A methodological framework combining a facilitated and expert mode to extend the simulation model lifetime: a case study of an ambulance service
本研究提出一个方法框架，通过第一轮引导模式和第二轮专家模式来延长仿真模型的使用寿命，并以救护车服务案例展示其如何减少不必要的急诊转运。
Typically, simulation studies conclude after one modelling cycle, producing a model that addresses the objectives defined at the outset. Healthcare settings are complex and volatile, which means that simulation models and their findings can quickly become obsolete as the real system changes. This paper presents a real-life case study of a regional Ambulance Service Trust where simulation is used to evaluate the impact of changes to ambulance services on their efficiency. Our findings show that alternative ambulance- and community-based services, especially those placed early in the call cycle, can reduce avoidable conveyances to the Emergency Department. Drawing on our experience, this study proposes a methodological framework that prescribes a practice of moving from a facilitated mode in a first cycle to an expert mode in the second cycle to make necessary adjustments to the model. The paper discusses the benefits achieved in securing stakeholder buy-in by adopting a first facilitated modelling cycle and the saved time and effort by adopting an expert mode in the second cycle to extend model lifetime. Considering that facilitated modelling is time and resource-intensive, implications for simulation model development theory and practice are provided.