Representing Medical Protocols for Organizational Simulation: An Information-Processing Approach

Organizational simulations have been used in business, manufacturing, and engineering design tasks to gain insight into organizational process bottlenecks, and to improve the quality and efficiency of processes within these industries. As market pressures demand increased efficiencies within the health care industry, organizational simulation techniques could provide similar insight into the design of better medical care processes, or protocols, in medical organizations. To simulate the process of medical care within a specific organization however, requires models that can represent (1) unpredictable patient responses to care, (2) the flexibility needed to adapt to different patients, and (3) different preferences of health care professionals and the implicit preferences contained within the protocol. Using previous work on simulation in the Virtual Design Team (VDT), and an example protocol drawn from an existing protocol in bone marrow transplantation, we describe extensions to the VDT information-processing representation that will allow us to simulate the performance characteristics of a medical protocol used within a medical organization. Our representational extensions capture the uncertainty of medical care for patients, the activity flexibility within the organization, and the preferences of health care professionals that will make information-processing organizational simulations in the medical domain possible. We believe our representation will provide a robust simulation tool box that can be used to investigate the performance of specific medical protocols within different hospital settings, and explore organizational theory within the health care industry.