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

BMC Health Services Research

Carlos A Méndez³  Álvaro García-Sánchez¹  Miguel Ortega-Mier¹  Adrian M Aguirre³  Raul Pulido² 

[1] Escuela Técnica Superior de Ing. Industriales (ETSII-UPM), José Gutierrez Abascal 2, 28006 Madrid, Spain;Politecnico di Milano, Via Lambruschini 4/b, 20156 Milan, Italy;INTEC (UNL-CONICET), Güemes 3450, 3000 Santa Fe, Argentina

关键词: Teaching hospital;    Operation rooms;    Simulation;    MILP;    Scheduling;   

Others  :  1118416
DOI  :  10.1186/1472-6963-14-464

 received in 2014-02-10, accepted in 2014-09-16,  发布年份 2014

【 摘 要 】

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.

【 授权许可】

   
2014 Pulido et al.; licensee BioMed Central Ltd.

【 图 表 】

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