Scheduling Operating Rooms with Elective and Emergency Surgeries

50 Pages Posted: 11 May 2017

See all articles by Kyung Sung Jung

Kyung Sung Jung

Warrington College of Business, University of Florida

Michael Pinedo

New York University (NYU) - Leonard N. Stern School of Business

Chelliah Sriskandarajah

Texas A&M University

Vikram Tiwari

Vanderbilt University - School of Medicine

Date Written: May 9, 2017

Abstract

The issue of allocating capacity to accommodate emergent surgery cases while scheduling elective patients has major policy implications for Level-1 trauma centers including most large academic medical centers. This is because operating rooms (ORs) are the greatest source of revenues for hospitals, while also being the largest cost centers. However, scheduling ORs, especially at level-1 trauma hospitals, is challenging due to significant uncertainty in the arrivals of patients requiring emergent surgery. When scheduling surgeries, hospitals face a trade-off between the need to be responsive to emergency cases and the need to conduct scheduled elective surgeries as planned.

We develop a model that allocates the OR capacity to elective patients so that the emergency patients who arrive randomly can be accommodated without incurring any excessive delays. The objective is to develop a framework for aggregate weekly schedules and generate detailed daily schedules that minimize a weighted sum of the ORs’ operating time, idle time, and overtime. Optimization procedures are developed to devise effective block schedules while a rescheduling procedure schedules elective patients who are affected by an emergency arrival. Initially, the procedures are based on deterministic surgery times for the elective patients and then they are extended to stochastic surgery times. We illustrate our methodology on specialized ORs for trauma cases related to neurosurgery. We show that for a given arrival rate of emergency patients, the total expected cost is convex in the weekly load of the elective surgeries scheduled. Numerical experiments are devised to obtain the total expected cost curves for various arrival rates of emergency patients. Using these cost curves the optimal capacity allocation of ORs to elective patients can be determined as a function of the arrival rate of emergency patients.

Keywords: Healthcare, Operating Room, Scheduling, Planning, Service Operations

Suggested Citation

Jung, Kyung Sung and Pinedo, Michael and Sriskandarajah, Chelliah and Tiwari, Vikram, Scheduling Operating Rooms with Elective and Emergency Surgeries (May 9, 2017). Available at SSRN: https://ssrn.com/abstract=2965730 or http://dx.doi.org/10.2139/ssrn.2965730

Kyung Sung Jung (Contact Author)

Warrington College of Business, University of Florida ( email )

Gainesville, FL 32611
United States

Michael Pinedo

New York University (NYU) - Leonard N. Stern School of Business ( email )

44 West 4th Street
Suite 9-160
New York, NY NY 10012
United States

Chelliah Sriskandarajah

Texas A&M University ( email )

Langford Building A
798 Ross St.
77843-3137

Vikram Tiwari

Vanderbilt University - School of Medicine ( email )

Nashville, TN 37232-0685
United States

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