PERBANDINGAN RESILIENCE CONCEPT DAN RULE-BASED TERHADAP PENANGANAN JADWAL OPERASI BEDAH UNTUK EMERGENCY CASE DAN ELECTIVE SURGERY

Surgical schedule changes, caused by uncertainty case on the day of operation, can decrease the hospital’s service quality. Resilience Concept algorithm produces the risk value for schedule modification caused by the uncertainty case. However, this algorithm only managed the delay of elective surgery in previous research. Therefore, this study applies the resilience concept algorithm in handling the emergency case, and the shift of elective surgery into earlier than its current schedule. Resilience algorithm’s performance is compared to Rule-Based algorithm in managing the surgery’s schedule for uncertainty case. There are 20 test scenarios, consisting of 12 scenarios for elective surgery schedule changes and 8 scenarios for emergency case, that were given trial to the algorithms. Both of the algorithms 100% succeeded passing through all the scenarios. Yet, both of the algorithms could not give the priority schedule changes based on the risk level. Resilience algorithm could not give the priority based on the risk level of value caused by the imperfection of the resources delay calculation (Tn).Keywords: Surgical schedule, Resilience Concept, Rule-Based, Uncertainty Case, Emergency CaseAbstrakPerubahan jadwal operasi akibat kejadian tidak terduga (uncertainty case) di hari-H operasi dapat menurunkan kualitas layanan rumah sakit. Algoritma Resilience Concept menghasilkan nilai resiko untuk setiap perubahan jadwal operasi yang terjadi akibat uncertainty case. Namun, algoritma ini hanya mengelola perubahan jadwal akibat keterlambatan penyelesaian operasi elektif, yang merupakan salah satu uncertainty case, pada penelitian sebelumnya. Oleh karena itu, penelitian ini menerapkan algoritma resilience concept dalam menangani kasus gawat darurat (emergency case), dan perubahan waktu pelaksanaan operasi elektif menjadi lebih awal. Kinerja algoritma resilience concept dibandingkan dengan algoritma rule-based dalam mengelola jadwal operasi untuk uncertainty case. Terdapat 20 skenario pengujian diujicobakan kepada kedua algoritma, yang terdiri dari 12 skenario pengujian perubahan jadwal operasi elektif dan 8 skenario emergency case . Kedua algoritma 100% berhasil mengeksekusi semua skenario pengujian. Akan tetapi, keduanya belum dapat memberikan prioritas perubahan jadwal berdasarkan tingkatan resiko. Ketidakoptimalan perhitungan waktu keterlambatan sumber daya (Tn) menjadi penyebab algoritma Resilience belum dapat memberikan prioritas solusi berdasarkan nilai resiko yang dihasilkan.Kata Kunci: Jadwal Operasi, Resilience Concept, Rule-Based, Uncertainty Case, Emergency Case

Resilience in the Surgical Scheduling to Support Adaptive Scheduling System

Operating Room (OR) managers frequently encounter uncertainties related to real-time scheduling, especially on the day of surgery. It is necessary to enable earlier identification of uncertainties occurring in the perioperative environment. This study aims to propose a framework for resilient surgical scheduling by identifying uncertainty factors affecting the real-time surgical scheduling through a mixed-methods study. We collected the pre- and post-surgical scheduling data for twenty days and a one-day observation data in a top-tier general university hospital in South Korea. Data were compared and analyzed for any changes related to the dimensions of uncertainty. The observations in situ of surgical scheduling were performed to confirm our findings from the quantitative data. Analysis was divided into two phases of fundamental uncertainties categorization (conceptual, technical and personal) and uncertainties leveling for effective decision-making strategies. Pre- and post-surgical scheduling data analysis showed that unconfirmed patient medical conditions and emergency cases are the main causes of frequent same-day surgery schedule changes, with derived factors that affect the scheduling pattern (time of surgery, overtime surgery, surgical procedure changes and surgery duration). The observation revealed how the OR manager controlled the unexpected events to prevent overtime surgeries. In conclusion, integrating resilience approach to identifying uncertainties and managing event changes can minimize potential risks that may compromise the surgical personnel and patients’ safety, thereby promoting higher resilience in the current system. Furthermore, this strategy may improve coordination among personnel and increase surgical scheduling efficiency