D R I V I N G I M P R O V E M E N T W I T H O P E R AT I O N A L R E S E A R C H A N D D E C I S I O N A N A LY T I C S

SPRING 2021

OPTIMISATION
HELPS OCADO
PROTECT ITS STAFF
Producing weekly Covid testing
schedules across Ocado sites

BREAKING COVID-19
TRANSMISSION
LINKS IN WALES
Analytics helps develop a
Test-Trace-Protect scheme

HELPING PATIENTS
IN NEED OF
URGENT CARE
Providing real-time information
to reduce waiting times

SURGICAL
PRODUCTIVITY
IMPROVEMENTS IN
THE NETHERLANDS
Queueing model enables heart
surgeries to increase by 12%
© Brastock/Shutterstock
E D I TO R I A L
For a year we have been living through an unwelcome crisis
that most of us didn’t expect, despite warnings that to a large
part were ignored. But many readers will have been affected:
The OR Society is the trading name
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their family or close friends, having been affected by loss of which is a registered charity and a
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income, having had to cancel holidays or family events, or by
having to teach children at home. I extend my sympathy.
Seymour House,
Analysts continue to play their part in combating the
12 Edward Street,
pandemic, and I’m pleased to include some examples in this
issue of Impact. Ocado Technology produced weekly Covid Birmingham, B1 2RX, UK
testing schedules across the company’s sites to protect their
staff and in South Wales a group of analysts helped develop a Tel: + 44 (0)121 233 9300,

Covid Test-Trace-Protect scheme. Fax: + 44 (0)121 233 0321

Analysts are addressing other issues than the pandemic, of course. In this issue Email: email@theorsociety.com
you can read how O.R. and analytics have made an impact in medical care in Devon
and The Netherlands. In different ways, both are concerned with getting treatment to Secretary and General Manager:
patients more quickly. Gavin Blackett
But it’s not just in the medical field that analysts are at work. You can read about
logistical work in the UK and the US, avoiding airline disruption caused by dawdling President: Edmund Burke

passengers at Heathrow, and the work to make the most of the assets of a global energy
Editor: Graham Rand
company, Uniper.
I’m pleased to include in this issue the first article sourced and processed by my g.rand@lancaster.ac.uk

Associate Editor, James Bleach. James is an operational research analyst working for the
Associate Editor: James Bleach
UK Government. He is also a freelance science editor and manages the ōbex project - a
free language editing service for operational researchers whose native language is not Print ISSN: 2058-802X
English. There is another first: a guest column, written by Terry Young in response to Online ISSN: 2058-8038
www.tandfonline.com/timp
an article in the last issue.
I hope you enjoy reading these articles, which show how O.R. and analytics have Published by Taylor & Francis, an Informa
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OPERATIONAL RESEARCH AND DECISION ANALYTICS

Operational Research (O.R.) is the discipline of applying appropriate analytical methods to help those who run organisations
make better decisions. It’s a ‘real world’ discipline with a focus on improving the complex systems and processes that underpin
everyone’s daily life – O.R. is an improvement science. For over 70 years, O.R. has focussed on supporting decision making
in a wide range of organisations. It is a major contributor to the development of decision analytics, which has come to
prominence because of the availability of big data. Work under the O.R. label continues, though some prefer names such
as business analysis, decision analysis, analytics or management science. Whatever the name, O.R. analysts seek to work in
partnership with managers and decision makers to achieve desirable outcomes that are informed and evidence-based. As
the world has become more complex, problems tougher to solve using gut-feel alone, and computers become increasingly
powerful, O.R. continues to develop new techniques to guide decision-making. The methods used are typically quantitative,
tempered with problem structuring methods to resolve problems that have multiple stakeholders and conflicting objectives.
Impact aims to encourage further use of O.R. by demonstrating the value of these techniques in every kind of organisation –
large and small, private and public, for-profit and not-for-profit. To find out more about how decision analytics could help
your organisation make more informed decisions see https://www.theorsociety.com/about-or/or-in-business/. O.R. is the home
to the science + art of problem solving.
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accreditation.indd 1 22/09/2020 15:14

CO N T E N T S
7 HOW OCADO TECHNOLOGY AUTOMATED COVID 4 Seen Elsewhere
TEST SCHEDULING Analytics making an impact
Anna Moss tells us how constraint optimisation
helped schedule Covid tests at Ocado

10 COVID-19: TEST-TRACE-PROTECT IN WALES 13 O.R. support for planning

Doris A. Behrens, Daniel Gartner, Jeff Brown, Eryl Powell, under uncertainty
Daniel Westwood and Izabela Spernaes report how analytics has Nicola Morrill shares with us the
helped develop a Test-Trace -Protect scheme, and project staffing ratios role that Operational Research
required to deliver an effective service for the Gwent communities has in supporting planning in
16 INCREASING SURGICAL PRODUCTIVITY AT uncertain times
ERASMUS MEDICAL CENTER
Maartje Zonderland and Ad Bogers show how a 20 What can System Dynamics do
queueing model and other approaches helped to increase for you?
heart surgery productivity in Rotterdam Stephan Onggo shows why, and
25 PROVIDING REAL-TIME INFORMATION FOR in what circumstances, System
URGENT CARE Dynamics can be of use
Nav Mustafee and John Powell explain how the NHSquicker
platform was developed to help reduce the wait time for patients 30 Universities making an impact
in need of urgent care and help the NHS meet targets Brief reports of two postgraduate
35 MIRALIS DATA student projects
Brian Clegg tells us of the work of data science and software
company Miralis Data to support logistics through O.R. and provide 32 Healthcare Systems: Why
guidance on the move towards an electric vehicle infrastructure Simulation Overcomes the
40 TERMINAL PROBLEM Design Barriers
Neil Robinson reports the work of Bert De Reyck and colleagues Terry Young argues that an
to create and implement a system using machine learning to model important step for healthcare is to
passenger flows at Heathrow, and reduce flight schedule disruptions be able to estimate the Return on
Investment from a given amount of
46 PORTFOLIO OPTIMISATION IN UNIPER
Colin Silvester describes how mathematical programming modelling to determine how much
supports decisionmakers at global energy company Uniper, benefit to expect
to extract the maximum value from their assets
55 The flavour of equations
51 DATA ANALYSIS AND OPTIMAL ROUTING FOR
Geoff Royston gives us a taste of
COUNTRYMARK REFINING AND LOGISTICS
Monica Gentili, Lihui Bai, John Usher and Ash Titzer report a smorgasbord of equations: some
how CountryMark, a US oil company, use statistical analysis more appetizing than others
and optimisation models to support decision making, improve
logistical efficiencies, and identify potential cost savings

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 SEEN ELSEWHERE
FRESH FOOD DELAYS
Simul8, which featured in Impact’s last
issue, has been evaluating the additional
burden Brexit red-tape will bring at
UK ports. The i reported on January
15 their chief technical officer Frances
Sneddon saying: “Unfortunately, we’re
already beginning to see the cost of
perishable items being left to waste due
to the disruptions at ports and extended
queue times for freight vehicles. Fruit,
vegetables, seafood and meat are
affected in the food industry, while the
shelf life of medical supplies won’t allow
for the extended waiting times that our
model has predicted either.”
She also pointed to issues being
faced by manufacturers, which could
also suffer supply shortages due to a
lack of deliveries from the European
Union into the UK: “Manufacturers
that operate with just-in-time models
could feel the fallout and need to adapt
their operations to account for new
contingencies and delays.”
INFECTIONS
FROM STUDENTS
RETURNING HOME
Paul Harper and colleagues, the group
at Cardiff University was featured
in Impact’s last issue, have provided
© Cardiff University
an open-source model to estimate
the number of secondary Covid-19
infections caused by potentially
infectious students returning from
university to private homes with
other occupants. See http://bit.ly/
studentreturn. They predicted from
the model that each infected student
would generate one secondary within-
household infection. A Matlab code
and a helpful online app (http://
4 IMPACT © THE OR SOCIETY
bit.ly/Secondary_infections_app)
is available to estimate numbers of
secondary infections based on local
parameter values. This can be used
to support policy making. The total
number of secondary cases for all
returning students is dependent on
the virus prevalence within each
student population at the time of their
departure from campus back home.
Although the proposed estimation
method is general and robust, the
results are sensitive to the input data.
Their results were presented to
TAG (Task Advisory Group for Welsh
Government Covid-19 response) and
the Wales Higher Education Covid-19
Task and Finish Group, and used
to inform policy in relation to the
two-week firebreak (lockdown) in
Wales during the period 23 October
– November 8 2020, when students
were asked to remain at their university
lodgings, rather than return home. The
research was also communicated by
the Welsh Government to colleagues
in England, Scotland and Northern
Ireland Governments and helped
inform the wider development of
policy in this area relating to returning
students home safely for the vacation.
INTERACTIVE
COVID-19 DATA
NPC have built a regularly updating
and interactive dashboard, to help
charities and funders see the places
most affected by Covid-19, and those
that have underlying factors—such
as age, health, ethnicity, economic
indicators, and multiple deprivation—
which may put them at risk. The
dashboard also includes demand
data, allowing better understanding
of what charities are experiencing on
the ground and to set that against
the official Covid-19 cases and death
figures (see http://bit.ly/NPCdata).
Parastou Youssefi, Senior Program
Officer, Bill & Melinda Gates
Foundation said “NPC’s Covid-19 data
tracker is one of the best resources I’ve
seen globally that aims to track areas
of greatest need in our communities
due to coronavirus. A clear, aggregated,
data-driven view of the people and
places that need extra support is
particularly needed right now as
charities and donors struggle with
prioritization of resources and efforts”.
BRITISH RED
CROSS COVID-19
VULNERABILITY INDEX
To help focus help on the most
vulnerable people whose needs aren’t
being met, British Red Cross are
developing a COVID-19 Vulnerability
Index, consisting of Clinical
vulnerability, Other health/wellbeing
needs, Economic/financial vulnerability
and Social vulnerability (including
physical/geographical isolation). There
are also interactive maps available. See
http://bit.ly/RedCrossvulnerability.
 O.R. FOR MASS
VACCINATION
Computer simulation is being used to
support the operational planning for
mass vaccination centres in the UK.
The Bristol, North Somerset and South
Gloucestershire (BNSSG) healthcare
system used modelling to determine
a safe operating throughput and to
optimise capacity allocation along the
vaccination pathway at the Ashton
Gate stadium site, ahead of going ‘live’.
Collaborating with University of Bath’s
Centre for Healthcare Innovation and
Improvement, the BNSSG modelling
team – led by Dr Richard Wood
– used discrete event simulation to
model the flow of patients along the
four stages of the vaccination pathway,
from registration to clinical assessment,
immunisation, and observation.
The team used data collected
from Exercise Panacea – a live
walkthrough exercise of the Ashton
Gate site in early December – to
calibrate the various statistical
distributions for how long ‘players’
within the live exercise were taking
at each of the four pathway stages.
The PathSimR software (see https://
github.com/nhs-bnssg-analytics/
PathSimR) was thereafter used to
simulate a number of hypothetical
scenarios in safely maximising
throughput along the pathway.
Results have directly informed
the numbers of patients being
booked into the mass vaccination
© S. Moss
centre for its opening week. The
team is monitoring data from the
site in performing any necessary
refinements to the operating model.
SAFE IN-PERSON VOTING
Laura Albert and Adam Schmidt of
the University of Wisconsin-Madison
studied the operation of in-person
voting for the USA 2020 General
Election, based on Milwaukee data,
using discrete event simulation. Their
objective was to have short wait times,
a low-risk of COVID-19 transmission
for voters and poll workers, and
accommodate sanitation procedures
and personal protective equipment
(PPE). See http://bit.ly/SafeUSVoting.
One concern addressed was
whether it was sensible to consolidate
polling locations into a few large
polling locations, with the potential
to use fewer poll workers and decrease
average voter wait times. In particular,
the use of basketball arenas was
being considered. Amongst their
recommendations were that in-person
voting should occur at the standard
polling locations, because consolidated
polling locations require many check-in
booths to ensure short voting queues,
and doing so requires high staffing
levels. They did not recommend using
sports arenas as supplementary polling
locations for in-person voting on
Election Day.
UK’S NATIONAL
DATA STRATEGY
Phil Earl, Deputy Director, Data
Strategy, Implementation and
Evidence, with responsibility for
the National Data Strategy (NDS),
shared some reflections about the
recent consultation, and what’s
next for the strategy at http://bit.ly/
NationalDataStrategy. He comments
on what he calls “three myths”: ‘The
strategy is just about Government data’;
‘The strategy prioritises growth over
data protection’; and ‘A pro-growth data
rights regime means privacy is at risk.’
Department for Digital, Culture,
© National Data Strategy,
Media & Sport
He notes that “This year we have all
lived through huge change. The response
to COVID-19 has increased our
understanding of the importance of data
use within the economy, society and the
public sector, and in ensuring that data
can be shared in timely and trustworthy
ways. The UK’s exit from the EU will
bring new opportunities to leverage the
UK’s strengths; and ensure that we have
a data regime that promotes growth and
innovation, while maintaining public
trust by remaining committed to high
data protection standards, on which the
UK is a global leader”.
He concludes by saying, “You can
expect to hear from us soon with an initial
Government response, and what the path
forward will look like during 2021”.
COMPANY REPORTS
FOR AI READERS
John Naughton, professor of the public
understanding of technology at the
Open University, shared his concern in
the Guardian that companies are now
writing reports tailored for AI readers
(see http://bit.ly/NaughtononAI). His
article was prompted by a working
paper published by the US National
Bureau for Economic Research
IMPACT | SPRING 2021 5
 (NBER): How to Talk When a
Machine Is Listening: Corporate
Disclosure in the Age of AI (see https://
www.nber.org/papers/w27950).
© Data Orchard
Whilst much research in AI assesses
how good computers are at extracting
actionable meaning from such a tsunami
of data, the NBER researchers looked at
the supply side – how companies have
adjusted their language and reporting in
order to achieve maximum impact with
algorithms that are reading their corporate
disclosures. Naughton says that “The
researchers found that ‘increasing machine
and AI readership … motivates firms to
prepare filings that are more friendly to
machine parsing and processing’. So far,
so predictable. But there’s more: ‘firms
with high expected machine downloads
manage textual sentiment and audio
emotion in ways catered to machine and
AI readers’.” His concern arises because,
as he says, “There’s a lot riding on this,
because the output of machine-read
reports is the feedstock that can drive
algorithmic traders, robot investment
advisers, and quantitative analysts of all
stripes”.
DATA MATURITY
Data Orchard’s free Data Maturity
Assessment tool has been online now
for over a year and has been used
by hundreds of organisations. In
November 2020, people who had
completed an assessment were surveyed
to see what impact it had had on their
organisation. The details of this are
available in a report. It was determined
that three reasons why you should take
a data maturity assessment are:
• It is a great way to get people
talking about data;
• It makes it easier to develop a data
strategy or improvement plan;
• It can unlock additional resources.
6 IMPACT | SPRING 2021
The report can be read online or a
copy downloaded at http://bit.ly/
DataOrchardReport.
CHALLENGES TO ANALYSTS
Writing in OR/MS Today (http://
bit.ly/RobinLougee) Robin Lougee,
O.R. ambassador and member of the
US National Academies of Sciences,
Engineering and Medicine’s Board on
Agriculture and Natural Resources,
said “The direct impacts of COVID-19
and the indirect impacts of the efforts
to contain the virus have highlighted
challenges that need data science, analytics
and operations research skills, such as:
• More data and better models to
predict and mitigate food supply
chain risks.
• Building more resilient, sustaina-
ble regional and local food supply
chains.
• Forging more agility between
food retail and food service sector
supply chains.
• Increasing automation to address
the food and agriculture labour
challenges.
• Scaling e-commerce capabilities
for fresh products and groceries.
• Creating multiscale modelling of
the food system with sufficient
accuracy for useful stress testing
(as was done for the monetary
system following the financial
crisis)”.
NEW RULES FOR AI
TECHNOLOGIES
The European Union is expected to
announce new rules for AI technologies,
including compliance tests and controls.
Anupam Datta, a computer science
professor at Carnegie Mellon University
and co-founder of the start-up Truera,
thinks the commission is likely to take a
broad approach similar to General Data
Protection Regulation (GDPR).
Datta says. “I believe the rules will
be broadly applied – similar to GDPR
– to any technology that leverages AI.
Otherwise you leave loopholes and
risk missing important use cases that
really should be subject to the rules
and requirements. The expectations
of compliance tests and controls will
vary by materiality of the use cases.
For example, the expectations for
underwriting may be higher than the
expectations for marketing models.”
He argues that there needs to be a
combination of internal and external
oversight, and that companies will
need better tools to assess model
quality and performance. “There
has been a lack of good tools for
measuring model quality during
model development and on an
ongoing basis with monitoring,”
Datta says. “There is likely to be a
long grace period before penalties
begin, as we saw with GDPR, and
during that period, companies will
need to race to get the right test
and measurement tools in place to
ensure compliance.” (See https://doi.
org/10.1287/LYTX.2020.06.02).
© Ocado Group
HOW OCADO TECHNOLOGY
AUTOMATED COVID TEST
SCHEDULING
ANNA MOSS OCADO GROUP IS A UK BASED
TECHNOLOGY COMPANY that
provides end-to-end online grocery
fulfilment solutions to some of the
world’s largest grocery retailers and
holds 50% of Ocado Retail Ltd in the
UK in a Joint Venture with Marks
& Spencer. Ocado has spent two
decades innovating for grocery online,
IMPACT © 2021 THE AUTHOR
investing in a wide technology estate
that includes robotics, AI and machine
learning, simulation, and forecasting.
Ocado Retail Ltd is the world’s
biggest online-only grocery retail
business. It offers a range of over
50,000 products and serves over
639,000 active customers across the
UK, shipping 325,000 orders per week.
7
 Its fulfilment is based on Customer
Fulfilment Centres (CFCs), highly
automated warehouses powered by
cutting edge technology.
At the beginning of the
COVID-19 lockdown, Ocado
Group took a decision to
test all frontline employees
on a weekly basis in order to
protect the health of the staff
Ocado Group employs over 15,000
people, many of whom perform
frontline roles such as picking and
packing in CFCs, delivering orders to
customer homes, providing customer
service in the contact centre etc.
TEST SCHEDULING
CHALLENGES AND
AUTOMATED SOLUTION
At the beginning of the COVID-19
lockdown, Ocado Group took a
decision to test all frontline employees
on a weekly basis in order to protect
the health of the staff. This task
presented the business planning team
with a large-scale logistical problem
© Ocado Group
8 IMPACT | SPRING 2021
of scheduling frontline employees
at each site to available test slots
determined by room and testers’
availability subject to operational
constraints.
These constraints included, for
example, the requirements that each
employee should be scheduled for
a test within their working shift, a
spacing between tests performed on
the same employee should be within
given bounds, only a limited share of
employees from the same work area
© Ocado Group
could be scheduled for a test on the
same day etc.
The problem proved too difficult
to be solved manually, and the Ocado
Technology’s Data Science team was
approached for help, with extremely
tight time limitations. The team
leveraged their prior experience with
constraint optimisation problems, e.g.
staff rostering. The COVID-19 test
scheduling problem was solved using
Constraint Programming technology,
by creating an efficient constraint model
of the problem and feeding it to a
Constraint Solver. The task also involved a
significant implementational effort. Good
design practices allowed partial reuse
of the existing code base and enabled
execution of all stages of the project
from requirement collection through
research, implementation, refinement to
deployment in less than two weeks.
The COVID-19 test
scheduling problem was
solved using Constraint
Programming technology,
by creating an efficient
constraint model of the
problem and feeding it to a
Constraint Solver
AUTOMATED TEST
SCHEDULING ROLL
OUT AND IMPACT
As a result, the business planning
team was able to automatically create
test schedules for different Ocado sites
which complied with the specified
constraints. The tool has been used to
automate a substantial share of the test
scheduling tasks in different business
areas producing schedules for up to 3500
employees across 4 sites. The automated
test scheduling tool thus became a

