POST-COVID ORTHOPAEDIC ELECTIVE RESOURCE PLANNING USING SIMULATION MODELLING
POST-COVID ORTHOPAEDIC ELECTIVE RESOURCE PLANNING USING SIMULATION MODELLING
复制标题
使用模拟建模进行新冠疫情后骨科选择性资源规划
DOI：
10.1101/2023.05.31.23290774
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Harper A
中科院分区：
文献类型：
--
作者：
Harper A
ObjectivesTo开发一个模拟模型，以支持骨科选修能力planning.MethodsAn开源，generalisable离散事件模拟开发，包括基于网络的应用程序。该模型使用了2016年至2019年期间来自英国NHS信托的择期骨科手术的匿名患者记录。在本文中，它是用来调查的情况下，包括资源（病床和剧院）和生产力（住院时间，延迟出院，剧院活动），以支持规划，以满足新的NHS目标，旨在减少择期骨科手术积压在拟议的环围骨科手术设施。模拟是互动的，并打算使用卫生服务规划师和clinics.ResultsA更高的床位数（65-70）比建议的数量（40张）将需要如果长度的停留和延迟出院率保持不变。根据国家基准缩短住院时间，将床位利用率降低到约60%，从而允许额外的剧院活动，如周末工作。此外，将延迟出院的患者比例降低75%，使床位利用率降至40%以下，即使周末工作也是如此。一系列的其他情况下也可以直接调查NHS规划人员使用的交互式web application.ConclusionsThe模拟模型的目的是支持能力规划的骨科选修服务，通过确定一个平衡的能力，跨剧院和病床，并预测生产力措施的影响能力要求。本研究的优势和局限性模拟模型提供了快速的定量估计，以支持COVID后的选修服务恢复到中期选修目标。参数组合包括资源和生产力的变化。交互式Web应用程序使用户能够直观地更改参数，而底层源代码可以调整或重新配置。用于类似的应用。患者属性，如复杂性不包括在模型中，但反映在变量，如住院时间和延迟出院率。剧院时间表被简化，纳入五个关键的骨科择期手术程序。
ObjectivesTo develop a simulation model to support orthopaedic elective capacity planning.MethodsAn open-source, generalisable discrete-event simulation was developed, including a web-based application. The model used anonymised patient records between 2016-2019 of elective orthopaedic procedures from an NHS Trust in England. In this paper, it is used to investigate scenarios including resourcing (beds and theatres) and productivity (lengths-of-stay, delayed discharges, theatre activity) to support planning for meeting new NHS targets aimed at reducing elective orthopaedic surgical backlogs in a proposed ring fenced orthopaedic surgical facility. The simulation is interactive and intended for use by health service planners and clinicians.ResultsA higher number of beds (65-70) than the proposed number (40 beds) will be required if lengths-of-stay and delayed discharge rates remain unchanged. Reducing lengths-of-stay in line with national benchmarks reduces bed utilisation to an estimated 60%, allowing for additional theatre activity such as weekend working. Further, reducing the proportion of patients with a delayed discharge by 75% reduces bed utilisation to below 40%, even with weekend working. A range of other scenarios can also be investigated directly by NHS planners using the interactive web app.ConclusionsThe simulation model is intended to support capacity planning of orthopaedic elective services by identifying a balance of capacity across theatres and beds and predicting the impact of productivity measures on capacity requirements. It is applicable beyond the study site and can be adapted for other specialties.Strengths and Limitations of this studyThe simulation model provides rapid quantitative estimates to support post-COVID elective services recovery toward medium-term elective targets.Parameter combinations include changes to both resourcing and productivity.The interactive web app enables intuitive parameter changes by users while underlying source code can be adapted or re-used for similar applications.Patient attributes such as complexity are not included in the model but are reflected in variables such as length-of-stay and delayed discharge rates.Theatre schedules are simplified, incorporating the five key orthopaedic elective surgical procedures.
影响因子：
2.9
作者：
Sayers, Adrian;Steele, Fiona;Blom, Ashley W.
通讯作者：
Blom, Ashley W.