Bir Üniversite Hastanesinin Kadın Hastalıkları ve Doğum Bölümü’nde Simülasyon Modelleme Çalışması

Hastaların memnuniyet düzeyleri üzerinde önemli bir etki yaratan hasta bekleme süreleri, sağlık kurumlarında sunulan her hizmet alanında dikkat çeken bir durumdur. Özellikle uzun bekleme süreleri ve uzayan hasta kuyrukları, hastane yöneticilerinin çözmesi gereken problemlerin başında gelmektedir. Bu çalışmanın amacı da Ankara’da bulunan bir üniversite hastanesinin en yoğun bölümlerinden birisi olan Kadın Hastalıkları ve Doğum Bölümü’nde hastaların kuyrukta bekleme sürelerini azaltıcı ve personelin de çalışma oranını artırıcı yapısal öneriler sunabilmektir. Bunu gerçekleştirmek için simülasyon tekniğinden yararlanılmıştır. ARENA yazılımı kullanılarak gerçekleştirilen simülasyon çalışması sonucunda elde edilen sonuçlar doğrultusunda ise olası senaryolar geliştirilmiş ve birtakım öneriler sunulmuştur

A Simulation Modelling Study: The Case of Department of Gynaecology and Obstetrics of A

Patient waiting time is a significant topic in all services of medical institutions. It has considerable effects on patients’ satisfaction. Particularly long waiting times and long queues of patients are one of the prominent problems that are to be dealt with by hospital administrators. The aim of this study is to offer structural suggestions to reduce waiting times and increase efficiency of staff at one of the busiest departments, Department of Gynaecology and Obstetrics of a university hospital in Ankara. Simulation technique is used in order to achieve this goal. ARENA software is employed, possible scenarios are developed and several recommendations are made. Due to these scenarios, minimum patient waiting times were achieved. It can be said that all these scenarios can be useful in planning workforce, increasing satisfaction of patients and reducing queues at the department

