Bed and stoma nurse capacity planning for frail and elderly patients undergoing emergency laparotomy: a simulation modelling approach

Williams, Elizabeth ORCID: https://orcid.org/0000-0003-4515-441X, Gartner, Daniel ORCID: https://orcid.org/0000-0003-4361-8559, Harper, Paul ORCID: https://orcid.org/0000-0001-7894-4907, Long, Sara and Kalamakidou, Anna 2026. Bed and stoma nurse capacity planning for frail and elderly patients undergoing emergency laparotomy: a simulation modelling approach. Presented at: Winter Simulation Conference, Glasgow, Scotland, UK, 6-9 December 2026. Published in: Ramomohan, V., Djanatliev, A., Fakhimi, M., Krejci, C., Ruiz Martin, C., Onggo, B. S. and Mustafee, N. eds. Proceedings of 2026 Winter Simulation Conference. Item availability restricted.

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Abstract

Emergency laparotomy in older adults is associated with high morbidity and mortality, often complicated by the need for stoma formation and the presence of frailty. This study aims to optimize healthcare resources, with a focus on bed capacity and specialized stoma nurse allocation. A discrete event simulation (DES) model was developed and validated against historical data, achieving high accuracy in replicating cycle times and patient survival rates. Clinical data from 191 patients in the UK were used to inform the model. Simulation results indicate that a baseline configuration of 36 beds and 10 stoma nurses is sufficient to maintain an average care cycle of 18.5 days. Furthermore, the model demonstrated that implementing a geographically informed routing strategy, by routing patients to the nearest available stepdown facility, could further reduce the care cycle to 17.5 days, improving system efficiency and reducing hospital congestion. These findings highlight the importance of integrating frailty-informed care pathways with operational modelling to improve system efficiency and reduce hospital queues in high-risk populations.

Item Type:	Conference or Workshop Item - published (Paper)
Status:	In Press
Schools:	Schools > Computational & Mathematical Sciences Schools > Mathematics
Related URLs:	Organisation
Date of First Compliant Deposit:	27 August 2026
Date of Acceptance:	17 August 2026
Last Modified:	27 Aug 2026 14:15
URI:	https://orca.cardiff.ac.uk/id/eprint/189198

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