Review of Operational Research in scheduled and unscheduled care

South West PeninsulaGeneric Health Relevance
Start Date: 1 Jul 2016 End Date: 30 Apr 2017

PenCHORD - Review of Operational Research in scheduled and unscheduled care


Accident and Emergency Departments (A and E; also known as Emergency Departments or ED internationally) have been repeatedly modelled by Operational Researchers, with the aim of improving operations and processes. Many of these models have been published as conference papers or journal articles, and many less accessible ‘grey literature’ publications probably also exist (e.g. theses and professional output). 

As with other Operational Research projects in healthcare, the implementation of recommendations from this modelling work is likely to be limited to selected projects. This means there is a large body of simulation modelling work relating to Accident and Emergency departments worldwide, that has never been comprehensively reviewed and evaluated. 

Project aims

We aim to carry out a review and evaluation of modelling work on A and E departments, and build our findings into both a modelling resource and a guidance for researchers and clinicians.

Since PenCHORD's beginning, we have carried out a number of projects related to A and E problems (see Related projects below). In the launch cycle of the Health Service Modelling Associates (HSMA) programme, at least two of the projects were on A and E related themes. 

This project aims to review and research this body of literature in order to:

  • Compile a resource for the HSMA trainees to use to guide their own model development;
  • Write and publish a review for a suitable research journal;
  • Write and publish a suitably orientated clinical paper to highlight key results and how they relate to current ED workload problems;
  • Inform future work with the NHS.

The review paper will cover all the studies we can download from 2000 onward, highlighting the work so far done in this area and any gaps in the literature. It will assess impact and generate ideas for further work.

Anticipated outcomes

Building on the literature review, we aim to highlight what current techniques are being used in A and E departments, their limitations, and the conditions needed for them to be used effectively. This will help to:

  • Enable future HSMAs to guide their learning of modelling;
  • Inform the research community about the present needs of A and E;
  • Increase awareness of modelling and past results in the present NHS clinical community.

Project activity

The initial literature search began by searching the reference lists of and tracking citations of papers by known authors. This was extended to searching related papers to the references thus found, using Google Scholar.

We met with the PenCLAHRC Evidence Synthesis Team to put together a focussed search of the literature.  This search will be fully described in the ensuing publications.

Dr Andrew Salmon from PenCHORD and Simon Briscoe from the Evidence Synthesis Team have conducted the literature search. The results of the search have been filtered and cascaded into a definitive set of publications, and a review publication is currently being drafted. 

Next steps

Further publications will follow depending on the timescale of publication of the review.

Dr Andrew Salmon