A Cyber-Physical System to Improve the Management of a Large Suite of Operating Rooms

Abstract

Cyber-physical systems have been deployed with considerable success in many industries. However, the implementation of cyber-physical systems in hospitals has been limited. By nature, in clinical operations, patient safety and consideration for health outcomes are of the utmost importance, thus possibly slowing the implementation of innovative solutions with limited history. Revenues from operating room (OR) time and surgery account for about 50% of the income of major hospitals (Erdogan et al. 2011; Cuschieri 2006), but the efficiency of OR utilization is often reported to be relatively low. Therefore, improving OR management with a cyber-physical system should be a priority. In this article, we will report on our experience implementing a cyber-physical system at Houston Methodist Hospital and discuss some of the difficulties and potential drivers for success. Our pilot study was done in the context of the management of a large suite of ORs. It uses the agile codevelopment of a cyber-physical system through an intense collaboration of clinicians and computational scientists. While technology remains the foundation of a cyber-physical system, this experience reinforced that the human factor is an important driving force behind the design that promotes user acceptance.

A Systems Approach to Assess Transport and Diffusion of Hazardous Airborne Particles in a Large Surgical Suite: Potential Impacts on Viral Airborne Transmission

“…The parameters of that model are: the frequency of energy delivery denoted f , the duration of the impulse denoted ξ, and the number of repetition r. A uniform probabilistic distribution of events is used within these intervals of variation for each parameter. by the sensors of the cyber-physical infrastructure [27]. A stochastic model of door openings will be used based on a uniform frequency of door opening during surgery, even though this distribution is non-uniform in practice and tends to concentrate at the beginning and the end of a case.…”

“…To this end, several ORs were equipped with sensors that capture timestamps [27,28,43] corresponding to the different states described in the previous section.…”

“…We present in this paper a mathematical framework and experimental protocol to assess the transport and diffusion of hazardous airborne particles in any large OR suite. Human behavior factors are taken into account by using a systems and cyber-infrastructure approach [27][28][29] coupled to a multi-scale modeling of surgical flow in a large OR suite [30]. Overall, the model estimates staff's exposure to airborne contamination, such as surgical smoke or biological hazard.…”

A Model of Workflow in the Hospital During a Pandemic to Assist Management

“…9 A manager may have simple but essential questions such as: how many beds do I 10 need on the floor, how many beds are available in the critical care unit, how much 11 supplies should be ordered to take care of our patients and protect our staff from 12 infection, how long will the facility have to work at maximum capacity, is there enough 13 staff to hold this workload long enough, are we doing well with patient outcomes, etc. 14 15 easy access and understanding of global pandemic data. These applications are great to 16 give the general assessment of the pandemic but do not allow a projection of detailed 17 information at the local hospital scale that is necessary to optimize the management of 18 patient workflow.…”

“…Once again for simplicity and because of the lack of input data, 85 our model will not take into account these bottlenecks. There are no technical 86 April 28, 2020 3/18 difficulties required to add those constraints in the mathematical model with our 87 bottom up description of the workflow as in [10,15]. Additional steps can be recovery 88 for patient being well or unfortunately palliative care when the patient is not responsive 89 to treatment.…”