Papers by Eric Wolstenholme
Journal of The Operational Research Society, 1999
This paper addresses the issue of what are the wise uses of qualitative mapping and what are the ... more This paper addresses the issue of what are the wise uses of qualitative mapping and what are the conditions that require formal quantitative modelling within System Dynamics. The background to the evolution of qualitative and quantitative system dynamics will be explored. This analysis will recognises that although the history of feedback thought repeatedly contains the assertion that formal, quantitative models
Journal of The Operational Research Society, 1993
This paper uses a recent application of System Dynamics in community care to contribute to a clar... more This paper uses a recent application of System Dynamics in community care to contribute to a clarification of the role of System Dynamics as a framework for strategic debate. A revised framework for System Dynamics within a philosophy ofmodelling as learning'is ...
Systemic Practice and Action Research, 2004
This paper reviews trends in systems theory/thinking from the 1970s to the early 2000s. It propos... more This paper reviews trends in systems theory/thinking from the 1970s to the early 2000s. It proposes a maturation of the field based on certain conceptual and methodological advances that have sought to liberate systems thinking from earlier strictures. An edited dialogue among three prominent systems thinkers from different systems "schools"-Merrelyn Emery, Bob Flood, and Eric Wolstenholme-provides evidence. Similarities and differences are identified, complementarities among the schools are derived and analyzed, and trajectories for future research are indicated.
This paper provides an overview of an emergent need and a practical new approach to apply system ... more This paper provides an overview of an emergent need and a practical new approach to apply system dynamics (SD) in business. Potential opportunities and implications for consulting organisations and SD practitioners are examined.
Executive Development, 1995
Presents a case study in systems modelling for product improvement in a large manufacturing compa... more Presents a case study in systems modelling for product improvement in a large manufacturing company. Summarizes the background to and purpose of systems modelling as a change management tool as a prelude to introducing the case and its use in understanding a particular paradox.
This paper presents an example of the value that system dynamics can add to conventional cost ben... more This paper presents an example of the value that system dynamics can add to conventional cost benefit analysis. A static cost benefit analysis is described for planning the supply of new mental health services across the UK and the development of this analysis into a system dynamics model is explained. By developing a bigger picture of the issue, both upstream to where patients go after treatment and downstream from where patients originate in the labour market, and by simulation of the enhanced vision, the dynamic cost benefit analysis is shown to advance understanding of the issue and plans. It questions the magnitude of the potential benefit, introduces phasing issues, surfaces structural insights, takes account of the dynamics of the labour market and forces linkages between the plan and other initiatives. An overall conclusion is that dynamic factors are often left out of cost benefit analysis simply because they cause too much complexity for decision makers, whereas system dynamics allows these factors to be included without masking the clarity of the case. The paper suggests that cost benefit analysis and system dynamics are very complimentary and should be used together in strategic planning.
This paper describes the application of system dynamics to assist decision making in
Over the past two years OLM Consulting, initially in partnership with Cognitus, have used system ... more Over the past two years OLM Consulting, initially in partnership with Cognitus, have used system dynamics modelling in a wide range of health and social care settings to shed light on a number of difficult and complex issues. A related paper presented to this conference (Using System Dynamics to Influence and Interpret Health and Social Care Policy in the UK) describes the experience of introducing System Dynamics in a public service setting.
Kybernetes, 2010
... David Todd, Symmetric sd, Brighton, UK. ... Jones, AP, Homer, JB, Murphy, DL, Essien, JDK, Mi... more ... David Todd, Symmetric sd, Brighton, UK. ... Jones, AP, Homer, JB, Murphy, DL, Essien, JDK, Milstein, B., Seville, DA (2006), "Understanding diabetes population dynamics through simulation modelling and experimentation", American Journal of Public Health, Vol. ...
Over the past two years OLM Consulting, initially in partnership with Cognitus, have used System ... more Over the past two years OLM Consulting, initially in partnership with Cognitus, have used System Dynamics (SD) modelling in a wide range of health and social care settings to shed light on a number of difficult and complex issues.
In England and Wales, national government has introduced a range of policies for dealing with the... more In England and Wales, national government has introduced a range of policies for dealing with the most dangerous offenders. These include new sentencing arrangements, new treatment programmes, and enhanced supervision of those released on licence. Policy makers needed to estimate the impact of this policy on the prison population and to consider how much treatment and community supervision capacity would be needed over time. They worked with a small SD consultancy to develop and build a model using ithink software, to enable a variety of scenarios to be tested, adopting a group model building approach. A number of staff received training in SD, including model building. The paper outlines the policy background, model structure and examples of scenarios. As well as being a practical application of SD to a sensitive area of public policy, the project is an example of what can be achieved within a relatively short intervention.
