减少加拿大医院择期普外科手术的取消。
Reducing elective general surgery cancellations at a Canadian hospital.
机构信息
The Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ont.
出版信息
Can J Surg. 2013 Apr;56(2):113-8. doi: 10.1503/cjs.018411.
BACKGROUND
In Canadian hospitals, which are typically financed by global annual budgets, overuse of operating rooms is a financial risk that is frequently managed by cancelling elective surgical procedures. It is uncertain how different scheduling rules affect the rate of elective surgery cancellations.
METHODS
We used discrete event simulation modelling to represent perioperative processes at a hospital in Toronto, Canada. We tested the effects of the following 3 scenarios on the number of surgical cancellations: scheduling surgeons' operating days based on their patients' average length of stay in hospital, sequencing surgical procedures by average duration and variance, and increasing the number of postsurgical ward beds.
RESULTS
The number of elective cancellations was reduced by scheduling surgeons whose patients had shorter average lengths of stay in hospital earlier in the week, sequencing shorter surgeries and those with less variance in duration earlier in the day, and by adding up to 2 additional beds to the postsurgical ward.
CONCLUSION
Discrete event simulation modelling can be used to develop strategies for improving efficiency in operating rooms.
背景
在加拿大的医院中，手术室的过度使用是一个常见的财务风险，通常通过取消择期手术来进行管理。不同的排班规则如何影响择期手术的取消率尚不清楚。
方法
我们使用离散事件模拟模型来表示加拿大多伦多一家医院的围手术期流程。我们测试了以下 3 种方案对手术取消数量的影响：根据患者在医院的平均住院时间安排外科医生的手术日、按平均持续时间和方差对手术程序进行排序，以及增加术后病房床位。
结果
通过提前安排平均住院时间较短的患者的手术、优先安排较短的手术和持续时间方差较小的手术，以及在术后病房增加多达 2 张额外的床位，择期手术的取消数量减少了。
结论
离散事件模拟模型可用于制定提高手术室效率的策略。
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