significant part and an enabler of the
COVID-19 testing process in Ocado.
James Norton, a planning analytics
manager, observes: “Our analytical
teams in Logistics have always had a
close working relationship with Data
Science, collaborating on automation
projects to add significant value to
our delivery and fulfilment operation.
This meant we were already aware of
the potential they had to support our
challenge, and they had a working
knowledge of how we operate. Being
able to react quickly in an environment
of mutual understanding resulted in
a rapid proof of concept, created with
flexibility to adapt to the inevitable
changing circumstances.”
Lewis Momen, a business analyst,
says: “The COVID-19 Scheduling Tool
that Ocado Technology’s Data Science
department built for us has been and
continues to prove immensely useful.
When we first approached the test
scheduling problem, it quickly became
apparent that, given the scheduling
constraints, the vast number of
© Ocado Group
employees to be tested and the time requirements, and it is
pressures we were under to rollout the used several times a week
programme, a long-term and resilient to produce weekly testing
solution was required. schedules across several of
“We approached Ocado Ocado’s sites
Technology’s Data Science team with
the problem, and they were quickly Anna Moss is a
able to build a tool that outputted Principal Data
an optimised solution. Since its Scientist at Ocado
development, the tool has been Technology. She
refined to meet changing programme obtained a PhD in
requirements, and it is used several Computer Science
times a week to produce weekly from Technion,
testing schedules across several of specialising in
Ocado’s sites. Ultimately the tool has Combinatorial Optimisation. During her
facilitated an organised and efficient fifteen years of industry experience, Anna
testing programme, helping to keep has worked on several challenging projects
Ocado’s employees safe during these applying optimisation techniques to real-
unprecedented times.” world applications.
Since its development, the A shorter version of this article appeared
tool has been refined to in the December 2020 issue of IFORS
meet changing programme News.

IMPACT | SPRING 2021 9
 COVID-19: TEST-TRACE-
Cryptographer/Shutterstock
PROTECT IN WALES
DORIS A. BEHRENS,
DANIEL GARTNER, JEFF
BROWN, ERYL POWELL,
DANIEL WESTWOOD
AND IZABELA SPERNAES
10 IMPACT © 2021 THE AUTHORS
CONTACT TRACING IS AN
ACKNOWLEDGED STRATEGY
to limit the spread of Covid-19 in
the community by breaking potential
transmission links. In Wales, the
Test, Trace, Protect (TTP) strategy
includes an approach to testing people
with symptoms in the community,
tracing those they have come into
close contact with, who may be at risk
of having the virus, and protecting
family, friends and our community
by self-isolating. While so-called
tracers collect all relevant information
from symptomatic people only
once, TTP advisors stay connected
with (asymptomatic) contacts of
Covid-19 cases for up to a fortnight
– unless these contacts become cases
themselves.
 Aneurin Bevan University Health
Board (ABUHB) is responsible
for all healthcare needs of nearly
650,000 residents across Gwent,
an area covering five boroughs
in the South-East of Wales, and
parts of neighbouring Powys. The
Gwent TTP Service (GTTPS) is
a collaboration between five Local
Authorities (Caerphilly, Blaenau
Gwent, Monmouthshire, Newport and
Torfaen) and ABUHB.
The GTTPS asked the Modelling
Team at ABUHB’s Continuous
Improvement Centre (ABCi) to
develop a tool assisting long-run
workforce planning. It was intended
that this tool would ensure that the
GTTPS would better understand and
anticipate workforce demand through
autumn and winter 2020/21 to allow
timely recruiting and training of
contact tracers and advisors.
COPRODUCING A
DECISION-SUPPORT TOOL
Informed by intensive discussions and
continuous adaption to the GTTPS’s
needs, an Excel tool ‘translating’ the
FIGURE 1 SCREENSHOT OF GTTPS WORKFORCE TOOL
forecasted number of Covid-19 cases
into workforce requirements was jointly
developed. A screenshot of the tool
can be seen in Figure 1. The expected
(weekly) numbers of tracers and
advisors (needed to turn around 99.9%
of all service requests in 24 hours) were
expressed in whole-time equivalents
(WTE). The user must identify the
following information before running
the tool: ‘Utilisation of Service (in %)’,
‘Baseline number of contacts per case’,
‘Average length of tracer call’, ‘Average
length of first advisor call’, ‘Average
length of contact follow-up advisor
calls’, ‘Effective weekly working hours’
and ‘Proportion of contacts opting in
for a follow-up call’. Some of these
parameters are included as stationary
values, others as time series, like the
number of contacts per case.
All parameter values were initially
calibrated based on expert opinion/
experience and updated continuously,
guided by the GTTPS’s observations.
For example, around 65% of contacts
preferred to be followed up via phone
– not via text message. The number of
contacts per case varied substantially. It
came down from 6 to 7 in summer 2020
to a median of 1.9 through autumn
2020, dwindling to 1.4 since Wales went
into lockdown on 20th December 2020.
Also, for every four people hired to work
fulltime (37.5 hours per week), a fifth
person accounts for all sick leave, annual
leave, etc. This results in a WTE ratio
of 1.25. In other words, if a person is
employed to work 37.5 hours full-time,
the time effective for workforce planning
is equal to 30 hours.
ENABLING DIALOGUE AND
INFORMED DECISIONS
The number of positive cases can
be entered into the TTP Workforce
Planning tool to compute the
(modelled) number of tracers and
advisors over time. These numbers
enable decision-makers to come
together and test the impact of their
assumptions – embodied in parameter
choices – on recommendations. The
process of how parameters ‘translate’
into the expected workload becomes
transparent. Additionally, (automatically
updating) charts compare observed and
forecasted case numbers. Likewise, the
tool visualises modelled staff numbers
IMPACT | SPRING 2021 11
and those recruited (and planned to be
recruited) throughout the pandemic.
So far, these visualisations enabled
fruitful conversations between members
of Local Authorities and ABUHB,
mathematicians, epidemiologists, and
public health experts − and empowered
effective decision-making.
UNDERSTANDING THE
PITFALLS OF PLANNING
WITH AVERAGES
Another issue was made transparent
in discussions using the tool. The
‘fuzz-free’ modelling utilising average
numbers for strategic planning
anticipates implicitly service provision
at full capacity. In other words, the
recommended workforce size returned
by the model can cope with averaged
demand, not with peaks in demand.
The latter leads to delays, which are
highly counterproductive for contact
tracing. The tool enabled insightful
dialogue about this often-ignored fact.
As a way out, the TTP Workforce
Planning tool provided the inbuilt
functionality to dial down utilisation
from 100% to a lower level, e.g. 85%,
to also account for training.
COLLABORATING
FOR SUCCESS
By early February 2021, the strategic
Workforce Planning tool had
demonstrated the ability to support
decision-making for scale-up approaches
within the GTTPS. Jonathan Keen,
12 IMPACT | SPRING 2021
Head of the Coordination Unit for
the Gwent Test Trace Protect Service
(GTTPS): ‘The TTP Workload model
was an invaluable tool to assist the
Gwent Test Trace Protect Service to
determine the additional recruitment
required to deliver contact tracing at
a time of increasing case numbers. It
provided a clear understanding of the
potential trajectory for the number
of Covid-19 cases and contacts of
cases. It then estimated the workforce
required to manage this level of demand
effectively. This was used to provide
a rationale for the final decision on
numbers to be recruited, and therefore
for the additional financial cost that was
to be incurred’.
The TTP Workload model
was an invaluable tool
to assist the Gwent Test
Trace Protect Service to
determine the additional
recruitment required to
deliver contact tracing at
a time of increasing case
numbers
The tool has also been able
to project staffing ratios (using
epidemiological models) required
to deliver an effective service for the
Gwent communities. Looking into
the GTTPS’s future, the tool enables
a forward-thinking look of future
scale up and scale down approaches
for workforce planning that will
require utilising different staff ratios
as we progress through this pandemic.
Doris A. Behrens is a Professor at the
Danube University Krems, Austria, and
head of the department for Economy and
Health. She holds Postdoc positions at
Cardiff University and Aneurin Bevan
University Health Board.
Daniel Gartner is a Senior Lecturer of
Operational Research and a researcher-in-
residence at the Aneurin Bevan University
Health Board’s Mathematical Modelling
Unit.
Jeff Brown is Programme Manager for
the Regional Cell Delivery Programme
(part of the Gwent Test Trace and Protect
Service) and Director of JBPS Advisory
Solutions Limited.
Eryl Powell is a Consultant in Public
Health for Public Health Wales. During
the Covid-19 pandemic she is the lead
for the Aneurin Bevan University Health
Board Incident Coordination Centre and
is the Health Board lead for the Gwent
Test Trace Protect Service.
Daniel Westwood, Senior Project Manager
within Aneurin Bevan Health Board for
the Test, Trace and Protect Programme is
based at the Aneurin Bevan University
Health Board Incident Coordination
Centre.
Izabela Spernaes is a service lead for the
Mathematical Modelling team within the
Aneurin Bevan Continuous Improvement
team (ABCi). As part of this role, she is
raising the awareness of modelling in the
health board.
O.R. SUPPORT FOR PLANNING of fast, but predictable change. It is likely that the VUCA
dimensions do not happen in isolation of each other.
UNDER UNCERTAINTY
BRIEF DESCRIPTION
Nicola Morrill
The nature, speed, volume and
magnitude of change is not
Volatility
predictable, causing consistent
turbulence.
Lack of predictability in issues and
Uncertainty events make it difficult to see future
outcomes or make decisions.
Many difficult to understand and inter-
Complexity
connected variables
Lack of clarity behind causes of what
Ambiguity is happening – lots of ‘unknowns
unknowns’

TABLE 1 VUCA DESCRIPTION

‘We need diversity of thought in the world to face
new challenges’ Tim Berners-Lee
I thought it would be useful, given the current climate we all
find ourselves in, to share with you the role that Operational
Research (O.R.) has to play in supporting planning in
uncertain times.
I understand that there is a school of thought that would
argue against planning when everything is so changeable: I
DEALING WITH VUCA
VUCA means that plans are highly subject to change. The
balance of effort perhaps needs to shift between creating the
plan (less time) and testing and understanding the plan in a
range of contexts (more time).

© Jeroen Kraaijenbrink
subscribe to a different view. I accept that most plans ‘don’t
survive contact’ but believe the value lies in the process of
planning. The richer the common understanding is of a
situation, how it could evolve and how different options
could play out, the more able organisations will be able to
adapt in, hopefully, a timely manner.

VUCA AS A TOOL FOR THINKING

There are many different ways to think about uncertainty
and the different forms it can take. In business, VUCA is
an increasingly used phrase. It refers to a situation that is
volatile, uncertain, complex and ambiguous. Sounds pretty
relevant to life with COVID-19!
Table 1 provides a brief description of what is meant by
the terms.
Figure 1, of the four dimensions of VUCA (taken
from http://bit.ly/VUCAarticle with permission of Jeroen
Kraaijenbrink), provides a visual representation of each of
these characteristics in isolation, i.e. a purely volatile (but
not uncertain, complex or ambiguous) world, there is a lot FIGURE 1 THE FOUR DIMENSIONS OF VUCA

IMPACT © THE OR SOCIETY 13

 There is a lot of guidance and suggestions out there
about how to deal with a VUCA situation, including
VUCA Prime. Summing the key points from the material
I found:
• Volatility – Manage it. Build in slack. Create a vision.
• Uncertainty – Navigate it. Increase understanding.
Collect and share information.
• Complexity – Reduce it. Bring clarity.
• Ambiguity – Bring clarity. Experiment. Understand
cause and effect. Be agile.
A key theme is about improving understanding of the
situation.
HOW CAN O.R. HELP?
O.R. is a broad discipline with a huge range of tools used to
assist decision makers. Many of these are relevant in VUCA and
more than I have space to cover. I highlight a few areas that will
assist in the suggestions of how to deal with VUCA, particularly
aiding understanding and exploration of a situation.
© Declan Bradley
FIGURE 2 SYSTEMS DIAGRAM ILLUSTRATING SOME OF THE COMPONENTS IN RESPONSE TO THE COVID-19 THREAT
14 IMPACT | SPRING 2021
Problem structuring methods (PSMs)
PSMs refer to a whole host of methods that seek to support situa-
tions characterised by uncertainty, conflict and complexity; pretty
ideal for use in a VUCA world. They apply modelling approach-
es, normally in a group setting, to help structure a problem and
improve understanding of the situation and the dynamics, rather
than to directly find a solution. This ranges from drawing a (rich)
picture to represent views of the situation, identifying and explor-
ing stakeholder interests through to more complex modelling.
The level of expertise required for each different.
Systems modelling
Systems models are representations of socio-technical systems
that aim to improve understanding of a situation, helping
to identify problems and supporting planning. These range
from diagrams at one end of a spectrum through to quantita-
tive representations of a situation.
Figure 2 is from an article in The Lancet on a systems
approach to preventing and responding to COVID-19
(http://bit.ly/SystemDiagram). It is an example of a systems
diagram, which highlights key factors (from the perspective
of the model creators) influencing the management of
COVID-19. Words at the base of an arrow influence the
words at the head of the arrow, either in a negative of
positive way. This starts to build a rich understanding of the
situation, possible areas for influence and the likely impact of
these. See also the article on System Dynamics in this issue.
Foresight – scenario planning
An increasingly commonly used approach is that of scenar-
io planning, which helps explore what the future could look
like. There are a range of methods that are available to create
scenarios and these are widely written about. Scenarios are
not predictive tools but provide support to planning by, for
instance, providing insights into the key drivers of a situation
and surfacing assumptions that may be being made. Scenarios
are a particularly useful tool to use in a high uncertain situation
where a range of futures, some that many may think are unlike-
ly, can be articulated and their potential impacts explored.
Some questions organisations are using scenarios to
explore just now are:
• What might COVID-19 mean for the world this
decade? [Shell]
• What will the internet be like in 2025? [Cisco]
• How could tourism potentially evolve over the next 18
to 24 months? [Tourist Board]
A growing area of O.R., behavioural O.R., aims to
explore and understand the role and impact of behaviour
in O.R. work. The O.R. community has much more
information on the areas mentioned above and more -
whether that be case studies, training or further development
of the areas mentioned.
INCLUDING A DIVERSE RANGE
OF VOICES IS ESSENTIAL
Most of the tools that can help with VUCA, particularly
increase understanding of the situation, are participatory
and interactive in nature. While it is always good to
ensure diversity of thought; in a VUCA situation
it is key!
While experience absolutely has its place, it should not be
the only voice. Hearing from an alternative perspective could
very well highlight a whole new way of doing things or an
innovative way to address a current challenge. There is much
evidence of the business benefit it brings.
So, if you are not able to immediately access some
of the tools that can assist in planning in a VUCA
environment, one thing you can do is ensure there is a
diverse range of voices involved in the planning you are
undertaking. Make sure you have that fresh perspective
and welcome the challenge – it will help ensure that you
have a resilient plan able to adjust.
Hearing from an alternative perspective
could very well highlight a whole new way
of doing things or an innovative way to
address a current challenge
WANT TO LEARN MORE?
If there is something, related to O.R., that you would like me
to consider for my next ‘column’ in Impact then please get in
touch. I’ll be pondering what to write about over the coming
months…. The goal is to share the discipline with users/
potential users of O.R. by highlighting how it could support
‘business’ challenges they may be facing.
In the meantime, I’ll leave you with a quote I like
from Albert Einstein ‘Assumptions are made, and most
assumptions are wrong’.
Nicola Morrill is a Systems Thinking Consultant at Dstl, a
certified coach and the current Diversity Champion of the O.R.
Society. She writes in a private capacity – all views expressed are
her own and all examples are available in the open domain. You
can contact her on Nicola.impact@gmail.com
IMPACT | SPRING 2021 15
INCREASING SURGICAL
PRODUCTIVITY AT ERASMUS
MEDICAL CENTER
MAARTJE ZONDERLAND
AND AD BOGERS
16 IMPACT © 2021 THE AUTHORS
ERASMUS MEDICAL CENTER
(EMC) is one of the largest hospitals in
the Netherlands, situated in the densely
populated region of Rotterdam-
Rijnmond. During the first wave of
the COVID-19 pandemic early 2020,
EMC served as the national crisis
centre from which hospital capacity
in the Netherlands was centrally
coordinated. As a tertiary university
hospital, EMC’s Thoraxcenter is a
supra-regional referral centre for

