Abstract
Operating Room (OR) managers frequently encounter uncertainties related to real-time scheduling, especially on the day of surgery. It is necessary to enable earlier identification of uncertainties occurring in the perioperative environment. This study aims to propose a framework for resilient surgical scheduling by identifying uncertainty factors affecting the real-time surgical scheduling through a mixed-methods study. We collected the pre- and post-surgical scheduling data for twenty days and a one-day observation data in a top-tier general university hospital in South Korea. Data were compared and analyzed for any changes related to the dimensions of uncertainty. The observations in situ of surgical scheduling were performed to confirm our findings from the quantitative data. Analysis was divided into two phases of fundamental uncertainties categorization (conceptual, technical and personal) and uncertainties leveling for effective decision-making strategies. Pre- and post-surgical scheduling data analysis showed that unconfirmed patient medical conditions and emergency cases are the main causes of frequent same-day surgery schedule changes, with derived factors that affect the scheduling pattern (time of surgery, overtime surgery, surgical procedure changes and surgery duration). The observation revealed how the OR manager controlled the unexpected events to prevent overtime surgeries. In conclusion, integrating resilience approach to identifying uncertainties and managing event changes can minimize potential risks that may compromise the surgical personnel and patients’ safety, thereby promoting higher resilience in the current system. Furthermore, this strategy may improve coordination among personnel and increase surgical scheduling efficiency.
Highlights
Surgical scheduling has always been a challenge, especially when the operating room (OR)manager must perform same-day schedule changes
Even though all schedules are planned through Order Communication System (OCS), OR manager uses the printed schedule for practicality to manage the schedule updated in real-time
Uncertainties or unexpected events inevitably occur in an high-reliability organization (HRO) such as a hospital, especially the surgery department and OR manager behavior was considered as one of factors that determine the success of surgical scheduling management system
Summary
The difficulties with same-day surgical scheduling are commonly related to many factors, including possible delays or cancellations and resources availability [2,3,4,5,6]. Causes of same-day surgery cancellations were classified as either avoidable or unavoidable and subsequently subclassified as medical, facilities or patient-related cancellations [5,6,7,8,9]. These circumstances are often unanticipated and cause uncertainties. Public Health 2020, 17, 3511; doi:10.3390/ijerph17103511 www.mdpi.com/journal/ijerph
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: International journal of environmental research and public health
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
