Many hospitals generate substantial revenue by surgical procedures which are key value-adding processes. As these typically bind a large number of expensive resources, coordination and scheduling aspects are of paramount importance.
Due to a high density of resources, the hospital's operating unit is at center stage of these coordination-centric workflows. Such a unit typically operates a large number of operating rooms in concurrent mode. For any given patient case, many human (e.g. surgeons, anesthesiologists, scrub nurses, technicians) and non-human resources (e.g. technical medical equipment, instrument sets, and capacity for post-operative care) are required. However, in general these resources are shared and scarce. Consequently, OR-centric workflows are characterized by the challenge to utilize these resources as efficiently as possible and to synchronize them with multiple concurrent, dynamic patient care processes.
Besides the medical care of the patient, there are a number of complex administrative tasks to be done on the day of surgery. The latter is the job of the OR coordinator, who may be assisted by other decision-making people such as a charge nurse and a charge anesthesiologist.
While the operating unit generates the majority of the process costs, other departments such as the hospital's diagnostic center, the intensive care unit (ICU) and the in-patient wards, are by no means negligible and must also be integrated into a cost-aware, process-oriented supporting solution.
On the whole, the complete surgery-related business processes must be well-managed and scheduled in order to be cost-efficient while at the same time meeting the patient's expectations of timely service-delivery.
These challenges call for a supporting system that is process-oriented, resource-centric, and schedule-aware.
PERIKLES aims at introducing an IT-based solution that meets these requirements. The project specifically focuses on the period of perioperative care which refers to both medical treatment as well as administrative tasks that take place before, during or after the surgical procedure. In addition to the perioperative clinical stage of the patient's careplan, PERIKLES also takes into account the pre-admission part of the process. Thus, a typical elective case starts in the outpatient unit of the hospital, where the patient is assessed by the surgeon and the decision for an operative procedure is made.
By its very nature, perioperative processes are highly dynamic. For instance, due to deterioration of his or her condition, an elective patient may become an emergency case, requiring immediate surgery. Such unforeseen and unpredictable events are quite common and may call for short-term coordination decisions, possibly on the day of surgery itself. Therefore, the proposed process-aware solution must support the execution of business processes that can deviate from a predefined standard.
Given this scenario, our research initiative will investigate the potential of innovative software and hardware approaches to support typical coordination and cooperation challenges in a dynamic perioperative environment.
