An integrated approach for evaluating and improving the performance of surgical theaters with resilience engineering.

Operating rooms are among the most high-risk and vital parts of a hospital. Therefore, one of the most fundamental tasks of risk management is maintaining the safety of operating rooms. Resilience engineering (RE) can be introduced as a model for overcoming problems, and it seeks ways to raise success rates by focusing on and addressing complexities. To this end, an RE-based framework is presented to evaluate the performance of operating rooms. First, the RE indicators are identified, and the relative importance of each is calculated via the best-worst method (BWM). Subsequently, the required data are collected from operating room experts using a standard questionnaire. Next, a data envelopment analysis (DEA) method is employed to evaluate the performance of operating rooms in the study case. Lastly, drawing upon the sensitivity analysis and statistical tests, the effect of each RE indicator is examined on the surgical department. Accordingly, some improvement approaches are proposed. Besides, SWOT (strengths, weaknesses, opportunities, and threats) analysis is used to extract appropriate strategies to improve performance. To the best of our knowledge, this paper is the first to evaluate the performance of operating rooms quantitatively in terms of RE indicators, and the framework presented in this paper can have practical applications in different operating rooms.