Medication errors in hospitals are a large and increasing problem, which has traditionally been considered a result of human error. Recent attempts to reduce errors have emphasised systems approaches and improvements in information and communications technologies (ICT). As part of a multi-method evaluation project for hospital point of care clinical systems, we assembled a team of professionals from a variety of clinical, information management, health management, sociology, linguistics and engineering backgrounds. We built a systems simulation for explicitly representing the interactions among the key determinants of medication errors. These included the complex interactions of patients and staff, information, medications, work practices and the infrastructure and policies within a hospital environment.
Our team simulated hospital inpatient and staff flow, generation and interception of medication errors, and the potential impacts of ICT-enabled work practice changes. This paper describes the System Dynamics Model of long-term context that produces errors in the medication management process. Future extensions include the use of a combined agent based and SD simulation to produce a multi-method, multi-level systems simulation testbed as an integrating framework for evaluating combinations of improvement interventions.
KEYWORDS: health systems simulation, medication error, information and communications technology, multi-method evaluation
This research tries to offer a design of the cash waqf management system in a system dynamics model. The Cash Waqf Management is expected to become one of the alternative instruments for the poverty alleviation programs in Indonesia. These programs require huge amount of fund that cannot be provided thoroughly by the government. Therefore, initiation of new sources of fund for such a program is inevitable. In the Islamic sosio-economic concept, there is a source of social fund that is economically and politically free of charge, namely cash waqf. In this concept, Nadzir (cash waqf fund manager) collects the fund from Waqif (cash waqf payer) and invest the money in the real sector and in any syariah-based investment opportunities. Nadzir could allocate profits and returns gained from the investments to poverty alleviation programs. Nadzir is obliged to maintain the amount of fund in such a way that it does not go below the initial amount. Therefore, Nadzir not only should be highly capable, but also needs an experienced financial institution in helping SMEs development efforts. Using the system dynamics methodology, we tries to know the structure of cash waqf system and simulate the behaviour of cash waqf model.
This paper uses a system dynamics model to analyze rule compliance in organizations. The analysis takes securities regulation as an illustrative case but applies to other private, nonprofit, and public activities complying with rules overseen by external bodies in the course of producing goods and services. We consider how three levels of behaviorproducers, internal organizational controllers, and external regulatorsinteract in shaping compliance with rules.
This paper explores the history of the Beer Game, its rules, and lessons. By triangulating information from the literature, archival analysis, and interviews with experts in the field, we have identified the main changes in the game over its almost 50-year history. Additionally, an exploration of possible changes to the game and new games in the field of system dynamics are examined.
This paper describes a systems dynamics model that reflects the possibility of having three levels of complexity together and articulated on a synchronous synergy of all relevant participants of value added systems: the activities at the firm level, networks of industries, and supporting organizations at the regional level. Following a systemic approach, we have identified eight parameters to measure the attractiveness effect of a region: Clustering and associativeness, Value added, Differentiation value, EVA, Attractiveness leverage, Global market coverage, Innovation and Social Capital. Based on these indicators, we have developed dynamic models for emergent industries which have uncertain trends and no previous regional developments. At this moment we are working on models for the Software, Biotechnology, Aerospace and Autoparts Industries that are currently in the process of clustering in the State of Nuevo Leon (Mexico).
In the article we address recurring causes of failures in starting up a new company. In particular, we explore flaws in entrepreneurs mental model when dealing with feedback and delays in building up stocks of assets. The work that we are presenting is in progress but scored the following targets. First, under a theoretical point of view, we laid down borders to define a theoretical territory where the strong connections can be observed that entwine literatures on start-up, on the resource-based view of the firm and system dynamics. Second, we created an experimental laboratory to test individuals recurring mistakes when dealing with a start-up.
Further developments of this work are in the direction of setting an experimental protocol to conduct empirical research on a sample of players.
A system dynamics model was developed to help hospitals assess their ability to handle surges of demand during various types of disasters. The model represents all major flows of patients through a hospital and indicates how specific responses to a surge may ameliorate bottlenecks and their potentially harmful effects on patients. The model was calibrated to represent a specific hospital in West Virginia and was tested under three quite different surge scenarios: a bus crash, a chemical plant leak, and a SARS outbreak. Under the difficult conditions of the SARS scenario, avoidable deaths of patients awaiting emergency care could be effectively reduced by adding reserve nursing staff not in the emergency department, as might be expected, but in the overloaded inpatient wards. The model can help hospital planners better anticipate how patient flows may be affected by disasters, and identify best practices for maximizing the hospitals surge capacity under such conditions.
This paper integrates the resource-based view (RBV) with concepts from the literature on managerial cognition and organizational slack to show how shifts in resource constraints can lead to shifts in firm performance and even industry structure over time. Using a process-based method, we show that a shift in constraints of resources, under the moderating impact of heterogeneous mental models and resource structure, shift resource allocations. In turn, this creates and sustains resource heterogeneity, leading to differential performance. Previously developed propositions are tested using simulation in two strategic business units from a leading player in the UK insurance industry. The conclusion highlights implications for research methods, strategy theory and managerial practice.
In its Preface, The 9/11 Commission Report states: We learned that the institutions charted with protecting national security did not understand how grave this threat can be, and did not adjust their policies, plans, and practices to deter or defeat it (2004: xvi). Given current realities and uncertainties better preparedness can be achieved by identifying, controlling and managing the elusive linkages and situational factors that impact state stability and fuel state decay and destruction and hence create new threats to the nations security. We propose to focus on the use of system dynamics modeling techniques to help understand, measure and model the complex dynamics shaping state stability, initially for two regions. We will specifically consider the impacts of unanticipated disruptions, such as a tsunami and its aftermath, on the dynamics of the two regions. For each region, we will develop a country model, along with an analysis of conditions and casual links between predicted futures plus corresponding mitigated options. The presentation will include an update on the status of this project.
Decision-makers and managers have often an irresistible tendency to over intervene in the systems (companies, organizations, communities, etc) for which they are responsible hence generating unnecessary fluctuations and instability in their organizations. Sterman, et al (1989; 2000) and Maani & Li (2004) have studied these phenomena in simulated and experimental settings. This paper examines the impact of change and managerial intervention on firms performance. Frequency and magnitude of change actions are used as proxy for managerial intervention. Based on prevailing assumptions and common practice two hypotheses are postulated as follows:
H01 : The more frequent the change (interventions), the better the results.
H02 : Dramatic change leads to dramatic (positive) results.
The above hypotheses and our own observations collectively inform the key research question posed in this paper: How do the style (extent) and frequency of change and the interpretation of feedback affect the outcomes of interventions in organizations? In this research, Microworlds are employed as proxy for complex systems. Research subjects comprise MBA and graduate business students and practicing managers. With some exceptions, the results refute the above hypotheses and suggest that over intervention could often lead to counter productive outcomes.