Center of Healthcare Operations Improvement and Research (CHOIR), University of Twente, Enschede, P.O.Box 217, 7500 AE, Enschede, The Netherlands.
Health Care Manag Sci. 2012 Dec;15(4):355-72. doi: 10.1007/s10729-012-9202-2. Epub 2012 Jun 13.
Due to surgery duration variability and arrivals of emergency surgeries, the planned Operating Room (OR) schedule is disrupted throughout the day which may lead to a change in the start time of the elective surgeries. These changes may result in undesirable situations for patients, wards or other involved departments, and therefore, the OR schedule has to be adjusted. In this paper, we develop a decision support system (DSS) which assists the OR manager in this decision by providing the three best adjusted OR schedules. The system considers the preferences of all involved stakeholders and only evaluates the OR schedules that satisfy the imposed resource constraints. The decision rules used for this system are based on a thorough analysis of the OR rescheduling problem. We model this problem as an Integer Linear Program (ILP) which objective is to minimize the deviation from the preferences of the considered stakeholders. By applying this ILP to instances from practice, we determined that the given preferences mainly lead to (i) shifting a surgery and (ii) scheduling a break between two surgeries. By using these changes in the DSS, the performed simulation study shows that less surgeries are canceled and patients and wards are more satisfied, but also that the perceived workload of several departments increases to compensate this. The system can also be used to judge the acceptability of a proposed initial OR schedule.
由于手术持续时间的变化和急诊手术的到来，整个手术日的计划手术室（OR）时间表都会被打乱，这可能导致择期手术的开始时间发生变化。这些变化可能会给患者、病房或其他相关科室带来不良影响，因此，手术室时间表必须进行调整。在本文中，我们开发了一个决策支持系统（DSS），通过提供三个最佳调整后的手术室时间表，帮助手术室经理做出决策。该系统考虑了所有相关利益相关者的偏好，并且只评估满足资源约束的手术室时间表。用于该系统的决策规则是基于对手术室重新安排问题的深入分析。我们将该问题建模为整数线性规划（ILP），其目标是使考虑到的利益相关者的偏好偏差最小化。通过将此 ILP 应用于实际实例，我们确定给定的偏好主要导致（i）转移手术，（ii）在两次手术之间安排休息时间。通过在 DSS 中使用这些更改，进行的模拟研究表明，取消的手术更少，患者和病房更满意，但也有几个部门的感知工作量增加，以弥补这一点。该系统还可用于判断拟议的初始手术室时间表的可接受性。
