Article ID: | iaor20105074 |
Volume: | 13 |
Issue: | 3 |
Start Page Number: | 256 |
End Page Number: | 267 |
Publication Date: | Sep 2010 |
Journal: | Health Care Management Science |
Authors: | Litvak Nelly, Boucherie Richard J, Zonderland Maartje E, Vleggeert-Lankamp Carmen L A M |
Keywords: | timetabling |
This paper investigates the trade-off between cancellations of elective surgeries due to semi-urgent surgeries, and unused operating room (OR) time due to excessive reservation of OR time for semi-urgent surgeries. Semi-urgent surgeries, to be performed soon but not necessarily today, pose an uncertain demand on available hospital resources, and interfere with the planning of elective patients. For a highly utilized OR, reservation of OR time for semi-urgent surgeries avoids excessive cancellations of elective surgeries, but may also result in unused OR time, since arrivals of semi-urgent patients are unpredictable. First, using a queuing theory framework, we evaluate the OR capacity needed to accommodate every incoming semi-urgent surgery. Second, we introduce another queuing model that enables a trade-off between the cancelation rate of elective surgeries and unused OR time. Third, based on Markov decision theory, we develop a decision support tool that assists the scheduling process of elective and semi-urgent surgeries. We demonstrate our results with actual data obtained from a department of neurosurgery.