Abstract：
In hospital management, pinpointing steps that most enhance operating room (OR) throughput is challenging. While prior literature has utilized discrete event simulation (DES) to study specific strategies such as scheduling and resource allocation, our study examines an earlier planning phase, assessing all workflow stages to determine the most impactful steps for subsequent strategy development.
DES models real-world systems by simulating sequential events. We constructed a DES model for thoracic, gastrointestinal, and orthopedic surgeries summarized from a tertiary Chinese hospital. The model covers preoperative preparations, OR occupation, and OR preparation. Parameters were sourced from patient data and staff experience. Model outcome is OR throughput. Post-validation, scenario analyses were conducted for each department, including: (1) improving preoperative patient preparation time; (2) increasing PACU beds; (3) improving OR preparation time; (4) use of new equipment to reduce the operative time of a selected surgery type; three levels of improvement (slight, moderate, large) were investigated.
The first three improvement scenarios resulted in a 1%-5% increase in OR throughput across the three departments. Large reductions in operative time of the selected surgery types led to approximately 12%, 33%, and 38% increases in gastrointestinal, thoracic, and orthopedic surgery throughput, respectively. Moderate reductions resulted in 6%-17% increases in throughput and slight reductions of 1%-7%.
The model could reliably reflect OR workflows of the three departments. Among the options investigated, model simulations suggest that improving OR preparation time and operative time are the most effective.
DES models real-world systems by simulating sequential events. We constructed a DES model for thoracic, gastrointestinal, and orthopedic surgeries summarized from a tertiary Chinese hospital. The model covers preoperative preparations, OR occupation, and OR preparation. Parameters were sourced from patient data and staff experience. Model outcome is OR throughput. Post-validation, scenario analyses were conducted for each department, including: (1) improving preoperative patient preparation time; (2) increasing PACU beds; (3) improving OR preparation time; (4) use of new equipment to reduce the operative time of a selected surgery type; three levels of improvement (slight, moderate, large) were investigated.
The first three improvement scenarios resulted in a 1%-5% increase in OR throughput across the three departments. Large reductions in operative time of the selected surgery types led to approximately 12%, 33%, and 38% increases in gastrointestinal, thoracic, and orthopedic surgery throughput, respectively. Moderate reductions resulted in 6%-17% increases in throughput and slight reductions of 1%-7%.
The model could reliably reflect OR workflows of the three departments. Among the options investigated, model simulations suggest that improving OR preparation time and operative time are the most effective.
摘要：
背景：在医院管理中，精确定位最能提高手术室(OR)吞吐量的步骤是具有挑战性的。虽然现有文献已经利用离散事件模拟（DES）来研究特定的策略，如调度和资源分配，我们的研究检查了早期的计划阶段，评估所有工作流程阶段，以确定后续战略制定中最具影响力的步骤。
方法：DES通过模拟顺序事件来模拟真实世界的系统。我们建立了一个胸部的DES模型，胃肠,和骨科手术从中国一家三级医院总结。该模型包括术前准备，或职业，或准备。参数来源于患者数据和工作人员经验。模型结果为OR吞吐量。验证后，对每个部门进行了情景分析，包括：（1）提高患者术前准备时间；（2）增加PACU床位；（3）提高OR准备时间；（4）使用新设备以减少选定手术类型的手术时间；三个级别的改善（轻微，中度,大)进行了调查。
结果：前三个改进方案使三个部门的OR吞吐量增加了1%-5%。所选手术类型的手术时间大幅减少约12％，33%,胃肠道增加38%，胸廓,和骨科手术吞吐量，分别。适度减少导致吞吐量增加6%-17%，略有减少1%-7%。
结论：该模型可以可靠地反映三个部门的OR工作流程。在调查的选项中，模型模拟表明，改善OR准备时间和手术时间是最有效的。
方法：DES通过模拟顺序事件来模拟真实世界的系统。我们建立了一个胸部的DES模型，胃肠,和骨科手术从中国一家三级医院总结。该模型包括术前准备，或职业，或准备。参数来源于患者数据和工作人员经验。模型结果为OR吞吐量。验证后，对每个部门进行了情景分析，包括：（1）提高患者术前准备时间；（2）增加PACU床位；（3）提高OR准备时间；（4）使用新设备以减少选定手术类型的手术时间；三个级别的改善（轻微，中度,大)进行了调查。
结果：前三个改进方案使三个部门的OR吞吐量增加了1%-5%。所选手术类型的手术时间大幅减少约12％，33%,胃肠道增加38%，胸廓,和骨科手术吞吐量，分别。适度减少导致吞吐量增加6%-17%，略有减少1%-7%。
结论：该模型可以可靠地反映三个部门的OR工作流程。在调查的选项中，模型模拟表明，改善OR准备时间和手术时间是最有效的。
