A reusable discrete event simulation model for improving orthopedic waiting lists

Waiting lists for orthopedic treatment in Australia are lengthy and frequently breach time-based performance targets, due to high demand and limited resources. This paper presents a discrete event simulation model of an orthopedic treatment pathway in Australia from the point of referral to surgical intervention for knee pain patients. The simulation model was used to investigate strategies for reducing the backlog of patients and average waiting time for initial orthopedic review, showing that a reduction of 34% in average waiting time can be achieved by adding three additional appointments per week. The model demonstrates that introduction of community-based rehabilitation early in the patient journey can significantly reduce waiting lists and improve patient recovery, without the need for surgical intervention. This simulation model has been designed to be reusable for other types of orthopedic conditions, and for use in other health services.