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Surgical block scheduling in a system of hospitals: an application to resource and wait list management in a British Columbia health authority

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Scheduling surgical specialties in a medical facility is a very complex process. The choice of schedules and resource availability impact directly on the number of patients treated by specialty, cancellations, wait times, and the overall performance of the system. In this paper we present a system-wide model developed to allow management to explore trade-offs between OR availability, bed capacity, surgeons’ booking privileges, and wait lists. We developed a mixed integer programming model to schedule surgical blocks for each specialty into ORs and applied it to the hospitals in a British Columbia Health Authority, considering OR time availability and post-surgical resource constraints. The results offer promising insights into resource optimization and wait list management, showing that without increasing post-surgical resources hospitals could handle more cases by scheduling specialties differently.

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  1. Beliën J, Demeulemeester E (2004) Integer programming for building robust surgery schedules. Working paper, Katholieke Universiteit Leuven

  2. Blake JT, Donald J (2002) Mount Sinai Hospital uses integer programming to allocate operating room time. Interfaces 32(2):63–73

    Article  Google Scholar 

  3. Blake JT, Dexter F, Donald J (2002) Operating room manager’s use of integer programming for assigning block time to surgical groups: a case study. Anesth Analg 94:143–148

    Article  Google Scholar 

  4. Dexter F, Macario A (2002) Changing allocations of operating room time from a system based on historical utilization to one where the aim is to schedule as many surgical cases as possible. Anesth Analg 94:1272–1279

    Article  Google Scholar 

  5. Weiss E (1990) Models for determining estimated start times and case orderings in hospital operating rooms. IIE Trans 22:143–150

    Google Scholar 

  6. Dexter F, Traub R (2002) How to schedule elective surgical cases into specific operating rooms to maximize the efficiency of use of operating room time. Anesth Analg 94:933–942

    Article  Google Scholar 

  7. Blake JT, Carter M (2002) A goal programming approach to strategic resource allocation in acute care hospitals. Eur J Oper Res 140:541–561

    Article  Google Scholar 

  8. Guinet A, Chaabane S (2003) Operating theatre planning. Int J Prod Econ 85:69–81

    Article  Google Scholar 

  9. Population Section, BC Stats, Ministry of Management Services, Government of British Columbia. PEOPLE 29 population forecast for British Columbia and zones/communities within the province, May 2004. Government of British Columbia, Victoria

  10. Vissers JMH (1998) Patient flow-based allocation of inpatient resources: a case study. Eur J Oper Res 105:356–370

    Article  Google Scholar 

  11. Vissers JMH, Van der BIJ, Kusters RJ (2001) Towards decision support for waiting lines: an operations management view. Health Care Manag Sci 4:133–142

    Article  Google Scholar 

  12. Vissers JMH, Adan IJBF, Bekkers JP (2005) Patient mix optimization in cardiothoracic surgery planning: a case study. IMA J Manag Math 16:281–304

    Article  Google Scholar 

  13. Blake JT, Carter M (1997) Surgical process management: a conceptual framework. Surg Serv Manag 3(9):31–37

    Google Scholar 

  14. Litvak E, Long M (2000) Cost and quality under managed care: irreconcilable differences? Am J Manag Care 6:305–312

    Google Scholar 

  15. Dexter F, Blake JT, Penning DH, Sloan B, Chung P, Lubarsky DA (2002) Use of linear programming to estimate impact of changes in a hospital’s operating room time allocation on perioperative variable costs. Anesthesiology 96:718–724

    Article  Google Scholar 

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Correspondence to Pablo Santibáñez.

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Santibáñez, P., Begen, M. & Atkins, D. Surgical block scheduling in a system of hospitals: an application to resource and wait list management in a British Columbia health authority. Health Care Manage Sci 10, 269–282 (2007).

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