[Simulation of waiting time and effectiveness in hospitals]

Area of Science:

• Health Services Research
• Operations Research in Healthcare

Background:

• Norwegian hospitals frequently cancel elective surgeries due to acute cases.
• Ring fencing elective surgery is a proposed solution to manage capacity.
• This study evaluates the pros and cons of ring fencing using a simulation model.

Purpose of the Study:

• To analyze the advantages and disadvantages of ring fencing elective surgery.
• To compare the outcomes of combined versus separate acute and elective surgical departments.
• To assess the impact of different organizational models on hospital efficiency and patient waiting times.

Main Methods:

• Simulation modeling was conducted using the Powersim Constructor 2.5 software.
• The model evaluated scenarios with combined and separate acute and elective surgical departments.
• Key performance indicators such as waiting time, overtime, and capacity utilization were analyzed.

Main Results:

• Combined departments showed shorter waiting times and less overtime due to flexible capacity use and higher utilization.
• Separate departments may enhance efficiency within the elective surgery unit, potentially reducing waiting times.
• Elective patients in combined departments face cancellation risks but benefit from potentially shorter overall waiting periods.

Conclusions:

• Ring fencing alone is not beneficial and can decrease total capacity utilization.
• Separate departments for elective surgery might improve departmental efficiency and shorten waiting lists.
• Optimizing capacity utilization and managing patient flow are critical for improving surgical scheduling.