© Aerovista Luchtfotografie/Shutterstock
cardiology and cardio-thoracic surgery.
The Thoraxcenter experiences fierce
competition, since eight other cardiac
surgery centres are situated within
an 80km radius. In order to attain
economy of scale and to be able to
provide the necessary regional cardiac
surgical service, the EMC decided to
increase the number of open heart
surgeries (989 in 2015) with 150
extra in 2016, 2017 and 2018 (450
in total). After successful budget
negotiations with EMC’s prevalent
healthcare insurer, for 2016 a goal of
150 additional surgeries was indeed
set. Here we describe how we were able
to increase surgical productivity. For
more detail, please see Zonderland et al
(2020).
THE CHALLENGE:
INCREASE MARKET
SHARE AND INTRODUCE
CAPACITY MANAGEMENT
As in many hospitals, paradoxically
staff experience high work pressure,
while at the same time a significant
part of capacity is unused. Long and
highly variable surgery durations, many
(10%) urgent patients and the intensive
surgical preparation of patients (for
example: dental sanitation, additional
diagnostics, physiotherapy sessions
and adjustment of medication) is
typical for this patient cohort, thus
introducing additional patient flow
issues. Also, EMC’s market share for
open heart surgery was only around
50% within EMC’s catchment area,
compared to 85% for other cardiac
surgery centres in their catchment area.
Increasing EMC’s market share to 85%
would mean an additional 450 open
heart surgeries per year. In addition
to attracting the additional referrals
required to receive these additional
patients, capacity management was
required to increase utilisation, reduce
work pressure and improve operating
room (OR) patient planning. Also,
the long access time (defined as the
time between the request for surgery
and the day the surgery takes place) of
12–14 weeks had to be decreased to
2–3 weeks.
THE APPROACH:
INTERVENTIONS ON
SEVERAL LEVELS,
COMBINED WITH STRICT
PROJECT MANAGEMENT
Two external consultants were hired for
project management, problem analysis
and implementation of necessary
interventions. The project started with
a thorough examination of the waiting
list. Patients who weren’t eligible for
surgery anymore were removed from
the list. As a result, the waiting list
was reduced by 15%. For a sustainable
increase in the surgical production,
more referrals were required. This
was achieved by the cardiac surgeons
reaching out actively to referring
cardiologists in the hospitals
surrounding the EMC and discussing
the advantages of referring cardiac
patients to the Thoraxcenter.
From a capacity management
perspective, the most important
intervention was increasing capacity
by extending OR opening hours.
This was enabled by hiring additional
OR staff and anaesthesiologists. The
extension of opening hours had two
main advantages: long surgeries (more
than eight hours) could more often
be finished within regular working
hours, thus reducing the probability of
staff working in overtime. Also, with
an average surgery duration of almost
five hours, the original 8-hour shift
was usually too short to perform two
surgeries. With the new 10-hour shift,
this problem was eliminated and thus
capacity was used more efficiently.
To improve the scheduling of
urgent cases, a queueing model (see
Zonderland et al (2010)) was used
to calculate the required number of
OR slots for this patient category.
Using this model, a trade-off between
cancellations of elective patients on the
one hand and unused OR time due to
excessive reservation of OR time for
IMPACT | SPRING 2021 17
 urgent cases on the other hand can be
made. As a consequence, one (out of
four) ORs was earmarked for urgent
patients. When no urgent patients
were present, two elective patients were
placed in so-called ‘open-ticket beds’ on
the Medium Care Unit (this is a ‘step-
down’ unit, where patients are placed
who need close monitoring of their
vital functions, but do not need the
high-complex care that is provided on
the Intensive Care Unit). These patients
were awaiting and ready for surgery.
Thus, empty slots in the earmarked OR
would be used for elective surgeries,
creating high accessibility for both
urgent and elective patients, and
optimal usage of capacity at the same
time.
Another important intervention
was the introduction of the new role
of ‘surgeon of the day’ (SOTD).
All cardiac surgeons were regularly
scheduled for the SOTD role, being
the central point of communication
for referring cardiologists, having the
mandate to decide upon the final OR
schedule of that day. Introducing this
new role, with a clear mandate, reduced
© pirke/Shutterstock
18 IMPACT | SPRING 2021
the fuzzy communication between the
surgeons, anaesthesiologists, planning
office and OR staff about changes
in the schedule and the scheduling
of urgent patients significantly. The
SOTD also hosted a daily planning
meeting at 10.00am, where the
progress of ongoing surgeries and
possible changes in the schedule were
discussed with the anaesthesiologist on
call and coordinators from the OR and
clinical wards. This also improved the
decision-making process.
Finally, patient preparation was
improved by concentrating all pre-
operative preparation activities at
the outpatient clinic and scheduling
them on the same day if possible. The
number of times patients would need
to visit the hospital decreased, and the
overview of the process was improved.
The implementation of these
measures was accompanied by strict
project management, involving a
weekly project group meeting and
bi-monthly steering group meeting
with all stakeholders represented. Four
workshops were organised to align
patient flow in the cardio-thoracic care
chain. Member of the project group: “I
liked the clear analysis of the problem
and transparent communication. There
was good interaction with people on
the shop floor so we could implement
change.”
THE RESULTS FOR 2016:
AN INCREASE IN SURGICAL
PRODUCTIVITY AND
DECREASE IN ACCESS TIME
In all months of 2016, a higher
production than in 2015 was achieved.
The total increase in the number of
open-heart surgeries performed in
2016 was 165 (+17%), more than
originally intended. As the total
number of surgeries performed
increased by 186 (+12%), most of the
increase was related to the increase in
the number of open-heart surgeries
(89% of the total increase). Access
time decreased from 12–14 weeks to
2–3 weeks in the first quarter of 2016
and remained relatively stable in the
remainder of the year.
the total number of
surgeries performed
increased by 186 (+12%)
REFLECTION: A CONSTANT
DIALOGUE WITH STAFF
AND THE INVOLVEMENT
OF CLINICAL LEADERSHIP
IS CRITICAL
Four critical success factors can be
identified that determined the success
of this project (see Figure 1). The
required process changes could only
be implemented since there were two
surgeons in the project group who
were closely involved in the decision-
making process and in turn discussed

FIGURE 1 CRITICAL SUCCESS FACTORS.
the required interventions with
their fellow staff members. Having
a dedicated project team, in which
all stakeholders are represented (and
involved!), was essential in the success
of this project. The quick decision
making in the weekly project group
meetings and the involvement of the
two external consultants continuously
fed the sense of urgency perceived. As
one team member said: “Good project
management skills and leadership.
I like that they can take over work
that keeps us from doing our daily
jobs and provide us with the tools to
resolve issues.” Since the interventions
Thoraxcenter to scale up again when
demand increases.
the demands for heart
surgery have decreased
because of the COVID-19
pandemic, but the
schedules implemented
will enable to Thoraxcenter
to scale up again when
demand increases
Maartje Zonderland is an expert in
the optimisation of healthcare processes
using quantitative modelling and data
science techniques. She holds a PhD
degree in Operations Research and
Statistics and works currently as a self-
employed management consultant, serving
healthcare organisations throughout
were discussed thoroughly, they
Europe.
were easy to understand and easy
to implement. During 2020 and
into 2021, the demands for heart Ad Bogers is professor of Cardiothoracic
surgery have decreased because of Surgery and head of the department of
the COVID-19 pandemic, but the Cardiothoracic Surgery in the Erasmus
schedules implemented will enable to MC Rotterdam.
FOR FURTHER READING
Zonderland, M.E., J. Bekkers, J. van Bommel, M. ter Horst, W. van Leeuwen,
F. van den Wall Bake, W. Wiegersma and A.J.J.C. Bogers (2020).
Increasing cardio-thoracic productivity at Erasmus MC. Health Systems.
DOI: 10.1080/20476965.2020.1848357
Zonderland, M.E., R.J. Boucherie, N. Litvak and C.L.A.M. Vleggeert-
Lankamp (2010). Planning and scheduling of semi-urgent surgeries. Health
Care Management Science 13: 256–267.
IMPACT | SPRING 2021 19
W H AT C A N SYS T E M
DY N A M I C S D O F O R YO U ?
STEPHAN ONGGO
20 IMPACT © 2021 THE AUTHOR
AS I WALKED TOWARDS
ANOTHER HALL AT THE
MANCHESTER ART GALLERY, I
stumbled upon ‘The Desert’, a painting
by Edwin Henry Landseer (1802–
1873). At first, I was too close to the
painting and could only see the detailed
brushstrokes. As I walked backwards,
the details gradually disappeared and,
finally, I found the sweet spot where I
could see the beauty of the painting.
What an amazing piece of art!
Have you ever been in a situation
where you observe the signs of a problem
and after some thinking and research,
you feel that you are drowning in too
many details and too much information
that makes you fail to see the problem?
I certainly have. Is there a tool that can
help us to see the bigger picture instead
of the details? Can we predict the pattern
or behaviour at the system level (such
as organisation, nation) that would
emerge from the interaction of the
smaller components within the system
as much as Landseer predicted how the
interaction of his many brushstrokes
would produce such a beautiful painting?
A more difficult question is which of the
interactions between smaller components
can explain the pattern or behaviour
that we observe at the system level
(such as the number of sales of a new
product or the growth and the decline
of manufacturing in a region). One of
the tools that we can use to answer these
questions is System Dynamics.
System Dynamics (SD) is a
computer-based simulation approach.
Other approaches include Discrete-
Event Simulation and Agent-Based
Simulation. An SD model can be used
as both a qualitative and a quantitative
tool. To illustrate this, let us consider
that we want to model the spread of an
infectious disease in a population.
As a qualitative tool, a
System Dynamics model is
used to capture the causality
and feedback loops of a
system that is being studied
QUALITATIVE SYSTEM
DYNAMICS
As a qualitative tool, a SD model is used
to capture the causality and feedback loops
of a system that is being studied. On
causality, we say that P causes Q when,
other things being equal (also known as
ceteris paribus), a change in P causes Q
to change. The change can move in the
same direction (for example, both P and
Q increase) or in different directions (for
example P increases and Q decreases).
As can be seen in Figure 1, an increase in
the number of new infections causes the
number of infectious people to increase.
The positive sign at the arrowhead
indicates that the change moves in the
same direction. Likewise, the negative
sign at the arrowhead between the
number of new infections and the
number of susceptible (who have not
been infected) people indicates that the
increase in the number of new infections
reduces the number of susceptible people.
Feedback loops exist when the
causality relations form a cycle in
which a change in a component
travels through a loop and eventually
returns to its point of origin. This

FIGURE 1 THE CAUSALITIES AND FEEDBACK LOOPS IN THE SPREAD OF AN INFECTIOUS DISEASE
suggests that an action done by a part
of the system will generate a chain of
reactions that eventually affect the part.
For example, in Figure 1, an increase
in the number of contacts between
susceptible and infectious people would
increase the number of new infections.
Subsequently, it will increase the
number of infectious people. Other
things being equal, the increase in
the number of infectious people will
increase the number of contacts between
them and the susceptible people. Hence,
this loop tends to reinforce the initial
change. To indicate the reinforcing loop,
we put an ‘R’ inside the loop indicator.
To take another example, the increase
in the number of new infections will
reduce the number of susceptible
people. Other things being equal, the
decrease in the number of susceptible
people will decrease the number
of contacts between them and the
infectious people. Subsequently, it will
reduce the number of new infections.
In this case, the loop tends to oppose
the direction of the initial change which
will create a balancing effect. To indicate
the balancing loop, we put a ‘B’ inside
the loop indicator. After some delay the
infected people will recover. The delay is
represented by the delay mark (double
vertical line) on the arrow. Capturing
the key causalities and feedback loops of
a system is important when using SD as
a qualitative tool.
The diagram in Figure 1 is useful for
decision makers. It helps us to see the
bigger picture by clearly visualising how
the different components in the system
interact and influence each other. With
experience, an SD modeller will learn
how to move the lens not so close as to
be confused by the details, but not so far
away as to miss the critical components
that form the key causalities and
feedback loops in the system. This is
very much the same as me trying to
find the sweet spot to be able to see the
beauty of the painting in the gallery.
Too close, I will only see detailed
brushstrokes; too far away, I will not
see the important features depicted in
the painting. It is at this very sweet spot
where we can find the useful insights
into the structure of the system that
determines its dynamic behaviour.
Having seen the bigger picture by
visualising how the different feedback
loops interact, can we predict the pattern
or behaviour of the system that would
emerge from the interaction of feedback
loops? I will use Figure 2 to illustrate
this. In the beginning of an epidemic,
there is only a handful of infectious
people. Hence, the number of contacts
FIGURE 2 THE SHIFT IN THE LOOP DOMINANCE OVER TIME
between infectious and susceptible
people is relatively low and generates
only a few new infections. However,
very soon the number of infectious
people will increase exponentially (as
how compound interest works). This is
the period in which the reinforcing loop
R dominates the system. Over time,
the number of susceptible people will
decrease, and the number of infectious
people will increase. Because there are
fewer people who can be infected, the
number of new infections will gradually
decrease. At the same time, some
infectious people will start to recover.
This is the period where the balancing
loop B1 dominates the system. The
tipping point happens when the number
of new infections is the same as the
number of newly recovered (at the
peak in Figure 2). After this point, the
balancing loop B2 will dominate the
behaviour of the system. This is shown
by the rapid decline in the number of
infectious people because the number of
people newly recovered is much greater
than the number of new infections.
As the number of infectious people
is declining, the number of newly
recovered people will decrease. This
shows that we can use SD to predict
the behaviour of a system even before
we collect some data. This is because
we know that some feedback structures
will produce certain behaviours such as
exponential growth, S-shape growth,
goal seeking, oscillation and collapse.
IMPACT | SPRING 2021 21
QUANTITATIVE
SYSTEM DYNAMICS
When the number of feedback loops in a
system is small, we may be able to predict
the system behaviour qualitatively.
However, it is virtually impossible to
do this when the number of feedback
loops in the system is moderate to high.
For example, if we add variables to the
diagram to represent interventions so
that we estimate their impact, it will
lead to a more detailed model with more FIGURE 3 THE STOCKS AND FLOWS IN THE SPREAD OF AN INFECTIOUS DISEASE
feedback loops. An example of such
model can be seen on page 14 in this
issue. In a complex system, it is common visualise the system in a stock-and-flow mathematician, the model can be shown
to find many interacting feedback loops. diagram shown in Figure 3. The blue as a set of differential equations.
In this situation, we need to use SD as a fonts are additional parameters to the To illustrate how this model can be
quantitative tool so that we can simulate causal loop diagram in Figure 1 that we useful for decision making, the model
the dynamic behaviour of the system. need to run the simulation. In general, is run under a specific combination of
To do this, we need to collect data a causal loop diagram can be converted parameter values. The result is shown in
to quantify how a component affects into a stock-and-flow diagram, and vice Figure 4. This is a scenario in which we
another component in the system. versa. The ‘infectivity’ parameter’s value let the disease spread in the population
To use SD as a quantitative tool, indicates how contagious the disease is. to achieve herd immunity. The number
we can view a system as a collection of Hidden beneath the stock-and-flow of infectious people will reach the peak
stocks and flow. To illustrate this, we diagram is a set of differential equations at roughly 150,000 people around 130
can use a simple analogy of a tank into that will need to be solved numerically to days after the first infection case. When
which water flows and from which it produce the simulation result. This shows the epidemic ends, roughly 80% of the
may flow. The tank is a stock which is the two front ends of an SD model. For population will have been infected and
an accumulation (of people, assets, etc). a lay person, the model shown in a stock- gained immunity. This is the reason why,
The water level in the tank is controlled and-flow diagram is intuitive. It allows for herd immunity to work, a significant
by the inflow and outflow rates. We can an effective communication between proportion of the population will need
connect one tank to another through modellers and decision makers about the to be infected and gain immunity. If
a pipe controlled by a flow. Hence, in structure of the system. For a modeller or 1% of the infectious people would need
the SD model, the world is seen as a
network of tanks in which the water
can flow from one tank to another.
Using the infectious disease example,
the stocks in the systems are the number
of susceptible people, the number of
infectious people and the number of
people recovered. Let us consider that we
want to simulate the daily spread of the
disease. The movement from susceptible
to infectious is controlled by the number
of new infections on that day (or
infection rate). Likewise, the movement
from infectious to recovered is controlled
by the number of newly recovered on
that day (or recovery rate). Hence, we can FIGURE 4 THE SIMULATION RESULT

