加强手术室管理的综合方法:能力规划、公平调度和外科医生弹性

IF 4.5 3区 管理学 Q1 OPERATIONS RESEARCH & MANAGEMENT SCIENCE
Vahid Kayvanfar, Roberto Baldacci, Kannan Govindan
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引用次数: 0

摘要

在手术室管理(ORM)领域,一些关键挑战迫在眉睫,包括减少外科医生的加班和空闲时间,避免手术室的过度使用和利用不足,以及公平分配患者给外科医生以减轻工作量压力。此外,与外科医生相关的潜在中断风险可能导致手术取消。本研究提出了一个全面的框架,通过统一的方法解决这些挑战,包括能力规划和外科部门的公平调度。该方法的一个重要组成部分包括确定备用外科医生,以尽量减少由于外科医生不可用而导致的手术取消风险。容量规划阶段在初始阶段执行,利用马尔可夫排队系统来优化资源分配。在第二阶段,引入弹性调度模型,考虑病人与外科医生的公平分配。该调度模型采用目标规划方法建立,并采用一种基于分解的启发式方法求解,以加快最优解的实现。为了验证这种创新方法的有效性,进行了一个现实世界的案例研究,展示了它的实际应用,并展示了它在解决ORM固有的复杂挑战方面的熟练程度,随后是一些有价值的管理见解。通过实施该方法,在容量规划阶段从前面的排队模型中得到最优手术室数量,并分析了外科医生数量变化的影响。结果表明,优化单元容量改善了手术调度,证明了所提框架的有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An integrated approach for enhancing operating room management: capacity planning, fair scheduling, and surgeon resilience

In the realm of operating room management (ORM), several key challenges loom large, including the reduction of overtime and idle time for surgeons, avoiding overutilization and underutilization of ORs, and the equitable allocation of patients to surgeons to mitigate workload pressures. Moreover, the potential disruption risks associated with surgeons can lead to surgery cancellations. This research presents a comprehensive framework for addressing these challenges through a unified approach encompassing capacity planning and equitable scheduling within surgery departments. An essential component of this approach involves the identification of backup surgeons to minimize the surgery cancellations risk attributable to surgeon unavailability. The capacity planning phase is executed in the initial stage, leveraging Markovian queueing systems to optimize resource allocation. In the second stage, a resilient scheduling model is introduced, considering the equitable assignment of patients to surgeons. This scheduling model is developed using a goal programming approach and is solved efficiently using a novel decomposition-based heuristic method designed to expedite the optimal solution attainment. To validate the efficacy of this innovative approach, a real-world case study is undertaken, showcasing its practical application and demonstrating its proficiency in addressing the complex challenges inherent in ORM, followed by some valuable managerial insights. By implementing the proposed approach, the optimal number of operating rooms is obtained from the preceding queueing model in the capacity planning phase, and the effect of changing surgeon numbers is analyzed. Results show that optimizing unit capacity improves surgery scheduling and demonstrates the proposed framework’s efficiency.

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来源期刊
Annals of Operations Research
Annals of Operations Research 管理科学-运筹学与管理科学
CiteScore
7.90
自引率
16.70%
发文量
596
审稿时长
8.4 months
期刊介绍: The Annals of Operations Research publishes peer-reviewed original articles dealing with key aspects of operations research, including theory, practice, and computation. The journal publishes full-length research articles, short notes, expositions and surveys, reports on computational studies, and case studies that present new and innovative practical applications. In addition to regular issues, the journal publishes periodic special volumes that focus on defined fields of operations research, ranging from the highly theoretical to the algorithmic and the applied. These volumes have one or more Guest Editors who are responsible for collecting the papers and overseeing the refereeing process.
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