Impact of surgical sequencing on post anesthesia care unit staffing

被引：91

作者：

Marcon E. ^{[1
,2
,3
]}

Dexter F. ^{[4
,5
]}

机构：

[1] Laboratory of Signal and Manufacturing Systems Analysis, Jean Monnet University of Saint Etienne

[2] Department Manufacturing System Management and Maintenance, Jean Monnet University of Saint Etienne

[3] LASPI - IUT de Roanne, City, Roanne, 42334 Cedex

[4] Division of Management Consulting, University of Iowa, Iowa City, IA

[5] Departments of Anesthesia and Health Management and Policy, University of Iowa, Iowa City, IA

来源：

Health Care Management Science | 2006年 / 9卷 / 1期

关键词：

Economics; Operating Room and PACU; Optimization; Schedule; Staffing;

D O I：

10.1007/s10729-006-6282-x

中图分类号：

学科分类号：

摘要：

This paper analyzes the impact of sequencing rules on the phase I post anesthesia care unit (PACU) staffing and over-utilized operating room (OR) time resulting from delays in PACU admission. The sequencing rules are applied to each surgeon's list of cases independently. Discrete event simulation shows the importance of having a sufficient number of PACU nurses. Sequencing rules have a large impact on the maximum number of patients receiving care in the PACU (i.e., peak of activity). Seven sequencing rules are tested, over a wide range of scenarios. The largest effect of sequencing was on the percentage of days with at least one delay in PACU admission. The best rules are those that smooth the flow of patients entering in the PACU (HIHD (Half Increase in OR time and Half Decrease in OR time) and MIX (MIX OR time)). We advise against using the LCF (Longest Cases First) and equivalent sequencing methods. They generate more over-utilized OR time, require more PACU nurses during the workday, and result in more days with at least one delay in PACU admission. © Springer Science + Business Media, Inc. 2006.

引用

页码：87 / 98

页数：11

共 33 条

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[2]

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[3]

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[4]

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[8]

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[10]

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