Balancing Workload in the PACU by Using an Integrated OR Planning Methodology

Abstract

PurposeThe individual scheduling of the operating rooms (ORs) has a significant influence on postoperative care at hospital facilities. We studied the effect of incorporating postoperative departments in the decision process with regard to scheduling ORs and developed an integrated OR planning methodology that determines an optimal surgery sequence and postanesthesia care unit (PACU) nursing staff level, with the objective to level the variability in inflow of patients in the PACU. DesignWe developed an integrated OR planning methodology that investigates the sequencing of a surgical suite process with multiple ORs and postoperative hospital facilities. MethodsThis research was performed by representing a discrete-time two-stage flow shop problem. A retrospective study was performed in which the derived model was validated using discrete-event simulation. FindingsSimulation results show that applying the integrated planning methodology decreased the variability in bed demand and smoothed the workload for the nursing staff in the PACU. Moreover, applying the algorithm led to a decrease in PACU completion time and a reduced amount of overtime hours for the surgical suite. Based on our results, we derived simple scheduling guidelines. ConclusionsOur simulation results confirmed the hypothesis that prospectively sequencing ORs' cases can effectively decrease the variability in bed demand and smoothen the workload for the staff personnel. Moreover, applying the algorithm leads to a decrease in PACU completion time and less overtime hours for the surgical suite. As such, an integrated OR planning methodology facilitates hospitals in improving OR efficiency.