A robust mixed-integer binary programming model for operating theater scheduling to the patient and the surgeon under uncertainty in an open-heart Surgery Department

Abstract

In hospitals, the surgical ward is both a cost and revenue center. In this ward, hospitals face challenges such as increasing demand, limited resources, and rising costs. Consequently, the decisions made have an implications effect on the hospital's performance. Therefore, in this paper a robust mixed-integer binary programming model is proposed with three objectives of maximizing the efficiency of available resources, minimizing the patients waiting time, and minimizing surgery costs that are formulated utilizing the augmented epsilon constraint approach. This model allocates the operating room to the patient and the surgeon and then obtains the required bed capacity inside the downstream units for stand-alone cardiac hospitals. This model includes different preferences for hospital, surgeon, and patient: waiting time, patient cancellations, tardiness, uncertainties in surgery durations, the patient operation start times, the overtime per working day, time windows, SICU beds, planning horizon, and the idle times of the surgeons, operating theater, and working day. The proposed model is solved using robust optimization to deal with stochastic. The proposed model is formulated on the stochastic programming method proposed by Bertsimas and Sim. In the proposed model, a rolling horizon method is used to reschedule the program after cancellation. The computational results illustrate that the rolling horizon method reduces waiting time and increases throughput. The results illustrate that the benefit obtained from the introduced model has improvements in reducing the surgery costs, and patient waiting time, and increasing the efficiency of available resources. This study has been performed at Shahid Rajaei Heart Hospital in Iran.