Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully selected papers dealing with optimization and decision analysis problems in the field of health care operations management

Carter, M.W.

Hans, E.W.

Kolisch, R.

English

Michael Carter

Erwin W. Hans

Rainer Kolisch

Springer - Publisher Connector

OR Spectrum (2012) 34:315–317
DOI 10.1007/s00291-012-0288-1
EDITORIAL
Health care operations management
Michael Carter · Erwin W. Hans · Rainer Kolisch
Published online: 14 February 2012
© The Author(s) 2012. This article is published with open access at Springerlink.com
Health care operations management has become a major topic for health care service
providers and society. Operations research already has and further will make con-
siderable contributions for the effective and efficient delivery of health care services.
This special issue collects seven carefully selected papers dealing with optimization
and decision analysis problems in the field of health care operations management.
The papers cover a considerable range of health care problems including location
planning for hospital and health services (Mestre et al., Zhang et al.), organization
of hospital resources (Vanberkel et al., Hulshof et al.), surgery scheduling (Marques
et al., Herring and Herrmann) and treatment scheduling (Schimmelpfeng et al.). These
problems are addressed within a number of different health care environments such as
hospitals, preventive care, outpatient clinics and rehabilitation hospitals. The opera-
tions research techniques which are employed are mixed-integer linear programming,
stochastic dynamic programming, hierarchical decomposition, queueing theory, sim-
ulation and choice models. The special issue thus covers a broad range of problems,
environments and techniques. It is noteworthy that all papers are either treating a
real life problem or are inspired by the latter, which demonstrates the problem-driven
M. Carter
Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Canada
e-mail: carter@mie.utoronto.ca
E. W. Hans
CHOIR Center for Healthcare Optimization and Research,
School of Management and Governance, University of Twente, Enschede, The Netherlands
e-mail: e.w.hans@utwente.nl
R. Kolisch (B)
TUM School of Management, Technische Universität München, München, Germany
e-mail: rainer.kolisch@wi.tum.de
123
316 M. Carter et al.
nature of health care operations research. In particular, this special issue addresses the
following topics.
Location, supply and referrals in planned hospital systems
The paper of A.M. Mestre, M.D. Oliveira and A. Barbosa-Póvoa revolves around mak-
ing decisions on geographic location and organization of hospital services to achieve
equitable health care access and efficient health care delivery. A hierarchical multiser-
vice mathematical programming model is proposed, which simultaneously considers
the multiservice structure of hospitals’ production, the hospital network configuration
costs, the articulation between different hospital services and between hospital units,
and the ascendant and descendent flows related to two-way referrals of patients in the
hospital hierarchy. The model is applied to the real case of the South region of the
Portuguese National Health Service.
Preventive health care facility network design
Y. Zhang, O. Berman and V. Verter contribute an interesting study of the design of
preventive healthcare facility networks, where the aim is to maximize participation of
the clientele. Clientele has access to preventive health care in their region on a volun-
tary basis. Therefore, when designing the facility network, it is essential to study how
