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Managing daily surgery schedules in a teaching hospital: a mixed-integer optimization approach.

Abstract：

BACKGROUND:This study examined the daily surgical scheduling problem in a teaching hospital. This problem relates to the use of multiple operating rooms and different types of surgeons in a typical surgical day with deterministic operation durations (preincision, incision, and postincision times). Teaching hospitals play a key role in the health-care system; however, existing models assume that the duration of surgery is independent of the surgeon's skills. This problem has not been properly addressed in other studies. We analyze the case of a Spanish public hospital, in which continuous pressures and budgeting reductions entail the more efficient use of resources. METHODS:To obtain an optimal solution for this problem, we developed a mixed-integer programming model and user-friendly interface that facilitate the scheduling of planned operations for the following surgical day. We also implemented a simulation model to assist the evaluation of different dispatching policies for surgeries and surgeons. The typical aspects we took into account were the type of surgeon, potential overtime, idling time of surgeons, and the use of operating rooms. RESULTS:It is necessary to consider the expertise of a given surgeon when formulating a schedule: such skill can decrease the probability of delays that could affect subsequent surgeries or cause cancellation of the final surgery. We obtained optimal solutions for a set of given instances, which we obtained through surgical information related to acceptable times collected from a Spanish public hospital. CONCLUSIONS:We developed a computer-aided framework with a user-friendly interface for use by a surgical manager that presents a 3-D simulation of the problem. Additionally, we obtained an efficient formulation for this complex problem. However, the spread of this kind of operation research in Spanish public health hospitals will take a long time since there is a lack of knowledge of the beneficial techniques and possibilities that operational research can offer for the health-care system.

journal_name

BMC Health Serv Res

journal_title

BMC health services research

authors

Pulido R,Aguirre AM,Ortega-Mier M,García-Sánchez Á,Méndez CA

doi

10.1186/1472-6963-14-464

subject

Has Abstract

pub_date

2014-10-15 00:00:00

pages

464

issn

1472-6963

pii

1472-6963-14-464

journal_volume

pub_type

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Managing daily surgery schedules in a teaching hospital: a mixed-integer optimization approach.