About the Project
Healthcare-associated infections (HAIs) pose a serious risk for patients and providers, increasing morbidity, mortality, and length of stay as well as costs to patients and the health system. An estimated 55,500 (one in 13) adults in acute care settings in Scotland suffer from at least one HAI annually, and in 2014, HAIs were estimated to cost the NHS in Scotland £137 million annually. The threat of multi-drug resistant organisms (MDROs) causing HAIs, which are often associated with high rates of morbidity and mortality and for which few or no treatment options exist, exacerbate this burden. Detecting and containing outbreaks of MDROs causing HAIs is complicated since their transmission is largely unobservable. Furthermore, once MDROs are introduced in a healthcare setting they tend to spread and persist because of the presence of vulnerable patients, medical procedures, and selective pressure by high antibiotic use.
Assessing the effectiveness of interventions, as well as their costs and cost-effectiveness, requires understanding the healthcare system as a whole. A substantive body of literature has shown that within a healthcare facility measures such as contact isolation, environmental decontamination, hand hygiene, and active case detection and surveillance can reduce the prevalence of HAIs. However, the healthcare system is an interconnected ecosystem where patients encounter multiple providers both within and across facilities. The effectiveness of an intervention therefore depends on the actions of other units, facilities, and providers. By modelling the entire system, its components and their interaction, we can design more cost-effective monitoring and interventions.
The objective of the proposed studentship is to develop models to support decision-makers in assessing the relative effectiveness and economic efficiency of changes to the system and to utilize these models in the context of the Scottish healthcare system. Implementing combinations of strategies to prevent HAIs without understanding their potential outcomes, knock-on effects, and overlapping impacts and effects, including unexpected ones, can be costly.
Approaches that attempt to find solutions to problems to improve quality and cost of care and to reduce morbidity and mortality within the healthcare system need to consider the numerous links to and from different parts of the system. One such approach with proven impact in a healthcare environment is simulation.
Three key simulation approaches have been used in healthcare: discrete-event simulation (DES), system dynamics (SD) and agent-based modelling (ABM).
Although each simulation method has previously had success in supporting decision-makers in a healthcare context, each method considers a problem from a different perspective and some problems can benefit from the complementary view gained from using multiple simulation methods together. The combination of all three methods of simulation will be particularly useful for understanding the impact of interventions in one part of the system on other components of that system or on the system as a whole.
The aim of this project would therefore be to develop a hybrid simulation framework that considers all three types of simulations and how they may be combined to provide support to decision-makers involved in controlling HAIs. The student will have access to experts in the Scottish healthcare system, who are existing contacts of the Management Science department.
Eligibility
Candidates are required to have:
An excellent undergraduate degree with Honours in a relevant business, scientific/technological or social science subject
A Masters degree (or equivalent) will be strongly preferred
Students may also have other relevant experience or skills which are relevant to this project
Candidates who are not native English speakers will be required to provide evidence for their English skills (such as by IELTS or similar tests that are approved by UKVI, or a degree completed in an English speaking country)
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