Simulation of Quality Death Spirals based on Human Resources Dynamics

Although the hospital managers always try to improve the quality of the medical services, sometimes their efforts might affect reversely and push the system in what is so commonly called as “the death spirals of quality.” The most important reason of falling into these spirals is the lack of a systemic thought that considers the feedback relationships between the numerous effective variables in the system performance, such as human resources service capacity. In this regard, the purpose of the present research is to design and simulate a dynamic human resources service capacity–based model to demonstrate the death spirals of quality phenomenon based on the service time per service and the possibility of error generation along with identifying the policies to cope with them. The system dynamics simulation approach is used to show the dynamics of the capacity of service from the standpoint of human resources. A model is simulated for the services of a hospital clinic as a case study. The simulation results of the designed dynamic model express that applying the desired policies for the case study can provide a good basis for fighting these spirals in a dynamic situation.