Surgery scheduling heuristic considering OR downstream and upstream facilities and resources
Autor(a) principal: | |
---|---|
Data de Publicação: | 2020 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/220303 |
Resumo: | Background: Surgical theater (ST) operations planning is a key subject in the healthcare management literature, particularly the scheduling of procedures in operating rooms (ORs). The OR scheduling problem is usually approached using mathematical modeling and made available to ST managers through dedicated software. Regardless of the large body of knowledge on the subject, OR scheduling models rarely consider the integration of OR downstream and upstream facilities and resources or validate their propositions in real life, rather using simulated scenarios. We propose a heuristic to sequence surgeries that considers both upstream and downstream resources required to perform them, such as surgical kits, post anesthesia care unit (PACU) beds, and surgical teams (surgeons, nurses and anesthetists). Methods: Using hybrid flow shop (HFS) techniques and the break-in-moment (BIM) concept, the goal is to find a sequence that maximizes the number of procedures assigned to the ORs while minimizing the variance of intervals between surgeries’ completions, smoothing the demand for downstream resources such as PACU beds and OR sanitizing teams. There are five steps to the proposed heuristic: listing of priorities, local scheduling, global scheduling, feasibility check and identification of best scheduling. Results: Our propositions were validated in a high complexity tertiary University hospital in two ways: first, applying the heuristic to historical data from five typical ST days and comparing the performance of our proposed sequences to the ones actually implemented; second, pilot testing the heuristic during ten days in the ORs, allowing a full rotation of surgical specialties. Results displayed an average increase of 37.2% in OR occupancy, allowing an average increase of 4.5 in the number of surgeries performed daily, and reducing the variance of intervals between surgeries’ completions by 55.5%. A more uniform distribution of patients’ arrivals at the PACU was also observed. Conclusions: Our proposed heuristic is particularly useful to plan the operation of STs in which resources are constrained, a situation that is common in hospital from developing countries. Our propositions were validated through a pilot implementation in a large hospital, contributing to the scarce literature on actual OR scheduling implementation. |
id |
UFRGS-2_baaeee25d3618bc6ef0fc34addb317a7 |
---|---|
oai_identifier_str |
oai:www.lume.ufrgs.br:10183/220303 |
network_acronym_str |
UFRGS-2 |
network_name_str |
Repositório Institucional da UFRGS |
repository_id_str |
|
spelling |
Calegari, RafaelFogliatto, Flavio SansonLucini, Filipe RissieriAnzanello, Michel JoséSchaan, Beatriz D'Agord2021-04-28T04:31:06Z20201472-6963http://hdl.handle.net/10183/220303001123940Background: Surgical theater (ST) operations planning is a key subject in the healthcare management literature, particularly the scheduling of procedures in operating rooms (ORs). The OR scheduling problem is usually approached using mathematical modeling and made available to ST managers through dedicated software. Regardless of the large body of knowledge on the subject, OR scheduling models rarely consider the integration of OR downstream and upstream facilities and resources or validate their propositions in real life, rather using simulated scenarios. We propose a heuristic to sequence surgeries that considers both upstream and downstream resources required to perform them, such as surgical kits, post anesthesia care unit (PACU) beds, and surgical teams (surgeons, nurses and anesthetists). Methods: Using hybrid flow shop (HFS) techniques and the break-in-moment (BIM) concept, the goal is to find a sequence that maximizes the number of procedures assigned to the ORs while minimizing the variance of intervals between surgeries’ completions, smoothing the demand for downstream resources such as PACU beds and OR sanitizing teams. There are five steps to the proposed heuristic: listing of priorities, local scheduling, global scheduling, feasibility check and identification of best scheduling. Results: Our propositions were validated in a high complexity tertiary University hospital in two ways: first, applying the heuristic to historical data from five typical ST days and comparing the performance of our proposed sequences to the ones actually implemented; second, pilot testing the heuristic during ten days in the ORs, allowing a full rotation of surgical specialties. Results displayed an average increase of 37.2% in OR occupancy, allowing an average increase of 4.5 in the number of surgeries performed daily, and reducing the variance of intervals between surgeries’ completions by 55.5%. A more uniform distribution of patients’ arrivals at the PACU was also observed. Conclusions: Our proposed heuristic is particularly useful to plan the operation of STs in which resources are constrained, a situation that is common in hospital from developing countries. Our propositions were validated through a pilot implementation in a large hospital, contributing to the scarce literature on actual OR scheduling implementation.application/pdfengBMC health services research. London. Vol. 20 (2020), 684, 11 p.Salas cirúrgicasHospitais universitáriosSurgery schedulingOR sequencingBreak-in-momentSurgical theater managementOperating roomSurgery scheduling heuristic considering OR downstream and upstream facilities and resourcesEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001123940.pdf.txt001123940.pdf.txtExtracted Texttext/plain46113http://www.lume.ufrgs.br/bitstream/10183/220303/2/001123940.pdf.txt74a22b0681efd478d694d9d910dd505aMD52ORIGINAL001123940.pdfTexto completo (inglês)application/pdf1455180http://www.lume.ufrgs.br/bitstream/10183/220303/1/001123940.pdf7ebf2e33147a43a7779112b649c2cabbMD5110183/2203032023-07-30 03:46:05.405064oai:www.lume.ufrgs.br:10183/220303Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2023-07-30T06:46:05Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Surgery scheduling heuristic considering OR downstream and upstream facilities and resources |
