University of Twente Student Theses


Logistics implementation of colon surgery in day-care at Medisch Spectrum Twente

Lubbers, Lars (2022) Logistics implementation of colon surgery in day-care at Medisch Spectrum Twente.

[img] PDF
Abstract:The research takes place at the surgery department at the Medisch Spectrum Twente hospital in Enschede, the Netherlands. In the upcoming years, it is expected that there will be more cases of colon surgery in the upcoming years in the Netherlands since colon surgeries are most prevalent with elderly people. Currently, the number of people in this age group is increasing due to the general aging of the Dutch population (CBS, 2022). This leads to more patients being hospitalized. In the current situation, after colon surgery all patients stay for on average 3.7 days in the hospital to recover and monitor complications. This is a comparatively long time as 50-70% of patients do not have any complications. So, they remain at the hospital unnecessarily. This is a disadvantage for both the hospital and patients as more beds are occupied and patients do recover better at home (Hentenaar & Demmer, 2021). A solution for this is implementing day-care for some colon surgery patients (CID). However, currently the logistics operations changes needed to implement CID are still unknown. In this research these logistics operations changes and their associated costs are evaluated. The aim of this thesis is on providing an overview of logistics implementations needed for performing colon surgery in day-care and subsequent in-home monitoring instead of a three-day hospital recovery and a cost-benefit analysis on the potential results of this implementation. To achieve this the following research question is formulated: Which logistics operations changes are needed to implement day-care for colon surgery and what does it cost Medisch Spectrum Twente? In this study, the first step is to create an overview of the current situation and the desired situation with CID. When comparing these situations, the logistics changes needed to transition to CID are evaluated. Following this, experts assist in choosing the best possible way of implementing these changes. To be able to give an insight into the project set-up costs the logistic changes are then programmed into a Monte Carlo simulation and are also put into a sensitivity analysis. Finally, these results are used to give a conclusion on the viability of CID. The main result is that the cost of introducing CID is approximately €37,000.00 . This is calculated in the Monte Carlo simulation dashboard. The main cost reduction comes from patients occupying hospital beds for a shorter period after surgery. The main costs involved are the set-up of the monitoring centre, the monitoring equipment, the extra policlinic time slots needed and the slight increase in rehospitalization rate. Furthermore, the sensitivity analysis showed that CID was very susceptible to upscaling as it became significantly more profitable when more patients are using CID. This is mainly due to the fixed costs that are made for the monitoring centre and equipment. As a conclusion, the logistics changes needed to transition to CID are the set-up of a monitoring centre and finding a suitable supplier for the remote monitoring, hiring, or assigning staff for the monitoring centre and increasing the available timeslots for the policlinic. The choice for a monitoring centre is to have a monitoring centre in the MST itself instead of a regional monitoring centre or nurses checking the monitoring during their regular shifts. The needed remote monitoring is either from Masimo or Luscii. These are two companies that provide remote monitoring for hospital use. Furthermore, to implement CID it is needed to reserve extra timeslots at the policlinic. This can be either one or two extra timeslots per patient. According to the simulation, the cost of introducing everything is approximately €37,000. Due to the potential for upscaling at the monitoring centre, it is recommended to investigate which other surgery types can make use of remote monitoring.
Item Type:Essay (Bachelor)
MST, Enschede, The Netherlands
Faculty:BMS: Behavioural, Management and Social Sciences
Programme:Industrial Engineering and Management BSc (56994)
Link to this item:
Export this item as:BibTeX
HTML Citation
Reference Manager


Repository Staff Only: item control page