Developing a multi-methodological approach to hospital operating theatre scheduling

Abstract

Operating theatres and surgeons are among the most expensive resources in any hospital, so it is vital that they are used efficiently. Due to the complexity of the challenges involved in theatre scheduling we split the problem into levels and address the tactical and day-to-day scheduling problems.Cognitive mapping is used to identify the important factors to consider in theatre scheduling and their interactions. This allows development and testing of our understanding with hospital staff, ensuring that the aspects of theatre scheduling they consider important are included in the quantitative modelling.At the tactical level, our model assists hospitals in creating new theatre timetables, which take account of reducing the maximum number of beds required, surgeons’ preferences, surgeons’ availability, variations in types of theatre and their suitability for different types of surgery, limited equipment availability and varying the length of the cycle over which the timetable is repeated. The weightings given to each of these factors can be varied allowing exploration of possible timetables.At the day-to-day scheduling level we focus on the advanced booking of individual patients for surgery. Using simulation a range of algorithms for booking patients are explored, with the algorithms derived from a mixture of scheduling literature and ideas from hospital staff. The most significant result is that more efficient schedules can be achieved by delaying scheduling as close to the time of surgery as possible, however, this must be balanced with the need to give patients adequate warning to make arrangements to attend hospital for their surgery.The different stages of this project present different challenges and constraints, therefore requiring different methodologies. As a whole this thesis demonstrates that a range of methodologies can be applied to different stages of a problem to develop better solutions