Mark Davies, Helen Miscampbell, Claire Howland, Jane Cummings. Martin Reddy and Lis Nixon from the IST. Matthew Cooke on validation. Roger Quincy, Numerous ESOR colleagues for advice and support. Roger Kirby at Oldham hospital. Staff at participating NHS trusts.