Computer-aided optimization of operation planning

Introduction  The Corona pandemic has made us particularly aware of how much clinical performance is limited by resource constraints. This is also true for the OR planning of an ENT clinic, which is mostly performed with the expert knowledge of experienced staff. So far, there are only a few approaches to optimize this planning task with computer support.

Material and Methods  The most frequent procedures of the ENT clinic from the year 2019 were clustered into 20 procedure groups according to operation duration, inpatient length of stay and E1 revenue. A tool was implemented in Microsoft Excel​ to simulate real-world surgery scheduling based on the procedure groups. This information was used to determine the daily utilization of bed capacity and the expected revenue development.

Result The OR utilization at regular working hours was 99.8%. The bed demand is subject to weekly fluctuations with an occupancy maximum from Wednesday to Friday with up to 12.1% overcrowding and an occupancy minimum on Sunday evening. Comparison with 1000 randomly generated alternative scenarios showed that improved utilization of available bed capacity would have been possible 11.6% of the time.

Conclusion  Even if the computer-aided simulation of ward occupancy and OR utilization greatly simplifies the real clinical process, the effects known from everyday life, such as the weekly occupancy fluctuations and the emergency volume, can be simulated well. By changing the initial parameters, the effects of an additional operating room or variable bed capacities can also be investigated. It remains to be clarified whether and how optimized surgical planning can also find prospective clinical implementation.

Publication History

Article published online:
12 May 2023