On the use of partitioning for scheduling of surgeries in the inpatient surgical department.

Lien Wang, Erik Demeulemeester, Nancy Vansteenkiste, Frank E Rademakers

Health care management science 2022 Dec

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In hospitals, the efficient planning of the operating rooms (ORs) is difficult due to the uncertainty inherent to surgical services. This is especially true for the inpatient surgical department where complex and long surgeries are often performed along with surgeries on emergency patients. This paper aims to improve the scheduling of the inpatient department by partitioning the elective surgeries into the more predictable surgeries (MPS) group and the less predictable surgeries (LPS) group, based on surgery duration variability, and by scheduling each of the two surgery groups in different ORs. Through a simulation study that comprehensively investigates the impact of the partitioning on different performance measures under various environmental settings, we report important findings and insights. First, partitioning can effectively shorten the waiting times of elective patients for both MPS and LPS groups, but the option should be allowed to reassign patients from the MPS or LPS ORs to the other ORs when needed. Meanwhile, partitioning sometimes slightly increases the elective cancellation rate. Second, the ability to use the available capacity of the ORs as much as possible is key to reducing elective waiting times. Third, partitioning might slightly worsen the waiting times of emergency patients, while the slightly negative impact on emergency patients decreases when the number of ORs is higher. Fourth, the beneficial impact of partitioning on elective patients increases with an increased patient demand. Last, for the settings considered in this study there was no benefit in partitioning the elective patients into more than two groups. © 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Citation

Lien Wang, Erik Demeulemeester, Nancy Vansteenkiste, Frank E Rademakers. On the use of partitioning for scheduling of surgeries in the inpatient surgical department. Health care management science. 2022 Dec;25(4):526-550