Cost and Delay Time Analytics in OR: A Simulation-based Approach

Background: Operating room (OR) is one of the main hospital parts and management of time and cost are very important in this essential unit. Also, due to the close relationship with other departments, improving its service quality and performance, significantly increases the efficiency of hospital. OR is a complex system in which each lack of coordination effects on all hospital departments. So it is important to identify and categorize the factors that caused loss of OR orchestration and analyze the cost and delay times that imposed by this loss of orchestrations. Method: Computer simulation is a useful technique for modelling system and its behavior. OR is a complex system which has lots of agents interacting with each other, so the agent based simulation method is a suitable technique for modelling OR agents, relationships, defining loss of orchestrations and analyzing the results on the system performance. Results: By identifying OR non-orchestration factors, the most frequencies are related to the lack of recovery beds, emergency surgery, surgeon delay, lack of patient transferor, prolongation of other surgical procedures, anesthesia and pediatric surgery; and the less frequencies are for Clinical changes in the patient status, inadequate testing, and patient's cancellation or lack of readiness. Also, the most delayed and lost time were due to the inadequacy of patient tests, anesthesia and pediatric surgery, prolongation of other surgical procedures, and lack of recovery beds. Conclusion: Surgery procedure is not just a surgical technique, but has many aspects that should be addressed and resolved. The results indicated that the most effective factor in hospital delay and costs is the shortage of resources and lack of planning, which can be improved by interconnecting communication and on-time information sharing.