22 IMPACT | SPRING 2021
ICU beds, then 1,500 ICU beds would
be needed at the peak of the epidemic. If
the region has only 70 ICU beds for the
population of 1,000,000 people, then
clearly the hospitals in the region will
not be able to cope with the demand
for ICU beds. Hence, while waiting
for the vaccines, non-pharmaceutical
interventions are needed to flatten the
curve (the orange curve in Figure 4).
The quality of prediction depends
on the quality of data that we have.
In practice, this model is often used
to make decisions at the beginning of
an epidemic when the data is limited.
In our example, it depends on our
estimation on how contagious the
disease is. Even when the data has
become available as the epidemic
progresses, it is difficult to know the
exact number of infectious people and
how they get infected. This is especially
difficult for diseases like COVID-19 in
which some people are asymptomatic.
However, in our case, the model is still
useful for decision making because
we are more interested in whether our
health care system would be able to cope
with the epidemic instead of the exact
number of infectious people at the peak.
CONCLUSION
So far, I have not defined what System
Dynamics (SD) is. From the above
explanation, we can view SD as a
modelling approach that is used to
model the behaviour of a complex system
based on the causalities, feedback loops
and delays in the system. Therefore,
SD is arguably the best tool to support
decisions that require us to consider broad
system boundaries to capture important
feedback loops relevant to the problem
and to anticipate possible unintended
consequences.
These are typically strategic
management decisions. For example,
Decision Analysis Services Ltd is
currently developing an SD model to to seek feedback from the public that
support nursing workforce planning would inform how the painting should
decision in England (see ‘For Further be displayed and contextualized in this
Reading’ for detail). Other examples modern world, especially in the context of
include strategic policy decisions on race, gender, and sexuality.
sustainable agriculture policy, renewable
energy, sustainable transportation, water
resource management and health and
social care.
To use SD as a quantitative tool
needs special training. However, I
would argue that as a qualitative tool,
SD is reasonably easy to use. Drawing
a diagram that captures the causalities
and feedback loops in a system helps us
to structure our understanding about
the system. Furthermore, the diagram
can be developed together by a group of Stephan Onggo is an Associate Professor
stakeholders so that different perspectives of Business Analytics at Southampton
about the structure of the system can Business School and a member of
be discussed to achieve a common the Centre for Operational Research,
Management Sciences and Information
understanding. The diagram can show
Systems (CORMSIS). He teaches
who will be affected by a certain change in
Simulation Modelling including System
the system by following the causalities and Dynamics, Agent-Based Simulation and
feedback loops. This exercise can be very Discrete-Event Simulation. Currently,
useful before we make a policy decision he is leading an EPSRC funded project
that is intended to solve a problem in the researching on the design of relief food
system that affects multiple stakeholders. supply chains for natural disaster using
This reminds me of the temporary removal simulation optimisation and advising
of Waterhouse’s masterpiece Hylas and Decision Analysis Services Ltd on the
the Nymphs from Manchester Art Gallery nursing workforce planning project.
FOR FURTHER READING
Cave, S., E. Woodham, D. Exelby, K. Derbyshire, R. Wildblood and N.
Shembavnekar (2020). Nurse supply model: Progress so far. https://www.
health.org.uk/publications/nurse-supply-model-progress-so-far
Currie, C.S.M., J.W. Fowler, K. Kotiadis, T. Monks, B.S.S. Onggo, D.A.
Robertson and A.A. Tako (2020). How simulation modelling can help
reduce the impact of COVID-19. Journal of Simulation, 14: 83–97.
Gary, M.S., M. Kunc, J.D.W. Morecroft and S.F. Rockart (2009). System
dynamics and strategy. System Dynamics Review 24: 407–429.
Morecroft, J.D.W. (2015). Strategic Modelling and Business Dynamics: A
Feedback Systems Approach, 2nd ed. Chichester: John Wiley & Sons.
Warren, K.D. (2007). Strategic Management Dynamics. Chichester: John
Wiley & Sons.
The System Dynamics Society provides good resources for learning more
about System Dynamics. https://systemdynamics.org/
IMPACT | SPRING 2021 23
 Operational Research
events to suit you and your schedule
The OR Society are here to support the OR community with a wide range of events to
enhance your career.

Join us for an event in 2021 to:

• Discover new insights and the latest OR developments
• Learn new skills during workshops
• Explore your interests with our special interest group meetings
• Network with likeminded peers
• Meet your local OR community at our regional group sessions

To find out more about our events, visit: www.theorsociety.com/events

events.indd 1 24/02/2021 17:26

P R OV I D I N G R E A L-T I M E
I N F O R M AT I O N F O R
URGENT CARE
NAV MUSTAFEE AND A&E WAITING TIMES HAVE
JOHN POWELL INCREASED SUBSTANTIALLY
OVER RECENT YEARS. In the U.K.,
it is expected that 95% of patients should
be assessed, treated, then either admitted,
transferred (to a different provider)
or discharged within four hours of
presentation. This is commonly referred
to as the four-hour standard. Nationally,
NHS emergency departments have not
met the standard in any year since 2013-
14, and it has been missed in every month
since July 2015, as reported by the King’s
Fund (see http://bit.ly/NHS4hour).
IMPACT © 2021 THE AUTHORS
This standard also applies to Minor Injury
Units (MIUs) and Urgent Care Centres
(UCCs), which treat non-life-threatening
conditions, and which, together with
A&E departments, are part of the
NHS Urgent Care Network. Here we
explain how the NHSquicker platform
was developed to help patients in need
of urgent care to make more informed
decisions about available healthcare
choices, thereby not only reducing the
wait time being experienced by the
patients but also helping the NHS meet
the four-hour standard.
25
MOTIVATION
In 2015, while working on a project
modelling the A&E department at
Torbay Hospital, we found that in the
Torbay Urgent Care Network, which
in 2015 consisted of one A&E and
seven MIU/UCC centres, all MIU/
UCCs met the four-hour standard,
while A&E underperformed by nearly
20%. We concluded that research
on the levelling of demand across
the Network would offer an exciting
new dimension to our existing A&E
patient flow simulation work. A further
motivation of our work was the 2013
Keogh Review of urgent and emergency
care. It stated that patients with urgent
but non-life-threatening needs should
be treated outside of hospitals by
services that deliver care in or as close
to people’s homes as possible, in MIU/
UCCs, while those with more serious
or life-threatening emergency needs are
treated in centres (A&E departments)
having the very best expertise and
facilities specific to those needs. It
was argued that increased localisation
of the treatment of those with less
serious needs will relieve pressure on
the hospital-based emergency services,
thus freeing up resources to cater
for patients with more serious and
life-threatening conditions such as
severe chest pain, serious blood loss,
choking and unconsciousness. The
success of this partitioning policy is
dependent on two related factors,
namely the presentation of patients at
the appropriate treatment facility and
the capacity of the A&E, in particular,
to cope with demand. Inevitably
the capacity of A&E departments is
finite, and it is highly desirable that
patient demand be spread among the
available facilities in a given region, so
as to reduce waiting time and to shape
demand, thus spreading the pressures
on staff and facilities.
26 IMPACT | SPRING 2021
it is highly desirable that
patient demand be spread
among the available
facilities in a given region,
so as to reduce waiting
time and to shape demand
PARTNERSHIP BETWEEN
THE UNIVERSITY
AND THE NHS
In response to these policies and
requirements, we worked with several
NHS Trusts in the South West of
England to investigate how existing
data, already being captured by NHS,
could be used to relieve pressure on
A&E departments. We founded the
Health and Care IMPACT Network in
2016 through a collaboration between
the University of Exeter Business
School and Torbay and South Devon
NHS Foundation Trust (Directorate of
Strategy & Improvement). The purpose
of the Network, Co-Chaired by
Professor Nav Mustafee and Dr Andrew
Fordyce from Torbay Hospital, is to
improve delivery of health and care
through applied research, knowledge
dissemination and decision support.
The Network enabled us to bring
together clinicians, managers and O.R./
data people from multiple NHS Trusts
in the South West of England and to
work towards agreeing on a format for
A&E waiting time data. A common data
standard was necessary as our objective
was to develop a digital platform at a
regional level (rather than a Trust-specific
solution), and as the Trusts deploy
various A&E patient flow systems (I.T.
systems such as Symphony, PatientFirst
and IMS Maxims), a consistent data
format would ensure that the platform
would receive data feeds from multiple
systems. Further, the design and user
interface of the NHSquicker app was
co-developed with the NHS. Towards
this, in June 2017, we organised the
third IMPACT Network workshop on
Urgent and Emergency Care in Exeter
Business School. Susan Martin (Quality
Lead at Torbay and South Devon NHS
Foundation Trust) can be seen leading a
session in Figure 1.
AN APP FOR URGENT CARE
FOR THE SOUTHWEST
The co-development work was
instrumental in outlining the design
of the architecture of the real-time
platform and the app. We worked with
an SME for the implementation work
(funded through a grant). In a nutshell,
the NHSquicker platform provides
indirect suggestions (nudges) to support
patients in need of urgent care to help
them make more informed decisions
about available healthcare choices. The
platform comprises (a) a user-facing app
(Android and iOS) that provides nudges
taking into account the live waiting
time from the urgent care centres and
combining them with real-time travel
time (retrieved through Google Maps
APIs); (b) the platform backend that
receives real-time feeds and allows for
easy integration of new feeds; (c) a
business intelligence dashboard designed
for use in MIU/UCCs and A&E.
the NHSquicker platform
provides indirect
suggestions (nudges) to
support patients in need
of urgent care to help
them make more informed
decisions about available
healthcare choices.
The NHSquicker app helps patients
make informed decisions, for example,
FIGURE 1 THE CO-DEVELOPMENT WORKSHOP FOR NHSQUICKER
whether to visit a facility which may be
nearer to them but with a long waiting
time or travel to an alternative location
that is further away but with a shorter
waiting time. By transforming real-time
wait time data to actionable insights and
nudges, NHSquicker seeks to:
a) Encourage prospective patients
to choose the appropriate type of
treatment facility for their condition,
so that only those with more serious
needs present at the A&E. The
aim of this is to reduce the overall
demand on the A&E facilities by
redirecting less serious cases to the
more appropriate facilities of MIUs/
UCCs, thus reducing waiting times
at the A&E facilities.
b) Shape demand at A&E facilities by
encouraging patients needing such
facilities to choose a destination with
a lower waiting time.
NHSquicker aims to influence
destination choices made by
prospective patients so as to aid
NHS frontline staff in their day-to-
day operations, firstly by improving
the appropriateness of centre choice
and secondly by smoothing demand
over inevitably stretched facilities,
particularly those offering emergency
treatment. What effect does (a) have
on (b)? Patients do not have a direct
role in managing the operations of
an urgent care facility. However, the
decisions they take have a bearing on
its performance. For example, when
confronted with the need for urgent
treatment, the intended users have to
make location decisions as to the place
of treatment. If they are unaware of
the availability of urgent care services
appropriate to meet their needs close
to where they are located, they will
usually choose to go to A&E as they
are confident they will be seen and
have their needs met. This may lead
to the overcrowding of A&E, while
at the same time, MIU/UCCs that
are located nearby may be operating
under capacity; both cases will have
operational implications.
IMPACT | SPRING 2021 27
 NHSquicker (version 1) was
launched in December 2017. Since
then, the solution has worked
uninterruptedly for almost three years.
We have worked to expand its reach
and to develop the real-time platform
further (e.g. version 2 was released
in February 2020 and now includes
integration with the NHS Directory
of Services). At the time of writing
(December 2020), NHSquicker receives
real-time data on waiting times from
27 A&E departments and Urgent Care
Centres (UCC) that are operated by
seven NHS Trusts in Devon, Cornwall,
Somerset and Bristol. The wait time
data is not open-source data, but data
that is available only to us through
Trust-level contacts made possible
through the Health and Care IMPACT
Network which we developed.
BENEFIT OF THE
O.R. SOLUTION
We outline three instances which
demonstrate the efficacy of NHSquicker
28 IMPACT | SPRING 2021
and the benefits being experienced by
both patients and by the Trusts.
First, NHS Trusts in the South
West have adopted this technology
by interfacing their I.T. systems
with NHSquicker. At launch (Dec
2017), only data feeds from Torbay
& South Devon NHS Foundation
Trust (TSDFT), Royal Devon &
Exeter (RD&E) and Northern Devon
Healthcare NHS Trust (NDFT) were
integrated. As of December 2020,
NHSquicker receives data from all
four acute Trusts in the Devon STP
(sustainability and transformation
partnership), the Cornwall and the
Isles of Scilly STP, one Trust from the
Somerset STP and one from Bristol.
Trusts invest in terms of their technical
manpower to integrate our app with
their services and for the operational
upkeep. This demonstrates the benefits
realised by Trusts in using the app.
Nic Harrison, data analyst at NDFT,
said: “We collect a huge amount of
data in the NHS to help us to monitor
and improve the care we provide. This
project was about using information
that is already available in a new way
which helps to improve the experience
of our services and helps us to make
sure NHS resources are focused where
they are most needed.”
Second, patients are finding the
app useful. We know this because we
developed an in-app questionnaire
and integrated it with NHSquicker
version 2 (launched Feb 2020). We
received 543 responses between
24/03/2020 and 10/09/2020. The
analysis of the questionnaire shows that
∼78% (424) of the users agreed that
NHSquicker helped them decide where
to go and a further 4% responded
that NHSquicker provided helpful
information at the point of use (in
addition to real-time wait time and
information from NHS Directory
of Services on local services, the
app also includes links for users to
find information on conditions and
treatment and a link to access NHS
111 Online - 111.nhs.uk).
Third, evidence from two early
adopters of NHSquicker (TSDFT
and NDFT) has shown that our
solution is having the desired impact
of signposting patients away from
busy A&E department at peak times.
For TSDFT, when analysing the data
at peak time (between 11.00-18.00),
our data analysis for the period Jan.
2016–Feb. 2019 has shown that there
is a significant shift from the start of
2018 (when NHSquicker was first
launched and we benefited from
media publicity) in the pattern of
attendances, with a reduction in A&E
attendances and an increase in MIU
attendances. The quarterly changes
from the previous equivalent quarter
confirm this. Our analysis of data for
NDFT shows a similar pattern. Dr
Nick Mathieu, consultant in emergency
medicine and clinical director of the
emergency department at TSDFT,
said: “This app will give people the
information they need so they can
make informed decisions about where
to go for treatment. We hope this
will improve things for patients, as
they may be able to receive the care
they need more quickly and perhaps
closer to home than they realise. NHS
services across England are busier than
ever and we hope NHSquicker will
increase awareness of the different
options for treating minor injuries and
illnesses. We hope this will contribute
to reducing pressure on emergency
departments, so they can focus on the
most urgent cases.”
In conclusion, it has been a rich
experience working with the NHS
and various other organisations like
NHS Digital and Reactor15 (SME).
We have shown that local-level digital
initiatives can be scaled-up to regional
level solutions. We have demonstrated
that unlocking existing data, captured in
different A&E systems and stored in a
multitude of databases, is possible through
common standards and that it could also
be accessible at real-time. We have shown
how data from multiple sources could be
joined (wait time data with travel data),
and then transformed into a form that
helps empower patient decision making.
ACKNOWLEDGEMENTS
The work of this magnitude could
only be realised through the shared
vision of ‘making data work at both an
individual (patient) level and at a more
system (Trust) level’. We would like to
specially acknowledge the contribution
of Susan Martin, Dr Andrew Fordyce,
Steve Judd (Torbay), Alison Harper,
Surajeet Chakravarty and Todd Kaplan
(Exeter), Alaric Moore (RD&E) and
Nic Harrison (NHDT), Nick Metcalfe
(SWAST), Paul Uren (Plymouth),
Paul Brandwood (RCHT), Steve
Read (Taunton & Somerset), Fran
Draper (Bristol), Mike Saunders, Lee
Wade and Mark Saunders (R15).
We acknowledge funding that was
received from the University of Exeter,
ESRC Impact Acceleration Awards,
Torbay Medical Research Fund and
South West Academic Health Sciences
Network.
Nav Mustafee is Professor of Analytics
and Operations Management at
University of Exeter Business School. He
is an honorary researcher at Torbay &
South Devon NHS Foundation Trust
and is the founding co-chair of the
Health and Care IMPACT Network.
Nav has research interests in the use of
interdisciplinary methods and techniques
with computer simulation (hybrid
modelling), simulation methodologies
and hybrid simulation, and bibliometric
analysis of knowledge domains. He is
an Associate Editor for Simulation: The
Transactions of the SCS, the Journal
of Simulation and the Health Systems
journal. He has an undergraduate degree
from the University of Calcutta (India)
and MSc and PhD degrees from Brunel
University.
John Powell is Professor Emeritus at
the University of Exeter. He is a Board
Member for the Sustainable Leadership
Foundation. His research interests are in
systems modelling of strategic situations,
scenario planning and modelling,
knowledge in strategy and knowledge
management. He was formerly the Head
of School of the Stellenbosch University
Business School, South Africa. He has
a B.A. and an M.A. degree from the
University of Cambridge and a PhD
from Cranfield University.
IMPACT | SPRING 2021 29
U N I V E R S I T I E S M A K I N G A N I M PAC T
EACH YEAR, STUDENTS ON MSC PROGRAMMES in analytical subjects at several UK universities spend
their last few months undertaking a project, often for an organisation. These projects can make a significant impact. This
issue features reports of projects recently carried out at two of our universities: Lancaster and Edinburgh. If you are interested
in availing yourself of such an opportunity, please contact the Operational Research Society at email@theorsociety.com

