Using Discrete Event Simulation (DES) to manage theatre operations in healthcare: An audit-based case study

This paper discusses the application of Discrete Event Simulation (DES) in modelling the complex relationship between patient types, case-mix and operating theatre allocation in a large National Health Service (NHS) Trust in London. The simulation model that was constructed described the main features of nine theatres, focusing on operational processes and patient throughput times. The model was used to test three scenarios of case-mix and to demonstrate the potential of using simulation modelling as a cost effective method for understanding the issues of healthcare operations management and the role of simulation techniques in problem solving. The results indicated that removing all day cases will reduce patient throughput by 23.3% and the utilization of the orthopaedic theatre in particular by 6.5%. This represents a case example of how DES can be used by healthcare managers to inform decision making. © 2008 IEEE.

Analysis of basic processes inside the keyhole during deep penetration ND-YAG CW laser welding

During laser welding, the keyhole is generated by the recoil pressure induced by the evaporation processes occurring mainly on the front keyhole wall (KW). In order to characterize the evaporation process, we have measured this recoil pressure by using a plume deflection technique, where the plume generated for static conditions (i. e. with no sample displacement) is deflected by a transverse side gas jet. From the measurement of the plume deflection angle, the recoil pressure can be determined as a function of incident intensity and sample material. From these data one can estimate the pressure generated on the front KW, during laser welding. Therefore, the corresponding dynamic pressure exerted by the vapor plume expansion on the rear KW, in contact with the melt pool, can be also estimated. These pressures appear to be in close agreement with those generated by an additional side jet that has been used in previous experiments, for stabilizing the observed melt pool oscillations or fluctuations.