A multi-objective planning and scheduling model for elective and emergency cases in the operating room under uncertainty

Abstract

Hospitals are paramount hubs for delivering healthcare services, with their Operating Rooms (ORs) as a pivotal and financially substantial component. Efficient surgery ward planning is crucial in healthcare institutions, aiming to improve medical service quality while reducing costs. This research delves into the intricacies of integrated OR planning and scheduling, focusing on elective and emergency patients in an uncertain environment. To address these challenges, a mixed integer programming (MIP) framework is developed to minimize inactivity and patient wait times while optimizing high-priority resource allocation. Both upstream and downstream units of the ward, the Pre-operative Holding Unit (PHU), Post Anesthesia Care Unit (PACU), and Intensive Care Unit (ICU) are included. The inherently uncertain aspects of surgery, including surgical duration, Length of Stay (LOS), and the influx of emergency patients, demand an intelligent optimization approach. Consequently, a robust optimization strategy is harnessed to effectively grapple with this pervasive uncertainty. A deterministic model is introduced and improved using an enhanced epsilon constraint method. The culmination of this analytical journey yields a collection of Pareto-optimal solutions. Empirical results, supported by managerial insights, highlight the superiority of the proposed method over the traditional weighting approach.