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ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH

Determining the Number of Beds in the Postanesthesia Care Unit: A Computer Simulation Flow Approach

Eric Marcon, PhD^*, Saïd Kharraja^*, Nicole Smolski, MD, Brigitte Luquet, and Jean Paul Viale, MD PhD

*Department of Industrial Maintenance, Jean Monnet University, Saint Etienne; and Departments of Anesthesiology and Surgery, Hospital Croix-Rousse, Lyon, France

Address correspondence and reprint requests to Eric Marcon, Laboratoire d’Analyze des Signaux et des Processus Industriels (LASPI), IUT de Roanne, 20 Ave de Paris, 42334 Roanne Cedex. Address e-mail to marcon{at}univ-st-etienne.fr

Designing a new operating room (OR) suite is a difficult process owing to the number of caregivers involved and because decision-making managers try to minimize the direct and indirect costs of operating the OR suite. In this study, we devised a computer simulation flow model to calculate, first, the minimum number of beds required in the postanesthesia care unit (PACU). In a second step, we evaluated the relationship between the global performance of the OR suite in terms of OR scheduling and number of staffed PACU beds and porters. We designed a mathematical model of OR scheduling. We then developed a computer simulation flow model of the OR suite. Both models were connected; the first one performed the input flows, and the second simulated the OR suite running. The simulations performed examined the number of beds in the PACU in an ideal situation or in the case of reduction in the number of porters. We then analyzed the variation of number of beds occupied per hour in the PACU when the time spent by patients in the PACU or the number of porters varied. The results highlighted the strong impact of the number of porters on the OR suite performance and particularly on PACU performances.

IMPLICATIONS: Designing new operating room (OR) facilities implies many decisions on the number of ORs, postanesthesia care unit (PACU) beds, and on the staff of nurses and porters. To make these decisions, managers can use rules of thumb or recommendations. Our study highlights the interest of using flow simulation to validate these choices. In this case study we determine the number of PACU beds and porter staff and assess the impact of decreasing the number of porters on PACU bed requirements.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999