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Scheduling elective and emergency surgeries at shared operating rooms with emergency uncertainty and waiting time limit
Computers & Industrial Engineering ( IF 7.9 ) Pub Date : 2021-07-13 , DOI: 10.1016/j.cie.2021.107551
Hongru Miao 1 , Jian-Jun Wang 1
Affiliation  

While timely emergency OR access is strictly required in many specialties, this paper provides a highly responsive preventive-reactive scheduling procedure to address emergency arrivals with waiting time limits before and on surgery day with no assumption on the emergency arrival patterns. To improve responsiveness in situations where existing break-in-moments-based scheduling does not perform well, a MIP model is first developed to generate initial schedules by making ex-ante preparations for future possible arrivals with the objective of minimizing the sacrifice in the throughput of elective surgeries. For applicability, two additional heuristics, which are derived from the MIP model but include other scheduling ideas, are also designed for preventive scheduling. Furthermore, as a supplement to preventive scheduling, a corresponding reactive scheduling method is designed to be applied on surgery day. Facing different emergency realizations, it provides effective and satisfactory adjustments on surgery day by scheduling arrived emergencies timely, properly updating the remaining schedule to prepare for subsequent arrivals with consideration of minimizing the adjusting impact on scheduled elective cases. The effectiveness and performances of the proposed procedures and heuristics are evaluated in comparison with traditional preventive and reactive scheduling strategies through simulations and statistical tests. The numerical results show that the methods developed in this study can significantly improve the responsiveness with an acceptable sacrifice in OR utilization and can provide satisfactory schedules for both types of patients. Some scheduling guidelines based on simulation results and the applicability of the proposed scheduless are also discussed at the end of this study.



中文翻译:

在具有紧急情况不确定性和等待时间限制的共享手术室安排择期和紧急手术

虽然及时进行紧急或访问在很多专业严格要求,本文提供了一个高度敏感的预防性reactiv è调度程序来解决紧急到达的时间限制,在手术前和手术当天没有对紧急到达模式的假设。为了在现有的基于中断时刻的调度表现不佳的情况下提高响应能力,首先开发了一个 MIP 模型,通过为未来可能的到达做事前准备来生成初始调度,目标是最小化吞吐量的牺牲择期手术。为了适用性,还设计了两个额外的启发式方法,它们源自 MIP 模型但包含其他调度思想,也用于预防性调度。此外,作为预防性调度的补充,设计了相应的反应性调度方法以应用于手术日。面对不同的应急实现,它通过及时安排到达的紧急情况,在手术当天提供有效和令人满意的调整,适当更新剩余的时间表,为随后的到来做好准备,同时考虑最大限度地减少对已安排的择期病例的调整影响。通过模拟和统计测试,与传统的预防性和反应性调度策略相比,评估了所提出的程序和启发式方法的有效性和性能。数值结果表明,本研究中开发的方法可以显着提高反应性,同时可接受的 OR 利用率牺牲,并且可以为两种类型的患者提供令人满意的时间表。在本研究的结尾还讨论了一些基于模拟结果的调度指南和提议的调度的适用性。

更新日期:2021-07-22
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