Operating theatre modelling: integrating social measures

Hospital resource modelling literature is primarily focussed on productivity and efficiency measures. In this paper, our focus is on the alignment of the most valuable revenue factor, the operating room (OR) with the most valuable cost factor, the staff. When aligning these economic and social decisions, respectively, into one sustainable model, simulation results justify the integration of these factors. This research shows that integrating staff decisions and OR decisions results in better solutions for both entities. A discrete event simulation approach is used as a performance test to evaluate an integrated and an iterative model. Experimental analysis show how our integrated approach can benefit the alignment of the planning of the human resources as well as the planning of the capacity of the OR based on both economic related metrics (lead time, overtime, number of patients rejected) and social related metrics (personnel preferences, aversions, roster quality)

Taxonomic classification of planning decisions in health care: a review of the state of the art in OR/MS

We provide a structured overview of the typical decisions to be made in resource capacity planning and control in health care, and a review of relevant OR/MS articles for each planning decision. The contribution of this paper is twofold. First, to position the planning decisions, a taxonomy is presented. This taxonomy provides health care managers and OR/MS researchers with a method to identify, break down and classify planning and control decisions. Second, following the taxonomy, for six health care services, we provide an exhaustive specification of planning and control decisions in resource capacity planning and control. For each planning and control decision, we structurally review the key OR/MS articles and the OR/MS methods and techniques that are applied in the literature to support decision making

Operating room planning and scheduling: A literature review.

This paper provides a review of recent research on operating room planning and scheduling. We evaluate the literature on multiple fields that are related to either the problem setting (e.g. performance measures or patient classes) or the technical features (e.g. solution technique or uncertainty incorporation). Since papers are pooled and evaluated in various ways, a diversified and detailed overview is obtained that facilitates the identification of manuscripts related to the reader's specific interests. Throughout the literature review, we summarize the significant trends in research on operating room planning and scheduling and we identify areas that need to be addressed in the future.Health care; Operating room; Scheduling; Planning; Literature review;

Integrating nurse and surgery scheduling.

Scheduling; Surgery scheduling; International; Theory; Applications; Euro; Researchers;

Robust Optimization Framework to Operating Room Planning and Scheduling in Stochastic Environment

Arrangement of surgical activities can be classified as a three-level process that directly impacts the overall performance of a healthcare system. The goal of this dissertation is to study hierarchical planning and scheduling problems of operating room (OR) departments that arise in a publicly funded hospital. Uncertainty in surgery durations and patient arrivals, the existence of multiple resources and competing performance measures are among the important aspect of OR problems in practice. While planning can be viewed as the compromise of supply and demand within the strategic and tactical stages, scheduling is referred to the development of a detailed timetable that determines operational daily assignment of individual cases. Therefore, it is worthwhile to put effort in optimization of OR planning and surgical scheduling. We have considered several extensions of previous models and described several real-world applications. Firstly, we have developed a novel transformation framework for the robust optimization (RO) method to be used as a generalized approach to overcome the drawback of conventional RO approach owing to its difficulty in obtaining information regarding numerous control variable terms as well as added extra variables and constraints into the model in transforming deterministic models into the robust form. We have determined an optimal case mix planning for a given set of specialties for a single operating room department using the proposed standard RO framework. In this case-mix planning problem, demands for elective and emergency surgery are considered to be random variables realized over a set of probabilistic scenarios. A deterministic and a two-stage stochastic recourse programming model is also developed for the uncertain surgery case mix planning to demonstrate the applicability of the proposed RO models. The objective is to minimize the expected total loss incurred due to postponed and unmet demand as well as the underutilization costs. We have shown that the optimum solution can be found in polynomial time. Secondly, the tactical and operational level decision of OR block scheduling and advance scheduling problems are considered simultaneously to overcome the drawback of current literature in addressing these problems in isolation. We have focused on a hybrid master surgery scheduling (MSS) and surgical case assignment (SCA) problem under the assumption that both surgery durations and emergency arrivals follow probability distributions defined over a discrete set of scenarios. We have developed an integrated robust MSS and SCA model using the proposed standard transformation framework and determined the allocation of surgical specialties to the ORs as well as the assignment of surgeries within each specialty to the corresponding ORs in a coordinated way to minimize the costs associated with patients waiting time and hospital resource utilization. To demonstrate the usefulness and applicability of the two proposed models, a simulation study is carried utilizing data provided by Windsor Regional Hospital (WRH). The simulation results demonstrate that the two proposed models can mitigate the existing variability in parameter uncertainty. This provides a more reliable decision tool for the OR managers while limiting the negative impact of waiting time to the patients as well as welfare loss to the hospital

An efficient decomposition approach for surgical planning

This talk presents an efficient decomposition approach to surgical planning. Given a set of surgical waiting lists (one for each discipline) and an operating theater, the problem is to decide the room-to-discipline assignment for the next planning period (Master Surgical Schedule), and the surgical cases to be performed (Surgical Case Assignment), with the objective of optimizing a score related to priority and current waiting time of the cases. While in general MSS and SCA may be concurrently found by solving a complex integer programming problem, we propose an effective decomposition algorithm which does not require expensive or sophisticated computational resources, and is therefore suitable for implementation in any real-life setting. Our decomposition approach consists in first producing a number of subsets of surgical cases for each discipline (potential OR sessions), and select a subset of them. The surgical cases in the selected potential sessions are then discarded, and only the structure of the MSS is retained. A detailed surgical case assignment is then devised filling the MSS obtained with cases from the waiting lists, via an exact optimization model. The quality of the plan obtained is assessed by comparing it with the plan obtained by solving the exact integrated formulation for MSS and SCA. Nine different scenarios are considered, for various operating theater sizes and management policies. The results on instances concerning a medium-size hospital show that the decomposition method produces comparable solutions with the exact method in much smaller computation time

A framework for health care planning and control

Rising expenditures spur health care organizations to organize their processes more efficiently and effectively. Unfortunately, health care planning and control lags far behind manufacturing planning and control. Successful manufacturing planning and control concepts can not be directly copied, because of the unique nature of health care delivery. We analyze existing planning and control concepts or frameworks for health care operations management, and find that they do not properly address various important planning and control problems. We conclude that they only focus on hospitals, and are too narrow, focusing on a single managerial area, such as resource capacity planning, or ignoring hierarchical levels. We propose a modern framework for health care planning and control. Our framework integrates all managerial areas involved in health care delivery operations and all hierarchical levels of control, to ensure completeness and coherence of responsibilities for every managerial area. The framework can be used to structure the various planning and control functions, and their interaction. It is applicable broadly, to an individual department, an entire health care organization, and to a complete supply chain of cure and care providers. The framework can be used to identify and position various types of managerial problems, to demarcate the scope of organization interventions, and to facilitate a dialogue between clinical staff and managers. We illustrate the application of the framework with examples

An Automatic and Intelligent System for Integrated Healthcare Processes Management

In this work, an automatic and intelligent system for integrated healthcare processes management is developed on a constraint based system. This project has been carried out in collaboration with a real assisted repro-duction clinic. Our goal is to improve the efficiency of the clinic by facilitating the management of the integrated healthcare system. This is very important in an environment in which the healthcare processes present complex temporal and resource constraints.Ministerio de Economía y Competitividad TIN2016-76956-C3-2-RMinisterio de Economía y Competitividad TIN2015-71938-RED