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.
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Veatch RM (1976) What is a ‘just’ health care delivery? In Veatch R, Branson R (eds) Ethics and health policy. Ballinger, Cambridge, MA.
Gross M (2004) Wait times; The appropriateness of the methodology and how they affect patients. Can J Surg 47(3):167–169
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
Pitt F, Noseworthy TW, Guilbert J, Williams J (2003) Waiting lists: management, legalities and ethics. Can J Surg 46(3):170–175
HCFS 2004, Waiting times. Available: http://www.hcsc.gc.ca/english/media/releases/2004/fmm09.htm (accessed on 4/5/2005).
Dalgensurg, 2006. About us Available: http://www.dalgensurg.ca/about_us.htm. (accessed on 10/02/2006)
Harper PR, Shahani AK (2002) Modelling for the planning and management of bed capacities in hospitals. J Oper Res Soc 53(1):11–18
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.
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
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
Harper P (2002) A framework for operational modelling of hospital resources. Health Care Manage Sci 5(3):165–173
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
Preater J (2002) Queues in health. Health Care Manage Sci 5(4):283
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
Worthington D (1987) Queueing models for hospital waiting lists. J Oper Res Soc 38(5):413–422
Worthington D (1991) Hospital waiting list management models. J Oper Res Soc 42(10):833–843
Harper PR, Gamlin HM (2003) Reduced outpatient waiting times with improved appointment scheduling: a simulation modelling approach. OR Spectrum 25:207–222
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
Wujciak T, Opelz G (1993) Computer analysis of cadaver kidney allocation procedures. Transplantation 55(3):516–521
Davies H, Davies R (1987) A simulation model for planning services for renal patients in Europe. J Oper Res Soc 38(8):693–700
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
Bowers J, Mould G (2004) Managing uncertainty in orthopaedic trauma theatres. Eur J Oper Res 154(3):599–608
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
Vasilakis C, El-Darzi E (2001) A simulation study of the winter bed crisis. Health Care Manage Sci 1(2):143–149
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
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)
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
Tuft S, Gallivan S (2001) Computer modelling of a cataract waiting list. Br J Ophthalmol 85(5):582–585
Davies R (1994) Simulation for planning services for patients with coronary artery disease. Eur J Oper Res 72(2):323–332
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
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
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
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
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
Blake JT (2005) Shooting arrows in the dark: the policies and practices of waitlist management in Canada. Clin Invest Med 28(6):308
CDHA 2005. Update of Anesthesia Recruitment and OR Schedules. Available: http://www.cdha.nshealth.ca/newsroom/NewsItems/NewsDetail.cfm (accessed on 11/12/2005)
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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
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DOI: https://doi.org/10.1007/s10729-007-9035-6