clients choose the facilities to patronize. The authors propose two alternative mixed
integer models to study the impact of client choice behavior on the configuration of a
preventive care facility network and the resulting level of participation. Problems are
solved with a probabilistic search algorithm and a genetic algorithm. The models are
used to analyze the network of mammography centers in Montreal.
Comparison of centralized and focused clinics
P.T. Vanberkel, R.J. Boucherie, E.W. Hans, J.L. Hurink and N. Litvak compare central-
ized clinics where health care resources are pooled according to function to achieve
economies of scale with focused clinics where health care resources are organized
around patient groups such as breast cancer patients. Using queueing theory and sim-
ulation, the authors derive a number of interesting results under what circumstances
each of the two settings, pooled versus focused, is more advantageous.
Analytical models to determine room requirements in outpatient clinics
P.J.H. Hulshof, P.T. Vanberkel, R.J. Boucherie, E.W. Hans, M. van Houdenhoven and
J.-K.C.W. van Ommeren consider the question of how many examination rooms to
assign to a doctor working in an ambulatory clinic. The problem arises when patients
have some activities that do not require the doctor to be present such as when a
nurse performs a preliminary consult. Since all times are stochastic, the authors used
123
Health care operations management 317
queueing theory to find the optimal trade-off between doctor utilization, access time,
and patient wait time.
Scheduling of surgeries
The paper of I. Marques, M.E. Captivo and M.V. Pato addresses the popular topic
of elective surgery scheduling. In particular, they study the problem of simultaneous
advance and allocation scheduling, thus assigning elective surgeries to an operating
room, day, and period to maximize utilization. The authors develop an integer linear
programming approach and improvement heuristics, and test these on a real case of
a hospital in Lisbon. The results are benchmarked against the actual performance of
the hospital’s surgical suite.
The single-day surgery scheduling problem
W.L. Herring and J.W. Herrmann propose a new approach to surgery scheduling. In
practice, many hospitals use a threshold date to release unused operating room time.
They know that high priority cases continue to arrive, and allocating surgical time to
lower priority patients could create problems on the actual day. To make more equi-
table waiting list decisions, the authors recommend that operating room managers
should gradually release unused OR time over the course of several days leading up
to the day of surgery.
Scheduling treatments in rehabilitation hospitals
K. Schimmelpfeng, S. Helber and S. Kasper consider the problem of scheduling treat-
ments in rehabilitation hospitals. This problem has several unique characteristics such
as fixed and deterministic processing times, the assignment of a specific resource to a
specific patient for a series of treatments, and scheduling of collective activities such
as groups of patients for some joint therapy. The authors propose a large-scale mixed
integer linear program (MILP) which, due to its size, is hierarchically decomposed into
a three-stage model. By experimental comparison of the MILP and the decomposition
approach, it is shown that the latter is capable of solving large real-world problems
without sacrificing too much solution quality.
Open Access This article is distributed under the terms of the Creative Commons Attribution License
which permits any use, distribution, and reproduction in any medium, provided the original author(s) and
the source are credited.
123


