A discrete‐event simulation model for assessing operating room efficiency of thoracic, gastrointestinal, and orthopedic surgeries

• Published in: World journal of surgery Vol. 48; no. 5; pp. 1102 - 1110
• Main Authors: Pu, Zhongchan, Wu, Shuqing, Han, Yi
• Format: Journal Article
• Language: English
• Published: United States 01.05.2024
• Subjects: Computer Simulation; Digestive System Surgical Procedures - methods; discrete event simulation; efficiency; Efficiency, Organizational; hospital management; Humans; operating room; Operating Rooms - organization & administration; operations research; Operative Time; Orthopedic Procedures - methods; Thoracic Surgical Procedures - methods; Workflow; efficiency; hospital management; discrete event simulation; operations research; operating room
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1002/wjs.12116

Background 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. Methods 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. Results 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%. Conclusions 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.