Perioperative bed capacity planning guided by theory of constraints

In most hospitals, space planning and bed capacity decisions for the various stages of the perioperative system (preoperative, intraoperative, and postoperative capacity) are made by specialized architect firms, using data supplied by hospital finance department personnel. The planners make decisions using simple rules of thumb and base their decisions on average flow-times. Facing a similar situation, and under time pressure, we showed the superiority of a simple discrete-event simulation model: one that accounted for variability in flow-times, as opposed to traditional decision-making that is based on average times. The simulation model's logic was guided by the Theory of Constraints, which enabled focusing on the key issue - how many pre- and post-op beds are needed if all the Operating Rooms work at full capacity. Under some assumptions, our simulation output showed that there was already sufficient pre-op and post-op bed capacity, thus preventing the hospital from undertaking expensive capacity expansion.