SHS2013 poster presentations supported
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Below is a simple simulation of the common malady consisting of surgeons who are late for their first case. It’s a good example for other healthcare management engineering problems in that there are many solutions, each with their benefits and drawbacks. There’s a balance among difficulty of initial capital investment, implementation, training, and ongoing cost.
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Habitually late surgeons are either unaware of the effects of their tardiness on everyone else…or they don’t care. If unaware, then the following graphs will help clarify the problem. If they don’t care … the solution will be more difficult, but the graphs will help direct other surgeons’ ire to the appropriate cause (the late surgeon and not the OR staff).
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The solution to the congestion in the Pre-Op area can be a combination of any of any of the following: architectural, early starts, late starts, anesthesia technique, nursing algorithm for patient retrieval, surgeon policy for late start time with enforcement provisions, OR scheduling portfolios, sequencing of parts of the surgical process. Every PreOP solution has an effect on the OR and PACU.
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Use the vertical pastels bars (each is 60 minutes wide) to help compare the two graphs.
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Without 2 surgeons’ delays <click on graphs to enlarge>
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With 2 surgeons’ delays
The only changes from the first graph to the second graph are the effects of Surgeons Smith and Green being late 70 minutes and 40 minutes to start their 7am cases. Notice the repercussions for other surgeons, the OR crew and PACU overtime, and (not visualized) anesthesia.
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An increasing case load, or a greater proportion of short cases, will make the problem worse.
ORTimes 