Skip to main content
Log in

A comprehensive simulation for wait time reduction and capacity planning applied in general surgery

  • Published:
Health Care Management Science Aims and scope Submit manuscript

Abstract

This paper describes the use of operational research techniques to analyze the wait list for the Division of General Surgery at the Capital District Health Authority in Halifax, Nova Scotia, Canada. A discrete event simulation model was developed to aid capacity planning decisions and to analyze the performance of the division. The analysis examined the consequences of redistributing beds between sites, and achieving standard patient lengths of stay, while contrasting them to current and additional resource options. From the results, multiple independent and combined options for stabilizing and decreasing waits for elective procedures were proposed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Veatch RM (1976) What is a ‘just’ health care delivery? In Veatch R, Branson R (eds) Ethics and health policy. Ballinger, Cambridge, MA.

    Google Scholar 

  2. Gross M (2004) Wait times; The appropriateness of the methodology and how they affect patients. Can J Surg 47(3):167–169

    Google Scholar 

  3. Blake JT, VanBerkel P, Dunbar MJ, Malloy L, Hennigar A (2004) Waiting list management at capital district health authority. Proceedings of the 30th Meeting of the European Working Group on Operational Research applied to Health Services Edited by M. Lagergren. Stockholm, Sweden: ORAHS, 2004

  4. Pitt F, Noseworthy TW, Guilbert J, Williams J (2003) Waiting lists: management, legalities and ethics. Can J Surg 46(3):170–175

    Google Scholar 

  5. HCFS 2004, Waiting times. Available: http://www.hcsc.gc.ca/english/media/releases/2004/fmm09.htm (accessed on 4/5/2005).

  6. Dalgensurg, 2006. About us Available: http://www.dalgensurg.ca/about_us.htm. (accessed on 10/02/2006)

  7. Harper PR, Shahani AK (2002) Modelling for the planning and management of bed capacities in hospitals. J Oper Res Soc 53(1):11–18

    Article  Google Scholar 

  8. Lowery JC (1998) Getting started in simulation in health care. Proceedings of the 1998 Winter Simulation Conference. In DJ Medeiros, EF Watson, JS Carson and MS Manivannan. Association for Computing Machinery, New York.

    Google Scholar 

  9. Everett JE (2002) A decision support simulation model for the management of an elective surgery waiting system. Health Care Manage Sci 5(2):89–95

    Article  Google Scholar 

  10. Lagergren M (1998) What is the contribution of models to management and research in the health services? A view from Europe. Eur J Oper Res 105(2):257–266

    Article  Google Scholar 

  11. Harper P (2002) A framework for operational modelling of hospital resources. Health Care Manage Sci 5(3):165–173

    Article  Google Scholar 

  12. De Angelis V, Felici G, Impelluso P (2003) Integrating simulation and optimization in health care centre management. Eur J Oper Res 150(1):101–114

    Article  Google Scholar 

  13. Preater J (2002) Queues in health. Health Care Manage Sci 5(4):283

    Article  Google Scholar 

  14. England W, Roberts SD (1978) Applications of computer simulation in health care. In Hull LG, Nielsen, NR (eds) Proceedings of the 10th conference on Winter simulation. IEEE Computer Society, Los Alamitos, CA

    Google Scholar 

  15. Worthington D (1987) Queueing models for hospital waiting lists. J Oper Res Soc 38(5):413–422

    Article  Google Scholar 

  16. Worthington D (1991) Hospital waiting list management models. J Oper Res Soc 42(10):833–843

    Article  Google Scholar 

  17. Harper PR, Gamlin HM (2003) Reduced outpatient waiting times with improved appointment scheduling: a simulation modelling approach. OR Spectrum 25:207–222

    Article  Google Scholar 

  18. Ratcliffe J, Young T, Buxton M, Eldabi T, Paul R, Burroughs A, Papatheodoridis G, Rolles K (2001) A simulation modelling approach to evaluating alternative policies for the management of the waiting list for liver transplantation. Health Care Manage Sci 4(2):117–124

    Article  Google Scholar 

  19. Wujciak T, Opelz G (1993) Computer analysis of cadaver kidney allocation procedures. Transplantation 55(3):516–521

    Google Scholar 

  20. Davies H, Davies R (1987) A simulation model for planning services for renal patients in Europe. J Oper Res Soc 38(8):693–700

