Balancing operating theatre and bed capacity in a cardiothoracic centre

Cardiothoracic surgery requires many expensive resources. This paper examines the balance between operating theatres and beds in a specialist facility providing elective heart and lung surgery. Without both operating theatre time and an Intensive Care bed a patient's surgery has to be postponed. While admissions can be managed, there are significant stochastic features, notably the cancellation of theatre procedures and patients' length of stay on the Intensive Care Unit. A simulation was developed, with clinical and management staff, to explore the interdependencies of resource availabilities and the daily demand. The model was used to examine options for expanding the capacity of the whole facility. Ideally the bed and theatre capacity should be well balanced but unmatched increases in either resource can still be beneficial. The study provides an example of a capacity planning problem in which there is uncertainty in the demand for two symbiotic resources.