Productivity improvement in heart surgery – a case study on care process development

Karvonen, Sauli; Rämö, Juhani; Leijala, M.; Holmström, Jan

doi:10.1080/09537280410001670322

Cited by 30 publications

(22 citation statements)

References 7 publications

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“…Another solution of the double-queue scheduling, as described by Karvonen et al [15], was most recently applied by Harders et al [16] to augment the effects of parallel Mean differences (%) = difference compared to centralized induction room model. Data for centralized induction room model are presented as mean ± SD.…”

Section: Discussionmentioning

confidence: 99%

What is the best workflow for an operating room? A simulation study of five scenarios

Marjamaa

Torkki²,

Hirvensalo

et al. 2008

Health Care Manag Sci

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Parallel induction of anesthesia improves operating room (OR) efficiency. To support decision-making as to optimal facilities and optimal use of resources, we compared the cost-efficiency of several workflow models of parallel induction to that of the traditional model, using discrete-event simulation. For each scenario, average number of procedures performed, surgery time, daily over- and underutilized time, and staffing costs per operation were assessed. We also studied whether scheduling short and long procedures in separate rooms would amplify the effects of the parallel processing. All parallel work-flow models demonstrated better cost-efficiency than the traditionally sequenced working pattern. Staffing costs per procedure were 7% lower in the best induction model than in the traditional model. When short procedures were scheduled separately, differences between induction models were small.

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Section: Discussionmentioning

confidence: 99%

What is the best workflow for an operating room? A simulation study of five scenarios

Marjamaa

Torkki²,

Hirvensalo

et al. 2008

Health Care Manag Sci

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show abstract

“…For example, after coronary disease diagnosis and the decision to perform the surgery, the patient should receive care as soon as possible, because delays in the process consume hospital resources such as intensive care beds and at the same time the condition of the patient is decreased. In many previous studies applying industrial process management approaches (see for example [2,4] and [5]), value-adding time required to perform a specific operation has been treated as a black box with the implicit assumption that pressure to decrease active operation time may lead to lower quality. However, if also operation time could be decreased without sacrificing quality of care, that could lead to further efficiency improvements.…”

Section: Introductionmentioning

confidence: 99%

Speed and quality in Coronary Artery Bypass Graft (CABG) surgery: is there a connection?

Lehtonen

Hippeläinen

Kattainen

et al. 2008

Health Care Manag Sci

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In this paper we study the connection between coronary artery bypass graft (CABG) operation time and quality. Our quality metric was the improvement in health related quality of life (HRQoL) survey score in a sample of 432 patients admitted to Kuopio University Hospital. Patients were interviewed with a structured questionnaire a day before the procedure and the follow-up questionnaires were mailed 6 and 12 months after the surgery. However, the HRQoL metric used did not have high retest reliability. Subsequently, we did not find any connection between CAGB operation times and HRQoL. Likewise, we did not find the speed of the surgeon to have any connection to HRQoL improvement.

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“…Predictive solutions are recognised as being useful in anticipating the potential performance of a system. A tool that integrates process simulation modelling and optimal scheduling would have obvious benefits in the health sector (Karvonen et al, 2004). Simulation can be used initially to analyse patient arrival rates and to study different system's behaviours (Fetter et al, 1965).…”

Section: Introductionmentioning

confidence: 99%

Computer simulation and swarm intelligence organisation into an emergency department: a balancing approach across Ant Colony Optimisation

Fruggiero

Lambiase

Fallon

2008

IJSOI

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Healthcare system must be sensitive to the needs of patient, financially viable and cost-effective. Emergency Department (ED) crowding and rising healthcare costs are perceived as significant issues that are getting worse. In order to respond to the growing number of incoming patients, hospital departments, including emergency rooms, have to re-evaluate their current facilities, procedures and practises from an operations management perspective. In a typical ED, it is important to minimise not only the patient's waiting time but also the staff idle time while maintaining the high utilisation rate of medical facilities. Computer simulation is recognised as a powerful tool, for medical management, to enquire productivity trying to increase service level to patients. Based on the analogy of a Job Shop Scheduling Problem (JSSP) and known patient scheduling methodologies, a metaheuristic Swarm Intelligence (SI) approach, focused on Ant System (AS) behaviour, was used in the balancing of an ED. The Ant Colony Optimisation (ACO) algorithm was implemented with the proposal to optimise patient scheduling under defined precedence, zoning and capacity constraints while balancing the workload between and within resource types. The ED of Cork University Hospital (CUH), Ireland, is the case in issue.

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Productivity improvement in heart surgery – a case study on care process development

Cited by 30 publications

References 7 publications

What is the best workflow for an operating room? A simulation study of five scenarios

What is the best workflow for an operating room? A simulation study of five scenarios

Speed and quality in Coronary Artery Bypass Graft (CABG) surgery: is there a connection?

Computer simulation and swarm intelligence organisation into an emergency department: a balancing approach across Ant Colony Optimisation

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