Simulation conceptual modeling for optimizing acute stroke care organization

Stroke is the second leading cause of death and a leading cause of long-term disability world-wide. Treatment with intravenous tissue plasminogen activator (tPA) is the most effective medical treatment for acute brain infarction within 4.5 hours after the onset of stroke symptoms to improve functional outcome. Unfortunately, tPA remains substantially underutilized. Stroke care organization is among the dominant factors determining undertreatment. Recently, simulation has been suggested and successfully implemented as a tool for optimizing stroke care pathway logistics. Starting from this observation we propose a domain specific simulation conceptual modeling framework, aiming to enhance decision making on acute stroke organization. The modeling framework provides guidance for the analyst, through specifying and structuring key modeling activities, and suggesting good practices and supportive methods for executing them. Relevance of the framework for project success is illustrated by a case example.