Surgery scheduling heuristic considering OR downstream and upstream facilities and resources.

Area of Science:

• Healthcare Management
• Operations Research
• Surgical Operations

Background:

• Operating room (OR) scheduling is crucial in healthcare management, often relying on mathematical models and software.
• Existing OR scheduling models frequently overlook integrated resource management and real-world validation, preferring simulations.
• This research addresses the need for a heuristic that incorporates upstream and downstream resources for surgical theater (ST) operations planning.

Purpose of the Study:

• To develop and validate a novel heuristic for sequencing surgeries within the surgical theater.
• To optimize operating room (OR) utilization and patient flow by considering critical resources like surgical kits, PACU beds, and staffing.
• To enhance the efficiency of ST operations planning through a practical, resource-aware approach.

Main Methods:

• Utilized hybrid flow shop (HFS) techniques and the break-in-moment (BIM) concept to sequence surgeries.
• Developed a five-step heuristic: priority listing, local scheduling, global scheduling, feasibility check, and best scheduling identification.
• Integrated consideration of upstream (e.g., surgical kits) and downstream (e.g., PACU beds, staffing) resources into the scheduling process.

Main Results:

• Achieved an average 37.2% increase in OR occupancy and a 4.5 increase in daily surgeries performed.
• Reduced the variance of intervals between surgery completions by 55.5%, leading to smoother downstream resource demand.
• Validated the heuristic through historical data analysis and a ten-day pilot implementation in a tertiary university hospital across multiple surgical specialties.

Conclusions:

• The proposed heuristic effectively enhances surgical theater (ST) operations planning, particularly in resource-constrained environments common in developing countries.
• Demonstrated practical applicability and significant performance improvements through real-world validation, contributing to the literature on OR scheduling implementation.
• The heuristic offers a valuable tool for hospitals seeking to optimize operating room (OR) efficiency and resource allocation.