title: Methodology of the Access to Care and Timing Simulation Model for Traumatic Spinal Cord Injury Care.
abstract: Despite the relatively low incidence of traumatic spinal cord injury (tSCI), the management and care of persons with tSCI can be resource intensive and complex, spanning multiple phases of care and disciplines. Using a simulation model built with a system level view of the healthcare system allows for prediction of the impact of interventions on patient and system outcomes from injury through to community reintegration after tSCI. As has been previously described, the Access to Care and Timing (ACT) project developed a simulation model for tSCI care using techniques from operations research. The objective of this article is to briefly describe the methodology and the application of the ACT Model, as it was used in several of the articles in this focus issue. The approaches employed in this model provide a framework to look into the complexity of interactions both within and among the different SCI programs, sites, and phases of care.
authors.affiliation: Rick Hansen Institute, Vancouver, British Columbia, Canada.
authors.forename: Argelio
authors.initials: A
authors.lastname: Santos
authors.affiliation: Rick Hansen Institute, Vancouver, British Columbia, Canada.
authors.forename: Nader
authors.initials: N
authors.lastname: Fallah
authors.affiliation: Sauder School of Business, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Rachel
authors.initials: R
authors.lastname: Lewis
authors.affiliation: Department of Orthopedics, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Marcel F
authors.initials: MF
authors.lastname: Dvorak
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Fehlings
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Burns
authors.affiliation: Rick Hansen Institute, Vancouver, British Columbia, Canada.
authors.forename: Vanessa K
authors.initials: VK
authors.lastname: Noonan
authors.affiliation: Rick Hansen Institute, Vancouver, British Columbia, Canada.
authors.forename: Christiana L
authors.initials: CL
authors.lastname: Cheng
authors.affiliation: Rick Hansen Institute, Vancouver, British Columbia, Canada.
authors.forename: Elaine
authors.initials: E
authors.lastname: Chan
authors.affiliation: SCI Clinical Research Unit, Toronto Western Hospital, Toronto, Ontario, Canada.
authors.forename: Anoushka
authors.initials: A
authors.lastname: Singh
authors.affiliation: Acute Spine Unit, Vancouver General Hospital, Vancouver, British Columbia, Canada.
authors.forename: Lise
authors.initials: L
authors.lastname: Bélanger
authors.affiliation: Sauder School of Business, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Derek
authors.initials: D
authors.lastname: Atkins
keywords: health progression model; operations research; processes of care; simulation model; spinal cord injury