Abstract CSIP NW are using a novel approach to communicate and accelerate implementation of a ste... more Abstract CSIP NW are using a novel approach to communicate and accelerate implementation of a stepped care approach to depression services in North West England. They are collaborating with Symmetric SD to develop a whole system simulation model, ...
The paper describes a partnership project between three parties, centred on the use of System Dyn... more The paper describes a partnership project between three parties, centred on the use of System Dynamics (SD) in a Mental Health Trust (MHT). The main learning experiences relate to the politics of introducing challenging concepts in a situation where participants prefer to avoid confrontation. The rigorous nature of SD modeling and simulation raises questions which operational managers may fear reflect badly on the organization and their own capabilities. They may be uncomfortable with questions about the evidence-base for current treatments, or the research to back their ideas for future developments. A further issue is the ambiguity inherent in definitions of SD and the likelihood that many managers prefer single-issue projects, based on their comfort zone of practice/expertise. A hypothesis is developed to describe the observed reactions in the project and suggest alternative approaches in carrying out SD projects in the UK public sector.
Over the past two years OLM Consulting, initially in partnership with Cognitus, have used System ... more Over the past two years OLM Consulting, initially in partnership with Cognitus, have used System Dynamics (SD) modelling in a wide range of health and social care settings to shed light on a number of difficult and complex issues and to influence and interpret health and social care policy in the UK. This work has been instrumental in causing health legislation to be modified in the Upper House of Parliament as well as helping local health communities implement sustainable performance improvement.
System Dynamics Review, 2007
This paper develops a hypothesis that the 'normal' mode of operation for many organisations is we... more This paper develops a hypothesis that the 'normal' mode of operation for many organisations is well beyond their safe design capacity and that many health and social care organisations in the UK are in this position. This situation arises from having to cope with demand, irrespective of their supply capability.
The field of health and social care in the UK has been very receptive to systemic thinking in rec... more The field of health and social care in the UK has been very receptive to systemic thinking in recent years and has been extensively and successfully modelled. This paper describes two trends in health care thinking in the UK which build upon this receptivity and are creating market pulls for whole systems ideas. These are the related areas of health needs analysis and service-line reporting, two concepts that are in search of a language and methodology to help deliver their potential. The paper describes how system dynamics is being applied to both these trends. The work is creating a natural progression for communicating system dynamics models and improving their impact on the thinking of clinicians and managers, particularly in mental health as epitomized by the contribution to this paper of the general manager responsible for the case study used.
This paper develops a hypothesis that the 'normal' mode of operation for many organisat... more This paper develops a hypothesis that the 'normal' mode of operation for many organisations today is well beyond their safe design capacity and that many health and social care organisations in the UK are in this position. This situation arises from having to cope with whatever demand arrives at their door irrespective of their supply capability. Risk levels can be high in these organisations and the consequences could be catastrophic. The irony is that such organisations appear to cope at the strategic, 'whole-systems' level, where they can appear to be matching supply with demand and be in equilibrium. This is because operational managers employ a variety of well-intended, informal, survival policies to meet performance targets and avoid patient bottlenecks In fact, they are actively encouraged to find new ways of working and productivity gains to cope with more for less. However, such practices can perpetually mask the underlying reality and have severe unintended consequences. Organisations can become locked into a state of inefficiency, reduced patient safety and overspending. When additional funding is forthcoming it is immediately absorbed by the cumulated deficits, rather than being available for development and whole systems improvement. Evidence for the hypothesis has emerged at many points along patient pathways in health and social care from a number of studies carried out using system dynamics simulation to identify and promote systemic practice in local health communities. The rigour involved in knowledge-capture and quantitative simulation model construction and running has identified mismatches between how managers claim their organisations work and the observed data and behaviour. The discrepancies can only be explained by surfacing informal coping strategies. Indeed, the data itself becomes questionable as it reflects more the actions of managers than the true characteristics of patients. The result of capacity pressure can mean that managers are unable, physically and financially, to break out from a fire-fighting mode to implement better resource investment and development policies for systemic and sustainable improvement. There are important messages in the paper for Health and Social Care management, the meaning of data and for modelling. The key message of the paper is that much- needed systemic solutions and whole system thinking can never be successfully implemented until organisations are allowed to articulate and dismantle their worst coping strategies and return to working within best practice capacities. This is the ultimate new way of working.
Purpose -This paper aims to describe the application of system dynamics to enhance traditional co... more Purpose -This paper aims to describe the application of system dynamics to enhance traditional cost benefit analysis (CBA) in planning a significant expansion of therapy capacity for mental health treatment in the UK. The aim of the initiative is to benefit the health of individuals, reduce costs to society and the exchequer and increase employment. Design/methodology/approach -The paper describes a conventional CBA and comments on its merits and limitations. The development and use of a system dynamics model of the situation is then described, together with how this complements and supports the conventional analysis and its outcome.
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Papers by Eric Wolstenholme