    Article  Google Scholar 

  21. Blake JT, Carter MW, O’Brien-Pallas LL, McGillis-Hall L (1991) A surgical process management tool. In Greenes R (ed) 8th World Congress on Medical Informatics. International Medical Informatics Association, Vancouver, BC

    Google Scholar 

  22. Bowers J, Mould G (2004) Managing uncertainty in orthopaedic trauma theatres. Eur J Oper Res 154(3):599–608

    Article  Google Scholar 

  23. Dexter F, Traub RD (2002) How to schedule elective surgical cases into specific operating rooms to maximize the efficiency of use of operating room time. Anesth Analg 94(4):933–942

    Article  Google Scholar 

  24. Vasilakis C, El-Darzi E (2001) A simulation study of the winter bed crisis. Health Care Manage Sci 1(2):143–149

    Google Scholar 

  25. MacAulay S, Blake J (2002) A bed planning project at the children’s hospital of eastern Ontario. In Malby N (ed) The 32nd Annual Conference Proceedings of the Atlantic Schools of Business. St. Francis Xavier University, Antigonish, NS

    Google Scholar 

  26. Bagust A, Place M, Posnett, JW (1999) Dynamics of bed use in accommodating emergency admissions: stochastic simulation model. Br Med J 319:155–158, (July 17, 1999)

    Google Scholar 

  27. Vissers JM, Van Der Bij JD, Kusters RJ (2001) Towards decision support for waiting lists: an operations management view. Health Care Manage Sci 4(2):133–142

    Article  Google Scholar 

  28. Tuft S, Gallivan S (2001) Computer modelling of a cataract waiting list. Br J Ophthalmol 85(5):582–585

    Article  Google Scholar 

  29. Davies R (1994) Simulation for planning services for patients with coronary artery disease. Eur J Oper Res 72(2):323–332

    Article  Google Scholar 

  30. Martin E, Grønhaug R, Haugene K (2003) Proposals to reduce over-crowding, lengthy stays and improve patient care: study of the geriatric department in Norway’s largest hospital. In Chick S, Sanchez PJ, Ferrin D, Morrice DJ (eds) Proceedings of the 2003 Winter Simulation Conference. Association for Computing Machinery, New York

    Google Scholar 

  31. Cahill W, Render M (1999) Dynamic simulation modeling of ICU bed availability. In Farrington PA, Nembhard HB, Sturrock DT, Evans GW (eds) Proceedings of the 1999 Winter Simulation Conference. Association for Computing Machinery, New York

    Google Scholar 

  32. Isken M, Ward TJ, McKee TC (1999) Simulating outpatient obstetrical clinics. In Farrington PA, Nembhard HB, Sturrock DT, Evans GW (eds) Proceedings of the 1999 Winter Simulation Conference. Association for Computing Machinery, New York

    Google Scholar 

  33. Iskander WH, Carter DM (1991) A simulation model for a same day care facility at a University Hospital. In Nelson BL, Kelton WD, Clark GM (eds) Proceedings of the 1991 Winter Simulation Conference. Association for Computing Machinery, New York

  34. Pitt M (1997) A generalized simulation system to support strategic resource planning in healthcare. In Andradóttir S, Healy KJ, Withers DH, Nelson BL (eds) Proceedings of the 1997 Winter Simulation Conference. ACM, New York

    Google Scholar 

  35. Blake JT (2005) Shooting arrows in the dark: the policies and practices of waitlist management in Canada. Clin Invest Med 28(6):308

    Google Scholar 

  36. CDHA 2005. Update of Anesthesia Recruitment and OR Schedules. Available: http://www.cdha.nshealth.ca/newsroom/NewsItems/NewsDetail.cfm (accessed on 11/12/2005)

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to John T. Blake.

Rights and permissions

Reprints and permissions

About this article

Cite this article

VanBerkel, P.T., Blake, J.T. A comprehensive simulation for wait time reduction and capacity planning applied in general surgery. Health Care Manage Sci 10, 373–385 (2007). https://doi.org/10.1007/s10729-007-9035-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10729-007-9035-6

Keywords

Navigation