Evidence map›Paper›PMID 28389485›Full record

ArticleBMJ open2017

Operational strategies to manage non-elective orthopaedic surgical flows: a simulation modelling study.

Marie Persson, Helena Hvitfeldt-Forsberg, Maria Unbeck, Olof Gustaf Sköldenberg, Andreas Stark, Paula Kelly-Pettersson, Pamela Mazzocato

Abstract read
In one paragraph

Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Discrete-Event Simulation Modeling in Healthcare: A Comprehensive Review.International journal of environmental research and public health · 2021
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Marie PerssonDepartment of Computer Science and Engineering, Blekinge Institute of Technology, Karlskrona, Sweden.
Helena Hvitfeldt-ForsbergDepartment of Learning, Informatics, Management and Ethics, Medical Management Centre (MMC), Karolinska Institutet, Stockholm, Sweden.
Maria UnbeckDepartment of Orthopaedics, Danderyd Hospital, Stockholm, Sweden.
Olof Gustaf SköldenbergDepartment of Orthopaedics, Danderyd Hospital, Stockholm, Sweden.
Andreas StarkDepartment of Orthopaedics, Danderyd Hospital, Stockholm, Sweden.
Paula Kelly-PetterssonDepartment of Orthopaedics, Danderyd Hospital, Stockholm, Sweden.
Pamela MazzocatoDepartment of Learning, Informatics, Management and Ethics, Medical Management Centre (MMC), Karolinska Institutet, Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo explore the value of simulation modelling in evaluating the effects of strategies to plan and schedule operating room (OR) resources aimed at reducing time to surgery for non-elective orthopaedic inpatients at a Swedish hospital.

methodsWe applied discrete-event simulation modelling. The model was populated with real world data from a university hospital with a strong focus on reducing waiting time to surgery for patients with hip fracture. The system modelled concerned two patient groups that share the same OR resources: hip-fracture and other non-elective orthopaedic patients in need of surgical treatment. We simulated three scenarios based on the literature and interaction with staff and managers: (1) baseline; (2) reduced turnover time between surgeries by 20 min and (3) one extra OR during the day, Monday to Friday. The outcome variables were waiting time to surgery and the percentage of patients who waited longer than 24 hours for surgery.

resultsThe mean waiting time in hours was significantly reduced from 16.2 hours in scenario 1 (baseline) to 13.3 hours in scenario 2 and 13.6 hours in scenario 3 for hip-fracture surgery and from 26.0 hours in baseline to 18.9 hours in scenario 2 and 18.5 hours in scenario 3 for other non-elective patients. The percentage of patients who were treated within 24 hours significantly increased from 86.4% (baseline) to 96.1% (scenario 2) and 95.1% (scenario 3) for hip-fracture patients and from 60.2% (baseline) to 79.8% (scenario 2) and 79.8% (scenario 3) for patients with other non-elective patients.

conclusionsHealthcare managers who strive to improve the timelines of non-elective orthopaedic surgeries may benefit from using simulation modelling to analyse different strategies to support their decisions. In this specific case, the simulation results showed that the reduction of surgery turnover times could yield the same results as an extra OR.

Indexed as

Computer SimulationOrthopedic ProceduresTime-to-TreatmentWorkflowEfficiencyHip FracturesHospitals, UniversityHumansOperating RoomsSwedenefficiencyoperating roomorthopaedic surgeryQuality improvementsimulation modelling

Identifiers

PMID28389485
PMCPMC5558823

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LicenceCC BY-NC
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.