Investigating the potential to simulate hospital-based infection outbreaks using the STAMP architecture

In this paper we describe our use of the STAMP architecture to analyse the C. difficile infection outbreaks which occurred at the Maidstone and Tunbridge Wells NHS trust. Background data from other outbreaks in the UK (e.g., at Stoke Mandeville NHS trust) were also used to build STAMP models. The specification uses components of STAMP such as negative and positive feedback loops to represent the degree to which decisions taken at a higher level in the system (e.g., bed turnover targets) impacted upon system components at lower levels (e.g., the morale and attitude of staff at ward level). In addition, the specification includes elements which aim to model the degree to which organisational learning was inhibited or facilitated within the system (e.g., through the provision of balancing loops Kontogiannis, in press). Finally, we examine the role played by the different types of mental model held by the various human actors in the system and how these change over time/are impacted by external constraints.