Simulation of a hospital′s theatre suite

Abstract

Describes a study of sex operating theatres in a modern hospital where management was concerned about the throughput of the system. Senior medical staff were of the opinion that insufficient recovery spaces had been provided when the suite of theatres had been built which, if correct, was a physical constraint requiring considerable financial investment to remedy. They also thought that shortage of porters (¿You can never find a porter when you need one!¿) and recovery nurses were current operational problems. The relationship issues encountered when interfacing with the staff involved, the collection and analyses of relevant data and the building of a visual interactive simulation model are described.

Strategies to reduce delays in admission into a postanesthesia care unit from operating rooms

“…1,2,6,11 The risk of delays in PACU admission has been shown consistently not to be reduced through practical reduction in PACU length of stay. 2,11 Large reductions in PACU stay affecting many patients are generally required to lower the risk of delays.…”

“…2,11 Even when there is a strong impression that a managerial intervention will be helpful (eg, hire more transporters), often statistical analysis using computer simulation shows that financially achievable interventions will have little effect. 1 For example, eliminating every adverse anesthetic event including all nausea and vomiting was found to be able to reduce the total PACU time of all patients at an ambulatory surgery center by 6.7%. 10 Figure 2 shows the impact on reductions in delays in PACU admission.…”

“…To minimize the number of full-time PACU staff, in one of the ORs the 1-hour cases would be performed before the 4-hour case and in the other OR the opposite sequence would be followed. 1 The peak number of patients in the PACU from those two ORs would be three patients. However, to minimize patient waiting times, in both ORs the 1-hour cases would be performed first.…”

“…30 Specialized software is required to perform discrete event computer simulation that incorporates these factors. 1,2 The processes essentially follow the steps described in Table 2 but include the other factors and simulate many days instead of many pairs of patients. Evaluating the impact on delays in admission of an intervention to reduce 11h 12h 13h 14h 15h 16h 17h 18h 19h 20h 21h A v e ra ge N um be r of P a tie nts OR Sam e PACU PACU -LOS reduced by 6.7% PACU length of stay by modeling an existing PACU will generally be elementary for anyone with expertise in operations research.…”

Modeling the impact of changing patient transportation systems on peri-operative process performance in a large hospital: insights from a computer simulation study

“…To our knowledge, there are relatively few studies of hospital transportation systems [8][9][10][11][12]; these approaches seem to be rather limited to the specific applications in question [12]. The focus of most operations research literature in healthcare is investigating systems with relatively simple structure, such as appointments in an outpatient practice [13], desired level of staffing in a medical department [14][15][16], or surgery scheduling [17,18].…”