Analysis of patient flows in elective surgery: modelling and optimisation of the hospitalisation process
by Dario Antonelli; Giulia Bruno; Teresa Taurino
International Journal of Services and Operations Management (IJSOM), Vol. 31, No. 4, 2018

Abstract: Rationalising costs while guaranteeing a good quality of service is a challenge that healthcare systems are currently facing. In elective surgery departments, as operations can be scheduled in advance, the goal is usually to maximise the utilisation index of the operating theatre. Nevertheless, the optimisation of a single stage of the process is pointless without an efficient management of the entire routing from income to dismissal. The paper presents discrete events simulation of the actual patient flows in elective surgery exploiting the recovery logs of a hospital department. A UML activity diagram of the surgery process together with the collected hospital data have been used to build a stochastic model of queuing network, identify its parameters and conduct different simulated experiments in order to select the solution that best optimises the performances of the system. The simulation results have shown that there is a large variation in waiting times in correspondence to small variations of the average value of the inter-arrival times. Therefore, solutions that optimise utilisation indexes of both beds and operating theatres should consider a concurrent effort to reduce the variance of admittance processes, otherwise the waiting times will lengthen beyond acceptable limits.

Online publication date: Thu, 15-Nov-2018

The full text of this article is only available to individual subscribers or to users at subscribing institutions.

 
Existing subscribers:
Go to Inderscience Online Journals to access the Full Text of this article.

Pay per view:
If you are not a subscriber and you just want to read the full contents of this article, buy online access here.

Complimentary Subscribers, Editors or Members of the Editorial Board of the International Journal of Services and Operations Management (IJSOM):
Login with your Inderscience username and password:

Username:        Password:          Forgotten your password?

Want to subscribe?
A subscription gives you complete access to all articles in the current issue, as well as to all articles in the previous three years (where applicable). See our Orders page to subscribe.

If you still need assistance, please email subs@inderscience.com