1. The Use of Simulation to Determine Maximum Capacity in the Surgical Suite Operating Room Sarah M. Ballard Michael E. Kuhl Industrial and Systems Engineering Department Rochester Institute of Technology Rochester N.Y., 14623, USA Presented by: Mike Reed, Midwestern State University

2. Rising Health Care Costs Growing concern for health care costs Basic health care unaffordable for many people/businesses 45 million under 65 uninsured

3. Whats Causing This? From 1950-2000, population over 75 rose 3-6% By 2050, over 12% be over 75 Elderly require more services, and more expensive

4. Whats Causing This? Increasing equipment costs Shortage of Qualified Health Care Professionals Growing Demand

5. Overloaded Surgical Suites If Caseload is greater than capacity, lower patient satisfaction Increased waiting times Surgeons / Nurses become physically/mentally exhausted Hospital incurs cost of overtime Lack of quantifiable data of what impact of adding new surgical procedures and surgical suite capacity

6. Ultimate Goal Care for largest number of patients while maintaining highest standards of patient satisfaction

7. What needs to be done? In order to make healthcare affordable, must make efficient use of resources Determining capacity is the first step

8. What needs to be done? So, create a simulation model that can be used to determine current efficiency of surgical suite, potential maximum of suite, and how changing resources or adding surgical procedures affects surgical suite performance

10. Simulation Details Used Arena Based on one hospital, generalized so others can just input data –Percentage receiving certain type of surgery –Up to 10 surgeries in category, with how long they take –What percentage receive each surgery type –Inpatient/Outpatient –Time to administer Anesthesia

11. Simulation Details Additional Resources –Nurses –OR teams –Preparation rooms Fortunately, hospitals keep great records useful in determining averages

12. Simulation Details Additional Time Users –Room cleaning –Pre-Operative Interviews –Paperwork. Lots of it. –Restocking equipment –OR preparation

13. Performance Measures Number of each patient type seen Patient time in system Utilization in operating rooms, OR teams, and Nurses, as well as any other potentially constraining resources

14. Verification/Validation Model verified by hospital administrator Based mostly on detailed records. Two months worth were used Five days were simulated 100 times. No significant difference between actual data over simulated data.

15. Administration was underestimating OR utilization by 15%, as it only considered actual procedure time (Some) Results

16. CONCLUSION This new simulation model accurately determines current an maximum capacity far better than older models Old systems tended to overestimate how many patients could be seen Still not in its final state, still being improved

17. Questions? Hmmmm?