Industrial Production Engineering, Instituto Tecnológico de Costa Rica, Cartago, Costa Rica.
Computer Engineering, Instituto Tecnológico de Costa Rica, Cartago, Costa Rica.
Front Public Health. 2022 Apr 4;10:809534. doi: 10.3389/fpubh.2022.809534. eCollection 2022.
Anatomic pathology services study disease in hospitals on the basis of macroscopic and microscopic examination of organs and tissues. The focus of this research investigation was on improving clinical biopsy diagnosis times through simulation based on the Box-Muller algorithm to reduce the waiting time in the diagnosis of clinical biopsies. The data were provided by a hospital in San José (Costa Rica). They covered 5 years and showed waiting times for a pathological diagnosis that for some biopsies were close to 120 days. The correlation between the main causes identified and the cycle time in the biopsy diagnostic process was defined. A statistical analysis of the variables most representative of the process and of the waiting times was carried out. It followed the DMAIC structure (Define, Measure, Analyse, Improve, Control) for the continuous improvement of processes. Two of the activities of the process were identified as being the main bottlenecks. Their processing times had a normal distribution, for which reason a Box-Muller algorithm was used to generate the simulation model. The results showed that waiting times for a diagnosis can be reduced to 3 days, for a productive capacity of 8 000 biopsies per annum, optimizing the logistics performance of health care.
解剖病理学服务基于对器官和组织的宏观和微观检查，在医院中研究疾病。本研究调查的重点是通过基于 Box-Muller 算法的模拟来提高临床活检诊断时间，以减少临床活检诊断的等待时间。数据由哥斯达黎加圣何塞的一家医院提供。这些数据涵盖了 5 年的时间，显示出一些活检的病理诊断等待时间接近 120 天。确定了主要原因与活检诊断过程中的循环时间之间的相关性。对最能代表该过程和等待时间的变量进行了统计分析。随后，遵循 DMAIC 结构（定义、测量、分析、改进和控制）对流程进行持续改进。确定了两个过程活动是主要瓶颈。它们的处理时间呈正态分布，因此使用 Box-Muller 算法生成了模拟模型。结果表明，诊断等待时间可以减少到 3 天，每年可处理 8000 次活检，优化了医疗保健的物流绩效。
