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Evaluating the operational function of intermediate care using a multimethodology of soft systems methodology and discrete event simulation modelling

Kotiadis, Katholiki (2003) Evaluating the operational function of intermediate care using a multimethodology of soft systems methodology and discrete event simulation modelling. Doctor of Philosophy (PhD) thesis, University of Kent. (doi:10.22024/UniKent/01.02.94466) (KAR id:94466)


This thesis is about evaluating the operational function of Intermediate Care, a health and social care system for older people, by undertaking an action research project using a multimethodology of both “soft” and “hard” Operational Research. The Department of Health has invested heavily in the development of intermediate Care systems and their services and their evaluation is worthwhile and important. A group of local stakeholders commissioned in 1999 the University of Kent to evaluate Intermediate Care for the Shepway locality in East Kent. The commissioning project was named ICON and the work described herein is allied to the ICON project.

The multimethodology used for this project is Soft Systems Methodology and Discrete Event Simulation Modelling. The Soft Systems Methodology (SSM) approach was to use primary task root definitions to understand and examine the Operational Function of Intermediate Care (IC) in Shepway. The actions resulting from SSM included to extract Service Entry Eligibility Criteria and confirmed the need to undertake a simulation study to examine the services resource utilisation and the services compliance to these criteria. For the Simulation Study four models have been built, one for each of the “hard core” IC Services and a “whole system” model that examines the decision making mechanism of allocating patients to services in the system.

The contribution of this research is multidimensional. The primary contribution is the understanding and the evaluation of the operational function of Shepway IC. The project has contributed a multimethodology that can potentially be adapted to evaluate other IC systems and their services. Other dimensions are learning about applying each of these methods to the system of interest and learning about the combination of these two methods that are traditionally associated with different paradigms.

Item Type: Thesis (Doctor of Philosophy (PhD))
DOI/Identification number: 10.22024/UniKent/01.02.94466
Additional information: This thesis has been digitised by EThOS, the British Library digitisation service, for purposes of preservation and dissemination. It was uploaded to KAR on 25 April 2022 in order to hold its content and record within University of Kent systems. It is available Open Access using a Creative Commons Attribution, Non-commercial, No Derivatives ( licence so that the thesis and its author, can benefit from opportunities for increased readership and citation. This was done in line with University of Kent policies ( If you feel that your rights are compromised by open access to this thesis, or if you would like more information about its availability, please contact us at and we will seriously consider your claim under the terms of our Take-Down Policy (
Subjects: H Social Sciences
Divisions: Divisions > Kent Business School - Division > Department of Analytics, Operations and Systems
SWORD Depositor: SWORD Copy
Depositing User: SWORD Copy
Date Deposited: 14 Jul 2023 13:49 UTC
Last Modified: 14 Jul 2023 13:49 UTC
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