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Viewing the Role of Alternate Care Service Pathways in the Emergency Care System through a Causal Loop Diagram Lens

Publication ,  Journal Article
Kumar, A; Liu, Z; Ansah, JP; Ng, YY; Leong, BSH; Matchar, DB; Ong, MEH; Siddiqui, FJ
Published in: Systems
May 1, 2023

Globally, Emergency Care Systems (ECS) are a critical resource that needs to be used judiciously as demand can easily exceed supply capacity. Sub-optimal ECS use contributes to Emergency Department (ED) crowding; this adversely affects ECS as well as system-wide service performance. Alternate Care Service Pathways (ACSPs) are innovations intended to mitigate ED crowding by re-routing less-urgent cases to sites of care other than the ED. As in other countries, policymakers in Singapore need to respond to increasing ED utilization and are evaluating the introduction of ACSPs. However, developing ACSPs is costly, entails tinkering with established critical services, and runs the risk of unintended adverse consequences. Through a Causal Loop Diagram (CLD) developed in four stages, we present a view of the current Singapore ECS and the intended role of ACSPs in relieving its stress. This exercise suggests that to be successful ACSPs must change the prevailing mental model of the ED as a “one-stop shop” but should focus on integrating with primary care. The discussions stimulated by the development, critiquing, and revision of the CLD highlighted the importance of accounting for the reservations of stakeholders for changes. The CLD has enhanced shared understanding and will be used to guide quantitative simulation modeling to promote informed policy.

Duke Scholars

Published In

Systems

DOI

EISSN

2079-8954

Publication Date

May 1, 2023

Volume

11

Issue

5

Related Subject Headings

  • 0806 Information Systems
  • 0803 Computer Software
  • 0801 Artificial Intelligence and Image Processing
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kumar, A., Liu, Z., Ansah, J. P., Ng, Y. Y., Leong, B. S. H., Matchar, D. B., … Siddiqui, F. J. (2023). Viewing the Role of Alternate Care Service Pathways in the Emergency Care System through a Causal Loop Diagram Lens. Systems, 11(5). https://doi.org/10.3390/systems11050215
Kumar, A., Z. Liu, J. P. Ansah, Y. Y. Ng, B. S. H. Leong, D. B. Matchar, M. E. H. Ong, and F. J. Siddiqui. “Viewing the Role of Alternate Care Service Pathways in the Emergency Care System through a Causal Loop Diagram Lens.” Systems 11, no. 5 (May 1, 2023). https://doi.org/10.3390/systems11050215.
Kumar A, Liu Z, Ansah JP, Ng YY, Leong BSH, Matchar DB, et al. Viewing the Role of Alternate Care Service Pathways in the Emergency Care System through a Causal Loop Diagram Lens. Systems. 2023 May 1;11(5).
Kumar, A., et al. “Viewing the Role of Alternate Care Service Pathways in the Emergency Care System through a Causal Loop Diagram Lens.” Systems, vol. 11, no. 5, May 2023. Scopus, doi:10.3390/systems11050215.
Kumar A, Liu Z, Ansah JP, Ng YY, Leong BSH, Matchar DB, Ong MEH, Siddiqui FJ. Viewing the Role of Alternate Care Service Pathways in the Emergency Care System through a Causal Loop Diagram Lens. Systems. 2023 May 1;11(5).

Published In

Systems

DOI

EISSN

2079-8954

Publication Date

May 1, 2023

Volume

11

Issue

5

Related Subject Headings

  • 0806 Information Systems
  • 0803 Computer Software
  • 0801 Artificial Intelligence and Image Processing