A dynamic approach to surgical scheduling

A mixed integer programming (MIP) formulation is presented that simultaneously tackles operating theatre (OT) planning and scheduling problems through the combined Master Surgical Scheduling (MSS) and Surgical Case Assignment (SCA) problems. We consider stochastic surgical durations and non-elective arrivals whilst applying a dynamic approach to adjust the schedule after cancellations, equipment failure, or new arrivals on the waiting list. The model is based on an Australian public hospital with a large surgical department. Significant detail is included in the formulation to provide practitioners with a model that can be implemented in hospitals. We show that good feasible solutions can be provided in short amounts of computational time with hyper metaheuristics. A dynamic approach is used to show how schedule predictability affects patient throughput. It was found that the use of a two-week schedule increases patient throughput and can help reduce waiting lists.

The real-time reactive surgical case sequencing problem

In this paper, the multiple operating room (OR) surgical case sequencing problem (SCSP) is addressed. The objective is to maximise total OR utilisation during standard opening hours. The work here is based on a case study of a large Australian public hospital with long surgical waiting lists and high levels of non-elective demand. Due to the complexity of the SCSP and the size of the instances considered herein, heuristic techniques are required to solve the problem. Constructive heuristics are presented based on both a modified block scheduling policy and an open scheduling policy. A number of real-time reactive strategies are presented that can be used to maintain schedule feasibility in the case of disruptions. Results of computational experiments show that the approach presented in this paper can be used to maintain schedule feasibility in real-time, whilst increasing OT utilisation and throughput, and reducing the waiting time of non-elective patients. The framework presented here is applicable to the real-life scheduling of OT departments, and recommendations have been provided regarding implementation of the approach.