Marcon Eric, Kharraja Saïd, Smolski Nicole, Luquet Brigitte, Viale Jean Paul
*Department of Industrial Maintenance, Jean Monnet University, Saint Etienne; and Departments of †Anesthesiology and ‡Surgery, Hospital Croix-Rousse, Lyon, France.
Anesth Analg. 2003 May;96(5):1415-1423. doi: 10.1213/01.ANE.0000056701.08350.B9.
Designing a new operating room (OR) suite is a difficult process owing to the number of caregivers involved and because decision-making managers try to minimize the direct and indirect costs of operating the OR suite. In this study, we devised a computer simulation flow model to calculate, first, the minimum number of beds required in the postanesthesia care unit (PACU). In a second step, we evaluated the relationship between the global performance of the OR suite in terms of OR scheduling and number of staffed PACU beds and porters. We designed a mathematical model of OR scheduling. We then developed a computer simulation flow model of the OR suite. Both models were connected; the first one performed the input flows, and the second simulated the OR suite running. The simulations performed examined the number of beds in the PACU in an ideal situation or in the case of reduction in the number of porters. We then analyzed the variation of number of beds occupied per hour in the PACU when the time spent by patients in the PACU or the number of porters varied. The results highlighted the strong impact of the number of porters on the OR suite performance and particularly on PACU performances.
Designing new operating room (OR) facilities implies many decisions on the number of ORs, postanesthesia care unit (PACU) beds, and on the staff of nurses and porters. To make these decisions, managers can use rules of thumb or recommendations. Our study highlights the interest of using flow simulation to validate these choices. In this case study we determine the number of PACU beds and porter staff and assess the impact of decreasing the number of porters on PACU bed requirements.
设计一个新的手术室套件是一个困难的过程，这是由于涉及的护理人员数量众多，并且决策管理者试图将手术室套件运营的直接和间接成本降至最低。在本研究中，我们设计了一个计算机模拟流程模型，首先计算麻醉后护理单元（PACU）所需的最少床位数。第二步，我们评估了手术室套件在手术安排方面的整体性能与配备人员的PACU床位数量和搬运工数量之间的关系。我们设计了一个手术安排的数学模型。然后我们开发了手术室套件的计算机模拟流程模型。这两个模型相互连接；第一个执行输入流程，第二个模拟手术室套件的运行。所进行的模拟研究了理想情况下或搬运工数量减少情况下PACU的床位数。然后，当患者在PACU花费的时间或搬运工数量发生变化时，我们分析了PACU每小时占用床位数的变化。结果突出了搬运工数量对手术室套件性能，特别是对PACU性能的强烈影响。
设计新的手术室（OR）设施意味着要对手术室数量、麻醉后护理单元（PACU）床位数量以及护士和搬运工人员配置做出许多决策。为了做出这些决策，管理者可以使用经验法则或建议。我们的研究强调了使用流程模拟来验证这些选择的益处。在这个案例研究中，我们确定了PACU床位数量和搬运工人员配置，并评估了减少搬运工数量对PACU床位需求的影响。
