考虑现实生活中的约束条件和手术室综合运营成本的手术排班优化

Surgery scheduling optimization considering real life constraints and comprehensive operation cost of operating room.

作者信息

Xiang Wei, Li Chong

出版信息

Technol Health Care. 2015;23(5):605-17. doi: 10.3233/THC-151017.

Abstract

BACKGROUND

Operating Room (OR) is the core sector in hospital expenditure, the operation management of which involves a complete three-stage surgery flow, multiple resources, prioritization of the various surgeries, and several real-life OR constraints. As such reasonable surgery scheduling is crucial to OR management.

OBJECTIVE

To optimize OR management and reduce operation cost, a short-term surgery scheduling problem is proposed and defined based on the survey of the OR operation in a typical hospital in China.

METHOD

The comprehensive operation cost is clearly defined considering both under-utilization and overutilization. A nested Ant Colony Optimization (nested-ACO) incorporated with several real-life OR constraints is proposed to solve such a combinatorial optimization problem.

RESULTS

The 10-day manual surgery schedules from a hospital in China are compared with the optimized schedules solved by the nested-ACO. Comparison results show the advantage using the nested-ACO in several measurements: OR-related time, nurse-related time, variation in resources' working time, and the end time.

CONCLUSIONS

The nested-ACO considering real-life operation constraints such as the difference between first and following case, surgeries priority, and fixed nurses in pre/post-operative stage is proposed to solve the surgery scheduling optimization problem. The results clearly show the benefit of using the nested-ACO in enhancing the OR management efficiency and minimizing the comprehensive overall operation cost.

摘要

背景

手术室是医院支出的核心部门,其运营管理涉及完整的三个阶段手术流程、多种资源、各类手术的优先级以及一些实际的手术室限制条件。因此,合理的手术排班对手术室管理至关重要。

目的

基于对中国一家典型医院手术室运营情况的调查,提出并定义一个短期手术排班问题,以优化手术室管理并降低运营成本。

方法

明确界定综合运营成本,同时考虑资源利用不足和过度利用的情况。提出一种结合了若干实际手术室限制条件的嵌套蚁群优化算法(nested - ACO)来解决此类组合优化问题。

结果

将中国一家医院的10天手工手术排班与通过嵌套蚁群优化算法求解得到的优化排班进行比较。比较结果显示了嵌套蚁群优化算法在多个指标上的优势:与手术室相关的时间、与护士相关的时间、资源工作时间的变化以及结束时间。

结论

提出考虑诸如首例与后续病例差异、手术优先级以及术前/术后阶段固定护士等实际运营限制条件的嵌套蚁群优化算法来解决手术排班优化问题。结果清楚地表明了使用嵌套蚁群优化算法在提高手术室管理效率和最小化综合总体运营成本方面所带来的益处。

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