Work-force Planning Inside and Outside the Operating Room: a Simulation Approach

The operating room represents a major hospital cost centre and a highly technical area in hospitals. Thus, it is of high interest for human re- source management (Guerriero 2011, Butler 1996). Simulations of the surgical process from a human resources perspective are numer- ous in the literature. However, activities performed outside the oper- ating room (i.e. "external activities') are generally neglected (Blake and Carter 1996, Sobolev, Sanchez, and Vasilakis 2011). Our contri- bution aims to fill this gap and answer the following research question: what is the impact of external activities planning on surgical activity? The methodology used in this article is a discrete event simulation of both the surgical process and external activities. We apply our model to a case study of three French military hospitals with 20 months of historical data. In this case, external activities are military missions conducted abroad. Medical and paramedical staffs are both involved in the missions. The simulation evaluates the impact of external activi- ties on the volume of surgical care delivered and the number of wasted working hours in the operating suite. Our study shows that external activities often destabilise the surgical process, lowering the operating room efficiency. A global vision of staff activity can be gained through simulation. Critical resources are identified and simulation can be used as a decision support tool for tactical human resource planning in the operating room.