Simulation-Based Analysis of Patient Flow in Elective Surgery

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.