Multi-objective stochastic scheduling of inpatient and outpatient surgeries

Abstract

With the advancement of surgery and anesthesiology in recent years, surgical clinical pathways have changed significantly, with an increase in outpatient surgeries. However, the surgical scheduling problem is particularly challenging when inpatients and outpatients share the same operating room blocks, due to their different characteristics in terms of variability and preferences. In this paper, we present a two-phase stochastic optimization approach that takes into account such characteristics, considering multiple objectives and dealing with uncertainty in surgery duration, arrival of emergency patients, and no-shows. Chance Constrained Integer Programming and Stochastic Mixed Integer Programming are used to deal with the advance scheduling and the allocation scheduling, respectively. Since Monte Carlo sampling is inefficient for solving the allocation scheduling problem for large size instances, a genetic algorithm is proposed for sequencing and timing procedures. Finally, a quantitative analysis is performed to analyze the trade-off between schedule robustness and average performance under the selection of different patient mixes, providing general insights for operating room scheduling when dealing with inpatients, outpatient, and emergencies.