TREATMENT PATHWAYS FOR PATIENTS WITH MULTIDRUG-RESISTANT TUBERCULOSIS

(Mengdi Jin, Lancaster University, MSc Business Analytics)

The Liverpool School of Tropical Medicine
(LSTM) is a centre of excellence in
research in the field of tropical medicine.
It is the oldest institution of its kind in
the world and has been at the forefront of
tropical medicine since 1898. Mengdi’s
project aimed to model decentralised
treatment management strategies for
multidrug-resistant tuberculosis (MDR-
TB) patients in Ethiopia. This project
used data (patient and health system
costs and frequency of patient assessment
visits) from the STREAM Phase I trial*
for which LSTM coordinated the Health
Economics component.
During the project Mengdi required
excellent communication skills to build
high fidelity conceptual models of the
MDR-TB treatment pathways. This
process involved iterative discussions with
her LSTM advisors to ensure the model
captured the correct patient behaviour.
She then translated the conceptual model
into the discrete event simulation software
WITNESS to run experiments comparing
the cost to patients and to the health
system of different treatment regimens
and pathways. At the end of the project
Mengdi delivered the simulation model
to LSTM along with a user-friendly Excel
interface which had the capability to set
up and analyse the output from the model
experiments.
Mengdi was selected for the project
because of her strong performance
within the Masters taught simulation
module. Mengdi was supported
through the process by supervisors from
Lancaster University and LSTM but was
encouraged to take ownership of her own
project. From the start of the project
Mengdi was very engaged and took time
to learn about MDR-TB, a previously
unknown area for her, before building her
model. This attention to detail ultimately
led to her presenting her model and
findings to Liverpool’s Tuberculosis
Research group (LIV-TB), which
included a number of TB Clinicians
and modellers, including some globally
renowned experts. She received positive
feedback from this presentation.
Ewan Tomeny and Laura Rosu
supervised the project for LSTM. They
said: ‘Mendy was a pleasure to work
with. Over the course of her dissertation
period she built a good model that well
captured the essence of the conceptual
problem, including several complexities
of MDR-TB treatment. She familiarised
herself well with the field of MDR-TB
treatment pathways and developed a
good foundational knowledge in the
area. She was engaged in our project
meetings, and between them, via MS
Teams, always asking appropriate
and insightful questions. We were
particularly impressed with Mendy’s
presentation given to Liverpool’s
Tuberculosis Research group “LIV-TB”’.
Mendgi commented that she
enjoyed working with LSTM to build a
working model of a real- world process.
She found joy in the project and in
overcoming the challenges it presented.
Going forward Mengdi, LSTM, and
Lancaster University are continuing
their working relationship to publish
her work. This means additional model
development and experimentation to
gain further insights into the impact of
decentralising treatment pathways for
MDR-TB patients. The output of this
work will be useful for decision makers,
providing them with insight into the
potential costs and consequences of
implementing different MDR-TB
treatment management pathways in
Ethiopia, and potentially beyond.
*STREAM Stage 1 was supported
by the United States Agency for
International Development through
the TREAT TB Cooperative Agreement
No. GHN-A-00-08-00004, with
additional funding from the United
Kingdom Medical Research Council and
the United Kingdom Department for
International Development under the
MRC/DFID Concordat agreement.

30 IMPACT © THE OR SOCIETY

ANALYSIS OF A VEHICLE ROUTING PROBLEM FOR FREIGHT DELIVERY
(Dung Tran, University of Edinburgh, MSc Business Analytics)
Optimizing logistics systems
and reducing transportation and
distribution costs serve as effective
strategies for enterprises to enhance
their competitiveness. Many companies
have attempted to handle the logistics
challenges by designing appropriate
paths for their vehicles, which
underlines the importance of routing
and scheduling problems. However,
their difficulty is the lack of a decision
support system that can assist them in
tackling the problem effectively.
That was very much the case for
E. Tupling, a UK-based company
that distributes heating systems and
plumbing products to a group of
scattered customers from the Midlands
to Northern England every day. The
Company also guarantees to delivery
stocked products by trucks within
48 hours of receiving a customer order.
Business growth and customer expansion
had presented a number of logistics and
transportation challenges. The extra
mileage involved through serving more
customers has led to a considerable
increase in delivery cost as well as an
additional drop in profit margin.
Dung’s objective was to build
models and algorithms for the Vehicle
Routing Problem with Time Windows
(VRPTW) in which appropriate tours
are designed for multiple vehicles
visiting customers during a specific
time horizon, with the minimum
total travel distance. In his project,
the problem was analysed by two
approaches: an exact algorithm that is
associated with a classical mixed-integer
programming (MIP) formulation and a
Variable Neighbourhood Search (VNS)
based heuristic. Dung also investigated
the performance of multiple VNS
algorithms that had been generated
by modifying and utilising different
elements of the general framework.
All algorithms were first assessed using
some benchmark instances and then
applied to E. Tupling’s data set.
For the benchmark instances the
MIP formulation could optimally
solve some simple problems; however,
the heuristic method offered better
solutions with limited computational
resources. The VNS proved successful
for small and medium instances, and
the solutions were better than, or
competitive with, the best-known
solutions from the literature for large
instances with up to 100 customers.
In terms of the real-world
application, experimental results
indicated that the heuristic method
was well suited for freight delivery
scheduling on a daily basis. Compared
to the actual schedule manually
designed by E. Tupling, on a typical
working day Dung’s solution
reduced the total travel distance by
approximately 14%. One key strength
of the heuristic is that the approach
generates suitable plans for truck
scheduling in a timely fashion. In fact,
the problem of E. Tupling with about
30 customers was solved within only
20 seconds. The Company therefore
will benefit from the new methodology
in terms of time and financial savings.
Ross Duncanson, Commercial
Director from E. Tupling, stated that
Dung’s research had been an extremely
useful piece of work: ‘We were proud
to have been selected for a Business
Analytics Dissertation Project by the
University of Edinburgh Business
School. One of our greatest challenges,
as we grow, is the management of
increased deliveries across a wider
geographical area. This has been
studied and thoroughly researched by
Dung, and the analysis submitted to us
was brilliantly insightful. We are hugely
impressed by the suggested solutions
and they will definitely influence our
decision making in relation to transport
and logistics going forward.’
The project has demonstrated the
undeniable efficiency and effectiveness of
Operational Research methods to assist
enterprises in achieving their business
goals in the best possible manner.
IMPACT | SPRING 2021 31
 HEALTHCARE SYSTEMS: WHY
SIMULATION OVERCOMES THE
DESIGN BARRIERS
Terry Young
© AD Young
It is not difficult to find good news stories about health
service improvement from modelling, or studies that led
to faster service at lower cost. Some were included in the
last issue of Impact in Paul Harper’s Healthy O.R. in Wales,
describing his journey to close the gap between academic
capability and healthcare’s needs. He notes such benefits as:
• An increasing appetite for modelling services by local
Health Boards;
• Better organisational planning;
• Efficiency gains worth £1.6m p.a. in one Emergency
Department.
Paul and I first collaborated in 2004. Ever since, we have
each tried to fulfil our vision of putting health service design
on a better footing. Here is where the quest took me.
I began my career in contract research with GEC,
modelling the photonic components our research division
was producing. Since hand-crafted laboratory prototypes
were costly and far too small to probe accurately, computer
modelling made sense. Fortunately, another GEC team
modelled generators, and their world was millions of times
bigger than mine: by swapping metres for microns, the
graphics interfaces were quickly converted and we were soon
up and running. Later, a paper on the topic won the 1989
IEE Premium, not due to novel modelling, but because it
combined industrial graphics with leading-edge algorithms,
and made routine design possible. Later, my appreciation
of simulation was broadened as I encountered systems
32 IMPACT © 2021 THE AUTHOR
engineers who modelled to prototype their radar and
avionics systems.
Moving in 2001 from industry, where models were
ubiquitous, to academia, where modelling was a more
boutique pursuit, was a shock. As in industry, however,
working with those in different fields was still critical.
After all, the glory of O.R. is breadth – not quite business,
computing, engineering, manufacturing, or maths and
certainly not quite social science, yet with roots in all.
THE CHALLENGE
Paul has consistently demonstrated that models lead to better
understanding of processes, as had many before him. However,
the UK is not beating a path to his door to save £1.6m a year
for every Emergency Department, despite urgent care having
been a strategic challenge for most of this century. Why?
What would it take to convince senior health managers to
model every time they design or modify a service?
In my first decade as an academic, this question led
into unexpected territory: health economics. Again, I was
privileged to work with some great thinkers – Martin
Buxton, Alan Girling, and Richard Lilford among them –
connecting business decisions to value-for money, where the
UK’s National Institute for Health and Clinical Excellence,
NICE, leads the world.
How does one convince hard-nosed senior
managers, for whom simulation is not a
natural design choice, to model in this way
during design?
A collaboration between Brunel, Cambridge,
Southampton and Ulster Universities in 2007–9 revealed
that health O.R. lagged other sectors significantly when it
came to implementation, so in 2010 a group of us set up the
Cumberland Initiative to furnish the evidence and make the
case for better and more robust modelling in health. Despite
running Festivals of Evidence in 2014 and 2016, most of
our findings were still by way of stories. It needed a different
tack if we were to persuade service commissioners that each
£ invested in simulation would generate or save £X later on.
And we did not know what X might be.
So how much do you save or gain from every £ invested
in modelling-based design?
GOOD NEWS
Healthcare is unusual because epidemiologists have analysed
what, in other sectors, would be termed the market.
Furthermore, in health we can estimate both operational
gains (e.g. greater efficiency) and health gains (where healthier
individuals emerge from their care encounters).
In 2014, a collaboration with Sada Soorapanth started to
unite a business view of Return on Investment (RoI) with
the health economics of value for money. Our first paper,
at WinterSim 2015 (see For Further Reading), analysed the
financial case for improving a stroke service by modelling it.
This laid the foundations: if you reach stroke patients faster
you are likely to save on downstream treatment costs, so you
can start to say what the modelling was worth.
However, patients who have recovered also enjoy better
health – a benefit in addition to any downstream savings, so
our second paper addressed the health benefits. This showed
how to include health benefits in building an investment case
(see For Further Reading).
In 2017–18 a sabbatical provided time to build a set of case
studies from around the world to pin down modelling costs
and quantify the benefits. It turned out that this was easier in
the US, where the health services use modelling much more
routinely. Two collaborations – one with Jim Wilkerson’s team
at Memorial Health and one with David Morgareidge, led to
evidence that the return can be anything from tens of times to
many thousands of times the original investment in modelling.
By adopting architectural and engineering perspectives rather
than O.R., they are realising the same benefits. The first
publication arising from these US studies has appeared in
Health Systems (see For Further Reading).
Clearly, even this is not the end. For instance, we have
yet to value insight, or to say what it is worth spending on
a model that will convince the board to commission a new
service. However, it is now possible in principle to answer
the basic exam question.
NOT SUCH GOOD NEWS
Perhaps the most compelling, but least popular, reason
to model is the hidden cost of failure. Let’s close with the
A$2bn (£1.2bn) Royal Adelaide Hospital (RAH), which
opened in September 2017. My research took me to Adelaide
before and after the opening, so I was interested in what was
an imaginative and ambitious project.
An article in The Australian (May 15, 2018) not
long after opening listed the travails of the RAH and
© Stephen Barnes/Shutterstock
highlighted the ramping of ambulances (queues at the
hospital entrance), waits in the emergency department
and general failures to sweep patients through the system
smoothly and effectively. In a sad and costly development,
see http://bit.ly/RAHinABCNews, administrators were
appointed to run the hospital’s finances in November 2018.
The scale and scope of healthcare is now well beyond
the experience or intuition of any group of people. Even
when we start from scratch and design conscientiously,
the options are beyond our ability to plan and deliver
what we think will be needed by the time we have finished
building. The nearest we can get to a crystal ball is a model
of what our new facilities will look like and models of
what the world around them will look like by then.
And now we can say how much it is worth spending, to
stave off how much of a disaster.
With new health facilities being built all over the
world, this is a reminder of how important it is to get
every stage of a design fully proven ahead of opening.
The health sector has tended to take a conservative view
of design and migrates its designs slowly. To stay on top
of burgeoning needs, however, better design processes are
now needed. Simulation modelling is a proven tool for
that very task.
SUMMARY
Until now, the case for models in healthcare service design
has relied largely on listing the benefits of good practice
and citing examples of those benefits. Once we can estimate
the RoI ahead of time, it is possible to say how much
benefit to expect from a given amount of modelling – both
operationally and in better health outcomes. Alternatively,
given the improvements required, the calculation may
IMPACT | SPRING 2021 33
 be reversed to work out how much modelling might
appropriately be invested in solving the problem.
This is an important step for healthcare and also for
the O.R. specialists seeking to engage with health services.
© Monkey Business Images/Shutterstock

Hopefully, they should find more of a welcome mat next

time they go knocking.

For 16 years Terry Young designed devices and systems at

GEC and Marconi and for 17 years was Professor of ­Healthcare
Systems at Brunel where he built and led large multi-­
disciplinary research teams in healthcare, while learning fun
things about teaching and learning. He is Emeritus ­Professor at
Brunel and Director of Datchet Consulting Ltd.

FOR FURTHER READING

Soorapanth, S. and T. Young (2015). Evaluating the financial impact of modeling and simulation in healthcare:
Proposed framework with a case study. Proceedings of the 2015 Winter Simulation Conference (L. Yilmaz et al. eds.)
pp. 1492–1502.
Soorapanth, S. and T. Young (2019). Assessing the value of modelling and simulation in health care: An example
based on increasing access to stroke treatment. Journal of the Operational Research Society, 70: 226–236.
Young, T., S. Soorapanth, J. Wilkerson, L. Millburg, T. Roberts and D. Morgareidge (2020). The costs and value of
modelling-based design in healthcare delivery: Five case studies from the US. Health Systems, 9: 253–262.

34 IMPACT | SPRING 2021
© Miralis Data
M I R A L I S DATA
BRIAN CLEGG ACCORDING TO THE
DICTIONARY, ‘logistics’ describes
the organisation of materials and
accommodation for use by the military,
the word taken from the French ‘loger’
– to provide quarters. The term has
been taken up by business to refer to
the transport and storage of goods, and
this activity sits at the heart of the work
of data science and software company
Miralis Data, whether they are advising
on loading pallets and containers, or
simulating a warehouse. As well as
supporting logistics through Operational
Research (O.R.) techniques, the company
provides guidance on some of the tricky
aspects of moving towards an electric
vehicle infrastructure. Head of R & D of
IMPACT © THE OR SOCIETY
Miralis Data, Will Maden, notes that this
unusually wide portfolio is ‘mostly driven
by consultancy work we have undertaken
in the past, however employees’ interests
often drive that as well.’
As well as supporting
logistics through
Operational Research
techniques, the company
provides guidance on some
of the tricky aspects of
moving towards an electric
vehicle infrastructure
Maden was first immersed in O.R.
when he took a Master’s degree at the
University of Lancaster in 1999. ‘After
35

FIGURE 1 PACKING 9, 10 AND 11 CIRCLES OPTIMALLY
a year, I was offered a job as a Research
Associate with a Part-Time PhD,
working with Richard Eglese at Lancaster
University Management School on
real life vehicle routing problems – in
the green logistics area routing around
congestion. The funding for the job
and the PhD came from industry, so I
became quite used to solving consultancy
problems, all focussed on logistics.
‘After I finished my PhD, I set up
as an independent consultant, but I
also worked part-time as a lecturer at
Huddersfield University. After a few
years, I realised that the consultancy
was working well, and I had become
relied upon by my original clients.
I therefore shifted my focus onto
consultancy full time. In 2013, I
was appointed by the automotive
supply chain company BCA, one of
my clients, as Director of Network
Optimisation. After successfully
making changes in reporting, data
analytics and planning, I again
refocussed on the problem-solving
element of consultancy.
‘About this time, Michael Gibson
[now Managing Director of Miralis]
had sold his digital marketing agency
and was looking for a new challenge,
so together we founded Miralis Data,
a data consultancy focussed mainly on
logistics. We decided early on that to
grow Miralis we would need to develop
software solutions to problems, allowing
the consultancy to drive new software
options. The main focus for the company
36 IMPACT | SPRING 2021
is on reducing the environmental impact
of logistics, by shifting to more suitable
means of transport or optimising the
logistics requirement that footprint is as
small as possible.’
PACKING PROBLEMS
Optimising the packing of items onto
a pallet or into a container is a classic
Operational Research challenge. O.R.
has always involved the application of
apparently abstract mathematics to very
practical problems – here the aim is
twofold. To get the maximum amount
of goods into the minimum volume,
while making sure that the products
are accessible at the correct stage of a
distribution round. Sometimes this is
simply a matter of space packing.
A good example of the surprising
variation in effective solutions to space
packing problems can be seen by the
range of solutions that arise from
attempting to pack circular objects
optimally into a square container.
While ‘square’ numbers such as 2, 4,
FIGURE 2 INCREASING PACKING EFFICIENCY
96 boxes (vertically packed) 91 boxes (horizontally packed) 34 (vertical) + 63 horizontal) =
97 boxes
9 and 16 involve satisfyingly regular
packing, many of the other optimal
packings look surprisingly messy (see
Figure 1).
Even with the apparently simpler
requirement to pack rectangular
boxes, there can be surprises. It may
be, for example, that by placing some
rectangular items on a pallet in a
different orientation from others it is
possible to incorporate more on each
layer than would be possible if all the
items had the same orientation.
However, Miralis Data has been
able to go beyond simple packing
advice to make recommendations on
modifications to product packaging
design, where a small change in the
shape of a container could allow
more to be stacked on a pallet. One
of Miralis’ clients, Mookie Toys,
commented that the advice from
Miralis ‘enabled us to save £25,000 per
year in distribution costs on just one
of our hundreds of product lines.’ As
a simple example, imagine a product
could be packaged into either of two
slightly differently shaped boxes – by
mixing both boxes on a pallet layer it’s
possible to get more boxes on the pallet
than a layer made up entirely of either
individual shape (see Figure 2).
A similar, but more complex
problem arises with packing shipping
containers, where there is rarely a
single type of package but often a
whole mix of different shapes and

