Factors affecting the implementation of simulation modelling in healthcare: A longitudinal case study evaluation

Simulation modelling is becoming an increasingly popular tool in healthcare management, however published evaluations of simulation modelling are rare. This study therefore aimed to provide an empirical evaluation of simulation model implementation. The study used a qualitative, longitudinal case study approach, grounded in Pragmatism, complexity theory, and the critical incident approach. Semi-structured interviews were conducted with 13 senior healthcare managers and 5 researchers during a simulation modelling project. Twenty-three critical incidents were identified, including changes in government policy and funding, organisational context, intervention activities, project management, and staffing. The analysis revealed a complex adaptive system, where the role of specific implementation factors changed over time, and through interaction with each other. Constant throughout was the agency displayed by participants in pursing their individual strategic goals. Based on these findings, we argue for a flexible definition of implementation success that allows for emergent project outcomes.