An integrated rolling horizon approach to increase operating theatre efficiency

Abstract

Demand for healthcare is increasing rapidly. To meet demand, we must improve the efficiency of our public health services. We present a mixed integer programming formulation that simultaneously tackles the integrated master surgical schedule and surgical case assignment problems under a modified block scheduling policy. That is, we allocate specialties, surgeons, and patients to surgical time blocks. We consider volatile surgical durations and non-elective arrivals while applying a rolling horizon approach to adjust the schedule after cancellations, equipment failure, or new arrivals on the waiting list. The model is based on a case study of an Australian public hospital with a large surgical department. The formulation includes significant detail and provides practitioners with a globally implementable model. We produce good feasible solutions in short amounts of computational time with a constructive heuristic and two hyper-metaheuristics. Using a rolling horizon schedule increases patient throughput and can help reduce waiting lists.