title |
Surgery scheduling heuristic considering OR downstream and upstream facilities and resources |
spellingShingle |
Surgery scheduling heuristic considering OR downstream and upstream facilities and resources Calegari, Rafael Salas cirúrgicas Hospitais universitários Surgery scheduling OR sequencing Break-in-moment Surgical theater management Operating room |
title_short |
Surgery scheduling heuristic considering OR downstream and upstream facilities and resources |
title_full |
Surgery scheduling heuristic considering OR downstream and upstream facilities and resources |
title_fullStr |
Surgery scheduling heuristic considering OR downstream and upstream facilities and resources |
title_full_unstemmed |
Surgery scheduling heuristic considering OR downstream and upstream facilities and resources |
title_sort |
Surgery scheduling heuristic considering OR downstream and upstream facilities and resources |
author |
Calegari, Rafael |
author_facet |
Calegari, Rafael Fogliatto, Flavio Sanson Lucini, Filipe Rissieri Anzanello, Michel José Schaan, Beatriz D'Agord |
author_role |
author |
author2 |
Fogliatto, Flavio Sanson Lucini, Filipe Rissieri Anzanello, Michel José Schaan, Beatriz D'Agord |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Calegari, Rafael Fogliatto, Flavio Sanson Lucini, Filipe Rissieri Anzanello, Michel José Schaan, Beatriz D'Agord |
dc.subject.por.fl_str_mv |
Salas cirúrgicas Hospitais universitários |
topic |
Salas cirúrgicas Hospitais universitários Surgery scheduling OR sequencing Break-in-moment Surgical theater management Operating room |
dc.subject.eng.fl_str_mv |
Surgery scheduling OR sequencing Break-in-moment Surgical theater management Operating room |
description |
Background: Surgical theater (ST) operations planning is a key subject in the healthcare management literature, particularly the scheduling of procedures in operating rooms (ORs). The OR scheduling problem is usually approached using mathematical modeling and made available to ST managers through dedicated software. Regardless of the large body of knowledge on the subject, OR scheduling models rarely consider the integration of OR downstream and upstream facilities and resources or validate their propositions in real life, rather using simulated scenarios. We propose a heuristic to sequence surgeries that considers both upstream and downstream resources required to perform them, such as surgical kits, post anesthesia care unit (PACU) beds, and surgical teams (surgeons, nurses and anesthetists). Methods: Using hybrid flow shop (HFS) techniques and the break-in-moment (BIM) concept, the goal is to find a sequence that maximizes the number of procedures assigned to the ORs while minimizing the variance of intervals between surgeries’ completions, smoothing the demand for downstream resources such as PACU beds and OR sanitizing teams. There are five steps to the proposed heuristic: listing of priorities, local scheduling, global scheduling, feasibility check and identification of best scheduling. Results: Our propositions were validated in a high complexity tertiary University hospital in two ways: first, applying the heuristic to historical data from five typical ST days and comparing the performance of our proposed sequences to the ones actually implemented; second, pilot testing the heuristic during ten days in the ORs, allowing a full rotation of surgical specialties. Results displayed an average increase of 37.2% in OR occupancy, allowing an average increase of 4.5 in the number of surgeries performed daily, and reducing the variance of intervals between surgeries’ completions by 55.5%. A more uniform distribution of patients’ arrivals at the PACU was also observed. Conclusions: Our proposed heuristic is particularly useful to plan the operation of STs in which resources are constrained, a situation that is common in hospital from developing countries. Our propositions were validated through a pilot implementation in a large hospital, contributing to the scarce literature on actual OR scheduling implementation. |
publishDate |
2020 |
dc.date.issued.fl_str_mv |
2020 |
dc.date.accessioned.fl_str_mv |
2021-04-28T04:31:06Z |
dc.type.driver.fl_str_mv |
Estrangeiro info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10183/220303 |
dc.identifier.issn.pt_BR.fl_str_mv |
1472-6963 |
dc.identifier.nrb.pt_BR.fl_str_mv |
001123940 |
identifier_str_mv |
1472-6963 001123940 |
url |
http://hdl.handle.net/10183/220303 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.ispartof.pt_BR.fl_str_mv |
BMC health services research. London. Vol. 20 (2020), 684, 11 p. |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UFRGS instname:Universidade Federal do Rio Grande do Sul (UFRGS) instacron:UFRGS |
instname_str |
Universidade Federal do Rio Grande do Sul (UFRGS) |
instacron_str |
UFRGS |
institution |
UFRGS |
reponame_str |
Repositório Institucional da UFRGS |
collection |
Repositório Institucional da UFRGS |
bitstream.url.fl_str_mv |
http://www.lume.ufrgs.br/bitstream/10183/220303/2/001123940.pdf.txt http://www.lume.ufrgs.br/bitstream/10183/220303/1/001123940.pdf |
bitstream.checksum.fl_str_mv |
74a22b0681efd478d694d9d910dd505a 7ebf2e33147a43a7779112b649c2cabb |
bitstream.checksumAlgorithm.fl_str_mv |
MD5 MD5 |
repository.name.fl_str_mv |
Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS) |
repository.mail.fl_str_mv |
|
_version_ |
1801225015594582016 |