FIGURE 3 OPTIMALLY PACKING
CONTAINERS
sizes. The challenge faced by Miralis
is how to pack objects in containers
to maximise what can be fitted into
the fixed shape of the container, while
recognising the order in which the
products will need to be accessed (see
Figure 3).
SIMULATING THE
STRUCTURES
Inside warehouses, Miralis uses
a different approach, employing
simulation rather than the
mathematical optimisation used for
packing algorithms. In a simulation,
computer code represents different
parts of the operation, with the
code elements interacting as much
as possible as real objects do in the
workplace. Where necessary, this
involves features such as queuing
structures and using random numbers
to provide selections from distributions
of characteristics, such as the arrival
rate of new products. Simulation tools
make it possible to try out different
warehouse layouts, or to study the
effects of adding in extra equipment
and technology to understand the
impact on the warehouse throughput.
Miralis refers to this approach as
creating a ‘digital twin’, where
experiments can be undertaken in the
simulation without any risk to the
business.
This is not just a matter of planning
future warehouse solutions. Miralis
believe that the technology of such
a simulation could be carried over
into real-time control through the
introduction of 5G mobile data
networks, which can carry vastly
more traffic than current wireless
networks. 5G is expected to give
between 10- and 100-times greater
bandwidth that the equivalent 4G
network. Miralis envisages using 5G
to integrate its pallet packing software
with palletisation robots, making use
of large numbers of sensors in the
system that would enable the digital
twin approach to be used not just for
the simulation of different layouts, but
to provide real time control of robotics
and autonomous vehicles. 5G could
also enable this monitoring to extend
across the logistics chain, bringing in
route and fleet optimisation – using the
right vehicle for a job and sending it on
the most cost-effective route.
LIFE OF A SALESMAN
This part of the requirement to work
with a vehicle fleet involves perhaps
the best-known of O.R. applications,
the travelling salesman problem. This
attempts to answer the question of
what the best route for a delivery
vehicle is where there are a number
of stop-off points. We are so familiar
with ubiquitous satellite navigation
applications that it might seem
that this is no longer a concern for
business. But the reality is far more
complex. The travelling salesman
problem is described as being ‘NP-
hard’ – one where the time taken to
produce an optimal solution shoots up
exponentially as the number of possible
route choices increases.
An app such as Google Maps may
appear to find the best route, but in
practice is unlikely to do more than
find an acceptable route. Usually, when
we use a sat nav we just want a good
route to make a single journey. But
the full travelling salesman problem
faced by a logistics company needs to
bring into the mix multiple vehicles
with different carrying capacities,
specific time windows (for example, the
opening hours of a customer – there’s
no point arriving to deliver when they
are closed), multiple depots and a range
of objectives. It is not just a matter of
finding the quickest route from A to B.
Miralis estimates that, depending on
the problem and existing solution, their
system can provide savings of around
15 per cent.
Miralis estimates that,
depending on the problem
and existing solution, their
system can provide savings
of around 15 per cent
Maden emphasised the change that
the use of technology to deliver far more
data than has ever been available before
has made to these kinds of solutions
in the logistics field. ‘Logistics has
always been, and still is, an iceberg of
costs, with the vast majority unknown.
Also, the effects of making changes on
logistics operations is still risky as the
reasoning behind a given approach is
often unknown and therefore making
changes could cause many unforeseen
side effects. Data availability has
managed to throw a light on some
of that, allowing for some low-level
advantages to be made. The advent
or application of machine learning to
logistics data means that more insight
and improvement can be generated
for the existing data gathered by some
logistics firms and also suggesting
potential new sources in data that may
be fundamental in making changes.’
IMPACT | SPRING 2021 37

© Chrispictures/Shutterstock
Machine learning techniques, which
are increasingly used in the data science
field, make it possible to deal with a
complex situation without being sure
about the structure of the problem.
The software modifies its weightings
for different factors until it is providing
the best solution to match the data
available. Although machine learning
has its limitations – there is always a
danger, for example, of ‘over-fitting’
data, to give a perfect match to what
has happened in the past that has no
bearing on what will happen in the
future – machine learning makes it
easier to cope with the increasingly
large volumes of data that modern
technology is throwing up.
THE ELECTRIC FUTURE
One particular interest for Maden and
the Miralis staff is the introduction of
electric vehicles, which will transform
transport infrastructure over the
coming decade. Miralis is developing
tools to help companies plan the
transition from conventional fleets
to using electric vehicles. Although
38 IMPACT | SPRING 2021
environmentally beneficial, electric
cars and trucks bring their own issues,
making it necessary, for example, to
provide tools to plan the location
of charging infrastructure. As well
as being an issue for companies
and organisations putting charging
points in place, this is also important
because being able to charge vehicles
adds another factor in the travelling
salesman problem.
Miralis is developing
tools to help companies
plan the transition from
conventional fleets to using
electric vehicles
As well as working with individual
companies on their electric vehicle
needs and how to move from their
current vehicles to an all-electric fleet,
Miralis has been involved with both
companies that offer electric charge
points, consulting on how to best locate
their technology, and a government-
funded project called SOSCI (Scaling
On-Street Charging Infrastructure).
This was one of a number of initiatives
looking at the specific problem that
around 8 million homes in the UK
have no access to off-street parking.
Miralis’ work on the SOSCI project
has developed into an innovative new
charge point management system
called Fuuse (www.fuuse.io) which is
currently a significant part of Miralis’
activity. Domestic electric vehicles are
usually charged using a home charging
point, attached to the house or garage
and wired into a mains distribution
box. If electric cars are parked on the
street, though, there is a need to be able
to charge them at the curbside. Miralis
worked with an existing operator,
Charge My Street, first to look at the
feasibility of different approaches to
locating community-funded charge
points in areas underserved by charge
point operators, and then to provide a
software platform to be used on up to
200 curbside charge points in Cumbria
and County Durham to test this new
approach.
Working in a company like
Miralis involves a satisfying mix of
problem-solving challenges that goes
beyond the specifics of logistics,
offering new and different challenges
to those working there. Will Maden
commented ‘Fundamentally I am
fixated by problems; give me a problem
to solve and I am happy. Once the
problem is solved, my interest quickly
wanes, which is where working for a
company like Miralis is brilliant as we
have within the team highly skilled
professionals who pick up where I
finish solving the problem, and turn
this into something that can be re-used
as either a consultancy solution or as a
software solution.’
Miralis recently were the first
winners of the ‘UK-Germany Digital
Catapult Global Challenge’, applying
AI and DLT to industrial challenges
(see https://bit.ly/Miraliswins). Katy think differently when it comes to It’s not surprising that Miralis is
Ho, Head of Innovation Practice innovation and customer solutions. growing rapidly: up from 5 people in
at Digital Catapult said: ‘Exciting Our organisations’ different March 2020 to 11 in January 2021,
high growth companies, such as backgrounds and different areas of and more to come. Going forward, it’s
Miralis, are evidence of the UK and expertise allow us to bounce off each likely that the company and its staff
Germany’s strengths in advanced other to facilitate real solutions, will have plenty more challenges to
digital technology innovation, providing additional value to our come.
matched with global industrial and customers.’
sustainability challenges. Finding Other exciting work currently on Brian Clegg is a science journalist
startups with innovative ideas and the books includes drone routing, and author and who runs the www.
fostering international collaboration is working with start-ups in the health popularscience.co.uk and his own www.
exactly what the Global Challenge is and logistics sector, extending the brianclegg.net websites. After graduating
all about.’ optimisation suite for a piece of with a Lancaster University MA in
On their books in January 2021 is supply chain costing software, used Operational Research in 1977, Brian
work on Goods As a Service (GaaS) internationally, and finishing a chain of joined the O.R. Department at British
partnering with CHEP. Geraint custody system for goods and materials, Airways. He left BA in 1994 to set up
Thomas, innovation Lead – Northern showing where, when and what a creativity training business. He is now
Europe for CHEP: ‘Collaboration environment the goods pass through, primarily a science writer: his latest title
between a scaled up and established with 5G sensors, working with BAE What Do You Think You Are? looks
business, like ourselves, and dynamic systems, IBM, Digital Catapult, at the science of what makes you an

EJIS
SMEs, like Miralis, allow for us to AMRC and AQL. individual.
Contents VOLUME 00 NUMBER 00 MONTH 00
JOURNAL OF THE OPERATIONAL RESEARCH SOCIETY

ISSN: 0960-085X

Apparatus bellis corrumperet Medusa, quod fiducias amputat verecundus suis. 00

Perspicax agricolae suffragarit Augustus. Suis vocificat fiducias. 00

Saburre miscere Aquae Sulis. Pessimus tremulus matrimonii insectat Octavius. 00

JOURNAL OF Journal
Satis saetosus ossifragi agnascor incredibiliter perspicax apparatus bellis. 00 of Simulation (JOS) aims to publish both articles and technical notes from researchers and

Satis quinquennalis fiducias imputat gulosus agricolae. practitioners

00 active in the field of simulation. In JOS, the field of simulation includes the techniques,

SIMULATION
Apparatus bellis corrumperet Medusa, quod fiducias amputat tools, methods and technologies of the application and the use of discrete-event simulation, agent-
verecundus suis. 00
based modelling and system dynamics. We are also interested in models that are hybrids of these
Apparatus bellis corrumperet Medusa, quod fiducias amputat
verecundus suis.
approaches.
00
including
THE EUROPEAN
JOS encourages theoretical papers that span the breadth of the simulation process,
both modelling and analysis methodologies, as well as practical papers from a wide
Perspicax agricolae suffragarit Augustus. Suis vocificat fiducias.

Saburre miscere Aquae Sulis. Pessimus tremulus matrimonii insectat

00

JOURNAL OF
range of simulation applications in domains including, manufacturing, service, defence, health care
and general commerce. JOS will particularly seek topics that are not “mainstream” in nature but
INFORMATION
Octavius. 00

Satis saetosus ossifragi agnascor incredibiliter perspicax apparatus bellis. interesting

00 and evocative to the simulation community as outlined above.
Particular interest is paid to significant success in the use of simulation. JOS will publish the
Satis quinquennalis fiducias imputat gulosus agricolae.

Apparatus bellis corrumperet Medusa, quod fiducias amputat

verecundus suis.
00

of simulation
00 modelling-related theory and/or practice.
SYSTEMS
methodological and technological advances that represent significant progress toward the application

Other streams of interest will be practical applications that highlight insights into the contemporary
practice of simulation modelling; articles that are tutorial in nature or that largely review existing
literature as a contribution to the field, and articles based on empirical research such as questionnaire
surveys, controlled experiments or more qualitative case studies.

Joint Editors
Christine Currie, University of Southampton, UK
John Fowler, Arizona State University, USA
Dov
Loo Hay Lee, National University of Te’eniSingapore
Singapore,
VOLUME 00

T&F STEM @tandfSTEM @tandfengineering

Explore more today… http://bit.ly/2Gg9Zv9

NUMBER 00
MONTH 2018

IMPACT | SPRING 2021 39
© Sundry Photography/Shutterstock.com
TERMINAL PROBLEM
NEIL ROBINSON
40 IMPACT © THE OR SOCIETY
THANKS TO THE COVID-19
PANDEMIC, many of us might have
forgotten how dizzyingly busy airports
can be in normal times – and how
easily late passengers can disrupt the
delicate ecosystem of flight arrivals
and departures. Can O.R. help solve
the problem of missed connections and
messed-up timetables?
Like creaking baggage carousels
and glitzy duty-free shops, last calls for
flights are a recognised element of an
airport’s ambience. They bring comfort
to those already safely ensconced
at a departure gate. They provoke
simmering resentment among those
long since ready for take-off. They
spark panic in those still desperately
rummaging in their luggage at some
distant passport control.
Crucially, they also indicate
potential problems for managers.
When last calls assume a genuine air
of imminent finality – that is, when
missing passengers are summoned by
name – the chances are that behind
the scenes, in whatever passes for
an airport’s nerve centre, brows are
becoming furrowed and timetables are
in danger of unravelling.
This is because a breakdown in
passenger flows, as they are known, is
© 2020, INFORMS. Reprinted with permission
likely to lead to a delay; and a delay,
in turn, could trigger ever-mounting
disruption. By way of illustration,
imagine that Mr John Smith is due
to travel from London to New York
and contrives to cause a hold-up by
enjoying just one more swift gin and
tonic at an ‘airside’ bar.
The consequences of this apparently
insignificant act could be surprisingly
far-reaching. Mr Smith’s own flight
would be the obvious victim, but
many others could also be affected
as controllers battle to revise their
priorities. It is even conceivable that
what happens in London could have
repercussions not only in the Big
Apple but at every other destination
somehow ensnared in the ensuing
chaos.
Thus, one man’s sneaky
G&T quickly metamorphoses
into something resembling an
international incident. While Mr
Smith is gazing into the bottom of his
tumbler and contemplating a brisk
scuttle along the concourse, a web
of interconnected complications is
spreading all around him. This is not
so much a domino effect or even a
ripple effect: it is akin to a butterfly
effect – a small change in initial
conditions resulting in substantial
differences subsequently.
One way of dealing with this issue
would be to locate Mr Smith and drag
him out of the bar with ample time to
spare. Another approach – rather more
scientific in its underpinnings and
considerably more wide ranging in its
impact – would be to apply the power
of O.R.
GOING WITH THE FLOW
Professor Bert De Reyck, director of
the UCL School of Management at
University College London, has an
impressive track record of using O.R.
to deliver improvements in transport
and travel. For example, as previously
featured in Impact, his work in the
shipping sector – carried out with one
of his former PhD students, Ioannis
Fragkos, now an Associate Professor at
Rotterdam School of Management –
has helped the maritime industry keep
pace with the demands of 21st-century
global trade (see the Autumn 2016
issue).
In 2008 De Reyck and another
of his former PhD students, Yael
Grushka-Cockayne, now a Professor
at the University of Virginia,
developed a decision-making system
to support the Single European
Sky (SES) initiative, a scheme to
integrate air traffic management
across the continent. He devised a
framework capable of accommodating
the requirements of numerous
stakeholders, allowing them to
trade off objectives while taking
into account both the need to act
quickly and the issues associated with
incomplete data.
Among the innovations to emerge
from the SES were Airport Operations
Centres (APOCs), the first of which
was established at London’s Heathrow
in 2014. An APOC brings together
all key airport stakeholders in a single
room, encouraging them to formulate
and implement joint plans while
maintaining their own respective areas
of responsibility.
APOCs have since boosted
collaborative operational decision-
making through proximity and the
sharing of information. Nonetheless,
Eurocontrol – also known as the
European Organisation for the Safety
of Air Navigation – has been keen to
see further progress, particularly with
regard to moving beyond myopically
designed legacy systems.
Commissioned to explore potential
enhancements at Heathrow, De
Reyck, Grushka-Cockayne and
Xiaojia Guo – a third former PhD
student of De Reyck and now an
Assistant Professor at the University
of Maryland – suggested a number
of processes that might gain from the
superior incorporation of advanced
analytics. Of these, the management
of passenger flows – especially in
relation to ‘connecting’ or ‘transfer’
passengers – was deemed the most
important.
‘Passengers navigating an airport
often encounter delays, most notably
at immigration and security’, says
De Reyck. ‘Arrivals can be predicted
to some extent, but there’s a lot of
uncertainty around various factors –
not least of which is that stakeholders
have little knowledge of a passenger’s
whereabouts within an airport,
irrespective of whether a passenger
is arriving, departing or connecting.
So the task we set ourselves, in
essence, was to track passengers in real
time.’
IMPACT | SPRING 2021 41

Arrivals can be predicted
to some extent, but
there’s a lot of uncertainty
around various factors –
not least of which is that
stakeholders have little
knowledge of a passenger’s
whereabouts within an
airport
CONNECTIONS AND
COMPLEXITY
As Europe’s busiest airport and a major
international hub, Heathrow has a large
proportion of connecting passengers:
32%. This would have equated to
around 24 million people prior to the
COVID-19 pandemic. Their transfers
from one flight to another are more
complex and involve more interaction
than the routes taken by individuals
who are merely arriving or departing.
As a member of Heathrow’s APOC
team, a passenger flow manager
(PFM) is chiefly reliant on volume
forecasts, queuing time estimates and
CCTV feeds to monitor passengers’
movements through terminals. A PFM
© 2020, INFORMS. Reprinted with permission
FIGURE 1 CONSOLIDATION AND MERGING OF KEY DATA
Source: Guo et al. (2020) See ‘For Further Reading’.
42 IMPACT | SPRING 2021
also participates in two conference calls
and two meetings each day with other
APOC stakeholders.
Another vital role in smoothing
connecting passengers’ journeys through
the airport is played by a security flow
manager (SFM). Using forecasts of
passenger traffic and assessments of
resource levels, an SFM aims to avoid
the so-called queue breaches – incidents
of passengers spending more time in a
given security area than the Civil Aviation
Authority recommends. Generally, an
SFM is said to have presided over a
© 2020, INFORMS. Reprinted with permission
breach if a passenger remains in a queue
for longer than 15 minutes.
Finally, taking into account
worldwide air traffic and weather
conditions, an aircraft flow manager
(AFM) has the job of maintaining a
continuous stream of planes. An AFM
can request that airlines alter their
schedules in light of developments
and can also amend stand plans – the
assignment of aircraft to gates.
‘From our discussions with the
APOC team, it became clear that the
PFM, the SFM and the AFM would all
benefit from more timely and accurate
predictions of passengers arriving at
various points throughout the airport’,
says De Reyck. ‘Such a predictive
system would enable the PFM to
resource immigration desks in advance
of passenger surges, reducing the
likelihood of queue breaches. It would
enable the SFM to ensure the proper
preparation and resourcing of security
areas for incoming passengers. And it
would enable the AFM to warn airlines
when passengers might not make their
connections, which would facilitate the
offloading or expediting of passengers
or the modifying of departure times.’
With these goals in mind, the
researchers identified the key target
variable for their study: the time
between a plane’s arrival at a gate and
a passenger reaching the ‘conformance
desk’, a checkpoint immediately
before immigration and security. The
conformance desk’s staff may deny
boarding to any passenger deemed
unlikely to catch a flight, but it can
also be a scene of lengthy queues –

© 2020, INFORMS. Reprinted with permission

itself leading to delays and missed
connections.

