Dexter F, Macario A
Department of Anesthesia, University of Iowa, Iowa City 52242, USA.
Anesth Analg. 1999 Jan;88(1):72-6. doi: 10.1097/00000539-199901000-00014.
We used Monte-Carlo computer simulation to determine whether surgical or anesthetic interventions to achieve small decreases in case duration may create enough new open operating room (OR) time to permit an additional case to be scheduled for completion in an OR suite during regular working hours. We used rules for scheduling of cases assuming that OR personnel are compensated so that the OR suite can profit financially from decreasing case duration to complete an additional case during regularly scheduled hours. The decreases in each case's duration required to create enough new open OR time to reliably (> or =95%) schedule another case were 30-39 min, 79-110 min, and 105-206 min for OR suites with 1-15 ORs and mean case durations of 1, 2, or 3 h, respectively.
Computer simulation shows decreasing case duration is unlikely to create sufficient operating room time to reliably permit an additional case to be scheduled for completion during working hours. Additional cases may best be added to the operating room suite schedule by optimizing case scheduling, not by decreasing the duration of all cases in the suite.
我们使用蒙特卡洛计算机模拟来确定，为使手术时长小幅缩短而采取的手术或麻醉干预措施，是否能创造出足够的新的手术室开放时间，以便在正常工作时间内在手术室安排另一台手术完成。我们使用了手术安排规则，假设手术室工作人员获得相应报酬，这样手术室就能通过缩短手术时长在正常排班时间内完成另一台手术而实现经济盈利。对于拥有1至15间手术室且平均手术时长分别为1小时、2小时或3小时的手术室，为创造足够的新的手术室开放时间以可靠地（≥95%）安排另一台手术所需的每台手术时长的缩短量分别为30 - 39分钟、79 - 110分钟和105 - 206分钟。
计算机模拟显示，缩短手术时长不太可能创造出足够的手术室时间来可靠地允许在工作时间内安排另一台手术完成。最好通过优化手术安排，而非缩短手术室所有手术的时长，来将更多手术添加到手术室排班中。
