Why the distribution matters: Using discrete event simulation to demonstrate the impact of the distribution of procedure times on hospital operating room utilisation and average procedure cost

Monnickendam, G; Asmundis, Carlo de

doi:10.1016/j.orhc.2017.12.001

Cited by 12 publications

(9 citation statements)

References 24 publications

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“…In this analysis, CBA for paroxysmal AF was associated with a reduction of 36.2% in days with overtime, 92.7% less cumulative overtime hours, and an increase of 46.7% in days with time for an additional EP lab usage. Monnickendam [ 6 ] also compared the impact on average procedure consumptions of AF ablation with CBA and RFA via a DES model, using data from a single surgical centre in Belgium. The study demonstrated that 28.6% of RFA procedures are over 30 min longer than the median duration, compared to only 4.4% of CBA procedures.…”

Section: Discussionmentioning

confidence: 99%

“…In the model, the first PVI case was scheduled at 7:30 am, and three PVI cases were scheduled in a lab day using either the CBA system (Arctic Front™ Cardiac Cryoablation system, Medtronic, Inc.) or an irrigated point-by-point RFA system. The EP lab was modelled fully flexible scheduling: each procedure started as soon as the lab opened or the previous case was over [ 6 ]. Operational delays were assumed in the model, including: (1) room turnover time of 20 min and (2) patient delays between 0 and 15 min.…”

Section: Methodsmentioning

confidence: 99%

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Electrophysiology lab efficiency comparison between cryoballoon and point-by-point radiofrequency ablation: a German sub-analysis of the FREEZE Cohort study

Metzner

Straube

Tilz

et al. 2023

BMC Cardiovasc Disord

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Background Pulmonary vein isolation (PVI) is recommended to treat paroxysmal and persistent atrial fibrillation (AF). This analysis aimed to assess the hospital efficiency of single-shot cryoballoon ablation (CBA) and point-by-point radiofrequency ablation (RFA). Methods The discrete event simulation used PVI procedure times from the FREEZE Cohort study to establish the electrophysiology (EP) lab occupancy time. 1000 EP lab days were simulated according to an illustrative German hospital, including 3 PVI cases per day using CBA at one site and RFA at the other. Results The analysis included 1560 CBA patients and 1344 RFA patients from the FREEZE Cohort. Some baseline patients’ characteristics were different between groups (age, AF type, and some concomitant diseases), without being statistically associated to ablation procedure time. Mean procedure time was 122.2 ± 39.4 min for CBA and 160.3 ± 53.5 min for RFA (p < 0.0001). RFA was associated with a more than five-fold increase of cumulative overtime compared to CBA over the simulated period (1285 h with RFA and 253 h with CBA). 70.7% of RFA lab days included overtime versus 25.7% for CBA. CBA was associated with more days with an additional hour at the end of the EP lab shift compared to RFA (47.8% vs 11.5% days with one hour left, respectively). Conclusion CBA is faster and more predictable than point-by-point RFA, and enables improvements in EP lab efficiency, including: fewer cumulative overtime hours, more days where overtime is avoided and more days with remaining time for the staff or for any EP lab usage. Clinical trial registration NCT01360008 (first registration 25/05/2011).

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Electrophysiology lab efficiency comparison between cryoballoon and point-by-point radiofrequency ablation: a German sub-analysis of the FREEZE Cohort study

Metzner

Straube

Tilz

et al. 2023

BMC Cardiovasc Disord

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“…Based on the above analysis, we examine the variable "surgery duration in minutes", especially regarding its distributional characteristics. On the one hand, this information is relevant for selecting a suitable statistical model for the empirical analyses; on the other hand, it is also important to obtain a realistic justification for any distributional assumptions made, which decisively influence the operating room utilization in scheduling activities (Monnickendam and de Asmundis 2018).…”

Section: Data Preparation and Descriptive Statisticsmentioning

confidence: 99%

Analyzing the relationship between physicians’ experience and surgery duration

Buchholz

Haager

Schimmelpfeng

et al. 2023

Operations Research for Health Care

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“…Major portion of the cost is consumed in managing the resources of operation room, besides choosing the best surgical procedure among different options. [3].…”

Section: Simulation Modeling Practicementioning

confidence: 99%

Traffic Simulation Modeling for Major Intersection

Bakhsh

2020

Sakarya University Journal of Science

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Nowadays, computer simulation is widely used in industries to support decision-making and performance enhancement. Real situations often require optimal solutions in the presence of multiple constraints. Present study aims to solve a transportation problem with the help of simulation modeling. Different kind of models are investigated using multiple iterations to reduce vehicle cycle and waiting time at roundabout intersection. Discrete Event Simulation (DES) is done to compare base model against two alternatives, while, ARENA soft ware is used for data analysis and computations. Results indicated that the alternative 2 of round about only is the best option considering cycle time, waiting time and number of vehicles transferred out of the system. Findings are beneficial to improve traffic flow at similar intersections, where commuters face long waiting time during peak hours.

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Why the distribution matters: Using discrete event simulation to demonstrate the impact of the distribution of procedure times on hospital operating room utilisation and average procedure cost

Cited by 12 publications

References 24 publications

Electrophysiology lab efficiency comparison between cryoballoon and point-by-point radiofrequency ablation: a German sub-analysis of the FREEZE Cohort study

Electrophysiology lab efficiency comparison between cryoballoon and point-by-point radiofrequency ablation: a German sub-analysis of the FREEZE Cohort study

Analyzing the relationship between physicians’ experience and surgery duration

Traffic Simulation Modeling for Major Intersection

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