Simulation of stroke care systems

Stroke is major cause of disability internationally, the leading cause of disability in England, and the third most common cause of death worldwide. The good news is that there is growing evidence that simulation modeling can play an important role in understanding and designing improvements in acute stroke systems in order to reduce this disability burden. This paper presents an overview of simulation methodology to tackle logistical and capacity planning problems in stroke. Four contributions are made to accelerate studies in this area. First, a grounding in the basic processes and operational issues that occur in stroke pathways is given. Second, modeling approaches for single and multiple hospitals in emergency and rehabilitation settings are described along with guidance on selection of performance measures. Third, common data issues are highlighted. Last, a range of model simplifications are presented to mitigate potential data and complexity issues that are inherent to stroke systems.