Abstract

Due to surgery duration variability and arrivals of emergency surgeries, the planned Operating Room (OR) schedule is disrupted throughout the day which may lead to a change in the start time of the elective surgeries. These changes may result in undesirable situations for patients, wards or other involved departments, and therefore, the OR schedule has to be adjusted. In this paper, we develop a decision support system (DSS) which assists the OR manager in this decision by providing the three best adjusted OR schedules. The system considers the preferences of all involved stakeholders and only evaluates the OR schedules that satisfy the imposed resource constraints. The decision rules used for this system are based on a thorough analysis of the OR rescheduling problem. We model this problem as an Integer Linear Program (ILP) which objective is to minimize the deviation from the preferences of the considered stakeholders. By applying this ILP to instances from practice, we determined that the given preferences mainly lead to (i) shifting a surgery and (ii) scheduling a break between two surgeries. By using these changes in the DSS, the performed simulation study shows that less surgeries are canceled and patients and wards are more satisfied, but also that the perceived workload of several departments increases to compensate this. The system can also be used to judge the acceptability of a proposed initial OR schedule.

Highlights

  • The Operating Room (OR) department is one of the most expensive resources of a hospital

  • The new OR schedule must fulfil quite a number of restrictions, and in addition, there are several stakeholders whose preferences and priorities must be met. Since it is hard for an OR manager to consider all these restrictions and preferences simultaneously, we develop a decision support system (DSS) which supports the OR manager with rescheduling the ORs

  • We describe the tasks the stakeholder has to perform during the day, the restrictions they impose on the OR schedule, the impact a change in the OR schedule has on the stakeholder and the preferences of the stakeholder

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Summary

Introduction

Another paper of Dexter et al [7] considers the sequencing of urgent surgical cases They proposed a sequencing which is based on the following three objectives: (i) minimize the average waiting time of surgeons and patients, (ii) sequence the surgeries in order of appearance, and (iii) schedule the surgeries in order of medical urgency. None of these objectives consider the preferences of the elective patients and other departments.

Problem formulation
Procedure Surgery
Patient
Holding department
Anesthetist
Surgeon
OR assistants
Recovery department
Radiology department
Pathology department
2.10 Logistic department
2.11 Objective function
2.12 Problem complexity
Computational results ILP
Parameter settings
Deriving decision rules
Potential improvements
Decision support system
Simulation study DSS
Conclusions
A Survey
Findings
Full Text
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