Objective:

To evaluate an asymmetric, centralized fast-track operating room allocation strategy using discrete-event simulation to manage increased pediatric surgery demand during peak seasons.

Approach:

• Model Construction: Developed a discrete-event simulation model using retrospective operational data from Shanghai Children's Medical Center.
• Simulation Mechanism: Introduced a Prospective Simulation Probing mechanism under a dynamic safety-buffer policy to determine daily capacities.
• Turnover Scenarios: Modeled fast-track turnover times with reductions of 5, 10, and 15 minutes compared to regular OR turnover times.

Key Findings:

• The optimized 15-minute turnover-reduction scenario yielded a mean total throughput of 3,588.7 cases (median 3,589; 95% simulation interval, 3,562–3,614), a 38.29% increase over the historical baseline of 2,595 cases (95% interval for increase, 37.26%–39.27%).
• The conservative 10-minute reduction scenario resulted in a mean throughput of 3,208.3 cases (median not specified), a 23.63% increase.
• Centralized pooling protected throughput for complex surgeries while increasing capacity for fast-track procedures.

Interpretation:

The study suggests that separating short fast-track procedures from complex surgeries can enhance OR efficiency and throughput.

Limitations:

• Implementation depends on staffing flexibility and local cost considerations.
• The study is based on a single medical center's data, which may limit generalizability.

Conclusion:

Discrete-event simulation indicates that a centralized fast-track OR allocation strategy can manage the surge in pediatric surgeries during peak seasons.