Tactical and operational decisions for operating room planning: efficiency and welfare implications

Area of Science:

• Operations Research
• Healthcare Management
• Medical Informatics

Background:

• Efficient operating room (OR) scheduling is crucial for healthcare systems.
• Current scheduling models often prioritize procedure volume over patient welfare.
• Optimizing the Master Surgical Schedule Problem (MSSP) and Surgical Case Assignment Problem (SCAP) remains a challenge.

Purpose of the Study:

• To develop and evaluate a 0-1 linear programming model for OR planning.
• To optimize OR block allocation and patient scheduling from a patient welfare perspective.
• To minimize welfare loss due to clinical deterioration and excessive waiting times.

Main Methods:

• A 0-1 linear programming model was formulated to solve the MSSP and SCAP simultaneously.
• The model's objective function prioritizes preventing welfare loss, focusing on health outcomes.
• The model was applied to a real-world case study of elective admissions in a General Surgery Department.

Main Results:

• The model effectively allocates OR blocks to sub-specialties and patients.
• It demonstrated the ability to solve complex, NP-hard combinatorial optimization problems.
• Computational results showed solutions within 600 seconds with an average optimality tolerance below 0.01%.

Conclusions:

• The developed model offers an optimal approach to OR planning by considering patient welfare.
• It provides a valuable tool for both operational (weekly planning) and tactical (resource expansion) decisions.
• The model successfully balances resource allocation with the critical goal of minimizing patient harm from waiting.