About 10 years ago, a local authority in the UK developed a really useful database of the local population to identify people who were at risk of being admitted to hospital. When they got down to using it, though, people didn’t seem to be in as acute a level of need as they expected them to be. What went wrong? Douglas helped them understand: “I don't know how long it would've taken them to figure out that that was what was happening. But the model brought them to that conclusion much faster.” Health policy is fashionable in the post-pandemic world. In this episode, we feature insights about analytics from someone who has been modeling health systems since 2002.
Douglas McKelvie, United Kingdom
Douglas McKelvie has had a varied career, starting as a social worker in 1980. In the 1990s, he worked for the UK regulator of social work education, where he took on responsibility for workforce development, whilst his further studies introduced him to modelling and simulation. In 2002, he moved into consultancy where he worked alongside Eric Wolstenholme, from whom he learned in depth about the System Dynamics approach.
Douglas uses simulation to support strategic planning in health and social services. He has built simulations for a wide range of organisations across the UK, including government departments, NHS bodies, and local authorities. He mostly uses System Dynamics, in a group model building context, an approach that takes a ‘whole system’ view of complex problems, such as are found in health and social care integration, where services span agency and functional boundaries, and in children’s services. Models include delayed discharges, commissioning and capacity planning, workforce planning, economic impact analysis, public health / population level issues, child-care workforce, and children’s mental health. Douglas is the Past President (2016/17) of the UK Chapter Policy Council of the System Dynamics Society and has written about the use of simulation in health, social care, and related human services. He is Edinburgh-based but works across the UK (and beyond).
See Wolstenholme E and McKelvie D (2019) The Dynamics of Care – Understanding People Flows in Health and Social Care (Springer)
Highlights:
[00:04:00] The kind of people who work in health and social care are generally very serious about what they do. They do it and they do important work and they, and they want to do it well.
[00:14:00] When you're dealing only with data and not with structure, you don't necessarily know what questions to ask of your data.
[00:20:00] We see something that's needed. We meet a need. That's a good thing. And in meeting that need, maybe we increase the level of need, and that's also a good thing. But it does make us pause and think, well, what kind of systems do we need, uh, in order to look after people properly?
[00:26:00] It seems to me implausible that in the realms of complex social systems that there is some kind of killer equation out there that's going to give you the answers.
[00:29:00] So sometimes I look at papers…where I think that somebody spent a lot of time trying to understand a problem and then has reconfigured that problem as some incredible equation that means something only to point not not not 5% of people who might read the article.
[00:33:00] I think there is an art in involved in trying to figure out what is going on in the client's mind and how might a model help.
Resources:
Symmetric Scenarios website: https://symmetriclab.com/
Angele Peters’ Ph.D. thesis: https://pure.uvt.nl/ws/portalfiles/portal/1540305/Thesis_Angele_Pieters_August.pdf
Geoff McDonnell: https://preventioncentre.org.au/people/geoff-mcdonnell/
Whole Systems Partnership: https://www.thewholesystem.co.uk/employees/peter-lacey/
The Health Foundation: http://health.org.uk/
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