Evaluation of booking systems for elective surgery using simulation experiments.
OBJECTIVE
This study compared two methods of booking elective surgery - booking from wait lists and pre-booking surgery dates at the time of decision to operate - in terms of cancellations of elective procedures and time to surgery.


METHODS
The authors conducted simulation experiments with group randomized design, in which the unit of allocation was the hospital and the units of analysis were both the hospital and the patient.


RESULTS
In the case of pre-booking, cancellation of high-priority elective procedures was only one-third as likely as it was in the case of booking from wait lists (odds ratio 0.35; 95% confidence interval 0.18-0.68). After adjustment for hospital and patient factors, the weekly likelihood that patients on the wait list had their operation was about 20% higher for medium-priority procedures (OR 1.21; CI 1.18-1.24) after pre-booking surgery dates.


CONCLUSIONS
The findings suggest that redesigning booking processes may improve the performance of surgical services.
Sobolev
Boris G
BG
Department of Health Care and Epidemiology, University of British Columbia, Vancouver, BC.
Sanchez
Victor
V
Kuramoto
Lisa
L
Levy
Adrian R
AR
Schechter
Martin
M
Fitzgerald
J Mark
JM