An application of computer simulation to improve scheduling of hospital operating room facilities in the United States

Many strategic and operational decisions have been enhanced through the utilisation of computer simulation modelling. Computer simulation can be used to model and analyse a wide variety of real–world problems that cannot be successfully approached by other types of management science/operations research techniques. Simulation is therefore considered an important and valuable tool in the decision–making process. In the present study, an application of computer simulation was employed for improving scheduling in a hospital operating room facility in an 800–bed medical centre in the southeastern United States. Using a simulation model, three alternative block schedules were compared against the scheduling procedure in use, which prioritised cases based on source (waiting list, elective and emergency) and used a first come/first–serve scheduling heuristic for the facility. Performance comparisons of the schedules were made on the basis of throughput, average waiting time, the distribution of waiting times, queue characteristics,and facility utilisation. In addition, the cost effectiveness and capacity utilisation of the alternative schedules were evaluated. Results indicated that by increasing the scheduling horizon and considering day–to–day seasonality in demand by case type, the facility can improve its efficiency and cost effectiveness while also improving the level of service provided.