FROM DATA TO DECISIONS

The information needed for the
prediction task at hand had to be
consolidated from three sources: the
business objective search system (BOSS),
the baggage daily download (BDD)
database and the conformance database.
BOSS contains flight information,
including arrival times and aircraft
capacity; BDD details every piece
of baggage belonging to passengers
connecting through Heathrow; and
the conformance database comprises
boarding pass scans, as well as time stamps
indicating when each passenger reaches
the conformance desk (see Figure 1).
In seeking to train and validate
their model, the researchers captured
data for a whole year. Around 1% was
found to be erroneous, leading to its
removal. The final data set contained
information related to almost
3,700,000 passengers with a mean
connection time of just over half an
hour. FIGURE 2 FROM DATA COLLECTION TO MODEL TRAINING TO PREDICTION GENERATION
Source: Guo et al. (2020). See ‘For Further Reading’. Δt denotes the time between a plane’s
The exercise revealed 30 variables, arrival at a gate and a passenger reaching the conformance desk. The IDAHO system pro-
of which 11 were used as predictors vides both flight-level and passenger-level information in real time. Flight-level information
includes a flight’s scheduled and actual arrival times. Passenger-level information is extract-
in the final model. The remainder, ed from PTMs (passenger transfer messages) sent by an airline and includes information
which were either unavailable in real about which passengers are known to be transferring to another flight. See the full journal
paper for further details.
time or did not improve accuracy,
were omitted. Drawing on Heathrow
experts’ knowledge of the aviation to build a truly effective machine- model’, says De Reyck. ‘We engaged
sector and familiarity with connecting learning tool (see Figure 2). in this process until we produced a
passengers’ journey, the researchers ‘Several iterations are often required model that could predict not only
also constructed new variables as part when engineering novel variables passengers’ connection times but also
of the ‘feature engineering’ necessary and then training and validating a the distribution of passenger flows –

IMPACT | SPRING 2021 43
that is, the number of arrivals at the
conformance desk – within specific
time intervals. These two tasks are
typically viewed as independent, but
we used the first to calculate the second
– an approach that yielded much
better predictions to those traditionally
achieved.’
we produced a model that
could predict not only
passengers’ connection
times but also the
distribution of passenger
flows – that is, the
number of arrivals at the
conformance desk – within
specific time intervals
The researchers eventually presented
what they believed to be the most
important features of their machine-
learning model to Heathrow and
APOC stakeholders. Tellingly, scientific
rigour squared with professional
experience and intuition. All concerned
emphasised much the same factors.
‘This confirmed that we were very
much on the right track’, says De
Reyck.
The model underwent its first live
trial following a further simulation
study, running for an entire day.
Additional testing and adaption in
July and August 2017 confirmed its
predictive power to be substantially
greater than that of Heathrow’s legacy
systems, and full implementation
followed shortly afterwards.
GOING GLOBAL
Now in use for over three years, the
model not only provides more accurate
44 IMPACT | SPRING 2021
and reliable forecasts: as expected, it
also supports APOC decision-making
more broadly. It assists managers’
understanding of the issues that
influence connection times; it allows
departures to be rescheduled in
accordance with predictions, bringing
more stability to airspace in general;
and it guides the efficient deployment
of resources.
Writing in 2019, Tom Garside,
who was Heathrow’s head of integrated
planning when the system was created,
remarked that the model should benefit
airports and airlines alike. Robert
Graham, Eurocontrol’s head of airport
research, has described the work carried
out by De Reyck and his team as
‘groundbreaking’, ‘a reference’ and an
example of ‘state-of-the-art thinking in
machine learning’.
Little wonder, then, that operators
around the world have taken an
interest. They include Group ADP,
which is responsible for France’s
Charles de Gaulle, Orly and Le Bourget
Airports, and managers at Singapore’s
Changi Airport and Los Angeles
International Airport in the USA.
Moreover, despite its huge
impact on air travel, the advent of
COVID-19 may have augmented
rather than diminished the study’s
relevance. Even before the pandemic
struck, researchers at the Institute
of Hygiene and Tropical Medicine
in Lisbon, Portugal, began using the
model to predict how passengers can
FOR FURTHER READING
Guo, X., Y. Grushka-Cockayne and B. De Reyck (2020). London Heathrow
Airport uses real-time analytics for improving operations. INFORMS
Journal on Applied Analytics, 50: 325–339.
spread infectious diseases – including
while they are moving through
airports.
‘To the best of our knowledge’, says
De Reyck, ‘ours was the first system
to use machine learning to model
passengers flows in this setting. One of
our hopes from the outset was that it
could ultimately be used to support the
development and implementation of
other real-time, data-driven systems –
and that’s precisely what has happened
since.’
One of our hopes from the
outset was that it could
ultimately be used to
support the development
and implementation of
other real-time, data-
driven systems – and
that’s precisely what has
happened since
Countless passengers are likely
to be grateful for this cutting-edge
innovation when normality is finally
restored to global travel. Persuading
Mr Smith to abandon the bar in good
time might yet prove another matter
altogether, of course; but there are some
problems that even O.R. cannot solve.
Neil Robinson is the managing editor of
Bulletin Academic, a communications
consultancy that specialises in helping
academic research have the greatest
economic, cultural or social impact.
 Make 2021 a year of
personal development
Widen your skillset with the help of OR Society training
to unlock new knowledge, improved strategy, increased
employability, and so much more with the help of
world-class renowned tutors.

It has never been easier to embark upon new courses

with online training designed to support and enhance
your OR skills from the comfort of your very own home.

To find out more visit: www.theorsociety.com/training

training 2021.indd 1 24/02/2021 17:21

 PORTFOLIO OPTIMISATION
© Uniper
IN UNIPER
COLIN SILVESTER UNIPER IS A GLOBAL ENERGY
COMPANY that generates, trades,
and markets energy on a large
scale. Uniper also procures, stores,
transports, and supplies energy-
related commodities such as natural
gas, LNG, and coal. It is a major
power producer in Western Europe
and Russia with around 40 gigawatts
of installed generating capacity with
a portfolio mix of conventional and
renewables assets.
In recent years, the power systems of
Western Europe have been undergoing
a transition towards high levels of
renewable generation. Much of the
new capacity is provided by wind
46 IMPACT © 2021 THE AUTHOR
and photovoltaics (PV). This has led
to dramatic changes in how Uniper
utilises its gas, hydro and coal assets
within these markets. New renewable
capacity reduces the amount of
energy to be served by conventional
generators but, as it is both variable
and intermittent, conventional capacity
is still required to meet demand at all
times. Additionally, the reduction in
conventional plant load factors reduces
the supply of many ancillary services to
the system operator.
The challenge of providing reliable
power and grid support services
whilst minimising costs and emissions
means that mathematical optimisation
IMPACT
solutions are growing in importance
within Uniper.
MARKET-BASED
OPERATIONS
Prior to the 21st century, most
countries operated their electricity
sectors through a single buyer model
where a system operator would be
responsible for determining the
demand for electricity and then
procuring generation to meet that
demand. In many cases this single
operator would fulfil all the roles of
production, system operation and
supply to customers.
Over the last two decades, market
liberalisation has swept across
Europe and many other countries
around the world and electricity
production is governed largely by
market mechanisms. These changes
mean that an electricity generation
company has the freedom to decide if
and how it operates each generating
unit. The decision whether or not
to run a generating unit in any
particular period is based upon what
is economically optimum and this
changes from hour-to-hour.
A gas generator, for example, will
have production costs that change
from day-to-day as market prices for
gas and carbon permits change on the
commodities spot markets. Of course,
energy companies will usually procure
some or all of their gas requirements
under longer term agreements and so
will not need to buy gas on the volatile
spot market. However, as contracted
gas can be resold into the spot market,
it is the spot market value that forms
the basis of the determination of
the economic optimum. The power
produced is sold to the electricity
market whose products have an hourly,
or sub-hourly, basis.
Electricity generators are subject
to physical constraints on starting
up, the rate at which they can change
load, minimum production levels,
minimum on and off times and many
other limitations. These mean that
the economic optimum cannot be
immediately calculated by a simple
calculator or spreadsheet and in general
they require complex optimisation
algorithms. The reach of market
solutions has also extended beyond the
supply of electrical energy to include
markets for a range of reserve and
system support products to ensure both
the quality and quantity of electricity
supply. Electricity companies have
to choose not only which generators
to run and when, but also in which
market channels they should be
operating.
PORTFOLIO OPTIMISATION
An important task for electricity
companies is to carry out portfolio
optimisation calculations. These
have a number of roles across a range
of timescales. In the short term,
optimisation is required to understand
which generators to run in each period.
As Figure 1 shows, this is subject to
FIGURE 1 SAMPLE GENERATION PROFILE
a number of dynamic constraints
that means generators cannot switch
between maximum output and off
instantaneously. As discussed above,
each generator has a different threshold
price for which generation is profitable
and this is itself a function of the input
prices of fuels and carbon obligations.
This price is also affected by whether
the unit must start up, as starting
imposes extra costs that need to be
recovered to make the running period
profitable. Starting costs can be a
function of the recent running history
as a hot gas-fired generator requires less
fuel to restart than a cold one. There
are also constraints between generators
as sometimes it will not be possible to
start two generators at the same site
simultaneously.
Beyond the short term, portfolio
optimisation is required to support risk
management activities, as a company
will seek to strike contracts for future
months and years for power sales and
input fuels and carbon in order to give
a more predictable financial outlook
for investors. Portfolio optimisation
also supports decisions about when
to schedule major maintenance on
plant, so as to minimise the financial
impact of lost availability. Maintenance
activities also can generate long term
IMPACT | SPRING 2021 47
constraints on generators as the number
of starts or running hours available
up to a planned maintenance may be
limited. In an optimisation model, the
long-term constraint can be included,
and its shadow costs extracted and
used as an input to the short-term
optimisation process.
Uniper must optimise the
overall delivery of customer
demands for heat and
steam but also the delivery
of the power output either
to the electricity market or
an industrial customer
Uniper’s electricity assets are not
limited to conventional gas, coal
and oil-fired generators producing
electricity alone. Uniper also plays an
important role in the delivery of heat
and steam to customers in Germany
and the Netherlands. The generation
of electricity from combustion
processes naturally produces heat and
so Combined Heat and Power (CHP)
generation units are an attractive
option to deliver this. In this case
Uniper must optimise the overall
FIGURE 2 COMBINED HEAT AND POWER
48 IMPACT | SPRING 2021
delivery of customer demands for
heat and steam but also the delivery
of the power output either to the
electricity market or an industrial
customer.
This is an interesting area for
optimisation modellers. Firstly, the
CHP plant itself has flexibility in
its mix of output of heat and power
as shown by the Feasible Region in
Figure 2. A CHP plant must produce
a minimum amount of power before
any heat can be delivered, but once
this is reached then there is a high
degree of flexibility in its ability to
deliver heat and power. When power
prices are attractive to the generator
this is the best way of delivering
the heat. However, in times of
low, or even negative, power prices
the minimum power production
requirement can be costly to supply
and so the optimal decision may
be to run an efficient boiler instead
- which can produce heat without
power. The requirement to use boilers
can be reduced by optimal use of a
heat store. This allows the CHP to
run when it is most economically
attractive and produce excess heat
which can be stored and used later
instead of using a boiler.
HYDROELECTRIC POWER
In Sweden and Germany, Uniper
operates a large number of hydroelectric
generators. Hydroelectric units are
subject to many of the same constraints
as thermal units but bring additional
modelling challenges since it is essential
to model reservoirs and water flows to get
a realistic view of available production.
Hydro units also have a strong coupling
between assets as often a number of
generators lie on the same river system.
Production at one location results in
additional water being delivered to
reservoirs and generators downstream
sometime later.
When modelling reservoirs, we take
account of minimum and maximum
surface level constraints. We also
estimate inflows to each reservoir from
precipitation and inflow from sources
outside the scope of our optimisation
such as smaller rivers and streams. We
also need to take into account the flows
from upstream that are a result of our
optimiser’s decisions.
Hydro generation is modelled using
non-linear relationships between water
flow and power output and operation
can be subject to flow limits, including
some minimum flow limits where there
may be an irrigation requirement.
The optimisation is complicated
by the time taken for water to travel
from one reservoir to the next and the
fact that some of the reservoirs have
little or no storage – meaning that
the optimal production profile for the
whole system can be quite different
from an optimisation of each unit
independently. Transfer times between
reservoirs range from minutes to over
twelve hours and some river systems
can consist of over twenty reservoirs
(each with one or several generators)
spread over hundreds of kilometres. It
is also the case that it may be optimal
to spill water (i.e. flow more water than

is required to reach maximum output)
as this can allow the water to be better
used by generators downstream during
high price periods.
Our goals in medium-term hydro
portfolio optimisation are to forecast
generator running patterns and sales of
power and reserve products. In general,
the hydro inflows have a seasonal
pattern and the total amount of water
available over the year is insufficient
to allow continual production at full
load. As the energy source of hydro
units, i.e. water, has no purchase
cost, generators can generate income
by running at all periods where the
price is greater than zero. However,
this is suboptimal as the water will
be exhausted at some point and the
generators may then be unavailable
to benefit from high power prices
after this time. Therefore, we optimise
production with the goal of capturing
maximum value from limited available
water. A key output of our portfolio
optimisation models is the opportunity
cost of water in our large reservoir
storages which we call the Water Value.
The water value is used in short term
optimisation as a breakeven production
cost which discourages the short-
term planning of production during
lower price periods. Limited storage
FIGURE 3 MARKET CHANNEL OPTIMISATION
at each reservoir
means that,
once released
from the large
source reservoir,
the water must
pass through the
entire system in a
number of days –
and our challenge
is to do this in a
way that creates
the greatest value.
In Germany
we also model pumped-storage
hydroelectric power plants. These assets
use grid electricity to pump water
uphill during times of low prices and
then release water through a hydro
turbine at times of higher prices and
so return a profit, provided that the
difference between the prices overcomes
the efficiency losses in the pumping
process.
In addition, electricity generators
can also provide reserve services. We
optimise our mix of production across
these products according to market
prices. In the energy-only case we will
normally produce at our maximum
output whilst profitable (see Figure 3).
There are also products that can
be delivered to supply reserve. Here
© Uniper
we offer to the system operator the
ability to turn up or turn down a
running plant to help control the
system. In this case the generator is
offering capacity rather than delivering
energy. To offer Down Reserve the
generator must run at a higher level
than PMin to be able to supply the
down reserve and to supply Up Reserve
the generator must run at a level lower
than PMax. So, by choosing whether
to offer reserve we will calculate
whether the additional income from
the reserve product plus the saved
cost of production (from running at a
lower level in the Up Reserve case) is
greater than the lost energy income.
In practice there are several reserve
products traded for each period, some
of which are symmetrical – meaning
that generators must offer the same
amount of Up Reserve as Down
Reserve.
POWER PORTFOLIO
OPTIMIZER
Uniper has developed an optimisation
application called Power Portfolio
Optimizer which can carry out
portfolio optimisation over planning
horizons from days to as much as
thirty years, taking into account
power, fuel and carbon prices as
well as opportunities to sell multiple
IMPACT | SPRING 2021 49
reserve products. Within a single
system, based on Mixed Integer
Linear Programming, Uniper carries
out portfolio optimisation and
asset valuation for all its European
portfolios. The application also
models multiple asset types and
takes into account the special
considerations for different
assets discussed above. Power
Portfolio Optimizer models Hydro
and Heat Systems in addition to
Gas, Coal, Biomass and Nuclear
generation types.
Uniper has developed an
optimisation application
called Power Portfolio
Optimizer which can carry
out portfolio optimisation
over planning horizons
from days to as much as
thirty years
50 IMPACT | SPRING 2021
Power Portfolio Optimizer has been
used intensively for over five years for
all of Uniper’s European portfolios on a
daily basis and is a cornerstone of Uniper’s
generation forecasting, power and fuel
hedging and asset strategy activities. The
application is embedded within many
Uniper production systems but is also
available to external customers through
Uniper’s Enerlytics platform. Enerlytics
offers many of Uniper’s Energy Services
offerings to customers worldwide via web
browsers, allowing Uniper to serve many
external customers across the globe.
Maria Luisa Perez, Team lead - Asset
Parameter Optimization: “Power Portfolio
Optimizer makes an enormous difference
to the way Uniper optimises a wide
variety of market areas and technologies
on a daily basis. It supports decision-
makers to extract the maximum value
from our assets with a range of diverse
sensitivity analyses (covering different
market conditions and technical data).
The key for the success of this application
lies in an in-house development with
optimisation and business experts
working closely together - which is
continuously enhanced to reflect the up to
date requirements of the energy market.”
Colin Silvester is a Senior Modelling
Specialist working at Uniper. He has
over 20 years of experience in the energy
sector. In recent years, Colin has focused
on power and gas portfolio optimisation
and price modelling. He has developed
models that are used operationally within
Uniper Global Commodities to optimise
conventional, CHP and hydro assets
across a wide range of timescales. Earlier
experience included market modelling of
liberalising markets, power-to-heat and
power-to-gas evaluations and developing
and running business simulation games.
Colin holds a degree in Physics from
Imperial College, London and is a
Chartered Engineer.
DATA A N A LYS I S A N D
OPTIMAL ROUTING FOR
CO U N T RY M A R K R E F I N I N G
A N D LO G I S T I C S
MONICA GENTILI, MAINTAINING EFFICIENCIES IN collaboration between a major US-
LIHUI BAI, JOHN USHER THE OPERATIONAL PROCESSES based oil company, CountryMark, and
AND ASH TITZER OF CRUDE OIL GATHERING is the Logistics and Distribution Institute
essential to the competitiveness of (LoDI) at the University of Louisville,
every oil company and helps to ensure is described, in which statistical analysis
that consumers get the best products and optimisation models were applied
at the lowest possible prices. Here, a to support better decision making,

