Pulido Raul, Aguirre Adrian M, Ortega-Mier Miguel, García-Sánchez Álvaro, Méndez Carlos A
Escuela Técnica Superior de Ing, Industriales (ETSII-UPM), José Gutierrez Abascal 2, 28006 Madrid, Spain.
BMC Health Serv Res. 2014 Oct 15;14:464. doi: 10.1186/1472-6963-14-464.
This study examined the daily surgical scheduling problem in a teaching hospital. This problem relates to the use of multiple operating rooms and different types of surgeons in a typical surgical day with deterministic operation durations (preincision, incision, and postincision times). Teaching hospitals play a key role in the health-care system; however, existing models assume that the duration of surgery is independent of the surgeon's skills. This problem has not been properly addressed in other studies. We analyze the case of a Spanish public hospital, in which continuous pressures and budgeting reductions entail the more efficient use of resources.
To obtain an optimal solution for this problem, we developed a mixed-integer programming model and user-friendly interface that facilitate the scheduling of planned operations for the following surgical day. We also implemented a simulation model to assist the evaluation of different dispatching policies for surgeries and surgeons. The typical aspects we took into account were the type of surgeon, potential overtime, idling time of surgeons, and the use of operating rooms.
It is necessary to consider the expertise of a given surgeon when formulating a schedule: such skill can decrease the probability of delays that could affect subsequent surgeries or cause cancellation of the final surgery. We obtained optimal solutions for a set of given instances, which we obtained through surgical information related to acceptable times collected from a Spanish public hospital.
We developed a computer-aided framework with a user-friendly interface for use by a surgical manager that presents a 3-D simulation of the problem. Additionally, we obtained an efficient formulation for this complex problem. However, the spread of this kind of operation research in Spanish public health hospitals will take a long time since there is a lack of knowledge of the beneficial techniques and possibilities that operational research can offer for the health-care system.
本研究探讨了一家教学医院的每日手术排班问题。该问题涉及在典型手术日中使用多个手术室以及不同类型的外科医生，且手术持续时间（切开前、切开和切开后时间）是确定的。教学医院在医疗保健系统中发挥着关键作用；然而，现有模型假定手术持续时间与外科医生的技能无关。其他研究尚未妥善解决这一问题。我们分析了一家西班牙公立医院的案例，在该医院中，持续的压力和预算削减要求更有效地利用资源。
为了获得该问题的最优解，我们开发了一个混合整数规划模型和用户友好界面，以方便安排下一个手术日的计划手术。我们还实施了一个模拟模型，以协助评估针对手术和外科医生的不同调度策略。我们考虑的典型因素包括外科医生的类型、潜在加班时间、外科医生的闲置时间以及手术室的使用情况。
制定排班计划时必须考虑特定外科医生的专业技能：这种技能可以降低可能影响后续手术或导致最后一台手术取消的延误概率。我们通过从一家西班牙公立医院收集的与可接受时间相关的手术信息，为一组给定实例获得了最优解。
我们开发了一个计算机辅助框架，带有供手术管理人员使用的用户友好界面，该界面呈现了该问题的三维模拟。此外，我们为这个复杂问题获得了一个有效的公式。然而，这类运筹学在西班牙公立医院的推广将需要很长时间，因为缺乏对运筹学可为医疗保健系统提供的有益技术和可能性的了解。
