Liao Hung-Chang, Wang Ya-Huei
Department of Health Policy and Management, Chung Shan Medical University, Taichung 40201, Taiwan.
Department of Medical Management, Chung Shan Medical University Hospital, Taichung 40201, Taiwan.
Healthcare (Basel). 2025 Apr 29;13(9):1024. doi: 10.3390/healthcare13091024.
The study focused on the design of an ORMS in a medical center in central Taiwan, which also functions as a teaching hospital. : The research objectives were to design an ORMS simulation system based on the status quo of the operating room planning and scheduling in the medical center, obtain the optimal parameter setting in the ORMS, and find improvement strategies according to the sensitivity analysis based on the optimal parameter setting for total performance. : Taguchi's dynamic method was adopted to design the ORMS under human and material resource constraints. The scope of the study was internal medicine patients of the ORMS. A neural network was used to construct a relationship between parameters and performances. A genetic algorithm was used to obtain the optimal parameter setting for optimal performance. This study successfully established a robust operating room management system (ORMS) to help hospital manager to plan and schedule operating rooms and take the ORMS into account to meet patient needs. Decision-makers can use the insights from the sensitivity analysis to refine their strategies effectively. The sensitivity analysis showed that the impact power (the percentage change in ) of the "number of circulating nurses (-0.15 to -1.25; -0.25 to -1.85)" factor was less than (<) that of the "number of holding nurses (-0.85 to -2.04; -0.91 to -2.07)" factor < that of the "number of preoperative beds (-2.57 to -4.53; -2.23 to -4.10)" factor < that of the "number of anesthetists (-3.13 to -7.50)" factor. : In the optimal parameter setting obtained, the number of holding nurses was 18, the number of circulating nurses was 20, the number of anesthetists was 15, and the number of preoperative beds was 12. The optimal performance was 0.91.
该研究聚焦于台湾中部一家同时作为教学医院的医疗中心的手术室管理系统（ORMS）设计。研究目标是基于该医疗中心手术室规划与调度的现状设计一个ORMS模拟系统，获取ORMS中的最优参数设置，并根据基于总绩效最优参数设置的敏感性分析找到改进策略。采用田口动态方法在人力和物力资源约束下设计ORMS。研究范围是ORMS的内科患者。使用神经网络构建参数与绩效之间的关系。使用遗传算法获取最优绩效的最优参数设置。本研究成功建立了一个稳健的手术室管理系统（ORMS），以帮助医院管理者规划和调度手术室，并考虑ORMS以满足患者需求。决策者可以利用敏感性分析的见解有效完善其策略。敏感性分析表明，“巡回护士数量（-0.15至-1.25；-0.25至-1.85）”因素的影响力（ 的百分比变化）小于“器械护士数量（-0.85至-2.04；-0.91至-2.07）”因素的影响力<“术前床位数量（-2.57至-4.53；-2.23至-4.10）”因素的影响力<“麻醉师数量（-3.13至-7.50）”因素的影响力。在所获得的最优参数设置中，器械护士数量为18，巡回护士数量为20，麻醉师数量为15，术前床位数量为12。最优绩效为0.91。
