Improving surgeon utilization in an orthopedic department using simulation modeling

Abstract

Purpose

Worldwide more than two billion people lack appropriate access to surgical services due to mismatch between existing human resource and patient demands. Improving utilization of existing workforce capacity can reduce the existing gap between surgical demand and available workforce capacity. In this paper, the authors use discrete event simulation to explore the care process at an orthopedic department. Our main focus is improving utilization of surgeons while minimizing patient wait time.

Methods

The authors collaborated with orthopedic department personnel to map the current operations of orthopedic care process in order to identify factors that influence poor surgeons utilization and high patient waiting time. The authors used an observational approach to collect data. The developed model was validated by comparing the simulation output with the actual patient data that were collected from the studied orthopedic care process. The authors developed a proposal scenario to show how to improve surgeon utilization.

Results

The simulation results showed that if ancillary services could be performed before the start of clinic examination services, the orthopedic care process could be highly improved. That is, improved surgeon utilization and reduced patient waiting time. Simulation results demonstrate that with improved surgeon utilizations, up to 55% increase of future demand can be accommodated without patients reaching current waiting time at this clinic, thus, improving patient access to health care services.

Conclusion

This study shows how simulation modeling can be used to improve health care processes. This study was limited to a single care process; however the findings can be applied to improve other orthopedic care process with similar operational characteristics.

Keywords:

• waiting time
• patient
• health care process

Acknowledgments

The authors would like to thank the management of the Bugando Hospital for allowing us to collect data for this study. The authors would also like to thank all health care providers for their great help during the data collection period. The authors would further like to express their gratitude to Associate Professor Ketil Danielsen of Molde University College for comments on the simulation aspect.

Disclosure

The authors report no conflicts of interest in this work.