Surgical Scheduling

Hunter New England Area Health Service

Hunter New England Area Health Service is a large governmental health services organization in New South Wales, Australia. Serving approximately 850,000 people, the HNEAHS includes 3 teriary hospitals, 4 rural referral hospitals, 12 district hospitals and 10 community hospitals. NovaSim, working together with PricewaterhouseCoopers Australia, developed a comprehensive simulation model to help manage surgical block management and overall waitlist management for two of the largest facilities in the region. Used to solve a variety of what-if questions when it was first developed, the model remains in consistent use several years later as an ongoing wait list management tool. 

Project Goals

• Support the creation of a plan for managing the wait list to meet health service goals and governmental targets
• Evaluate changes to theatre block schedules
• Determine when and how to introduce new scheduling blocks
• Evaluate alternative patient-to-block assignment algorithms
• Evaluate alternate block filling algorithms (sequence of patients within a block)
• Determine the impact of changes to the roster of surgeons
• Evaluate shifting specialties or procedures to alternate surgical facilities
• Model a dedicated orthopedic facility
• Examine the impact of shifting all cataract surgeries to a regional hospital instead of dedicating the tertiary referral hospital's surgical resources

 

System Elements

• 9 operating theatres at John Hunter Hospital and 5 at the Royal New Castle
• More than 90 surgeons
• 30 surgical subspecialties
• Approximately 18,000 surgeries annually
• 245 "intended procedure" codes
• Wait list elective surgeries, organized into 4 categories
  • Within 30 days
  • Within 90 days
  • Within 365 days
  • Not Ready for Care
• Acute surgeries, grouped into 6 urgency categories
  
  • Immediate
  • less than 1 hour
  • less than 2 hours
  • less than 6 hours
  • less than 24 hours
  • More than 24 hours
• Procedure times organized by IPC, Surgeon, and category

SIMUL8 Window with the Patients (Demand) on left and Surgical Blocks (Capacity) on right