Using Discrete Event Simulation (DES) to Manage Theatre Operations in Healthcare: An Audit-Based Case Study

Komashie, Alexander; Mousavi, Amir; Gore, Justin

doi:10.1109/uksim.2008.112

Cited by 13 publications

(8 citation statements)

References 13 publications

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“…In hospital management, simulation has been applied for the analysis and optimization of pathway and workflow planning [35], optimization of patient flow [36] and resource planning [37]. In the OR setting, simulation methods have been also utilized, mainly to improve the OR scheduling [38]- [42] and the patient flow [7], [30], [43]. A detailed review of OR scheduling and planning using DES and other simulation techniques as well as mathematical models can be found in [44].…”

Section: State Of the Artmentioning

confidence: 99%

Surgical Workflow Simulation for the Design and Assessment of Operating Room Setups in Orthopedic Surgery

Neumann

Angrick

Höhn

et al. 2020

Preprint

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Abstract Background: The design and internal layout of modern operating rooms (OR) are influencing the surgical team’s collaboration and communication, ergonomics, as well as intraoperative hygiene substantially. Yet, there is no objective method for the assessment and design of operating room setups for different surgical disciplines and intervention types available. The aim of this work is to establish an improved OR setup for common procedures in arthroplasty. Methods With the help of computer simulation, a method for the design and assessment of enhanced OR setups was developed. New OR setups were designed, analyzed in a computer simulation environment and evaluated in the actual intraoperative setting. Thereby, a 3D graphical simulation representation enabled the strong involvement of clinical stakeholders in all phases of the design and decision-making process of the new setup alternatives. Results The implementation of improved OR setups reduced the instrument handover time between the surgeon and the scrub nurse, the travel paths of the OR team as well as shortened the procedure duration. Additionally, the ergonomics of the OR staff were improved. Conclusion The developed simulation method was evaluated in the actual intraoperative setting and proved its benefit for the design and optimization of OR setups for different surgical intervention types. As a clinical result, enhanced setups for total knee arthroplasty and total hip arthroplasty surgeries were established in daily clinical routine and the OR efficiency was improved.

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Section: State Of the Artmentioning

confidence: 99%

Surgical Workflow Simulation for the Design and Assessment of Operating Room Setups in Orthopedic Surgery

Neumann

Angrick

Höhn

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…In hospital management, simulation has been applied for the analysis and optimization of pathway and workflow planning [24], optimization of patient flow [25] and resource planning [26]. In the OR setting, simulation methods have been also utilized, mainly to improve the OR scheduling [27]- [31] and the patient flow [18], [32], [33]. A detailed review of OR scheduling and planning using DES and other simulation techniques as well as mathematical models can be found in [34].…”

Section: State Of the Artmentioning

confidence: 99%

Surgical Workflow Simulation for the Design and Assessment of Operating Room Setups in Orthopedic Surgery

Neumann

Angrick

Höhn

et al. 2019

Preprint

View full text Add to dashboard Cite

Abstract Background The design and internal layout of modern operating rooms are influencing the team’s collaboration and communication, ergonomics, as well as intraoperative hygiene substantially. Nevertheless, there is no objective method for the assessment and design of the personnel and table positions for different surgical disciplines and intervention types available. The aim of this work is to establish an improved OR setup for common procedures in arthroplasty. Methods With the help of computer simulation techniques, a method for the objective design and assessment of enhanced OR setups was developed. In this work, new OR setups were designed, analyzed in a computer simulation environment and evaluated in the actual intraoperative setting. Results The implementation of improved OR setups reduces the instrument handover time between the surgeon and the scrub nurse, the travel paths of the OR team as well as shortens the procedure duration. Additionally, the ergonomics of the OR staff were improved. Conclusion The developed simulation method was intraoperatively evaluated and proved its benefit for the design and optimization of OR setups for different surgical intervention types. As a clinical result, enhanced setups for total knee arthroplasty and total hip arthroplasty surgeries were established in daily clinical routine and the OR efficiency was improved.

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“…DES applications in healthcare modeling are rapidly grown in the past decades (Komashie et al, 2008). ED modeling is an important application of DES to estimate impact of key resources of healthcare systems (Fone et al, 2003;Komashie and Mousavi, 2005).…”

Section: Bottleneck Detectionmentioning

confidence: 99%

Bottleneck detection for improvement of Emergency Department efficiency

Zhao

Peng

Strome

et al. 2015

Business Process Management Journal

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Purpose -The purpose of this paper is to introduce a method of the bottleneck detection for Emergency Department (ED) improvement using benchmarking and design of experiments (DOE) in simulation model. Design/methodology/approach -Four procedures of treatments are used to represent ED activities of the patient flow. Simulation modeling is applied as a cost-effective tool to analyze the ED operation. Benchmarking provides the achievable goal for the improvement. DOE speeds up the process of bottleneck search. Findings -It is identified that the long waiting time is accumulated by previous arrival patients waiting for treatment in the ED. Comparing the processing time of each treatment procedure with the benchmark reveals that increasing the treatment time mainly happens in treatment in progress and emergency room holding (ERH) procedures. It also indicates that the to be admitted time caused by the transfer delay is a common case.Research limitations/implications -The current research is conducted in the ED only. Activities in the ERH require a close cooperation of several medical teams to complete patients' condition evaluations. The current model may be extended to the related medical units to improve the model detail. Practical implications -ED overcrowding is an increasingly significant public healthcare problem. Bottlenecks that affect ED overcrowding have to be detected to improve the patient flow. Originality/value -Integration of benchmarking and DOE in simulation modeling proposed in this research shows the promise in time-saving for bottleneck detection of ED operations.

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Using Discrete Event Simulation (DES) to Manage Theatre Operations in Healthcare: An Audit-Based Case Study

Abstract: This paper discusses the application of Discrete Event Simulation (DES)

Cited by 13 publications

References 13 publications

Surgical Workflow Simulation for the Design and Assessment of Operating Room Setups in Orthopedic Surgery

Surgical Workflow Simulation for the Design and Assessment of Operating Room Setups in Orthopedic Surgery

Surgical Workflow Simulation for the Design and Assessment of Operating Room Setups in Orthopedic Surgery

Bottleneck detection for improvement of Emergency Department efficiency

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