Analyze Resource Allocation in the Perioperative Process
As part of the Ontario Wait Times Initiative chaired by Dr. Alan Hudson, the expert panel on “Surgical Process Analysis and Improvement” chaired by Valerie Zellermeyer, released their recommendations in June 2005 stating the need for simulation systems to improve surgical efficiencies and move from scheduling based on “reacting to events” to a proactive model that can accommodate emergencies. This would not only reduce costs but also reduce the wait times for non-critical surgery, a key social issue.
In response to the panel report, an investigation into the entire perioperative process was launched; from decision to operate, when the patient joins the waiting list; to when the patient leaves the recovery area by either discharge or admission into another part of the hospital.
- How many additional resources are required to accommodate an increase in cardiac surgeries next year?
- What happens to cancellation rates if one more ICU bed is added?
- Is there enough surgical equipment sets to support the OR schedule?
The resulting simulation would be accompanied by the ideal data sets required for its successful implementation. These lists would help hospital administrators and health ministries to determine what types of data should be specifically collected for future, in-depth analysis of patient flow throughout hospitals and other healthcare facilities.
The overarching goal of the project is to develop a tool to aid in making knowledgeable and effective strategic decisions to improve patient care and access to surgical services.
A prototype Perioperative Decision Support System was developed, which will later be generalized to apply to all Ontario hospitals, for any type of operating room.
The Perioperative Decision Support System includes the operating rooms of a hospital, as well as all of the processes and procedures that support the OR. It can be used as a tactical tool to evaluate OR procedures in hospitals across Ontario in support of the provincial and national wait time initiatives.
Types of analysis supported by the Perioperative Decision Support System include:
- Shift times and staffing
- Procedures surrounding the minimum number of different operation types required each day
- Required numbers of beds in the PACU and ICU
- Allocation of surgical slots to surgeons in different disciplines
Plans have been made to generalize the model so that it can be commercialized and deployed to hospitals across the province of Ontario. Although the model will assume the data sources and organizational structures that are common in Ontario, it is anticipated that the final model will be adaptable to most other jurisdictions as well.