IMPACT © 2021 THE AUTHORS 51

improve operational efficiencies of the
oil gathering truck fleet, and identify
potential cost savings in CountryMark’s
overall logistics operations.
THE COUNTRYMARK
CHALLENGE
CountryMark is an American-owned
oil exploration, production, refining
and marketing company that traces its
historical roots back to the discovery
of oil near Griffin Indiana in 1938. It
is the largest buyer of crude oil from
the Illinois Basin, a geological region
that covers Southern Illinois, Southern
Indiana and Western Kentucky
(see Figure 1), and includes 22,000 oil
wells producing more than 12 million
barrels of crude oil per year.
In 2019, CountryMark purchased
and transported Illinois Basin crude oil,
worth $358 million, from thousands of
individual oil well leases, using its own
company fleet of trucks and pipeline
system. This process of purchasing and
transporting is known throughout the
industry as ‘Crude Oil Gathering’. Oil
well owners, called ‘Producers’, contract
with CountryMark to gather their oil on
an as-needed basis. Prior to collection,
each full tank of oil must first be checked
by a CountryMark ‘gauger’ who is
responsible for ensuring a variety of
quality metrics including solid sediment
materials, water content, and other
contaminants. Once the tank is deemed
to contain merchantable oil, it is cleared
for pickup by the CountryMark fleet.
A truck is then dispatched centrally to
individual leases where oil is transferred
from the tank and delivered to the
CountryMark refinery in Mt. Vernon,
Indiana for processing. Due to the size
of the geographical region, many of the
leases require long travel distances which
significantly increases CountryMark’s
costs for Crude Oil Gathering.
52 IMPACT | SPRING 2021
FIGURE 1 THE ILLINOIS BASIN: LOCATION OF COUNTRYMARK’S OPERATING AREA
In 2019, CountryMark contracted
with LoDI to:
1. Perform a complete statistical anal-
ysis of truck and oil quality gaug-
ing activity using data provided by
the company to evaluate and rank
the productivity and oil quality
characteristics for every contracted
lease in the system (Cost Analysis);
2. Analyse the current truck/gauger
productivity and routing to identify
the effectiveness and potential
savings by creating a truck/gauger
optimal routing (Routing Analysis).
Due to the size of the
geographical region, many
of the leases require long
travel distances which
significantly increases
CountryMark’s costs for
Crude Oil Gathering
THE TEAM
LoDI is a multi-disciplinary research
institute with a strong education
component aimed at preparing
students to be leaders in their field.
As part of the LoDI educational
strategy, students are exposed to both
methodological research challenges
and hands-on application oriented
projects to give them exposure to the
real challenges they will be facing
once they have graduated. In line
with this strategy, three students
were involved during different phases
of the project’s 11-month period: a
Master’s student for the cost analysis
phase, and two PhD students for
the routing analysis phase. Each of
them was supervised by a professor
in the team, and was responsible for
presenting results to CountryMark
during bi-weekly meetings. Essential
for the success of the project was
the intensive collaboration between
different members from both the
LoDI and CountryMark operations
teams. For Patrick Goodman,
Manager of Crude Transportation
at CountryMark, several benefits
were identified during the project.
He states ‘Working with the student
team provided an eye opening
experience on how the data collected
through our oil hauling operations
can be used to make critical business
decisions. In the past, we simply
dispatched and hauled oil when it
was ready; now we have the ability
to utilise a proactive approach in our
operations which creates efficiencies’.
THE LODI SOLUTION
METHOD
In order to address the requested
challenges, the LoDI team used
operational research and data analytics
tools which are essential for these types
of analysis. The two analyses were
performed with the goals of:
• Determining the actual cost per
barrel of collecting oil at each
lease to drive better pricing and
scheduling decisions.
• Developing long-term statistics
on oil quality and production
volumes to identify reliable and
unreliable leases.
• Reducing the total travel distance
of gaugers and transport drivers as
they visit multiple leases per day.
Cost Analysis
The cost analysis was performed using
Microsoft Excel and Minitab software.
The LoDI team received one-year of
data through the internal informational
storage system used by CountryMark.
Each record of the data represented
characteristics and attributes associated
with each barrel of oil gathered.
Records are assigned a ‘ticket’ with a
set of unique identifiers, which can
be issued for individual truck haul
requests, leases with a physical pipeline
connection, or used for daily inventory
stock control at the offload stations.
The team first cleaned the raw data by
removing redundancy and data errors.
After the cleaning and pre-processing
operations, the initial data set was
reduced to 41,136 tickets from the
initial 73,353 tickets. These tickets
were then statistically analysed with the
aim of producing meaningful metrics
to rank the leases with respect to a
subset of data to include:
• Productivity: barrels per trip and
barrels per time.
• Oil quality: specific gravity, tem-
perature, and basic sediment and
water (BSW) - an indicator of
impurities in oil.
• Time segments: time at the lease,
time in transit, and delivery time.
• Cost per barrel and per mile: inter-
nal operating costs.
The leases were ranked with respect
to the proposed metrics and the
analysis distinguished highest ranked
leases for overall quality production and
cost efficiency. The analysis revealed
that the current operation was highly
effective; however, efficiencies could be
captured in the gathering operations by
implementing minor adjustments
to the dispatching of the gaugers
and transport drivers (as defined in
greater detail in the following Routing
Analyses segment). These adjustments
have the potential to result in up to a
5% saving in operating costs.
Routing Analyses
The project also contains two routing
analyses, i.e., the truck-to-lease
assignment (TLA) analysis and the
gauger-to-lease routing (GLR) analysis.
The TLA model is a mixed integer
linear program that minimises the total
travel distance by all trucks on a given
day. It also ensures: daily transport
demands at leases are met, total daily
travel duration by a truck does not
exceed a pre-defined threshold, and a
truck serves exactly one lease per trip as
practiced by CountryMark. The GLR
model, on the other hand, is a standard
traveling salesman problem, which is a
well-known optimisation problem for
determining the shortest tour for visiting
a list of locations exactly once. The
TLA and GLR models were solved by
the state-of-the-art optimisation solvers
CPLEX and Concorde, respectively.
The TLA model was tested for 5
days involving 182 leases. Among them,
for 150 leases, the TLA offers the same
solution as the current CountryMark
assignment. This was due to the
restriction of one lease per trip policy.
For the remaining 32 leases, the TLA
offers more efficient assignment with an
average travel cost reduction of 37.8%.
Furthermore, when examining the
top 20 most costly leases, 14 of them
could be better managed by the TLA
solution with an average cost reduction
of approximately 29%. The GLR model
IMPACT | SPRING 2021 53
was tested for a typical day involving
11 gaugers. Compared to the current
routing practiced at CountryMark, the
GLR solution reduced travel distances
for all gaugers – with an average
reduction of 30.5%, a maximum of
55.8% and a minimum of 3.9%.
when examining the top
20 most costly leases, 14
of them could be better
managed by the truck-
to-lease assignment
solution with an average
cost reduction of
approximately 29%
CONCLUSION
The CountryMark and LoDI analysis
project proved that in-depth data
analysis can provide unforeseen
measures and identify opportunities,
54 IMPACT | SPRING 2021
even for well-established operations.
Summing up the project, team member
Adam Dickerson, CountryMark’s
Manager of Pipeline Operations stated:
‘With having gathering operations in
55 counties located in three states, it
is imperative that we use the data we
continuously collect to our advantage.
Partnering with the LoDI team at the
University of Louisville is allowing us to
develop an operational strategy that will
keep us competitive in the basin while
supporting the needs of our customers.’
Monica Gentili is an associate professor in
the Industrial Engineering Department
at the University of Louisville and
co-director of LoDI. She specializes in
applied optimisation and data analytics
for logistics and healthcare problems.
Lihui Bai is an associate professor in the
Industrial Engineering Department at
University of Louisville and co-director
of LoDI. Her research interests include
operational research, applied optimisation
and data analytics in transportation and
logistics operations, network design, traffic
network flows, energy systems and healthcare
systems.
John Usher is a professor of industrial
engineering at the University of Louisville.
He has over 30 years of experience in the
probabilistic modeling of complex systems,
with applications in logistics, quality
control, and reliability engineering.
Ash Titzer has been in the pipeline
industry for over 15 years and currently
holds the position of Director of
Midstream at CountryMark Refining
and Logistics. In his role, Ash leads
a workforce with responsibility
for operating and maintaining
CountryMark’s crude oil pipeline and
trucking operations.
THE FLAVOUR OF EQUATIONS
Geoff Royston
In his best-selling book, A Brief History of Time, Stephen
Hawking says that he was warned that for every equation he
featured his sales would drop by half. He compromised by
including just one, E = mc2, perhaps the world’s most famous
equation (at least of the 20th century: Pythagoras’ a2 + b2 = c2
for right-angled triangles or Archimedes’ A = π r2 for circles
must be challengers for the historical hall of fame). So
Hawking’s book arguably lost half of what could otherwise
have been 20 million readers, and I could already have lost
seven-eighths of my possibly slightly lower total.
That notwithstanding, my piece for this issue of Impact
does concern equations. It was prompted by the recent book
‘Ten equations that rule the world: and how you can use them
too’ by David Sumpter (a professor of applied mathematics at
the University of Uppsala), more of which later.
TASTY EQUATIONS?
Equations can be categorised into various types – let’s call
them flavours – such as famous, beautiful, amusing, horribly
wrong, and really useful. I have already given some examples
of the first type. Here are some examples of the others.
Beautiful equations. They say that beauty is in the eye of
the beholder, so you may or may not think an equation can be
beautiful. (To doubters, and youngsters, I recommend the book
‘The Most Beautiful Mathematical Formulas’ by Lionel Salem,
Frederic Testard and Coralie Salem, quite accurately described
as a ‘playful romp through 49 formulae’). My personal favourite
in this category happens to be eiπ+ 1 = 0, (Euler’s identity)
because it shows a surprising simple relationship between
three fundamental mathematical constants. (I say surprising,
but all correct mathematical equations are tautologies; to an
omniscient being they all would be immediately obvious!).
Amusing Equations. For example, from an exam paper:
Question: ‘expand 2(x + y)’; Answer: = 2 ( x + y ).
Horribly Wrong Equations. For that, contested, category
we can turn to the equation that formed the centrepiece of a
slide from one of the government’s coronavirus briefings:
Covid Alert Level = R (rate of infections) +
number of infections
There is a perfectly reasonable idea behind this equation –
that the level of Covid alert will depend on both how fast
the infection is spreading (which is not R itself but is driven
by it) and the current level of (daily?) infections. But what it
actually says is that the value of R, which will range from 0
to about 3, added to the number of infections, often in the
many 1000s, equals the Covid alert level, ranging from 1 to 5!
Really useful equations. Now for my last flavour, and the
book. In this David Sumpter discusses a variety of equations
that address ‘real world’ questions where randomness is
prevalent and information is imperfect. Questions about
finance, sport, technology, politics and social life. David
Sumpter makes a bold ‘five stars’ claim, that these equations
can bring ‘success, popularity, wealth, self-confidence and
good judgement’.
Here I select just a couple of Sumpter’s ten equations,
one related to popularity (and wealth) and another related
to good judgement. And from now on I am going to follow
the advice given to Stephen Hawking, and not state the
equations in mathematical symbolic form (you can look
them up easily enough if you wish). Instead I will focus on
the different ideas behind them and the use to which they can
be put - their flavour variants.
INFLUENCE
Let’s start with what David Sumpter terms ‘the influencer
equation’ underpinning the trillion-dollar industry of
internet giants such as Google, Amazon and Facebook,
giving it his accolade as ‘the single most important equation
of the twenty-first century’.
In cyberspace much depends on the popularity of
webpages. Google’s method to determine the importance
of a web page is based on its PageRank algorithm. The
idea behind this is that a good indicator of the importance
of a webpage would be how often (the probability) that a
websurfer clicking repeatedly at random would land on that
page compared to others. But how easy is it to calculate that
IMPACT © THE OR SOCIETY 55
probability (without having to have someone actually surf
vast numbers of webpages)? The answer was given long ago
by Andrey Markov, a 19th century Russian mathematician,
who investigated the mathematics of probability, chains
and networks. Websurfing is a process of moving around a
network (of course, it’s the internet) and Markov showed that
for many such network processes (appropriately now called
Markov processes) the probability of landing on a given point
(node) can readily be computed by an equation that requires
only a list of the forward links and the backward links
between nodes of the network (webpages in the case of the
internet). This ‘influencer equation’ therefore underlies the
PageRank algorithm. Subsequently, others such as Amazon,
Facebook, and Twitter went on to use the same approach, for
instance to identify key influencers on social media.
The PageRank algorithm was patented by Stanford
University, and sold to Google for shares worth $336
million in 2005 – say $3 billion at today’s prices. I guess that
supports Sumpter’s claim of wealth-bringing (though it looks
like Markov missed out!)
JUDGEMENT
The other equation in the book that I am going to discuss
is what Sumpter calls ‘the judgement equation’. This is more
commonly known as Bayes theorem, after its formulator, the
18th-century British mathematician the Reverend Thomas
Bayes. It provides an appropriate way of using additional
evidence, if and when it becomes available, to revise an initial
estimate of how likely you think something is. I discussed
this in an Impact piece some years back but it is worth
a second outing not least because it has a highly topical
relevance to the current pandemic, as the following example
(not the one used in the book) illustrates.
Suppose that a few – say about one in a thousand
people (0.1%) – in an area are infected with a new variant
of coronavirus. You want to try to stop the spread of this
virulent new strain by testing everybody in the area and
isolating those that test positive. A reasonable estimate for
the accuracy of the test is that it will detect (test positive for)
95% of people who have the infection and that if someone is
not infected the test will nevertheless test positive for about
2% of such cases. Someone tests positive; what now is the
best estimate of the chances that they have the condition?
56 IMPACT | SPRING 2021
Studies have shown that many people (including a
worrying number of medics!) are beguiled by the detection
rate figure in such tests and would say that if someone
tests positive in the above case the probability that they
have the virus is around 95%. The problem is a confusion
between two superficially similar but actually very different
questions – ‘what are the chances that someone with the
infection will have a positive test’ and ‘what are the chances
that someone with a positive test has the infection’? Bayes
showed how crucial it was to distinguish these questions.
The first probability is 95% but the second – the one
we really want – is much less. Using Bayesian equation
reasoning to adjust the baseline 0.1% estimate of someone
being infected shows that once we have a positive test result
this rises, but only to about 5% not to 95% (out of 1000
people in the group, 20 or so will test positive, of whom
only 1 will have the condition). All those that test positive
will (rightly) have to isolate but hopefully they can take
some comfort from knowing that they probably do not
have the infection!
The reasoning behind Bayes’ equation can be applied to
a whole range of seemingly different situations. It has deeply
affected scientific analysis over recent decades; providing a
logical approach for making appropriate use of new data.
And it can even be useful in keeping calm in everyday life:
improbable events (like a plane crashing) remain improbable
unless there is very strong new evidence for them. Worth
remembering next time you are on a plane and it makes an
unfamiliar noise.
To taste the full menu of the David Sumpter’s ten
equations and formulae and decide if you agree that they
merit his five-star claim, read the book!
Dr Geoff Royston is a former
© Allen Lane
president of the OR Society
and a former chair of the UK
Government Operational Research
Service. He was head of strategic
analysis and operational research
in the Department of Health for
England, where for almost two
decades he was the professional
lead for a large group of health
analysts.
JOURNAL OF THE OPERATIONAL
RESEARCH SOCIETY

JORS is published 12 times a year and is the flagship

journal of the Operational Research Society. It is the
aim of JORS to present papers which cover the theory,
practice, history or methodology of OR. However, since
OR is primarily an applied science,
Contents it is a major objective of the journal VOLUME 00 NUMBER
to attract and 00 MONTH 00

JOURNAL OF THE OPERATIONAL RESEARCH SOCIETY

ISSN: 0960-085X
publish accounts of good, practical case studies.
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00 Real applications of OR - forecasting, inventory,
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Editors-in-Chief:
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John Boylan, Lancaster University, UK
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