Figure 2. A simulation model for bed planning.
(Available at: http://www.xjtek.com/. Accessed on February 1, 2010.)
cleaning and disinfection of the surgical room, and hospital administrative practices. They considered two types of scheduling policies: 1) rigid scheduling, where rooms previously assigned to surgical teams could not be changed and 2) flexible scheduling, where a surgical room, whenever available, could be used by any surgical team.
By keeping the same number of PABs and using flexible scheduling, the
authors observed that nearly 38 surgeries could be performed daily, rather than the current 25, if no delays occurred. Troy and Rosenberg5 considered a problem at the Jewish General Hospital in Montreal, Quebec, which has a total of 637 beds, of which 14-16 staffed beds are for the combined Medical-Surgical Intensive Care Unit (ICU). This hospital had previously canceled all elective procedures known to require a one-week ICU stay due to a mismatch in the demand and supply of ICU beds.
In this study the authors
considered both the actual capacity (i.e., total number of ICU beds) and the functional capacity (i.e., the number of occupied ICU beds at which scheduled procedures known to require an ICU stay are canceled). Using their DES model of the ICU, they concluded that actual and functional ICU capacity jointly explained ICU utilization and the mean number of patients that should have been in the ICU who were parked elsewhere. Following the authors’ recommendation, hospital management, increased 101