___

  • Ahmed, M.A. ve Alkhamis, T.M. (2009) “Simulation Optimization for An Emergency Department Healthcare Unit in Kuwait” European Journal of Operational Research, 198:936–942.
  • Ajami, S., Ketabi, S, Yarmohammadian, M.H ve Bagherian, H. (2011) “Waiting Time in Emergency Department by Simulation” Studies In Health Technology And Informatics, 164:196-200.
  • Aksaraylı, M, Kıdak, L.B. ve Güneş, M. (2009) “Optimization Of The Bed Utilization By Simulation in Healthcare Services: An Application in an Education and Research Hospital” Gazi University The Journal of Faculty of Economics and Administrative Sciences, 11(1):1-22.
  • Anderson, D.R, Sweeney, D.J, Williams, T.A, Camm, J.D ve Martin, K. (2011) An Introduction Management Science, Quantitative Approaches to Decision Making, 13th Revised edition, USA, South-Western College Publishing.
  • Bai-lian, C., En-dong, L., Yamawuchi, K., Kato, K., Naganawa, S. ve Wei-jun, M. (2010) “Impact of Adjustment Measures on Reducing Outpatient Waiting Time in a Community Hospital: Application of a Computer Simulation” Chinese Medical Journal, 123(5):574-580.
  • Brahimi, M. ve Worthington, D.J. (1991) “Queueing Models for Out-patient Appointment Systems- Case Study” Journal of the Operational Research Society, 42:733-746.
  • Brosh, I. (1985) Quantitative Techniques for Managerial Decision Making, Rest on Publishing Company, Inc. Reston, Virginia, A Prentice-Hall Company.
  • Duguay, C. ve Chetouane, F. (2007) “Modeling and Improving Emergency Department Systems using Discrete Event Simulation” Society for Modeling and Simulation International, 83(4): 311-320.
  • Efficiency Engineers, Business Optimization Experts, http://www.efficiencyengineers.com /info/ EfficiencyEngineers_Simulation_Modeling_Healthcare. pdf, (21.03.2013).
  • Elkhuizen, S.G., Das, S.F, Bakker, P.J.M. ve Hontelez, J.A.M. (2007) “Using Computer Simulation to Reduce Access Time for Outpatient Departments” Quaity and Safety in Health Care,16(5):382–386.
  • Guo, M., Wagner, M. ve West, C. (2004) Outpatient Clinic Scheduling-A Simulation Approach. Proceedings of the 2004 Winter Simulation Conference, IEEE Computer SocietyPress, Piscataway, NJ.
  • Gül, M. ve Güneri, A.F (2012) “A Computer Simulation Model to Reduce Patient Length of Stay and to Improve Resource Utilization Rate in An Emergency Department Service System” International Journal of Industrial Engineering: Theory, Applications and Practice, 19(5):221-231.
  • Gül, M., Celik, E., Güneri, A.F. ve Gumus, A.T (2012) “Simulation with Integrated Multi Criteria Decision Making: An Application of Scenario Selection for a Hospital Emergency Department” Istanbul Commerce University Journal of Science, 11(22):1-18.
  • Günal, M.M. ve Pidd, M. (2010) “Discrete Event Simulation for Performance Modelling in Healthcare: A Review of The Literature” Journal of Simulation,4:42–51.
  • Hashimoto, F.B.S (1996) “Improving Outpatient Clinic Staffing and Scheduling with Computer Simulation” Journal of General Internal Medicine, 11:182- 184.
  • Komashie, A. ve Mousavi, A. (2005) “Modeling Emergency Departments Using Discrete Event Simulation Techniques” Proceedings of the 2005 Winter Simulation Conference, Orlando, FL, USA, December 4-7.
  • Krajewski, L.J., Ritzman, L.P. ve Malhotra, M.K. (2013) Operations Management Process and Supply Chains (Trans Ed. Semra Birgün) , Ankara, Nobel Press.
  • Levy, J.L., Watford, B.A. ve Owen, V.T. (1989) “Simulation Analysis of An Outpatient Services Facility” Journal of the Society for Health Systems, 1:35–49.
  • Najmuddin, A.F., Ibrahim, I.M. ve Ismail, S.R. (2010) “A Simulation Approach: Improving Patient Waiting Time for Multiphase Patient Flow of Obstetrics and Gynecology Department (O&G Department) in Local Specialist Centre” Wseas Transactions on Mathematics,10(9):778-790.
  • Özcan, Y. (2005) Quantitative Methods in Health Care Management Techniques and Applications, USA, Jossey- Bass Inc.
  • Özdağoğlu, A., Yalçınkaya, Ö. ve Özdağoğlu, G. (2009) “A Simulation Based Analysis of a Research and Application Hospital Emergency Patient Data in Aegean Region” Istanbul Commerce University Journal of Science, 8(16):61-73.
  • Paul, J.A ve Lin, L. (2012) “Models for Improving Patient Through put and Waiting at Hospital Emergency Departments” The Journal of Emergency Medicine, 43(6):1119-1126.
  • Rohleder, T.R., Lewkonia, P., Bischak, D., Duffy, P. ve Hendijani, R. (2011) “Using Simulation Modeling to Improve Patient Flow at an Outpatient Orthopedic Clinic” Health Care Management Science,14(2):135-145.
  • Sezen, H.K., Kaya, Ş. ve Günalı, M. (2012) “A Discrete Event Simulation for Resources Balancing in A University Hospital” Uludağ Journal of Economy and Society, 31(1): 179-191.
  • Sönmez, V. (2009) Simulation A Approach For Workforce Planning in A Blood Bank, M.Sc. Thesis, Ankara, Gazi University Institute of Science And Technology.
  • Su, Q. ve Yao, X. (2006) “Simulation and Optimization of the Hospital Registration Process Using Med Model, Service Operations and Logistics and Informatics” IEE international Conference, 102-106.
  • Taha, H.A (2007) Operations Research an Introduction, (Trans. Ed: Ş.Alp Baray ve Şakir Esnaf), Istanbul, Literatür Press.
  • Vanberkel, P.T. ve Blake, J.T. (2007) “A Comprehensive Simulation for Wait Time Reduction and Capacity Planning Applied in General Surgery” Health Care Management Science, 10(4):373-385.
  • Wijewickrama, A.K.A. ve Takakuwa, S. (2006) “Simulation Analysis of an Outpatient Department of Internal Medicine in a University Hospital” Proceedings of the 2006 Winter Simulation Conference, Monterey, California, USA, December 3-6.