Addressing the variation of post-surgical inpatient census with computer simulation
| Autor: | Albert Chi, Ashley J. Zahm, Matthew Harris Rutberg, Victoria M. Otarola, Caroline A. Pasquariello, Theodore Eugene Day, Jeffrey M. Feldman |
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| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
Post surgical Pediatrics System capacity Pediatric surgery medicine Humans Computer Simulation Discrete event simulation Baseline (configuration management) Child Inpatients Models Statistical business.industry Censuses General Medicine Perioperative Census medicine.disease Simulated data Surgical Procedures Operative Pediatrics Perinatology and Child Health Emergency medicine Surgery Medical emergency business Surgery Department Hospital |
| Zdroj: | Pediatric surgery international. 30(4) |
| ISSN: | 1437-9813 |
| Popis: | This study describes the development of a Discrete Event Simulation (DES) of a large pediatric perioperative department, and its use to compare the effectiveness of increasing the number of post-surgical inpatient beds vs. implementing a new discharge strategy on the proportion of patients admitted to the surgical unit to recover. A DES of the system was developed and simulated data were compared with 1 year of inpatient data to establish baseline validity. Ten years of simulated data generated by the baseline simulation (control) was compared to 10 years of simulated data generated by the simulation for the experimental scenarios. Outcome and validation measures include percentage of patients recovering in post-surgical beds vs. “off floor” in medical beds, and daily census of inpatient volumes. The proportion of patients admitted to the surgical inpatient unit rose from 79.0 % (95 % CI, 77.9–80.1 %) to 89.4 % (95 % CI, 88.7–90.0 %) in the discharge strategy scenario, and to 94.2 % (95 % CI, 93.5–95.0 %) in the additional bed scenario. The daily mean number of patients admitted to medical beds fell from 9.3 ± 5.9 (mean ± SD) to 4.9 ± 4.5 in the discharge scenario, and to 2.4 ± 3.2 in the additional bed scenario. Every hospital is tasked with placing the right patient in the right bed at the right time. Appropriately validated DES models can provide important insight into system dynamics. No significant variation was found between the baseline simulation and real-world data. This allows us to draw conclusions about the ramifications of changes to system capacity or discharge policy, thus meeting desired system performance measures. |
| Databáze: | OpenAIRE |
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