title: [Simulation of waiting time and effectiveness in hospitals].
abstract: BACKGROUND
  Many Norwegian hospitals have to cancel elective surgery because of acute cases, and ring fencing of elective surgery is a frequently discussed measure. In this article we discuss advantages and disadvantages of ring fencing in relation to the results from a simulation model.
  
  
  METHODS
  Model simulations were done in the computer program Powersim Constructor 2.5.
  
  
  RESULTS
  We found that combined acute and elective departments are expected to have shorter waiting time and less use of overtime compared with separate acute and elective departments, as more flexible use of capacity results in higher average capacity utilization. In a combined department, elective patients run the risk of having their operation cancelled, but they may expect a shorter waiting time before treatment.
  
  
  CONCLUSIONS
  Our results indicate that ring fencing in itself is not beneficial, as total capacity utilization declines. On the other hand, separate departments may facilitate an increase in efficiency in the elective surgery department; this may shorten waiting time.
authors.affiliation: Institutt for helseledelse og helseøkonomi, Universitetet i Oslo, Postboks 1089, 0317 Oslo. gtjoflot@medisin.uio.no
authors.forename: Gunn Kristin
authors.initials: GK
authors.lastname: Tjoflot
authors.forename: Hans Th
authors.initials: HT
authors.lastname: Waaler
authors.forename: Tor
authors.initials: T
authors.lastname: Iversen
mesh_terms: D001071:Appointments and Schedules; D003198:Computer Simulation; D017598:Efficiency, Organizational; D017558:Elective Surgical Procedures; D004636:Emergency Service, Hospital / Q000458:organization & administration / Q000706:statistics & numerical data; D006739:Hospital Administration; D017146:Models, Organizational; D009664:Norway; D009873:Operating Rooms / Q000458:organization & administration* / Q000706:statistics & numerical data; D012984:Software; D013503:Surgery Department, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D014850:Waiting Lists