Multiscale Modeling of Surgical Flow in a Large Operating Room Suite: Understanding the Mechanism of Accumulation of Delays in Clinical Practice

Garbey, Marc; Joerger, Guillaume; Rambourg, Juliette; Dunkin, Brian J.; Bass, Barbara L.

doi:10.1016/j.procs.2017.05.228

Cited by 11 publications

(31 citation statements)

References 13 publications

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“…To expand the study, this simplified air quality model was then coupled to the ABM of surgical flow that reproduces the daily activity of a large surgical suite over a long period of time [30]. The model was calibrated using custom-made sensor systems placed at key locations of the surgical suite to capture the daily activity over a period of a year [28].…”

Section: Clinical Agent-based Model Of Hazardous Airborne Particlesmentioning

confidence: 99%

“…The marker can also be the particles resulting from evaporation of any alcohol-based chemical used either to prep the patient or to clean the OR. The model has two parts: first, a compartment-like model that can monitor the indoor pollution [40]; second, a multi-scale ABM that simulates the surgical flow activity and the impact on the indoor air quality either from the source of surgical smoke or from door openings affecting the dispersion of pollutants [30]. Staff movement throughout the OR suite via door openings and closings will manifestly be a key mechanism for propagation of markers.…”

Section: Hybrid Box-pde Model Of Airborne Contamination In the Surgicmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Garbey

Joerger²,

Furr³

2020

Preprint

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Airborne transmission of viruses, such as the coronavirus 2 (SARS-CoV-2), in hospital systems are under debate: it has been shown that transmission of SARS-CoV-2 virus goes beyond droplet dynamics that is limited to 3-6 feet, but it is unclear if the airborne viral load is significant enough to ensure transmission of the disease. Surgical smoke can act as a carrier for tissue particles, viruses, and bacteria. To quantify airborne transmission from a physical point of view, we consider surgical smoke produced by thermal destruction of tissue during the use of electrosurgical instruments as a marker of airborne particle diffusion-transportation. Surgical smoke plumes are also known to be dangerous for human health, especially to surgical staff who receive long-term exposure over the years. There are limited quantified metrics reported on long-term effects of surgical smoke on staff's health. The purpose of this paper is to provide a mathematical framework and experimental protocol to assess the transport and diffusion of hazardous airborne particles in every large operating room suite. Measurements from a network of air quality sensors gathered during a clinical study provide validation for the main part of the model. Overall, the model estimates staff exposure to airborne contamination from surgical smoke and biological material. To address the clinical implication over a long period of time, the systems approach is built upon previous work on multi-scale modeling of surgical flow in a large operating room suite and takes into account human behavior factors.

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Section: Clinical Agent-based Model Of Hazardous Airborne Particlesmentioning

confidence: 99%

Section: Hybrid Box-pde Model Of Airborne Contamination In the Surgicmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Garbey

Joerger²,

Furr³

2020

Preprint

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“…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.…”

mentioning

confidence: 99%

“…First, the patient's condition is indeed dominated by 134 his/her biological time. Second, medical procedures with their associated time lag and 135 delay are also often best described as lognormal processes [10,22] with a long tail. This 136 is not in contradiction with the fact that patient LOS in the hospital may not ideally be 137 described by a simple exponential distribution or similar.…”

mentioning

confidence: 99%

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

Garbey

Joerger²,

Furr³

et al. 2020

Preprint

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We present a computational model of workflow in the hospital during a pandemic. The objective is to assist management in anticipating the load of each care unit, such as the ICU, or ordering supplies, such as personal protective equipment, but also to retrieve key parameters that measure the performance of the health system facing a new crisis. The model was fitted with good accuracy to France's data set that gives information on hospitalized patients and is provided online by the French government. The goal of this work is both practical in offering hospital management a tool to deal with the present crisis of COVID-19 and offering a conceptual illustration of the benefit of computational science during a pandemic.

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A Continuum of Interfaces to Engage Surgical Staff in Efficient Collaboration

et al. 2019

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Large hospital surgical suites must combine high quality of care with an efficient management of operations. However, the diversity of procedures, staff, and patients present important challenges for staff collaboration. The complexity of flows between tasks and places, such as interconnections between pre-operation, postoperation and intensive care units, led previous research to address these issues separately using checklists, scheduling, or specialized human-computer interfaces. Approaches to treat the surgical suite as a whole entity have not been explored yet. Here, we build upon a cyber-physical system comprising an electronic whiteboard and different sensors tracking the status of operating rooms to design a continuum of mobile and fixed, shared computer interfaces. The interfaces disseminate the information through different locations and devices and allow for its manipulation in order to foster appropriate collaboration on unforeseen events and decisions. We present our design rationale process, involving the different surgical suite users and stakeholders and report on the architecture of the system.

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Multiscale Modeling of Surgical Flow in a Large Operating Room Suite: Understanding the Mechanism of Accumulation of Delays in Clinical Practice

Cited by 11 publications

References 13 publications

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

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

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

A Continuum of Interfaces to Engage Surgical Staff in Efficient Collaboration

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