Skip to main content

Analytical Approaches to Operating Room Management

Projects at Lucile Packard Children’s Hospital Stanford

Part of the Springer Proceedings in Mathematics & Statistics book series (PROMS,volume 210)

Abstract

In recent decades, healthcare has become increasingly expensive, creating pressure on healthcare providers to cut costs while maintaining or improving quality. Operations research can play an important role in supporting such efforts. A key challenge faced by hospital planners is scheduling and management of operating rooms, as operating rooms typically provide highly specialized care, require significant resources, and contribute significantly to a hospital’s bottom line. We describe recent work on hospital operating room management at Lucile Packard Children’s Hospital Stanford. We describe preliminary outcomes of three projects aimed at improving the efficiency of the hospital’s operating rooms: machine learning to improve surgical case length estimation; queuing analysis to improve operational efficiency; and integer programming to schedule cases to reduce surgical delays.

Keywords

  • Healthcare
  • Operations management
  • Optimization
  • Machine learning
  • Queueing

This is a preview of subscription content, access via your institution.

References

  1. Aleman, D., Brandeau, M.L., Carter, M.W., Scheinker, D.: (Draft) Healthcare systems engineering: an analytical approach. Springer Publishers, New York

    Google Scholar 

  2. Banditori, C., Cappanera, P., Visintin, F.: A combined optimization-simulation approach to the master surgical scheduling problem. IMA J. Manage. Math. 24(2), 155–187 (2013)

    CrossRef  MathSciNet  MATH  Google Scholar 

  3. Bravo, F., Levi, R., Ferrari, L.R., McManus, M.L.: The nature and sources of variability in pediatric surgical case duration. Paediatr. Anaesth. 25(10), 999–1006 (2015)

    CrossRef  Google Scholar 

  4. Cappanera, P., Visintin, F., Banditori, C.: Comparing resource balancing criteria in master surgical scheduling: a combined optimisation-simulation approach. Int. J. Prod. Econ. 158, 179–196 (2014)

    CrossRef  Google Scholar 

  5. Cappanera, P., Visintin, F., Banditori, C.: Addressing conflicting stake-holders priorities in surgical scheduling by goal programming. Flex. Serv. Manuf. J. Epub. (2016) (ahead of print)

    Google Scholar 

  6. Cardoen, B., Demeulemeester, E., Beliën, J.: Operating room planning and scheduling: a literature review. Eur. J. Oper. Res. 201(3), 921–932 (2010)

    CrossRef  MATH  Google Scholar 

  7. Dexter, F., Epstein, R.H., Penning, D.H.: Statistical analysis of postanesthesia care unit staffing at a surgical suite with frequent delays in admission from the operating room: a case study. Anesth. Analg. 92(4), 947–949 (2001)

    CrossRef  Google Scholar 

  8. Dexter, F., Blake, J.T., Penning, D.H., Lubarsky, D.A.: Calculating a potential increase in hospital margin for elective surgery by changing operating room time allocations or increasing nursing staffing to permit completion of more cases: a case study. Anesth. Analg. 94(1), 138–142 (2002)

    Google Scholar 

  9. Dexter, F., Epstein, R.H., Marcon, E., de Matta, R.: Strategies to reduce delays in admission into a postanesthesia care unit from operating rooms. J. Perianesth. Nurs. 20(2), 92–102 (2005)

    CrossRef  Google Scholar 

  10. Durand, A., Kim, H., Pei, F., Petersen, K.: A generalizable, systematic approach to improving perioperative efficiency. Working Paper (2017)

    Google Scholar 

  11. Eijkemans, M.J., van Houdenhoven, M., Nguyen, T., Boersma, E., Steyerberg, E.W., Kazemier, G.: Predicting the unpredictable: a new prediction model for operating room times using individual characteristics and the surgeon’s estimate. Anesthesiology 112(1), 41–49 (2010)

    CrossRef  Google Scholar 

  12. Fairley, M.C., Scheinker, D., Caruso, T.J., Brandeau, M.L.: Improving the efficiency of the operating room environment with a generalizable optimization and machine learning model. Working Paper (2017)

    Google Scholar 

  13. Hiltrop, J.: Modeling neuroscience patient flow and inpatient bed management. Ph.D. Thesis, Massachusetts Institute of Technology (2014)

