Operation Planning of the Elective Patients in an Orthopedic Surgery Department

This paper considers the operation scheduling and planning of elective patients in the Orthopedic Department of the “Lozano Blesa” Hospital in Zaragoza. We assume an ordered list of patients that should be planned for surgery. We propose a mixed linear integer programming problem to obtain a utilization rate of 80% per room. The results are tested on some real data from the hospital and some simulation results are provided

Prospective Study of Proportions and Causes of Cancellation of Surgical Operations at Jimma University Teaching Hospital, Ethiopia

Background: Cancellation of scheduled surgery is a major quality of health care problem affecting the individual patients, family and the actual health care organization. Objective: The aim of this study was to assess the incidence, causes and magnitude of cancellation of elective surgical operations and to find the appropriate solutions for better patient management and effective utilization of resources. Methods: A longitudinal study design was conducted at Jimma University Teaching Hospital from February 1, 2014 to June 30, 2014. All consecutive scheduled cases (n=1438) to undergo elective surgical procedures were included in the study. Result: A total of 1438 patients were scheduled for elective surgical operations. Of these, 331(23.0%) were cancelled. about 45.6 % male and 54.4 % female ware not operated on the intended day of schedule respectively. General surgery had the highest rate of cancellations 198(23%) followed by orthopedic surgery 78(20%). In appropriate scheduling and unavailability of sterile drapes and lab sheets were the main causes of cancelation. Conclusion and Recommendation: Inappropriate scheduling and unavailability of sterile clothes were the main causes of Cancellation of elective surgical operations in our hospital. Concerned bodies should bring a sustainable change and improvement to prevent unnecessary cancellations and enhance cost effectiveness through communications, careful planning and efficient utilization of the available hospital resources

A decision support system for elective surgery scheduling under uncertain durations

The operation room (OR) is one of the most expensive material resources in hospitals. Additionally, the demand for surgical service is increasing due to the aging population, while the number of surgical interventions performed is stagnated because of budget reasons. In this context, the importance of improving the efficiency of the surgical service is accentuated. The main objective of this work is to propose and to evaluate a Decision Support System (DSS) for helping medical staff in the automatic scheduling of elective patients, improving the efficiency of medical teams'' work. First, the scheduling criteria are fixed and then the scheduling problem of elective patients is approached by a mathematical programming model. A heuristic algorithm is proposed and included in the DSS. Moreover, other different features are implemented in a software tool with a friendly user interface, called CIPLAN. Considering realistic data, a simulation comparison of the scheduling obtained using the approach presented in this paper and other similar approaches in the bibliography is shown and analyzed. On the other hand, a case study considering real data provided by the Orthopedic Surgical Department (OSD) of the "Lozano Blesa" hospital in Zaragoza (HCU) is proposed. The simulation results show that the approach presented here obtains similar occupation rates and similar confidence levels of not exceeding the available time than approaches in the bibliography. However, from the point of view of respecting the order of the patients in the waiting list, the approach in this paper obtains scheduling much more ordered. In the case of the Orthopedic Surgical Department of the "Lozano Blesa" hospital in Zaragoza, the occupation rate may be increased by 2.83%, which represents a saving of 110, 000 euros per year. Moreover, medical doctors (who use this tool) consider CIPLAN as an intuitive, rapid and efficient software solution that can make easier the corresponding task

Economic analysis of the implementation of autologous transfusion technologies throughout England

Objectives: This study aims to provide the first estimates of the costs and effects of the large scale introduction of autologous transfusion technologies into the United Kingdom National Health Service. Methods: A model was constructed to allow disparate data sources to be combined to produce estimates of the scale, costs, and effects of introducing four interventions. The interventions considered were preparing patients for surgery (PPS) clinics, preoperative autologous donation (PAD), intraoperative cell salvage (ICS), and postoperative cell salvage (PoCS). Results: The key determinants of cost per operation are the anticipated level of reductions in blood use, the mean level of blood use, mean length of stay, and the cost of the technology. The results show the potential for considerable reductions in blood use. The greatest reductions are anticipated to be through the use of PPS and ICS. Vascular surgery, transplant surgery, and cardiothoracic surgery appear to be the specialties that will benefit most from the technologies. Conclusions: Several simplifications were used in the production of these estimates; consequently, caution should be used in their interpretation and use. Despite the drawbacks in the methods used in the study, the model shows the scale of the issue, the importance of gathering better data, and the form that data must take. Such preliminary modeling exercises are essential for rational policy development and to direct future research and discussion among stakeholders

Using Lean Six Sigma in a Private Hospital Setting to Reduce Trauma Orthopedic Patient Waiting Times and Associated Administrative and Consultant Caseload

From Crossref journal articles via Jisc Publications RouterHistory: epub 2023-09-26, issued 2023-09-26Article version: VoRPublication status: PublishedSeán Paul Teeling - ORCID: 0000-0002-4102-7280 https://orcid.org/0000-0002-4102-7280In Ireland, the extent of outpatient orthopedic waiting lists results in long waiting times for patients, delays in processing referrals, and variation in the consultant caseload. At the study site, the Define, Measure, Analyze, Improve, and Control (DMAIC) Lean Six Sigma framework was applied to evaluate sources of Non-Value-Added (NVA) activity in the process of registering and triaging patients referred to the trauma orthopedic service from the Emergency Department. A pre- (October–December 2021)/post- (April–August 2022) intervention design was employed, utilizing Gemba, Process Mapping, and the TIMWOODS tool. Embracing a person-centered approach, stakeholder Voice of Customer feedback was sought at each stage of the improvement process. Following data collection and analysis, a co-designed pilot intervention (March 2022) was implemented, consisting of a new triage template, dedicated trauma clinic slots, a consultant triage roster, and a new option to refer directly to physiotherapy services. This resulted in the total wait time of patients for review being reduced by 34%, a 51% reduction in the process steps required for registering, and an increase in orthopedic consultant clinic capacity of 22%. The reduction in NVA activities in the process and the increase in management options for triaging consultants have delivered a more efficient trauma and orthopedic pathway.pubpu

