Reglas de despacho en la programación de procedimientos quirúrgicos electivos: impacto en los indicadores de ocupación y oportunidad

Abstract

Introduction: The performance of a surgery service is highly impacted by its schedule. This study measured the impact of the artificial variability caused by a manual scheduling of surgeries at “Hospital Universitario Mayor - Mederi (HUM)” (Colombia). The hypotheses were that the proposed algorithm is able to (i) reduce daily service variation, (ii) increase the availability of service resources, and (iii) improve the opportunity time for each surgery. Materials and methods: The studied surgical service performs around 35,000 annual surgeries and its scheduling process is presently manually made. Actual scheduling records of a regular month were compared to schedules generated by a Bin Packing (BP) algorithm hybridized with the Longest Processing Time (LPT) and Shortest Processing Time (SPT) dispatching rules. Results: It was found that the BP algorithm with LPT rule could improve service performance, reducing the variation coefficients of patients’ flow and daily service occupation by 25.09 % and 36.71 %, respectively. The programmed surgeries were also moved ahead 6.2 days, and the overall occupation rate increased by 26.72 %. Results were not better when a SPT rule was used, boosting the variability on patient flow by 22.7 % and reducing the occupation by 2.28 %. Conclusions: Semiautomatic scheduling of the surgical service at the HUM, a BP algorithm with LPT rule, may substantially increase service performance in terms of service occupation and opportunity.