Tyagi Meeta, Tyagi P K, Singh Sanjeet, Satpathy Sidhartha, Kant Sunil, Gupta Shakti Kumar, Singh Rajvir
Senior Consultant (Hospital Management), PMU, All India Institute of Medical Sciences, New Delhi, India.
Associate Professor (Preventive & Social Medicine), Government Institute of Medical Sciences, Greater Noida, UP, India.
Med J Armed Forces India. 2022 Sep;78(Suppl 1):S163-S171. doi: 10.1016/j.mjafi.2020.09.005. Epub 2021 Feb 20.
Cancellation of surgeries is a regular phenomenon in any hospital, and reasons may vary from clinical to managerial ones. The aim of the study is to suggest scheduling to address the problem of time over run related cancellations. This is an observational and descriptive study conducted in a tertiary care hospital with ophthalmology facilities. The sample size is calculated with 95% confidence interval using Epi Info 6 from the total surgeries performed in the last 5 years (n = 380). Simple random sampling technique was used.
Surgical time for all types of ophthalmic surgeries (n = 582) was observed. Allocation of listed cases to the available operating rooms (ORs) was carried out using the observed time using LEKIN software.
The time over-run of 2 h and 6 h was noted for two units, whereas idle OR time was observed in other units. An average idle time of 19% was noted on each day. Reallocation of the cases to the ORs was carried out taking all the planned cases (of both the operating units of the day) as the number of jobs and all the available ORs as parallel machines using LEKIN software. All the planned cases could be accommodated; still, an average of 17% of the total available operation theater (OT) time was found idle on each day.
Planning of cases using procedure time and scheduling on a daily basis using allocation models with simple algorithms can provide optimal utilization of OTs and can address the time over-run and related cancellations.
手术取消在任何医院都是常见现象，原因可能从临床到管理各有不同。本研究的目的是提出一种排程方法，以解决与时间超支相关的手术取消问题。这是一项在设有眼科设施的三级护理医院进行的观察性描述性研究。使用Epi Info 6软件，以过去5年进行的所有手术（n = 380）为基础，计算出95%置信区间下的样本量。采用简单随机抽样技术。
观察了所有类型眼科手术（n = 582）的手术时间。使用LEKIN软件，根据观察到的时间将已列入清单的病例分配到可用手术室。
两个手术室出现了2小时和6小时的时间超支，而其他手术室则出现了闲置时间。每天平均闲置时间为19%。使用LEKIN软件，将当天两个手术科室的所有计划病例作为作业数量，将所有可用手术室作为并行机器，对病例重新分配到手术室。所有计划病例都能得到安排；尽管如此，每天仍发现平均有17%的手术室总可用时间闲置。
利用手术时间规划病例，并使用具有简单算法的分配模型进行每日排程，可以实现手术室的最佳利用，并解决时间超支及相关的手术取消问题。
