Optimizing Resources for Endovascular Clot Retrieval for Acute Ischemic Stroke, a Discrete Event Simulation

Frontiers in Neurology

Ronil V. Chandra¹  Christen D. Barras²  Julian Maingard³  Hamed Asadi⁵  Hong Kuan Kok⁶  Duncan Mark Brooks⁹  Vincent Thijs⁹  Shiwei Huang^1,10 

[1] 0Department of Surgery and Department of Medicine, Monash University, Clayton, VIC, Australia;Department of Radiology, Royal Adelaide Hospital, Adelaide, SA, Australia;Faculty of Health, School of Medicine, Deakin University, Waurn Ponds, VIC, Australia;Interventional Neuroradiology Service, Department of Radiology, Austin Health, Heidelberg, VIC, Australia;Interventional Neuroradiology, Monash Imaging, Monash Medical Centre, Clayton, VIC, Australia;Interventional Radiology Service, Department of Radiology, Northern Health, Epping, VIC, Australia;South Australian Health and Medical Research Institute, The University of Adelaide, Adelaide, SA, Australia;Stroke Division, Department of Neurology, Austin Health, Melbourne, VIC, Australia;Stroke Division, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC, Australia;The Canberra Hospital, Canberra, ACT, Australia;

关键词: discrete event simulation (DES);    endovascular clot retrieval;    resource optimization;    mechanical thrombectomy;    resource allocation;    workflow simulation;   

DOI  :  10.3389/fneur.2019.00653

来源: DOAJ

【 摘 要 】

Objective: Endovascular clot retrieval (ECR) is the standard of care for acute ischemic stroke due to large vessel occlusion. Performing ECR is a time critical and complex process involving many specialized care providers and resources. Maximizing patient benefit while minimizing service cost requires optimization of human and physical assets. The aim of this study is to develop a general computational model of an ECR service, which can be used to optimize resource allocation.Methods: Using a discrete event simulation approach, we examined ECR performance under a range of possible scenarios and resource use configurations.Results: The model demonstrated the impact of competing emergency interventional cases upon ECR treatment times and time impact of allocating more physical (more angiographic suites) or staff resources (extending work hours).Conclusion: Our DES model can be used to optimize resources for interventional treatment of acute ischemic stroke and large vessel occlusion. This proof-of-concept study of computational simulation of resource allocation for ECR can be easily extended. For example, center-specific cost data may be incorporated to optimize resource allocation and overall health care value.

【 授权许可】

Unknown