جستجوی مقالات مرتبط با کلیدواژه "ضرب الاجل" در نشریات گروه "پزشکی"

The waiting list is a list of selected patients in the surgical queue. If demand exceeds capacity, the waiting list grows rapidly, which may lead to unacceptable waiting for patients, especially those in need of acute medical care. Patients waiting for heart surgery are placed on the waiting list for surgery, and sometimes the waiting time is longer than patients expect. Reducing the waiting time for medical services, including heart surgery, is one of the challenges of the health system. In this regard, the present study was performed by identifying an effective solution to reduce the queue length of patients undergoing cardiac surgery.

In this article, the process of scheduling open heart surgery at Shahid Rajaei Hospital was reviewed and improved with a discrete event simulation approach in Arena simulation software. After designing the process, the existing bottlenecks leading to the long waiting time of the patients were identified. The waiting time and the number of patients visited were determined as the objective function and the patient flow was improved by presenting improvement scenarios and selecting the best scenario.

Simulation results on 66 selected patients in 7 months from October 2020 to May 27, 2021 show that Scenario number 10 has the most improvement in performance criteria but is not applicable in practice. Therefore, due to system limitations, Scenario 2 was selected as the best scenario. Implementing Scenario 2 could reduce the waiting time by 40 percent and increase the number of patients visited by 21 percent.

Patient prioritization methods allow patients with higher needs to receive more services than those with lower urgent needs, although they also have longer waiting times for patients with lower urgent needs.

  The operating rooms in each health center are one of the most sensitive units in the center, whereas scheduling and scheduling operations are in particular importance and their optimization has a significant effect on the optimization of the whole complex. The scheduling of heart surgery in addition to the limitations of manpower, time, and facilities includes the limitation of the patient's surgical deadline, which is the purpose of the surgical scheduling given this parameter. In this quantitative study, an algorithm containing 3 + 1 function was proposed. This algorithm also addresses uncertainty while monitoring the limitations of available resources and the maximum delay for surgery. In this study, patients categorize to emergency and non-emergency patients which only the scheduling of non-emergency patients is considered. In this study 343 patient was studied. Based on a six-month period information reviewing from Shahid Rajaie Cardiovascular Center in Tehran, a 11% improvement has been made in respecting the maximum delay for the patient's referral process. The optimization rate is often related to the difference in patient selection based on their deadline for surgery, which in the present algorithm has been a major contributor to the denial of service patients. Another advantage of the proposed algorithm is the dynamic process of the algorithm and appropriate response to the changes. The longer the length of the queue, the lower the chance of accepting non-emergency patients with the shorter maximum delays.