Marcon Eric, Dexter Franklin
Laboratory of Signal and Manufacturing Systems Analysis, Department Manufacturing System Management and Maintenance, Jean Monnet University of Saint Etienne, France.
Health Care Manag Sci. 2006 Feb;9(1):87-98. doi: 10.1007/s10729-006-6282-x.
This paper analyzes the impact of sequencing rules on the phase I post anesthesia care unit (PACU) staffing and over-utilized operating room (OR) time resulting from delays in PACU admission. The sequencing rules are applied to each surgeon's list of cases independently. Discrete event simulation shows the importance of having a sufficient number of PACU nurses. Sequencing rules have a large impact on the maximum number of patients receiving care in the PACU (i.e., peak of activity). Seven sequencing rules are tested, over a wide range of scenarios. The largest effect of sequencing was on the percentage of days with at least one delay in PACU admission. The best rules are those that smooth the flow of patients entering in the PACU (HIHD (Half Increase in OR time and Half Decrease in OR time) and MIX (MIX OR time)). We advise against using the LCF (Longest Cases First) and equivalent sequencing methods. They generate more over-utilized OR time, require more PACU nurses during the workday, and result in more days with at least one delay in PACU admission.
本文分析了排序规则对麻醉后护理单元（PACU）第一阶段人员配备的影响，以及因PACU收治延迟导致的手术室（OR）时间过度使用的情况。排序规则分别应用于每位外科医生的病例清单。离散事件模拟显示了拥有足够数量的PACU护士的重要性。排序规则对在PACU接受护理的患者的最大数量（即活动高峰）有很大影响。在广泛的场景中测试了七种排序规则。排序的最大影响在于至少有一次PACU收治延迟的天数百分比。最佳规则是那些能使进入PACU的患者流程平稳的规则（HIHD（手术室时间增加一半和手术室时间减少一半）和MIX（混合手术室时间））。我们建议不要使用LCF（最长病例优先）及等效的排序方法。它们会产生更多过度使用的手术室时间，在工作日需要更多的PACU护士，并且会导致更多至少有一次PACU收治延迟的天数。
