Application of a computational model in simulating an endovascular clot retrieval service system within regional Australia.

2021-12

Ren, Yifan

Phan, Michael

Luong, Phillip

Wu, Jamin

Shell, Daniel

Barras, Christen D

Chryssidis, Steve

Kok, Hong Kuan

Burney, Moe

Tahayori, Baham

Maingard, Julian

Jhamb, Ashu

Thijs, Vincent N

Brooks, Duncan Mark

Asadi, Hamed

Google

acute ischaemic Stroke

computational model

discrete event simulation

endovascular treatment

Journal Article

0000-0001-6518-6828

0000-0001-7121-3597

0000-0002-3023-1892

0000-0003-1899-1909

0000-0003-2475-9727

10.1111/1754-9485.13255

The global demand for endovascular clot retrieval (ECR) has grown rapidly in recent years creating challenges to healthcare system planning and resource allocation. This study aims to apply our established computational model to predict and optimise the performance and resource allocation of ECR services within regional Australia, and applying data from the state of South Australia as a modelling exercise. Local geographic information obtained using the Google Maps application program interface and real-world data was input into the discrete event simulation model we previously developed. The results were obtained after the simulation was run over 5 years. We modelled and compared a single-centre and two-centre ECR service delivery system. Based on the input data, this model was able to simulate the ECR delivery system in the state of South Australia from the moment when emergency services were notified of a potential stroke patient to potential delivery of ECR treatment. In the model, ECR delivery improved using a two-centre system compared to a one-centre system, as the percentage of stroke patients requiring ECR was increased. When 15% of patients required ECR, the proportion of 'failure to receive ECR' cases for a single-centre system was 17.35%, compared to 3.71% for a two-centre system. Geolocation and resource utilisation within the ECR delivery system are crucial in optimising service delivery and patient outcome. Under the model assumptions, as the number of stroke cases requiring ECR increased, a two-centre ECR system resulted in increased timely ECR delivery, compared to a single-centre system. This study demonstrated the flexibility and the potential application of our DES model in simulating the stroke service within any location worldwide.

link

Journal of medical imaging and radiation oncology 2021; 65(7): 850-857

Journal of Medical Imaging and Radiation Oncology