Abstract
Health care providers face a continuous increase in the complexity of organizations mainly due to the increasing demand and to the development of new and expensive technologies. The operating room (OR) is a major challenge in the hospital and is crucial for the institution financial health. Moreover, the OR has a large impact in several units of the hospital and on the workforce of the immediate up- and downstream units. In the last decades, surgery demand has been increasing with restrictive resources, forcing ORs to be more efficiently and effectively managed. This work is developed under a partnership with a Portuguese public hospital and aims to achieve a major social impact, which is increasing surgical access and thus reducing the patients waiting lists. Given the hospital restrictions in terms of space and staff, this work focuses on the reallocation of the available OR time among the surgical services, proposing new master surgical schedules—aggregate production planning consisting of timetables with specific timeslots assigned to each specialty. The main objective is to match demand and the existing capacity while maximizing OR efficiency. This work proposes a mathematical programming model, with three objectives: to maximize the allocated slots weighted by aggregated staff preferences; to match supply and demand; and to level the workload of up- and downstream units. A comparison of the actual allocation of slots with the one suggested by this approach is performed. Results show that the workforce is one of the major bottlenecks, suggesting a new distribution of the workforce among the specialties.
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Notes
- 1.
\(t_{sw} = \textit{slots available}_w \displaystyle \frac{\textit{nb patients in the waiting list}_{sw}\times \textit{av surgery duration}_{s}}{\sum _{s \in \mathrm {S}}{} \textit{nb patients in the waiting list}_{sw}\times \textit{av surgery duration}_{s}}\).
References
Abdelrasol, Z., Harraz, N., Eltawil, A.: Operating room scheduling problems: a survey and a proposed solution framework. In: Kim, H.K., Ao, S.-I., Amouzegar, M.A. (eds.) Transactions on Engineering Technologies, pp. 717–731. Springer, Dordrecht (2014)
Banditori, C., Cappanera, P., Visintin, F.: A combined optimization-simulation approach to the master surgical scheduling problem. IMA J. Manag. Math. 24(2), 155–187 (2013)
Cappanera, P., Visintin, F., Banditori, C.: Addressing conflicting stakeholders’ priorities in surgical scheduling by goal programming. Fex. Serv. Manuf. J. 30(1–2), 252–271 (2018)
ERS: Deliberação do Conselho de Administração da Entidade Reguladora da Saúde (ERS). Entidade Reguladora da Saúde (2016) https://www.ers.pt/uploads/document/file/14103/Vers_o_n_o_Confidencial__ERS_61-17.pdf
Agnetis, A., Coppi, A., Corsini, M., Dellino, G., Meloni, C., Pranzo, M.: Long term evaluation of operating theater planning policies. Oper. Res. Health. Care. 1(4), 95–104 (2012)
Beliën, J., Demeulemeester, E.: Building cyclic master surgery schedules with leveled resulting bed occupancy. Eur. J. Oper. Res. 76(2), 1185–1204 (2007)
Blake, J.T., Dexter, F., Donald, J.: Operating room managers’ use of integer programming for assigning block time to surgical groups: a case study. Anesth. Analg. 94(1), 143–148 (2002)
Blake, J.T., Donald, J.: Mount Sinai hospital uses integer programming to allocate operating room time. Interfaces 32(2), 63–73 (2002)
Day, R., Garfinkel, R., Thompson, S.: Integrated block sharing: A win-win strategy for hospitals and surgeons. Manuf. Serv. Oper. Manag. 14(4), 567–583 (2012)
Dellaert, N., Jeunet, J.: A variable neighborhood search algorithm for the surgery tactical planning problem. Comput. Oper. Res. 84, 216–225 (2017)
Guido, R., Conforti, D.: A hybrid genetic approach for solving an integrated multi-objective operating room planning and scheduling problem. Comput. Oper. Res. 87, 270–282 (2017)
Liu, Y., Chu, C., Wang, K.: A new heuristic algorithm for the operating room scheduling problem. Comput. Ind. Eng. 61(3), 865–871 (2011)
Malik, M.M., Khan, M., Abdallah, S.: Aggregate capacity planning for elective surgeries: a bi-objective optimization approach to balance patients waiting with healthcare costs. Oper. Res. Health. Care. 7, 3–13 (2015)
Marques, I., Captivo, M.E., Barros, N.: Optimizing the master surgery schedule in a private hospital. Oper. Res. Health. Care. 20, 11–24 (2019)
Penn, M.L., Potts, C.N., Harper, P.R.: Multiple criteria mixed-integer programming for incorporating multiple factors into the development of master operating theatre timetables. Eur. J. Oper. Res. 262(1), 194–206 (2017)
Samudra, M., Van Riet, C., Demeulemeester, E., Cardoen, B., Vansteenkiste, N., Rademakers, F.E.: Scheduling operating rooms: achievements, challenges and pitfalls. J. Sched. 19(5), 493–525 (2016)
Santibáñez, P., Begen, M., Atkins, D.: Surgical block scheduling in a system of hospitals: an application to resource and wait list management in a British Columbia health authority. Health. Care. Manag. Sci. 10(3), 269–282 (2007)
Visintin, F., Cappanera, P., Banditori, C.: Evaluating the impact of flexible practices on the master surgical scheduling process: an empirical analysis. Flex. Serv. Manuf. J. 28(1–2), 182–205 (2016)
Visintin, F., Cappanera, P., Banditori, C., Danese, P.: Development and implementation of an operating room scheduling tool: an action research study. Prod. Plan. Control. 28(9), 758–775 (2017)
Zhang, B., Murali, P., Dessouky, M.M., Belson, D.: A mixed integer programming approach for allocating operating room capacity. J. Oper. Res. Soc. 60(5), 663–673 (2009)
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The authors acknowledge the support provided by FCT and P2020 under the project PTDC/EGE OGE/30442/2017, Lisboa-01.0145-Feder-30442.
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Oliveira, M., Lubomirska, L., Marques, I. (2020). Reallocating Operating Room Time: A Portuguese Case. In: Bélanger, V., Lahrichi, N., Lanzarone, E., Yalçındağ, S. (eds) Health Care Systems Engineering. ICHCSE 2019. Springer Proceedings in Mathematics & Statistics, vol 316. Springer, Cham. https://doi.org/10.1007/978-3-030-39694-7_11
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