Relying solely on historical surgical times to estimate accurately future surgical times is unlikely to reduce the average length of time cases finish late
Relying solely on historical surgical times to estimate accurately future surgical times is unlikely to reduce the average length of time cases finish late
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DOI：
10.1016/s0952-8180(99)00110-5
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发表时间：
1999-11-01
影响因子：
6.7
通讯作者：
Lubarsky, DA
中科院分区：
文献类型：
--
作者：
Zhou, JS;Dexter, F;Lubarsky, DA
研究目的：确定仅使用以前病例的手术时间来准确预测未来病例的手术时间是否有可能减少病例延迟完成的平均时间长度（在预定完成时间之后）。设计：计算机模拟。测量和主要结果：分析了来自两个手术室的手术室（OR）信息系统的数据。对于 1996 财年执行的每个病例，我们向后搜索 1 年，并计算由同一外科医生执行的相同类型手术的先前病例数。然后，对于每个套件，手术时间都适合统计模型，估计手术类型以及外科医生是谁对手术时间的影响。估计的“方差分量”用于蒙特卡罗计算机模拟，以评估可用于估计下一个病例手术时间的先前病例数量的假设增加是否会提高调度准确性。对新安排的病例需要多长时间的预测受到损害，因为三级手术室的 36.5% +/- 0.4%（平均值 +/- SE）的病例和门诊手术中心的 28.6% +/- 0.7% 的病例在上一年没有任何相同手术类型和外科医生的病例。计算机模拟用于生成额外的假设案例。使用这些数据，即使有许多以前的病例作为未来手术时间预测的基础，也只会将病例延迟完成的平均时间缩短几分钟。结论：考虑仅使用历史手术时间来估计未来手术时间的手术室经理应该首先使用来自自己手术室的数据调查没有历史数据的病例百分比。即使有足够的历史数据来准确估计未来的手术时间，仅仅依靠历史时间可能并不是让未来的病例按时完成的有效策略。 (C) 1999 年，爱思唯尔科学公司。
Study Objective: To determine whether using only previous cases' surgical times for predicting accurately surgical times of future cases is likely to reduce the average length of time cases finish late (after their scheduled finish times).Design: Computer simulation.Measurements and Main Results: Data from an operating room (OR) information system for two surgical suites were analyzed. For each case performed in fiscal year 1996, we searched backward for 1 year and counted the number of previous cases that were the Same type of Procedure performed by the same surgeon. Then, for each suite, surgical times were fitted to a statistical model estimating the effect of the type of procedure and who the surgeon was on surgical time. The estimated "variance components" were used in Monte-Carlo computer simulations to evaluate whether a hypothetical increase in the number of previous cases available to estimate the next case's surgical time would improve scheduling accuracy. Predictions of how long newly scheduled cases should take were impair-ed because 36.5% +/- 0.4% (mean +/- SE) of cases at a tertiary surgical suite and 28.6% +/- 0.7% of cases at an ambulatory surgery center did not have any cases in the previous year with the same procedure type and surgeon. Computer simulation was used to generate additional hypothetical cases. Using this data, even having many previous cases on which to base predictions of future surgical times would only decrease the average length of time that cases finish late by a few minutes.Conclusion: An OR manager considering using only historical surgical times to estimate future surgical times should first investigate, using data from their own surgical suite, what percentage of cases do not have historical data. Even if there are sufficient historical data to estimate future surgical times accurately, relying solely on historical times is probably an ineffective strategy to have future cases finish on time. (C) 1999 by Elsevier Science Inc.