A simulation based model for planning operating theater activity in complex hospitals: Case study in orthopedics

Operating theaters (OT) in hospitals represent some of the highest sources of economic expenditures since their high complexity in terms of technology equipment (integration of different complex devices and specific technical requirements), organization (multi-personnel area with complex patients flow) and usage (optimum planning between regular activity and emergency management). For the above reasons, it is essential to understand and plan the whole surgical path (patient and personnel) by avoiding foreseeable inefficiencies, delays and risks. Hence, the aim of this study is fully modeling a generic orthopedics OT in order to support hospital decision makers in OT design and activity planning for both regular and emergency scenarios. In order to do that and due to the complexity of the OT system, a simulation approach is fundamental for properly understanding the whole process and for clearly controlling and analyzing all the factors involved (surgical durations, types, working times and rooms availability, etc..). Discrete event models have been found reliable and accurate to simulate complex health systems (e.g. emergency management, beds management, logistic and assets estimation, etc.). Finally, after selecting the most appropriate type of model, and using past surgical data and experts’ opinions from the hospital for its development and implementation, a more precise and reliable clinical validation of the model is currently in progress, by concluding a data verification that needs a period of on-site data collection. © Springer International Publishing Switzerland 2015.