Proactive Evaluation of an Operating Room Prototype: A Simulation-Based Modeling Approach
Proactive Evaluation of an Operating Room Prototype: A Simulation-Based Modeling Approach
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DOI：
10.1097/pts.0000000000000693
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发表时间：
2021-12-01
影响因子：
2.2
通讯作者：
Reeves, Scott T.
中科院分区：
文献类型：
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作者：
Taaffe, Kevin;Joseph, Anjali;Reeves, Scott T.
目的提高手术室（OR）的安全性和效率是一个迫切的需求。术后不良事件，如手术部位感染和手术流程中断，在工业化国家发生率很高，其中相当一部分此类并发症导致死亡。这项研究的目的是确定一个理想的会议室设计，利用风险和安全业绩措施改善工作人员的流动。方法采用计算机仿真模型分析手术室内的交通流，比较手术室的设计。研究分两个阶段进行。首先基于从实际外科手术的23个视频观察中获得的手术流数据创建历史数据集。然后开发了一个详细的基于模拟的模型。结果随着房间面积的增加，工作人员有更多的可用空间在房间里移动，导致更多的距离行走，但大大减少了不良接触。最好将循环护士工作站设置在手术台底部，并采用倾斜手术台方向，因为这样可以为工作人员在手术室内移动提供更多空间，而不会增加接触次数。此外，当护士工作站靠近墙壁时，工作人员经历较少的不期望接触。结论仿真模型被用来评估的影响，或布局的替代方案上的三个性能指标，和中型或原型表现良好的指标。未来的研究将考虑几个因素对基于交通的安全和效率性能指标的相对影响，从而产生更具预测性的仿真设计模型。
Objectives There is a pressing need to improve safety and efficiency in the operating room (OR). Postsurgical adverse events, such as surgical site infections and surgical flow disruption, occur at a significant rate in industrial countries where a considerable portion of such complications result in death. The aim of the study was to identify an ideal room design that improves the flow of staff members using risk and safety performance measures. Methods Operating room designs were compared by using computer simulation modeling to analyze traffic flow inside an OR. The study was conducted in two phases. A historical data set was first created based on surgical flow data obtained from 23 video observations of actual surgical procedures. A detailed simulation-based model was then developed. Results As room size increases, staff members have more available space to maneuver in the room, resulting in more distance walked but far fewer undesirable contacts. An angled table orientation is preferred with the circulating nurse workstation at the foot of the OR table, as it provides more space for staff to move across the room without increasing the number of contacts. Furthermore, when the nurse workstation is near the wall, staff members experience fewer undesirable contacts. Conclusions Simulation modeling was used to assess the impact of OR layout alternatives on three performance metrics, and the medium-sized OR prototype performs well across the metrics. Future research will consider the relative influence of several factors on traffic-based safety and efficiency performance metrics, resulting in a more predictive simulation design model.