Health care operations management

Carter, Michael

Hans, Erwin W.

Kolisch, Rainer

University of Twente Research Information

OR Spectrum (2012) 34:315–317DOI 10.1007/s00291-012-0288-1EDITORIALHealth care operations managementMichael Carter · Erwin W. Hans · Rainer KolischPublished online: 14 February 2012© The Author(s) 2012. This article is published with open access at Springerlink.comHealth care operations management has become a major topic for health care serviceproviders and society. Operations research already has and further will make con-siderable contributions for the effective and efficient delivery of health care services.This special issue collects seven carefully selected papers dealing with optimizationand decision analysis problems in the field of health care operations management.The papers cover a considerable range of health care problems including locationplanning for hospital and health services (Mestre et al., Zhang et al.), organizationof hospital resources (Vanberkel et al., Hulshof et al.), surgery scheduling (Marqueset al., Herring and Herrmann) and treatment scheduling (Schimmelpfeng et al.). Theseproblems are addressed within a number of different health care environments such ashospitals, preventive care, outpatient clinics and rehabilitation hospitals. The opera-tions research techniques which are employed are mixed-integer linear programming,stochastic dynamic programming, hierarchical decomposition, queueing theory, sim-ulation and choice models. The special issue thus covers a broad range of problems,environments and techniques. It is noteworthy that all papers are either treating areal life problem or are inspired by the latter, which demonstrates the problem-drivenM. CarterDepartment of Mechanical and Industrial Engineering, University of Toronto, Toronto, Canadae-mail: carter@mie.utoronto.caE. W. HansCHOIR Center for Healthcare Optimization and Research,School of Management and Governance, University of Twente, Enschede, The Netherlandse-mail: e.w.hans@utwente.nlR. Kolisch (B)TUM School of Management, Technische Universität München, München, Germanye-mail: rainer.kolisch@wi.tum.de123316 M. Carter et al.nature of health care operations research. In particular, this special issue addresses thefollowing topics.Location, supply and referrals in planned hospital systemsThe paper of A.M. Mestre, M.D. Oliveira and A. Barbosa-Póvoa revolves around mak-ing decisions on geographic location and organization of hospital services to achieveequitable health care access and efficient health care delivery. A hierarchical multiser-vice mathematical programming model is proposed, which simultaneously considersthe multiservice structure of hospitals’ production, the hospital network configurationcosts, the articulation between different hospital services and between hospital units,and the ascendant and descendent flows related to two-way referrals of patients in thehospital hierarchy. The model is applied to the real case of the South region of thePortuguese National Health Service.Preventive health care facility network designY. Zhang, O. Berman and V. Verter contribute an interesting study of the design ofpreventive healthcare facility networks, where the aim is to maximize participation ofthe clientele. Clientele has access to preventive health care in their region on a volun-tary basis. Therefore, when designing the facility network, it is essential to study howclients choose the facilities to patronize. The authors propose two alternative mixedinteger models to study the impact of client choice behavior on the configuration of apreventive care facility network and the resulting level of participation. Problems aresolved with a probabilistic search algorithm and a genetic algorithm. The models areused to analyze the network of mammography centers in Montreal.Comparison of centralized and focused clinicsP.T. Vanberkel, R.J. Boucherie, E.W. Hans, J.L. Hurink and N. Litvak compare central-ized clinics where health care resources are pooled according to function to achieveeconomies of scale with focused clinics where health care resources are organizedaround patient groups such as breast cancer patients. Using queueing theory and sim-ulation, the authors derive a number of interesting results under what circumstanceseach of the two settings, pooled versus focused, is more advantageous.Analytical models to determine room requirements in outpatient clinicsP.J.H. Hulshof, P.T. Vanberkel, R.J. Boucherie, E.W. Hans, M. van Houdenhoven andJ.-K.C.W. van Ommeren consider the question of how many examination rooms toassign to a doctor working in an ambulatory clinic. The problem arises when patientshave some activities that do not require the doctor to be present such as when anurse performs a preliminary consult. Since all times are stochastic, the authors used123Health care operations management 317queueing theory to find the optimal trade-off between doctor utilization, access time,and patient wait time.Scheduling of surgeriesThe paper of I. Marques, M.E. Captivo and M.V. Pato addresses the popular topicof elective surgery scheduling. In particular, they study the problem of simultaneousadvance and allocation scheduling, thus assigning elective surgeries to an operatingroom, day, and period to maximize utilization. The authors develop an integer linearprogramming approach and improvement heuristics, and test these on a real case ofa hospital in Lisbon. The results are benchmarked against the actual performance ofthe hospital’s surgical suite.The single-day surgery scheduling problemW.L. Herring and J.W. Herrmann propose a new approach to surgery scheduling. Inpractice, many hospitals use a threshold date to release unused operating room time.They know that high priority cases continue to arrive, and allocating surgical time tolower priority patients could create problems on the actual day. To make more equi-table waiting list decisions, the authors recommend that operating room managersshould gradually release unused OR time over the course of several days leading upto the day of surgery.Scheduling treatments in rehabilitation hospitalsK. Schimmelpfeng, S. Helber and S. Kasper consider the problem of scheduling treat-ments in rehabilitation hospitals. This problem has several unique characteristics suchas fixed and deterministic processing times, the assignment of a specific resource to aspecific patient for a series of treatments, and scheduling of collective activities suchas groups of patients for some joint therapy. The authors propose a large-scale mixedinteger linear program (MILP) which, due to its size, is hierarchically decomposed intoa three-stage model. By experimental comparison of the MILP and the decompositionapproach, it is shown that the latter is capable of solving large real-world problemswithout sacrificing too much solution quality.Open Access This article is distributed under the terms of the Creative Commons Attribution Licensewhich permits any use, distribution, and reproduction in any medium, provided the original author(s) andthe source are credited.123

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