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A Discrete Event Simulation Model to Evaluate Operational Performance of a Colonoscopy Suite

Author

Listed:
  • Bjorn Berg

    (Edward P. Fitts Department of Industrial & Systems Engineering, North Carolina State University, Raleigh, North Carolina)

  • Brian Denton

    (Edward P. Fitts Department of Industrial & Systems Engineering, North Carolina State University, Raleigh, North Carolina, bdenton@ncsu.edu)

  • Heidi Nelson

    (Department of Mechanical and Industrial Engineering, University of Massachusetts at Amherst)

  • Hari Balasubramanian

    (Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota)

  • Ahmed Rahman

    (Division of Health Care Policy & Research, Mayo Clinic, Rochester, Minnesota)

  • Angela Bailey

    (Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota)

  • Keith Lindor

    (Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota)

Abstract

Background and Aims. Colorectal cancer, a leading cause of cancer death, is preventable with colonoscopic screening. Colonoscopy cost is high, and optimizing resource utilization for colonoscopy is important. This study’s aim is to evaluate resource allocation for optimal use of facilities for colonoscopy screening. Method. The authors used data from a computerized colonoscopy database to develop a discrete event simulation model of a colonoscopy suite. Operational configurations were compared by varying the number of endoscopists, procedure rooms, the patient arrival times, and procedure room turnaround time. Performance measures included the number of patients served during the clinic day and utilization of key resources. Further analysis included considering patient waiting time tradeoffs as well as the sensitivity of the system to procedure room turnaround time. Results. The maximum number of patients served is linearly related to the number of procedure rooms in the colonoscopy suite, with a fixed room to endoscopist ratio. Utilization of intake and recovery resources becomes more efficient as the number of procedure rooms increases, indicating the potential benefits of large colonoscopy suites. Procedure room turnaround time has a significant influence on patient throughput, procedure room utilization, and endoscopist utilization for varying ratios between 1:1 and 2:1 rooms per endoscopist. Finally, changes in the patient arrival schedule can reduce patient waiting time while not requiring a longer clinic day. Conclusions. Suite managers should keep a procedure room to endoscopist ratio between 1:1 and 2:1 while considering the utilization of related key resources as a decision factor as well. The sensitivity of the system to processes such as turnaround time should be evaluated before improvement efforts are made.

Suggested Citation

  • Bjorn Berg & Brian Denton & Heidi Nelson & Hari Balasubramanian & Ahmed Rahman & Angela Bailey & Keith Lindor, 2010. "A Discrete Event Simulation Model to Evaluate Operational Performance of a Colonoscopy Suite," Medical Decision Making, , vol. 30(3), pages 380-387, May.
    • Handle: RePEc:sae:medema:v:30:y:2010:i:3:p:380-387
    DOI: 10.1177/0272989X09345890
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    Citations

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    Cited by:

    1. S. Ayca Erdogan & Brian Denton, 2013. "Dynamic Appointment Scheduling of a Stochastic Server with Uncertain Demand," INFORMS Journal on Computing, INFORMS, vol. 25(1), pages 116-132, February.
    2. P. Troy & N. Lahrichi & D. Porubska & L. Rosenberg, 2020. "Fine-grained simulation optimization for the design and operations of a multi-activity clinic," Flexible Services and Manufacturing Journal, Springer, vol. 32(3), pages 599-628, September.
    3. Pauline Chauvin & Jean-Michel Josselin & Denis Heresbach, 2014. "The influence of waiting times on cost-effectiveness: a case study of colorectal cancer mass screening," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(8), pages 801-812, November.
    4. Bożena Mielczarek, 2016. "Review of modelling approaches for healthcare simulation," Operations Research and Decisions, Wroclaw University of Science and Technology, Faculty of Management, vol. 26(1), pages 55-72.

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