Discrete-event models for the simulation of computed tomography sectors according to hospital structural/organizational changes and expected patient arrival rates.

Abstract

To analyze the types of computed tomography (CT) scanners most suitable for different hospital sizes and 'scenarios' (exam rates and structural/organizational changes), using discrete-event simulation models. CT exams were divided into stages, measured during on-site surveys at CT services in small and average size private hospitals. Ten devices in nine health units, five cities and two states of Brazil were studied to this end, and the following data were collected: Time spent in each stage for each type of exam; average monthly number of exams performed and general characteristics of exams. Three arrival rates were defined (103, 154 and 206 patients/day), representing expected demand for the studied units. From these parameters, six scenarios were simulated, consisting of changes in personnel and hospital structure (e.g., 'adding a changing room') in a base scenario (one CT, one changing room, no nursing assistance, arrival rate 1). It was possible to identify a scenario most useful for very large demands, such as large emergency hospitals in big cities, (a CT, nursing assistance and three changing rooms added to the base scenario). Another identified scenario was more adequate for small demands (adding a changing room to the base scenario). Administrative/organizational measures are a very important factor in defining productivity in a hospital imaging sector. The focus of these measures should be on detecting bottlenecks and improving processes, regardless of the type of equipment used.