Optimization of surgery sequencing and scheduling decisions under uncertainty
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Operating rooms (ORs) are simultaneously the largest cost center and greatest source of revenues for most hospitals. Due to significant uncertainty in surgery durations, scheduling of ORs can be very challenging. Longer than average surgery durations result in late starts not only for the next surgery in the schedule, but potentially for the rest of the surgeries in the day as well. Late starts also result in direct costs associated with overtime staffing when the last surgery of the day finishes later than the scheduled shift end time. In this article we describe a stochastic optimization model and some practical heuristics for computing OR schedules that hedge against the uncertainty in surgery durations. We focus on the simultaneous effects of sequencing surgeries and scheduling start times. We show that a simple sequencing rule based on surgery duration variance can be used to generate substantial reductions in total surgeon and OR team waiting, OR idling, and overtime costs. We illustrate this with results of a case study that uses real data to compare actual schedules at a particular hospital to those recommended by our model.
KeywordsSurgery Scheduling Sequencing Stochastic Optimization Linear programming Simulation
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- 1.Achieving operating room efficiency through process integration (2005) Technical report, Health Care Financial Management Association ReportGoogle Scholar
- 2.Surgical services reform: executive briefing for clinical leaders (2001) Technical report, Washington, DC, Clinical Advisory BoardGoogle Scholar
- 5.Blake JT, Carter M (1997) Surgical process scheduling: a structured review. J Soc Health Syst 5(3):17–30Google Scholar
- 7.Magerlein JM, Martin JB (1978) Surgical demand scheduling: a review. Health Serv Res 13(4):418–433Google Scholar
- 8.Sabria F, Daganzo CF (1989) Approximate expressions for queuing systems with scheduling arrivals and established service order. Transp Sci 23:159–165Google Scholar
- 10.Bailey N (1952) A study of queues and appointment systems in hospital outpatient departments, with special reference to waiting-times. J R Stat Soc A 14:185–189Google Scholar
- 11.Soriano A (1966) Comparison of two scheduling systems. Oper Res 14:388–397Google Scholar
- 12.Mercer A (1973) Queues with scheduled arrivals: a correction simplification and extension. J R Stat Soc B 35:104–116Google Scholar
- 18.Dexter F, Ledolter J (2005) Bayesian prediction bounds and comparisons of operating room times even for procedures with few or no historic data. Anesth Analg 103(6):1259–1267Google Scholar