    Google Scholar 

  14. Kayış, E., Khaniyev, T.T., Suermondt, J., Sylvester, K.: A robust estimation model for surgery durations with temporal, operational, and surgery team effects. Health Care Manag. Sci. 18(3), 222–233 (2015)

    CrossRef  Google Scholar 

  15. Macario, A.: What does one minute of operating room time cost? J. Clin. Anesth. 22(4), 233–236 (2010)

    CrossRef  Google Scholar 

  16. Marcon, E., Dexter, F.: An observational study of surgeons’ sequencing of cases and its impact on postanesthesia care unit and holding area staffing requirements at hospitals. Anesth. Analg. 105(1), 119–126 (2007)

    CrossRef  Google Scholar 

  17. Organisation for Economic Co-operation and Development (OECD): Focus on health spending: OECD health statistics 2015. https://www.oecd.org/health/health-systems/Focus-Health-Spending-2015.pdf (2016)

  18. Schoenmeyr, T., Dunn, P.F., Gamarnik, D., Levi, R., Berger, D.L., Daily, B.J., Levine, W.C., Sandberg, W.S.: A model for understanding the impacts of demand and capacity on waiting time to enter a congested recovery room. Anesthesiology 110(6), 1293–1304 (2009)

    CrossRef  Google Scholar 

  19. Shippert, R.D.: A study of time-dependent operating room fees and how to save $100 000 by using time-saving products. Am. J. Cosmetic. Surg. 22(1), 25–34 (2005)

    CrossRef  Google Scholar 

  20. Smallman, B., Dexter, F.: Optimizing the arrival, waiting, and npo times of children on the day of pediatric endoscopy procedures. Anesth. Analg. 110(3), 879–887 (2010)

    CrossRef  Google Scholar 

  21. Stepaniak, P.S., Heij, C., Mannaerts, G.H., de Quelerij, M., de Vries, G.: Modeling procedure and surgical times for current procedural terminology-anesthesia-surgeon combinations and evaluation in terms of case-duration prediction and operating room efficiency: a multicenter study. Anesth. Analg. 109(4), 1232–1245 (2009)

    CrossRef  Google Scholar 

  22. Strum, D.P., Sampson, A.R., May, J.H., Vargas, L.G.: Surgeon and type of anesthesia predict variability in surgical procedure times. Anesthesiology 92(5), 1454–1466 (2000)

    CrossRef  Google Scholar 

  23. Visintin, F., Cappanera, P., Banditori, C.: Evaluating the impact of flexible practices on the master surgical scheduling process: an empirical analysis. Flex. Serv. Manuf. J. 28(1–2), 182–205 (2016)

    CrossRef  Google Scholar 

  24. Wright, I.H., Kooperberg, C., Bonar, B.A., Bashein, G.: Statistical modeling to predict elective surgery time. Comparison with a computer scheduling system and surgeon-provided estimates. Anesthesiology 85(6), 1235–1245 (1996)

    Google Scholar 

  25. Zenteno, A.C., Carnes, T., Levi, R., Daily, B.J., Dunn, P.F.: Systematic OR block allocation at a large academic medical center: comprehensive review of a data-driven surgical scheduling strategy. Ann. Surg. 264(6), 973–981 (2016)

    CrossRef  Google Scholar 

  26. Zenteno, A.C., Carnes, T., Levi, R., Daily, B.J., Price, D., Moss, S.C., Dunn, P.F.: Pooled open blocks shorten wait times for nonelective surgical cases. Ann. Surg. 262(1), 60–67 (2015)

    CrossRef  Google Scholar 

  27. Zhou, Z., Miller, D., Master, N., Scheinker, D., Bambos, N., Glynn, P.: Detecting inaccurate predictions of pediatric surgical durations. In: Data Science and Advanced Analytics (DSAA), 2016 IEEE International Conference. IEEE, pp. 452–457 (2016)

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Margaret L. Brandeau .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and Permissions

Copyright information

© 2017 Springer International Publishing AG

About this paper

Verify currency and authenticity via CrossMark

Cite this paper

Scheinker, D., Brandeau, M.L. (2017). Analytical Approaches to Operating Room Management. In: Cappanera, P., Li, J., Matta, A., Sahin, E., Vandaele, N., Visintin, F. (eds) Health Care Systems Engineering. ICHCSE 2017. Springer Proceedings in Mathematics & Statistics, vol 210. Springer, Cham. https://doi.org/10.1007/978-3-319-66146-9_2

Download citation