Stochastic Reactive Scheduling Model for Operating Rooms Considering the Moral and Human Virtues

Abstract

Gerami -Saidi-Mehrabad: Stochastic reactive scheduling model for operating rooms considering the moral and human virtues - STOCHASTIC REACTIVE SCHEDULING MODEL FOR OPERATING ROOMS CONSIDERING THE MORAL AND HUMAN VIRTUESGERAMI, F. * -SAIDI-MEHRABAD, M. Science and Technology Narmak, Tehran, *Corresponding author e-mail: geramifarzad@yahoo.com (phone: +98-31-3651-8673; fax: +98-31-3651-6098) (Received 18 th Aug 2016; accepted 15 th Nov 2016) Abstract. This study focuses on the issue of reactive scheduling for the operating room under the uncertain, arrival non-elective patients (emergency or urgent). For this a reactive rescheduling algorithm was proposed and also for steps of algorithm, several stochastic mixed integer programming models were developed. In these models, all duration, such as length of stay in the waiting room, the length of stay in the recovery room, surgery time, operating room preparation time, patient preparation time after anesthesia, patient awake time before transferring to the recovery room and operating room cleaning time are stochastic. The fact that this model is a chance-constraint problem, it looks very complex. In addition to financial goals (overtime, idle time), the important approach in this research is moral and humanitarian objectives such as patient satisfaction, justice, individual freedom, patient rights and medical ethics. In mathematical schedule models, we consider three level of patient's priority (F p 1 , F p 2 , F p 3 ). Based on these moral and human dimensions, the decision maker can prioritize patients. Restrictions on parts before (waiting room) and after (PACU) the operation room are also included in the mathematical models. For the evaluation of the proposed model the actual data related to the surgical center of a first-class hospital has been used. Keywords: humanitarian objectives, operating room, surgeries rescheduling, stochastic mixed integer programming, chance-constraint problems Department of Industrial Engineering, Iran University of IntroductionA large share of the costs and revenues of a hospital is related to operating rooms. Therefore, increasing productivity within the operating rooms has a significant impact on the ultimate performance of a hospital. Improved performance in operating rooms also increases economic indicators, rate of services and patients' satisfaction.Operating room scheduling problem is a special mode of the optimization problem. A lot of researches have been done on the optimization. Hajnal et al. (2007), Kaur (2007) and Tolner (2008) are tree good example. Operating room scheduling problem has some special features that have complicated the problem. Some of these features are: ethical and human relationship between the surgeon, patient and nurse;  human factor (surgeon, patient and nurse) satisfaction;  patient rights prism;  the principles of medical ethics; and  justice. For this reason, recently, attention has been given to research in the field of operating room planning and scheduling. Researches related ...