The operating room case-mix problem under uncertainty and nurses capacity constraints

Abstract

Surgery is one of the key functions in hospitals; it generates significant revenue and admissions to hospitals. In this paper we address the decision of choosing a case-mix for a surgery department. The objective of this study is to generate an optimal case-mix plan of surgery patients with uncertain surgery operations, which includes uncertainty in surgery durations, length of stay, surgery demand and the availability of nurses. In order to obtain an optimal case-mix plan, a stochastic optimization model is proposed and the sample average approximation method is applied. The proposed model is used to determine the number of surgery cases to be weekly served, the amount of operating rooms' time dedicated to each specialty and the number of ward beds dedicated to each specialty. The optimal case-mix selection criterion is based upon a weighted score taking into account both the waiting list and the historical demand of each patient category. The score aims to maximizing the service level of the operating rooms by increasing the total number of surgery cases that could be served. A computational experiment is presented to demonstrate the performance of the proposed method. The results show that the stochastic model solution outperforms the expected value problem solution. Additional analysis is conducted to study the effect of varying the number of ORs and nurses capacity on the overall ORs' performance.

Planning and scheduling operating rooms for elective and emergency surgeries with uncertain duration

“…Here uncertainty into surgery duration, lenght of stay, surgery demand and availability of nurses has to result in a case-mix set up for the surgery department. A recent paper using stochastic optimisation models for this problem is Yahia et al (2016).…”

A Design and Engineering Methodology for Organization-based simulation model for operating room scheduling problems

“…In Surgery Planning transaction T3, Surgery Planner A3 considers information from the Master Surgery Planning transaction T9 through an information link; similarly, the information link between the Master Surgery Planner A9 and Case-mix Planning T10. Readers are referred to Yahia et al 9,10 for more information about the case-mix plan and master surgery plan, respectively. Another main element in the CM is actor role, which responds to the need for decision making, commitment, or producing products in a transaction.…”

“…In this paper, we have two main objectives, arising during cooperation with Karmoze hospital, a non-profit hospital located in Alexandria, Egypt. The first one is to evaluate the operational performance of the case mix and master surgery plans that are obtained at the higher decision levels, the CMP and the MSSP, by solving the mathematical models proposed by Yahia et al 9,10 Three performance measures are applied: the overall average waiting list; the total number of surgery cases per year; and the overall average patient misplacement. The second objective is to model not only the implementation part of the OR scheduling, but also to represent the ontological part.…”

Facility Layout Planning with SHELL and Fuzzy AHP Method Based on Human Reliability for Operating Theatre

“…And hospital management needs to control the health cost and improve financial assets simultaneously [6]. The operating theatres, as the key resource in a hospital, present the largest cost source and act as the bottleneck which would influence the quality and efficiency of the overall health care service [7]. For the productive and effective functions of hospitals, management should ensure an optimum functioning of the system components.…”