Gillian Mould

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The orthopaedic trauma session is almost universally adopted as a means of coping with non-elective orthopaedic demand Here patients who can be stabilised are treated in a weekday planned theatre session. It allows for greater consultant involvement and a reduction in out-of-hours operating. The utilisation of trauma theatre time is typically low. However,(More)
The re-organisation of the acute health services in 1999 is causing many acute trusts to consider the practical implications of concentrating services. This may be in terms of the complete merger of departments at different units or a less radical policy of the alternation of the responsibility for emergency receiving between units. The benefits may include(More)
Discrete event simulation should offer numerous benefits in designing healthcare systems but the reality is often problematic. Healthcare modelling faces particular challenges: genuine, fundamental variations in practice and an opposition to any suggestion of standardisation from some professional groups. This paper compares the experiences of developing a(More)
OBJECTIVES Redesign in healthcare has increased the focus on the needs of the patient. The redesign process typically involves a review of current practice using the patient pathway before considering possible improvements. The patient pathway can serve various roles, and it may be mapped in different ways using a variety of media. This paper reviews the(More)
When health service managers in Nottingham planned to move much of their outpatient activity to a proposed Diagnosis and Treatment Centre (DTC) they welcomed the opportunity to re-design the delivery of these services in a new setting. However, the lack of accessible, detailed information about outpatients' resource requirements posed an initial problem.(More)
Continuity of care is often critical in delivering high quality health care. However, it is difficult to achieve in community health care where shift patterns and a need to minimise travelling time can reduce the scope for allocating staff to patients. Community midwifery is one example of such a challenge in the National Health Service where postnatal care(More)
Many healthcare systems are being redesigned to deliver local care with more services within the community. Relocation may enhance access but other aspects of healthcare quality should also be considered, notably waiting times and equity of care. This study examined a musculoskeletal physiotherapy service using a discrete event simulation with simple(More)
Care pathways provide a practical analytical tool that encompasses both organizational efficiency and individual patients’ care. In the UK, constructing the care pathway has been a recommended starting point for the re-design of health-care systems. This paper examines the re-design cycle for health-care systems and looks at the role of pathway-based models(More)