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E-132 Optimising resources for endovascular clot retrieval for acute ischaemic stroke using a discrete-event simulation model
  1. S Huang1,
  2. J Maingard2,
  3. H Kok3,
  4. C Barras4,
  5. V Thijs5,
  6. R Chandra6,
  7. D Brooks2,
  8. H Asadi2
  1. 1ANU Medical School, Australian National University, Garran, Australia
  2. 2Interventional Neuroradiology Service, Department of Radiology, Austin Health, Heidelberg, Australia
  3. 3Department of Interventional Radiology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
  4. 4The South Australian Health and Medical Research Institute, Adelaide, Australia
  5. 5Stroke Division, Department of Neurology, Austin Health, Heidelberg, Australia
  6. 6Department of Surgery, Monash University, Melbourne, Australia


Background Endovascular Clot Retrieval (ECR) is the standard of care for acute stroke due to a large vessel occlusion. It is a time critical and complex process involving many specialized care providers and resources. Maximizing patient benefit while minimizing cost of this service requires optimization of human and physical assets.

The aim of this study was to develop a computer simulation of an ECR service designed to optimize resource allocation.

Method Using Simmer-a Discrete Event Simulation (DES) software- as frequently employed in complex logistical operations, we have developed a comprehensive computational model that closely mimics the environment of an ECR service from presentation to emergency department to the angio suite.

This model was tested using real data collected from a quaternary institution with ECR service.

Results Our model assesses the impact of available services, and aids optimization of resource distribution and access, allowing comparison of various competing strategies.

In this simulation, the numbers of different human or capital resources such as stroke physicians, neuro-interventionists, and angiography equipment can be varied to assess the impact on efficiency and availability of service delivery.

Other factors and variables such as equipment breakdown, servicing or times taken during components of an individual stroke management pathway can also be integrated, to identify sources of systemic delay and cost-points, with a view to service improvement.

Conclusion A novel computer simulation is proposed to assess resource allocation, directed at optimizing the timely, effective and equitable application of human and physical resources.

This model can provide clinically important data to help existing ECR services, in targeting optimum service delivery and best patient outcomes.

Disclosures S. Huang: None. J. Maingard: None. H. Kok: None. C. Barras: None. V. Thijs: None. R. Chandra: None. D. Brooks: None. H. Asadi: None.

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