TY - JOUR
T1 - Operating room design using agent-based simulation to reduce room obstructions
AU - Taaffe, Kevin
AU - Ferrand, Yann B.
AU - Khoshkenar, Amin
AU - Fredendall, Lawrence
AU - San, Dee
AU - Rosopa, Patrick
AU - Joseph, Anjali
N1 - Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2023/6
Y1 - 2023/6
N2 - This study seeks to improve the safety of clinical care provided in operating rooms (OR) by examining how characteristics of both the physical environment and the procedure affect surgical team movement and contacts. We video recorded staff movements during a set of surgical procedures. Then we divided the OR into multiple zones and analyzed the frequency and duration of movement from origin to destination through zones. This data was abstracted into a generalized, agent-based, discrete event simulation model to study how OR size and OR equipment layout affected surgical staff movement and total number of surgical team contacts during a procedure. A full factorial experiment with seven input factors – OR size, OR shape, operating table orientation, circulating nurse (CN) workstation location, team size, number of doors, and procedure type – was conducted. Results were analyzed using multiple linear regression with surgical team contacts as the dependent variable. The OR size, the CN workstation location, and team size significantly affected surgical team contacts. Also, two- and three-way interactions between staff, procedure type, table orientation, and CN workstation location significantly affected contacts. We discuss implications of these findings for OR managers and for future research about designing future ORs.
AB - This study seeks to improve the safety of clinical care provided in operating rooms (OR) by examining how characteristics of both the physical environment and the procedure affect surgical team movement and contacts. We video recorded staff movements during a set of surgical procedures. Then we divided the OR into multiple zones and analyzed the frequency and duration of movement from origin to destination through zones. This data was abstracted into a generalized, agent-based, discrete event simulation model to study how OR size and OR equipment layout affected surgical staff movement and total number of surgical team contacts during a procedure. A full factorial experiment with seven input factors – OR size, OR shape, operating table orientation, circulating nurse (CN) workstation location, team size, number of doors, and procedure type – was conducted. Results were analyzed using multiple linear regression with surgical team contacts as the dependent variable. The OR size, the CN workstation location, and team size significantly affected surgical team contacts. Also, two- and three-way interactions between staff, procedure type, table orientation, and CN workstation location significantly affected contacts. We discuss implications of these findings for OR managers and for future research about designing future ORs.
KW - Agent-based simulation
KW - Markov chains
KW - Operating room design
KW - Operations management
KW - Operations research
KW - Statistical analysis
KW - Surgical safety
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U2 - 10.1007/s10729-022-09622-3
DO - 10.1007/s10729-022-09622-3
M3 - Article
C2 - 36529790
AN - SCOPUS:85144230496
SN - 1386-9620
VL - 26
SP - 261
EP - 278
JO - Health Care Management Science
JF - Health Care Management Science
IS - 2
ER -