Planning and scheduling of semi-urgent surgeries

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• 作者：Maartje E. Zonderland ; Richard J. Boucherie ; Nelly Litvak and Carmen L. A. M. Vleggeert-Lankamp
• 关键词：Surgical scheduling ; Operating rooms ; Emergency patient flow ; Queuing theory ; Markov decision processes
• 刊名：Health Care Management Science
• 出版年：2010
• 出版时间：September, 2010
• 年：2010
• 卷：13
• 期：3
• 页码：256-267
• 全文大小：442.6 KB

文摘

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.