Scheduling Elective Surgeries with Emergency Arrivals in Operating Rooms

Abstract

With the growing rate of surgical expenditures, improving operating room efficiency has become one of the most important targets for health care providers. Any delays, cancellations, or no-shows, result in increased costs for a hospital. In addition, it is difficult to predict the length of surgery procedures due to the variability inherent in surgery procedure times and account for emergency cases. Effective appointment schedules, which minimize the costs of patient waiting time and surgeon idle time and overtime, play an important role in terms of improving efficiency in hospital operating rooms. This research is to develop scheduling policies for elective and emergency surgeries with the objective of reducing waiting time, idle time and overtime. Simulation-based modeling is used to formulate and evaluate different scheduling policies under different operating conditions including different distributions for surgery duration, multiple types of surgical procedures, the arrival of emergency cases and different levels of cost coefficients for idle time and overtime. These factors have not been simultaneously studied in prior studies. The modeling framework is able to account for the significant uncertainty and complexity present in this problem setting. Historical surgery procedure data over a two-year period from the Canadian Institute for Health Information (CIHI) database is used to provide empirical support for the input parameters of the model and validate the efficiency of the different scheduling policies.