Process Flow Diagram of Cardiac Surgery Pathway

<p><em><strong>This image is supplementary material for:</strong></em></p> <p>Currie, C. S.M. Monks, T. (2018) <em>Modelling Diseases: Prevention, Cure, and Management.</em>&nbsp; In M. Rabe, A. Juan, N. Mustafee, A. Skoogh, &amp; B. Johansson (Eds.). Proceedings of the Winter Simulation Conference 2018.&nbsp; Gothenburg, Sweden.</p> <p><em>Relevant to:</em></p> <p><strong>Section 4.1.4.&nbsp; Spend some Time Observing How the Operations of the Disease Pathway are Managed</strong></p> <p>The description of the disease pathway obtained in the initial meeting may be idealized.&nbsp; It is advised that modelers spend at least a few hours in the one or more services in the real pathway to observe how it operates and to interview on-the-ground workforce.&nbsp; Observations of the system under pressure are useful to understand the complexities of the pathway and will reveal aspects that have been missed or that operate differently from described.&nbsp; This Figure illustrates a cardiac surgery pathway at a large hospital that operated on patients from a network of smaller hospitals in the UK.&nbsp; The diagram itself was primarily constructed in an initial meeting with a group of cardiac surgeons.&nbsp; Observation of the system and shadowing of specialist cardiac nurses revealed two differences from the idealized model.&nbsp; Firstly, patients could deteriorate and &lsquo;bounce back&rsquo; from post-operative care to higher levels of care.&nbsp; Secondly, in times of pressure, the post operative beds were used flexibly to accommodate patients waiting for surgery and those who had already undergone surgery.</p>