Operational research in the management of the operating theatre: a survey

Abstract

Operating theatre represents one of the most critical and expensive hospital resources since a high percentage of the hospital admissions is due to surgical interventions. The main objectives are to guarantee the optimal utilization of medical resources, the delivery of surgery at the right time, the maximisation of profitability (i.e., patient flow) without incurring additional costs or excessive patient waiting time. The operating theatre management is a process very complex: the use of mathematical and simulation models, and quantitative techniques plays, thus a crucial role. The main aim of this paper is to provide a structured literature review on how Operational Research can be applied to the surgical planning and scheduling processes. A particular attention is on the published papers that present the most interesting mathematical (optimization and simulation) models and solution approaches developed to address the problems arising in operating theatres. Directions for future researches are also highlighted.

Balancing operating theatre and bed capacity in a cardiothoracic centre

“…A distinguishing feature of this ICU is that the large majority of the activity is elective: a patient's surgery can only proceed if there is both operating theatre time and an ICU bed available otherwise it is postponed to another day. Capacity planning for surgical specialties often focuses on the operating theatres: the beds are regarded as a secondary resource requirement that seldom constrains the overall capacity (Guerriero, 2011). However, capacity in a facility such as the HLC depends on the balance of operating theatre and ICU bed availability.…”

Modeling the critical care pathway for cardiothoracic surgery

“…Magerlein et al [11] review the literature around surgical demand scheduling with different objectives and constraints used across different studies. Magerlein et al mention blocked booking systems where each surgeon is scheduled a certain amount of time each week, similar to the system used by GJNH and many other hospitals nowadays [12]. This highlights that this type of scheduling is embedded and has not changed over the intervening period.…”

“…Magerlein et al later point out an article written by Stimson and Stimson (1972) who mentioned that proposed scheduling techniques fail to satisfy medical staff, where perhaps blocked booking systems are a choice that make staff more comfortable in day to day operations. This was backed by a more recent study by Guerriero [12] who mentions the importance of taking into consideration medical staff preferences while comparing Operational Research (OR) studies on surgical scheduling. Blocked booking systems was one of the obstacles that was discussed during this study at GJNH when enhancing schedules was proposed, with the hopes that a mathematical approach combined with visualizations from simulation (discussed later) will help in convincing medical staff in making some changes.…”

Decision support for rehabilitation hospital scheduling

“…Its schedule influences many other pre-and post-operation processes, see, e.g., Beliën et al (2007Beliën et al ( , 2009), Guerriero and Guido (2011). In a rehab hospital, however, it is neither possible nor necessary to derive schedules for the entire institution from the schedule for a single type of bottleneck resource.…”