Towards fully-facilitated discrete event simulation modelling:Addressing the model coding stage

The literature suggests that increasing stakeholder engagement has a positive impact on projects using discrete-event simulation in healthcare. This suggests projects should strive to involve the stakeholders in as much of the project as possible, through facilitated workshops. A notable gap in stakeholder involvement is the model coding stage, in which a conceptual model is turned into a discrete-event simulation model running on a computer. This paper investigates how and under what circumstances model coding might also be conducted in facilitated workshops, in particular through the use of the Business Process Model and Notation (BPMN) modelling standard. This work arose from a series of modelling projects with two hospitals, one in Italy and the other in the UK. The paper describes how BPMN can contribute, with a case in which model coding was achieved in a facilitated workshop and a second in which it was not but which highlights further barriers to this in some contexts. These barriers arise from the detail necessary for requisite modelling regarding i) the level of complexity of the model and ii) challenges in data access and analysis to populate the model. The relationship between the technical capabilities of tools available and the impact of these barriers is also discussed. We believe this is the first time that discrete-event simulation model coding in a facilitated workshop in healthcare has been described, and we provide a clear view of the further barriers. To indicate when facilitated model coding is currently achievable, we suggest a contextual matrix.