Evidence map›Paper›PMID 36926489›Full record

ArticleFrontiers in health services2021

A Monte Carlo Simulation Approach to Optimizing Capacity in a High-Volume Congenital Heart Pediatric Surgical Center.

Eleni G Elia, Shirley Ge, Lisa Bergersen, Ravi R Thiagarajan, Jason Thornton, Lynn A Sleeper, Francis Fynn-Thompson, Derek Mathieu, Peta M A Alexander

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Article in Frontiers in health services, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

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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

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Eleni G EliaDepartment of Cardiology, Boston Children's Hospital, Boston, MA, United States.
Shirley GeDepartment of Cardiology, Boston Children's Hospital, Boston, MA, United States.
Lisa BergersenDepartment of Cardiology, Boston Children's Hospital, Boston, MA, United States.
Ravi R ThiagarajanDepartment of Cardiology, Boston Children's Hospital, Boston, MA, United States.
Jason ThorntonDepartment of Cardiology, Boston Children's Hospital, Boston, MA, United States.
Lynn A SleeperDepartment of Cardiology, Boston Children's Hospital, Boston, MA, United States.
Francis Fynn-ThompsonDepartment of Cardiac Surgery, Boston Children's Hospital, Boston, MA, United States.
Derek MathieuDepartment of Cardiology, Boston Children's Hospital, Boston, MA, United States.
Peta M A AlexanderDepartment of Cardiology, Boston Children's Hospital, Boston, MA, United States.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Elective surgeries are primarily scheduled according to surgeon availability with less consideration of patients' postoperative cardiac intensive care unit (CICU) length of stay. Furthermore, the CICU census can exhibit a high rate of variation in which the CICU is operating at over-capacity, resulting in admission delays and cancellations; or under-capacity, resulting in underutilized labor and overhead expenditures. Objective: To identify strategies to reduce variation in CICU occupancy levels and avoid late patient surgery cancellation. Design: Monte Carlo simulation study of the daily and weekly CICU census at Boston Children's Hospital Heart Center. Data on all surgical admissions to and discharges from the CICU at Boston Children's Hospital between September 1, 2009 and November 2019 were included to obtain the distribution of length of stay for the simulation study. The available data allows us to model realistic length of stay samples that include short and extended lengths of stay. Main Outcomes: Annual number of patient surgical cancellations and change in average daily census. Results: We demonstrate that the models of strategic scheduling would result in up to 57% reduction in patient surgical cancellations, increase the historically low Monday census and decrease the historically higher late-mid-week (Wednesday and Thursday) censuses in our center. Conclusions and Relevance: Use of strategic scheduling may improve surgical capacity and reduce the number of annual cancellations. The reduction of peaks and valleys in the weekly census corresponds to a reduction of underutilization and overutilization of the system.

Indexed as

congenital heart diseaseelective surgeries schedulinghigh volume hospitalMonte Carlo simulation (MC)pediatric surgical center

Identifiers

PMID36926489
PMCPMC10012657

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