Abstract
The reduction of waiting lists and length of stay in hospitals, together with an efficient utilization of system capacity is the challenge facing healthcare systems today. In an elective surgery department, as operations can be scheduled in advance, this goal is generally achieved by maximizing the utilization index of the operation theatres. Nevertheless, operations are only one of the many activities performed during patient flow inside hospital and these activities interact with each other. The optimization of any single stage of the process is pointless without an efficient management of the entire routing from admission to dismissal. The paper presents a thorough analysis of the patient flow in an elective surgery ward using data gathered in a large hospital in Italy. Data, derived from log files and questionnaires, together with solutions proposed by healthcare managers, are considered. A model is then built and validated, its parameters are defined, and a variety of experiments are simulated in order to select the solution that improves the performance of the system. The solutions are discussed and refined in the light of corresponding production management approaches.
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References
Culyer, J.G., Cullis, J.G.: Some economics of hospital waiting lists in the NHS. J. Soc. Policy 5(3), 239–64 (1976)
Antonelli, D., Bellomo, D., Bruno, G., Villa, A.: Evaluating collaboration effectiveness of patient-to-doctor interaction in a healthcare territorial network. In: PRO-VE 2012: Collaborative Networks in the Internet of Services, pp. 128–136. ISBN 9783642327742 (2012)
Young, T., Brailsford, S., Connell, C., Davies, R., Harper, P., Klein, J.H.: Using industrial processes to improve patient care. Br. Med. J. (BMJ) 328, 162–164 (2004)
Antonelli, D., Taurino, T.: Application of a patient flow model to a surgery department. In: 2010 IEEE Workshop on Health Care Management, Venezia, 18–20 Febbraio 2010
Gupta, D., Denton, B.: Appointment scheduling in health care: challenges and opportunities. IIE Trans. 40(9), 800–819 (2008)
Qi, E., Xu, G., Huo, Y., Xu, X.: Study of hospital management based on hospitalization process improvement. Proc. IEEE IEEM 74–78 (2006)
Akkerman, R., Knip, M.: Reallocation of beds to reduce waiting time for cardiac surgery. Health Care Manag. Sci. 7, 119–126 (2004)
Vissers, J.: Patient flow-based allocation of inpatient resources: a case study. Eur. J. Oper. Res. 105, 356–370 (1998). Elsevier Science
Xiong, H.H., Zhou, M.C., Manikopoulos, C.N.: Modeling and performance analysis of medical services systems Using Petri Nets. In: Proceedings of the IEEE International Conference on Systems, Man and Cybernetics, pp. 2339–2342 (1994)
Davies, R., Davies, H.T.O.: Modeling patient flows and resource provision in health systems. Omega Int. J. Manag. Sci. 22, 123–131 (1994)
Koo, P.-H., Jang, J., Ielsen, K.B., Kolker, A.: Simulation-based patient flow analysis in an endoscopy unit, Health Care Management (WHCM). In: 2010 Institute of Electrical and Electronics Engineers (IEEE) Workshop on, pp.1–6, 18–20 Feb 2010
American Society of Mechanical Engineers: ASME Standard Operation and Flow Process Charts. New York (1947)
Kelton, W.D., et~al.: Simulation with Arena. McGraw-Hill Professional, New York, NT, US (2006)
Smirnov, N.S.: Tables for estimating the goodness of fit of empirical distributions. Ann. Math. Stat. 19, 279 (1948)
Acknowledgements
The authors would like to thank Prof. Baudolino Mussa (University of Torino Medical School, Italy) for his support and fruitful hints.
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Antonelli, D., Bruno, G., Taurino, T. (2014). Simulation-Based Analysis of Patient Flow in Elective Surgery. In: Matta, A., Li, J., Sahin, E., Lanzarone, E., Fowler, J. (eds) Proceedings of the International Conference on Health Care Systems Engineering. Springer Proceedings in Mathematics & Statistics, vol 61. Springer, Cham. https://doi.org/10.1007/978-3-319-01848-5_7
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DOI: https://doi.org/10.1007/978-3-319-01848-5_7
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