Planning and scheduling of semi-urgent surgeries

Health Care Manag Sci. 2010 Sep;13(3):256-67. doi: 10.1007/s10729-010-9127-6.

Abstract

This paper investigates the trade-off between cancellations of elective surgeries due to semi-urgent surgeries, and unused operating room (OR) time due to excessive reservation of OR time for semi-urgent surgeries. Semi-urgent surgeries, to be performed soon but not necessarily today, pose an uncertain demand on available hospital resources, and interfere with the planning of elective patients. For a highly utilized OR, reservation of OR time for semi-urgent surgeries avoids excessive cancellations of elective surgeries, but may also result in unused OR time, since arrivals of semi-urgent patients are unpredictable. First, using a queuing theory framework, we evaluate the OR capacity needed to accommodate every incoming semi-urgent surgery. Second, we introduce another queuing model that enables a trade-off between the cancelation rate of elective surgeries and unused OR time. Third, based on Markov decision theory, we develop a decision support tool that assists the scheduling process of elective and semi-urgent surgeries. We demonstrate our results with actual data obtained from a department of neurosurgery.

MeSH terms

  • Humans
  • Markov Chains
  • Operating Rooms*
  • Patient Transfer / organization & administration*
  • Triage*