  For operating rooms (ORs) and hospitals, inventory management of surgical
instruments and material handling decisions of perioperative services are
critical to hospitals' service levels and costs. However, efficiently
integrating these decisions is challenging due to hospitals' interdependence
and the uncertainties they face. These challenges motivated the development of
this study to answer the following research questions: (R1) How does the
inventory level of surgical instruments, including owned, borrowed and
consigned, impact the efficiency of ORs? (R2) How do material handling
activities impact the efficiency of ORs? (R3) How do integrating decisions
about inventory and material handling impact the efficiency of ORs? Three
discrete event simulation models are developed here to address these questions.
Model 1, Current, assumes no coordination of material handling and inventory
decisions. Model 2, Two Batch, assumes partial coordination, and Model 3,
Just-In-Time (JIT), assumes full coordination. These models are verified and
validated using real life-data from a partnering hospital. A thorough numerical
analysis indicates that, in general, coordination of inventory management of
surgical instruments and material handling decisions has the potential to
improve the efficiency and reduce OR costs. More specifically, a JIT delivery
of instruments used in short-duration surgeries leads to lower inventory levels
without jeopardizing the service level provided.
