Abstract for:Improving Frontline Healthcare Operations: Adapted Use of the Oliva and Sterman Service Delivery Model

The Veterans Health Administration (VHA) has pledged to improve service delivery across multiple dimensions: increasing access and quality, decreasing risk and wait times, streamlining management. Frontline care teams face increasing pressure to meet multiple performance goals, often implementing operations changes that “rob Peter to pay Paul,” resulting in a flux of un-sustained improvements. As clinicians have little training in systems thinking, let alone simulation tools to enable the double-loop learning necessary to make sustainable improvements in their complex, feedback rich environment, they are blind to how their decisions contribute to the quality, access, and efficiency issues they are asked to improve. Here we describe the central simulation model in VHA’s Modeling to Learn Program, a transparent, locally-calibrated, healthcare delivery simulation model adapted from Oliva and Sterman’s (2010) service delivery model. The model captures key context differences between generic service delivery and mental healthcare delivery, and structural differences necessary to conduct experiments befitting users with a different sphere of control. We report on the experiences of 30+ teams who have used the model to conduct three or more experiments each, including their most prevalent experiment scenarios, key insights gleaned, and improvements in systems thinking. Model and full documentation are available at mlt.how.