Department of Applied Mathematics, University of Twente, Enschede, The Netherlands.
Anesth Analg. 2011 Jun;112(6):1472-9. doi: 10.1213/ANE.0b013e3182159c2f. Epub 2011 May 5.
As the demand for health care services increases, the need to improve patient flow between departments has likewise increased. Understanding how the master surgical schedule (MSS) affects the inpatient wards and exploiting this relationship can lead to a decrease in surgery cancellations, a more balanced workload, and an improvement in resource utilization. We modeled this relationship and used the model to evaluate and select a new MSS for a hospital.
An operational research model was used in combination with staff input to develop a new MSS. A series of MSSs were proposed by staff, evaluated by the model, and then scrutinized by staff. Through iterative modifications of the MSS proposals (i.e., the assigned operating time of specialties), insight is obtained into the number, type, and timing of ward admissions, and how these affect ward occupancy.
After evaluating and discussing a number of proposals, a new MSS was chosen that was acceptable to operating room staff and that balanced the ward occupancy. After implementing the new MSS, a review of the bed-use statistics showed it was achieving a balanced ward occupancy. The model described in this article gave the hospital the ability to quantify the concerns of multiple departments, thereby providing a platform from which a new MSS could be negotiated.
The model, used in combination with staff input, supported an otherwise subjective discussion with quantitative analysis. The work in this article, and in particular the model, is readily repeatable in other hospitals and relies only on readily available data.
随着医疗保健服务需求的增加，提高部门之间患者流量的需求也随之增加。了解主手术日程 (MSS) 如何影响住院病房，并利用这种关系，可以减少手术取消，使工作量更加平衡，并提高资源利用率。我们对这种关系进行了建模，并使用该模型为一家医院评估和选择新的 MSS。
结合员工的意见，采用运筹学模型来制定新的 MSS。员工提出了一系列 MSS，由模型进行评估，然后由员工进行详细审查。通过对 MSS 提案（即专业操作时间）进行迭代修改，可以深入了解病房入院的数量、类型和时间，以及这些因素如何影响病房入住率。
在对多个提案进行评估和讨论后，选择了一个新的 MSS，该 MSS 得到了手术室工作人员的认可，并平衡了病房入住率。在实施新 MSS 后，对床位使用统计数据的审查表明，它实现了均衡的病房入住率。本文所述的模型使医院能够量化多个部门的关注点，从而提供了一个可以协商新 MSS 的平台。
该模型与员工的意见相结合，支持了原本主观的讨论，并进行了定量分析。本文的工作，特别是模型，在其他医院中具有可重复性，并且仅依赖于现成的数据。
