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

Planning and scheduling of semi-urgent surgeries

Maartje E Zonderland  1 , Richard J Boucherie, Nelly Litvak, Carmen L A M Vleggeert-Lankamp
Affiliations

Planning and scheduling of semi-urgent surgeries

Maartje E Zonderland et al. Health Care Manag Sci. 2010 Sep.

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.

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Figures

Fig. 1
Fig. 1
An example of the progression of the number of semi-urgent slots waiting at the start of the week (s  =  3)
Fig. 2
Fig. 2
Number of semi-urgent slots performed in overtime: three different cases
Fig. 3
Fig. 3
State space of the system
Fig. 4
Fig. 4
formula image (interrupted line) and formula image for formula image
Fig. 5
Fig. 5
δ * for CC 1 (s * = 13)
Fig. 6
Fig. 6
δ M for CC 2 (s * = 11)
Fig. 7
Fig. 7
δ * for CC 3 (s * = 17 )
See this image and copyright information in PMC

References

    1. Schofield WN, Rubin GL, Piza M, Yin Lai Y, Sindhusake D, Fearnside MR, Klineberg PL. Cancellation of operations on the day of intended surgery at a major Australian referral hospital. MJA. 2005;182(12):612–615. - PubMed
    1. Wullink G, van Houdenhoven M, Hans EW, van Oostrum JM, van der Lans M, Kazemier G. Closing emergency rooms improves efficiency. J Med Syst. 2007;31(6):543–546. doi: 10.1007/s10916-007-9096-6. - DOI - PubMed
    1. Bhattacharyya T, Vrahas MS, Morrison SM, Kim E, Wiklund RA, Smith RM, Rubash HE. The value of the dedicated orthopaedic trauma operating room. J Trauma Injury Infect Crit Care. 2006;60(6):1336–1341. doi: 10.1097/01.ta.0000220428.91423.78. - DOI - PubMed
    1. Gerchak Y, Gupta D, Henig M. Reservation planning for elective surgery under uncertain demand for emergency surgery. Manag Sci. 1996;42(3):321–334. doi: 10.1287/mnsc.42.3.321. - DOI
    1. Cardoen B, Demeulenmeester E, Beliën J (2008) Operating room planning and scheduling: a literature review. Internal report, K.U. Leuven, Belgium. Available at https://lirias.kuleuven.be/handle/123456789/165923