Improving the process efficiency of catheterization laboratories using simulation

As the size of the population suffering from cardiac problems increases, the number of catheterization procedures performed is growing rapidly. The high costs associated with catheterization laboratories (cath labs) make managing these resources a critical task that impacts the efficiency and operating costs of hospitals as well as the quality of care. This study describes a discrete event simulation model developed to analyze the various factors that affect utilization of cath labs at a 337-bed full-service hospital in Scottsdale Arizona and provide decision support for improving the efficiency of the cath lab operations. The simulation model helped evaluate the performance of the existing approach at the hospital and compare alternative policies to improve operational efficiency. We consider both operational and patient satisfaction metrics and illustrate the tradeoffs between the two. Our analysis recommends reducing the initial time allotted to each case from 120 to 90 min, including a 30-min lunch buffer and end of the day buffer to absorb any delays, and potentially rescheduling inpatients when emergent cases have to be scheduled or other cases are taking longer than anticipated. We also perform detailed parametric analysis to develop more generic recommendations. The facility under study implemented our recommendations and realized a 19% increase in utilization as well as a 71% decrease in overtime.