Van Houdenhoven Mark, van Oostrum Jeroen M, Wullink Gerhard, Hans Erwin, Hurink Johann L, Bakker Jan, Kazemier Geert
Department of Operating Rooms, Erasmus University Medical Center, The Netherlands.
J Crit Care. 2008 Jun;23(2):222-6. doi: 10.1016/j.jcrc.2007.07.002. Epub 2007 Dec 11.
Mounting health care costs force hospital managers to maximize utilization of scarce resources and simultaneously improve access to hospital services. This article assesses the benefits of a cyclic case scheduling approach that exploits a master surgical schedule (MSS). An MSS maximizes operating room (OR) capacity and simultaneously levels the outflow of patients toward the intensive care unit (ICU) to reduce surgery cancellation.
Relevant data for Erasmus MC have been electronically collected since 1994. These data are used to construct an MSS that consisted of a set of surgical case types scheduled for a period or cycle. This cycle was executed repetitively. During such a cycle, surgical cases for each surgical department were scheduled on a specific day and OR. The experiments were performed for the Erasmus University Medical Center and for a virtual hospital.
Unused OR capacity can be reduced by up to 6.3% for a cycle length of 4 weeks, with simultaneous optimal leveling of the ICU workload.
Our findings show that the proposed cyclic OR planning policy may benefit OR utilization and reduce surgical case cancellation and peak demands on the ICU.
不断攀升的医疗保健成本迫使医院管理者最大限度地利用稀缺资源，同时改善医院服务的可及性。本文评估了一种利用主手术日程安排（MSS）的循环病例调度方法的益处。主手术日程安排可使手术室（OR）的容量最大化，同时使流向重症监护病房（ICU）的患者流量趋于平稳，以减少手术取消情况。
自1994年以来，伊拉斯姆斯医学中心的相关数据已通过电子方式收集。这些数据用于构建一个主手术日程安排，该日程安排由一系列在一个时间段或周期内安排的手术病例类型组成。这个周期会重复执行。在这样一个周期内，每个外科科室的手术病例会安排在特定的日期和手术室进行。实验在伊拉斯姆斯大学医学中心和一家虚拟医院进行。
对于为期4周的周期长度，未使用的手术室容量最多可减少6.3%，同时重症监护病房的工作量能实现最优的均衡。
我们的研究结果表明，所提出的循环手术室规划策略可能有益于手术室的利用率，减少手术病例取消情况以及重症监护病房的高峰需求。
