Coordinated and Priority-based Surgical Care: An Integrated Distributionally Robust Stochastic Optimization Approach

Posted: 18 Nov 2020

See all articles by Esmaeil Keyvanshokooh

Esmaeil Keyvanshokooh

University of Michigan at Ann Arbor - Department of Industrial and Operations Engineering

Pooyan Kazemian

Massachusetts General Hospital; Harvard Medical School

Mohammad Fattahi

Department of Technology and Innovation, University of Southern Denmark

Mark P. Van Oyen

University of Michigan at Ann Arbor

Date Written: October 1, 2020

Abstract

We study a Coordinated clinic and surgery Appointment Scheduling (CAS) problem in a surgical suite. Our models seek to provide timely access to care by coordinating clinic and surgery appointments to ensure that patients can see a surgeon in the clinic and (if needed) schedule their surgery within a maximum wait time target based on patient classes. There are different types of uncertainty including the number of appointment requests, whether a patient requires surgery, and surgery duration. We develop an Integrated Multi-stage Stochastic and Distribution-ally Robust Optimization (IMSDRO) approach to determine the optimal clinic and surgery dates for patients such that the access constraints are satisfied, and the clinical and surgical overtimes are minimized. The IMSDRO approach integrates a multi-stage stochastic program with a Distribution-ally robust optimization approach to simultaneously incorporate multiple types of uncertainties by including stochastic scenarios for appointment request arrivals and ambiguity sets for surgery duration. Several new transformations are introduced to turn the nonlinear program derived from the IMSDRO approach to a tractable one, and a constraint generation algorithm is developed to solve it efficiently. We propose a data-driven Rolling Horizon Procedure (RHP) to facilitate implementation. We use case data to assess the performance of our policies. The results suggest our policy can significantly improve surgical access delay times compared with the current practice. Our methodology is not limited to a particular setting and can be applied to other service industries where access matters.

Keywords: Healthcare Coordination, Access Delay to Care, Multi-Stage Stochastic Programming, Distribution-Ally Robust Optimization, Data-Driven Rolling Horizon

Suggested Citation

Keyvanshokooh, Esmaeil and Kazemian, Pooyan and Fattahi, Mohammad and Van Oyen, Mark P., Coordinated and Priority-based Surgical Care: An Integrated Distributionally Robust Stochastic Optimization Approach (October 1, 2020). Available at SSRN: https://ssrn.com/abstract=3703173

Esmaeil Keyvanshokooh (Contact Author)

University of Michigan at Ann Arbor - Department of Industrial and Operations Engineering ( email )

500 S. State Street
Ann Arbor, MI 48109
United States

Pooyan Kazemian

Massachusetts General Hospital ( email )

55 Fruit Street
Boston, MA 02114
United States

Harvard Medical School ( email )

25 Shattuck St
Boston, MA 02115
United States

Mohammad Fattahi

Department of Technology and Innovation, University of Southern Denmark ( email )

Denmark

Mark P. Van Oyen

University of Michigan at Ann Arbor ( email )

500 S. State Street
Ann Arbor, MI 48109
United States

Here is the Coronavirus
related research on SSRN

Paper statistics

Abstract Views
95
PlumX Metrics