Reducing elective general surgery cancellations at a Canadian hospital

Background In Canadian hospitals, which are typically financed by global annual budgets, overuse of operating rooms is a financial risk that is frequently managed by cancelling elective surgical procedures. It is uncertain how different scheduling rules affect the rate of elective surgery cancellati...

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Bibliographic Details
Published inCanadian Journal of Surgery Vol. 56; no. 2; pp. 113 - 118
Main Authors Azari-Rad, Solmaz, MASc, Yontef, Alanna L., BASc, Aleman, Dionne M., PhD, PEng, Urbach, David R., MD, MSc
Format Journal Article
LanguageEnglish
Published Canada Joule Inc 01.04.2013
CMA Impact, Inc
Canadian Medical Association
Subjects
Appointments and Schedules
Cancellations
Efficiency, Organizational
Elective Surgical Procedures - statistics & numerical data
Health aspects
Health care industry
Health Services Misuse - prevention & control
Hospitals
Humans
Length of Stay
Models, Organizational
Ontario
Operating Rooms - organization & administration
Quality management
Scheduling
Studies
Surgery
Surgery, Elective
Ontario
Canada
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Summary:Background In Canadian hospitals, which are typically financed by global annual budgets, overuse of operating rooms is a financial risk that is frequently managed by cancelling elective surgical procedures. It is uncertain how different scheduling rules affect the rate of elective surgery cancellations. Methods We used discrete event simulation modelling to represent perioperative processes at a hospital in Toronto, Canada. We tested the effects of the following 3 scenarios on the number of surgical cancellations: scheduling surgeons’ operating days based on their patients’ average length of stay in hospital, sequencing surgical procedures by average duration and variance, and increasing the number of post-surgical ward beds. Results The number of elective cancellations was reduced by scheduling surgeons whose patients had shorter average lengths of stay in hospital earlier in the week, sequencing shorter surgeries and those with less variance in duration earlier in the day, and by adding up to 2 additional beds to the postsurgical ward. Conclusion Discrete event simulation modelling can be used to develop strategies for improving efficiency in operating rooms.
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ISSN:0008-428X
1488-2310
DOI:10.1503/cjs.018411