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29 June 2017

Hospitals often reserve time, space and emergency facilities unnecessarily.

This emerged from research carried out by Nardo Borgman who developed a computer simulation model at the University of Twente.

This allows you to calculate how operating theatres are being used, to achieve the ideal situation. Dr Borgman was awarded a PhD on 23 June, for his research at the University of Twente.

Simulation model

Nardo Borgman’s research shows that keeping operating theatres (OTs) free, which is common practice in hospitals, is often unnecessary. Dr Borgman developed a simulation model to address this issue. This enables you to rapidly calculate the effects of all kinds of factors associated with hospital operating theatres. The model simulates the daily use of these OTs, to help you find the best way of dealing with emergency patients. One way to deal with emergency patients is to keep an OT free. Alternatively, you can allow emergency patients to ‘break into’ the schedules of regular OTs, by postponing regular patients’ appointments. The third option is to combine these two methods. The model simulates these three strategies, based on various factors such as the number of OTs, the number of patients, what percentage of patients are emergency cases, etc. The strategies can then be compared in terms of waiting times and of overrunning the allotted times. This will show which strategy is best for a given hospital situation.

Increasing pressure on hospitals

An ageing population, increased spending, and rising care demand are all forcing hospitals to work more efficiently. Nardo Borgman explains that “The treatment of emergency patients does not have to be at the expense of your ordinary patients. Provided that you put sufficient effort into planning, you will be able to handle both emergency patients and regular patients quickly and efficiently.”

Managers

The online simulation model can be easily used by OT managers and other professionals. They can fill in the factors for their hospital, such as ‘How many OTs are there?’, ‘How many patients are there?’, ‘What is the duration and variability of surgical procedures?’ and ‘What percentage of cases involve emergency patients?’. The system then generates a score based on waiting time and on making the best use of your OT. In this way, hospital managers can quickly find out which policy works best in their own particular hospital.  

CT scans

In the course of his research, Dr Borgman also analysed the logistics associated with CT scans. This work involves dealing with patients by appointment, interspersed by the occasional emergency patient from Accident and Emergency. Dr Borgman notes that “Accident and Emergency has a very predictable activity curve, reflecting the times when it’s busy and the times when things are quiet. If you schedule regular patients’ appointments for CT scans at times when it’s quiet in Accident and Emergency, this greatly reduces the waiting times for both groups of patients.”

CHOIR

The University of Twente’s Center for Healthcare Operations Improvement and Research (CHOIR) is constantly striving to structure healthcare processes more efficiently. Its staff use mathematical models and computer simulations to assess the various working practices, and to determine which one performs best. This provides hospitals with an objective and substantiated view of the most suitable working practice.

During his PhD research, Nardo Borgman worked at the Haga hospital in The Hague for several days each week. Dr Borgman’s research was funded by this hospital.

Industrial Engineering and Management

Nardo Borgman graduated from the Bachelor's programme in Industrial Engineering and Management at the University of Twente. As a specialist in Industrial Engineering and Management, you will make organizations and business processes more efficient, maximize profit, minimize risks and boost competitiveness and the quality of operations. The Industrial Engineering and Management programme teaches you how to effectively implement the required changes and evaluate their effects on the organization, its personnel, finances and market position. In doing so you will combine knowledge from the fields of business administration, ICT, mathematics, engineering and technology.