Singapore Healthcare
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Transcript of Singapore Healthcare
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8/13/2019 Singapore Healthcare
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BPR at Surgery Dept.Singapore Hospital
Camille Armand (193)
Abhijeet Kr. Sinha (001)
Amrit Pati (007)
Arnav Nandy (012)
Bikash Ranjan Sahoo (018)
Debadutta Patro (021)
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Introduction
Singapore Hospital department of surgery 21 operating theatres (OT):
- 19 for elective surgery (8h/day)
- 2 for emergencies (24h/day)
Daily reservations of the OT for a specific clinical discipline:
- some OT are exclusively reserved for some disciplines
- others free to be used by any other disciplines
The simulation is based on only 8 OT to make it simple (8categories of surgery)
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Overview of the problems faced by the
department of surgery
Rise in healthcare costs in the last 30 yearsrise in the department expenditures
Increase in the demand of surgery services in the last 20
years+ Lack of manpower in the sector (low doctor-to-patient ratio)
Each OT reached a high rate of utilization
the department has to deal with it and optimize its current resources to
improve the efficiency and effectiveness of the OT utilization+ they have to keep in mind to provide quality services
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Problems, possible solutions and outcomes
1. Elective operating theatres operate from 8.30 to 17.30. There are delaysdue to complexity of surgery or operational delays. Solution prescribed:Implementation of shift system
2. Each operating theatre was reserved for a specific clinical discipline.Solution prescribed: Declassifying the operation theatres
3. 19 of the 21 operation theatres were allocated for elective surgery. When
there was an increase in emergency cases, they needed to be scheduledin some other elective operation theatre thereby affecting the scheduling.Solution prescribed: Better scheduling system, More emergency operatingtheatres
4. Orthopedic surgery creates a bottle neck due to its high pre-operatingarea time. Solution prescribed: Model 3 with the declassified operatingtheatres.
As they reduce the wait time in the pre-operating area to 69%
from 90%. System efficiency also went up to 64.8%5. Specific surgeons with certain surgical specialties are highly utilized.
Same for the anaesthetists due to their work in the pre-operative and post-operative processes. Solution prescribed: collect data on a regular basisand review theatre utilization periodically
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O.T. PROCESS FLOWCHART
Arrival
Shift to
recovery cabin
Pre-Op
Surgery
O.T. Setup
Shift to O.T.
Summon to
O.T.
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Original Model
PATIENT STAFF (X) SURGEON (Y) ADMIN
RegisterSingleShift 0800-
1800 hrs
Approve
Schedule
Pre-Op
SetupExclusive OT
Arrive
Summon toExclusive OT
Shift on Gurney
to OT
Surgery
Exclusive OTs
Shift forRecovery
MiscProcesses
Exit
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Model #1
STAFF(X/2)
SURGEON(Y/2)
ADMINPATIENT
Register Approve
Arrive
Pre-Op
Setupspecific OT
Shift onGurney to
OT
Shift forRecovery
PATIENTSTAFF(X/2)
SURGEON(Y/2) ADMIN
Register Approve
Arrive
Pre-Op
Setupspecific OT
Shift onGurney to
OT
Shift forRecovery
Summonto OT
SurgeryExclusive OTs
SurgeryExclusive OTs
Summonto OT
MiscProcesses
MiscProcesses
Schedule Schedule
Exit Exit
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ADMINPATIENT
Register Approve
Arrive
Pre-Op
Setupspecific OT
Shift onGurney to
OT
Shift forRecovery
PATIENT ADMIN
Register Approve
Arrive
Pre-Op
Setupspecific OT
Shift onGurney to
OT
Shift forRecovery
Summonto OT
SurgeryExclusive OTs
SurgeryExclusive OTs
Summonto OT
MiscProcesses
MiscProcesses
Schedule Schedule
Exit Exit
STAFF
(X/2+)
SURGEON
(Y/2+) STAFF(X/2+)
SURGEON
(Y/2+)
Model #2
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Discussion and Conclusion
The simulation model was run for 168 hours (7 days), with a warm-upperiod of 48 hours, with 20 replications
Locations : Entrance, Pre-Op, Recovery, Exit, Specialty OTs.
Resources : Gurney, Anaesthetist, Surgeon.
Specialty Operating theatres : Highly Utilized Specialty Surgeons : High Demand
Anaesthetists : Highly Utilized
Declassification of OT
Utilization of Pre-operating area reduced from 90% to 69%, i.e., bottleneck improved.
Efficiency improvement from 45.6% to 64.8%.
Total no. of Exits almost doubled.
Total number of failed arrivals reduced by 28%.
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THANK YOU
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