title: Managing health care decisions and improvement through simulation modeling.
abstract: Simulation modeling is a way to test changes in a computerized environment to give ideas for improvements before implementation. This article reviews research literature on simulation modeling as support for health care decision making. The aim is to investigate the experience and potential value of such decision support and quality of articles retrieved. A literature search was conducted, and the selection criteria yielded 59 articles derived from diverse applications and methods. Most met the stated research-quality criteria. This review identified how simulation can facilitate decision making and that it may induce learning. Furthermore, simulation offers immediate feedback about proposed changes, allows analysis of scenarios, and promotes communication on building a shared system view and understanding of how a complex system works. However, only 14 of the 59 articles reported on implementation experiences, including how decision making was supported. On the basis of these articles, we proposed steps essential for the success of simulation projects, not just in the computer, but also in clinical reality. We also presented a novel concept combining simulation modeling with the established plan-do-study-act cycle for improvement. Future scientific inquiries concerning implementation, impact, and the value for health care management are needed to realize the full potential of simulation modeling.
authors.affiliation: Department of Learning Informatics Management and Ethics and Medical Management Center, Karolinska Institutet, Stockholm, Sweden. helena.hvitfeldt.forsberg@ki.se
authors.forename: Helena Hvitfeldt
authors.initials: HH
authors.lastname: Forsberg
authors.forename: Håkan
authors.initials: H
authors.lastname: Aronsson
authors.forename: Christina
authors.initials: C
authors.lastname: Keller
authors.forename: Staffan
authors.initials: S
authors.lastname: Lindblad
mesh_terms: D003142:Communication; D003198:Computer Simulation; D003657:Decision Making; D020000:Decision Support Systems, Clinical / Q000458:organization & administration*; D006801:Humans; D058996:Quality Improvement; D012107:Research Design