Obstetric operating room staffing and operating efficiency using queueing theory

Area of Science:

• Healthcare Operations Research
• Maternal Health Services
• Biostatistics

Background:

• Optimizing operating room (OR) efficiency in birth centers presents challenges due to emergencies and competing priorities.
• This study applied Queuing Theory Analysis (QTA) to address these challenges by identifying optimal OR and staffing resources.
• Real-world data from a Level 4 Maternity Center was utilized to inform the analysis.

Purpose of the Study:

• To determine optimal operating room (OR) and staffing allocations for birth centers using Queuing Theory Analysis (QTA).
• To identify benchmarks for efficient and safe perioperative care in maternity settings.
• To assess the feasibility of QTA in guiding resource management for varying maternity center volumes.

Main Methods:

• Queuing Theory Analysis (QTA) was employed, utilizing Mean Arrival Rate (λ) and Mean Service Rate (µ) variables.
• Multiphase multichannel analysis was performed on data from a Level 4 Maternity Center (July 2019-June 2020).
• Safety parameters, including decision-to-incision times and nil per os duration, were incorporated to ensure patient safety.

Main Results:

• Analysis revealed peak hour arrival rates (λ) of 0.45 patients/hour and a service rate (µ) of 0.87 patients/hour per OR team.
• With 3 OR teams during peak hours, the probability of 2 or more patients in the system (P≥2) was 0.07.
• The probability of no patients in the system (P0) was 0.61 over 24 hours and 0.48 during peak hours.

Conclusions:

• Queuing Theory Analysis (QTA) is an effective tool for enhancing birth center OR efficiency while maintaining safety standards.
• QTA provides a feasible framework for guiding staffing and space requirements in maternity centers of all sizes.
• The findings support the use of QTA for informed, hospital-level decision-making to achieve safe and efficient maternity perioperative care.