A Review of Virtual Reality Based Training Simulators for Orthopaedic Surgery

This review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is required to improve upon current simulators. In total 11 total hip replacement pre-operative planning tools were analysed, plus 9 hip trauma fracture training simulators. Additionally 9 knee arthroscopy simulators and 8 other orthopaedic simulators were included for comparison. The findings are that for orthopaedic surgery simulators in general, there is increasing use of patient-specific virtual models which reduce the learning curve. Modelling is also being used for patient-specific implant design and manufacture. Simulators are being increasingly validated for assessment as well as training. There are very few training simulators available for hip replacement, yet more advanced virtual reality is being used for other procedures such as hip trauma and drilling. Training simulators for hip replacement and orthopaedic surgery in general lag behind other surgical procedures for which virtual reality has become more common. Further developments are required to bring hip replacement training simulation up to date with other procedures. This suggests there is a gap in the market for a new high fidelity hip replacement and resurfacing training simulator

Economic impact of surgery cancellation in a general hospital, Iran

Background: Cancellation of surgical procedures creates a financial burden to health providers and patients. It also causes a potential emotional stress and a negative impact on perception of quality of care. It should be a priority to identify risks of surgery cancellations in view of modification to assure timely and efficient delivery of care.Objective: To identify and estimate costs borne by cancelation of elective surgeries in a general hospital.Methods: Data were collected from a general hospital of social security organization of Iran. In-patient medical records were reviewed for all patients scheduled for elective surgeries in a period of 1 year, starting from 21st of March 2011 to 20th of March 2012. The costing data were collected in 2014. Patients undergoing out-patient surgery and emergency surgical procedures were excluded from the study.Results: During the study period, 14,687 cases were scheduled to undergo inpatient elective surgical procedures. Of those 274 cases were cancelled, among the cancelled cases, 242 were cancelled during the preparation in the surgery ward and 32 cases were cancelled in operation room. The total cost of surgery cancellation was US$92, 049.0. Out of this: US$ 42,668.0 (46.4%) was related to bed expense; 32,363.0$US (35.1$ 16,569 (18.5%) was related to physician visits.Conclusion: The study demonstrated that cost of surgery cancelation was considerably high in the studied general hospital. More than half of the cost (62.1%) of surgery cancelation was due to avoidable reasons. [Ethiop. J. Health Dev. 2016;30(2):92-95]Keywords: Cost of illness; Cost of Cancelation; Direct Cost; Surgery Cancelation Cos

A review of virtual reality based training simulators for orthopaedic surgery

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordThis review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is required to improve upon current simulators. In total 11 hip replacements pre-operative planning tools were analysed, plus 9 hip trauma fracture training simulators. Additionally 9 knee arthroscopy simulators and 8 other orthopaedic simulators were included for comparison. The findings are that for orthopaedic surgery simulators in general, there is increasing use of patient-specific virtual models which reduce the learning curve. Modelling is also being used for patient-specific implant design and manufacture. Simulators are being increasingly validated for assessment as well as training. There are very few training simulators available for hip replacement, yet more advanced virtual reality is being used for other procedures such as hip trauma and drilling. Training simulators for hip replacement and orthopaedic surgery in general lag behind other surgical procedures for which virtual reality has become more common. Further developments are required to bring hip replacement training simulation up to date with other procedures. This suggests there is a gap in the market for a new high fidelity hip replacement and resurfacing training simulator.Wessex Academic Health Science Network (Wessex AHSN) Innovation and Wealth Creation Accelerator Fund 2014/15Bournemouth Universit

Hip Arthroplasty

Hip replacement is one of the most performed surgical procedures in orthopedic hip surgery. Through this surgery, the patient returns to most of his normal life and a life without pain. The primary indication for a hip arthroplasty remains osteoarthritis (OA). OA is a degenerative disease that affects synovial joints. A successful surgery is always preceded by good planning. The planning in turn takes into account the analysis of the patient and his physical examination and the radiological image. But also, the surgical planning must take into account another important factor, the choice of the surgical approach. In this chapter, the authors script a revision on the history of hip arthroplasty, total hip arthroplasty approaches, implant types, complications associated with hip arthroplasty, outcomes, and perspectives to the future. We wish you a good reading

Bulletin of the University of Nebraska: Annual Catalog of the College of Medicine, 1974-1975

•Education Programs University of Nebraska Medical Center •Calendar •College of Medicine History •Applications for Admission •Application Procedure •General Considerations in Planning a Medical Education •Specific Educational Recommendations •Registration and Admission to Classes •Requirements for Graduation •Fees and Expenses •Miscellaneous Information •Graduate Work •Graduate Fees •Graduate Registration •University Staff Exemption •Continuing Education •Financial Assistance •Student and Alumni Organizations •Learning Facilities •Curriculum 1974-75 •Departments and Courses •Baccalaureate Program in Community Health and Health Education •Baccalaureate Program in Environmental Health •Faculty •Residents 1973-74https://digitalcommons.unmc.edu/bulletin_com/1072/thumbnail.jp