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The operating room case-mix problem under uncertainty and nurses capacity constraints

Author

Listed:
  • Zakaria Yahia

    (Fayoum University)

  • Amr B. Eltawil

    (Egypt - Japan University of Science and Technology (E-JUST))

  • Nermine A. Harraz

    (Alexandria University)

Abstract

Surgery is one of the key functions in hospitals; it generates significant revenue and admissions to hospitals. In this paper we address the decision of choosing a case-mix for a surgery department. The objective of this study is to generate an optimal case-mix plan of surgery patients with uncertain surgery operations, which includes uncertainty in surgery durations, length of stay, surgery demand and the availability of nurses. In order to obtain an optimal case-mix plan, a stochastic optimization model is proposed and the sample average approximation method is applied. The proposed model is used to determine the number of surgery cases to be weekly served, the amount of operating rooms’ time dedicated to each specialty and the number of ward beds dedicated to each specialty. The optimal case-mix selection criterion is based upon a weighted score taking into account both the waiting list and the historical demand of each patient category. The score aims to maximizing the service level of the operating rooms by increasing the total number of surgery cases that could be served. A computational experiment is presented to demonstrate the performance of the proposed method. The results show that the stochastic model solution outperforms the expected value problem solution. Additional analysis is conducted to study the effect of varying the number of ORs and nurses capacity on the overall ORs’ performance.

Suggested Citation

  • Zakaria Yahia & Amr B. Eltawil & Nermine A. Harraz, 2016. "The operating room case-mix problem under uncertainty and nurses capacity constraints," Health Care Management Science, Springer, vol. 19(4), pages 383-394, December.
    • Handle: RePEc:kap:hcarem:v:19:y:2016:i:4:d:10.1007_s10729-015-9337-z
    DOI: 10.1007/s10729-015-9337-z
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    References listed on IDEAS

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    1. Angela Testi & Elena Tanfani & Giancarlo Torre, 2007. "A three-phase approach for operating theatre schedules," Health Care Management Science, Springer, vol. 10(2), pages 163-172, June.
    2. Blake, John T. & Carter, Michael W., 2002. "A goal programming approach to strategic resource allocation in acute care hospitals," European Journal of Operational Research, Elsevier, vol. 140(3), pages 541-561, August.
    3. Belií«n, Jeroen & Demeulemeester, Erik, 2008. "A branch-and-price approach for integrating nurse and surgery scheduling," European Journal of Operational Research, Elsevier, vol. 189(3), pages 652-668, September.
    4. Cardoen, Brecht & Demeulemeester, Erik & Beliën, Jeroen, 2010. "Operating room planning and scheduling: A literature review," European Journal of Operational Research, Elsevier, vol. 201(3), pages 921-932, March.
    5. Min, Daiki & Yih, Yuehwern, 2010. "Scheduling elective surgery under uncertainty and downstream capacity constraints," European Journal of Operational Research, Elsevier, vol. 206(3), pages 642-652, November.
    6. Francesca Guerriero & Rosita Guido, 2011. "Operational research in the management of the operating theatre: a survey," Health Care Management Science, Springer, vol. 14(1), pages 89-114, March.
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    Cited by:

    1. Sebastian McRae & Jens O. Brunner & Jonathan F. Bard, 2020. "Analyzing economies of scale and scope in hospitals by use of case mix planning," Health Care Management Science, Springer, vol. 23(1), pages 80-101, March.
    2. Sean Harris & David Claudio, 2022. "Current Trends in Operating Room Scheduling 2015 to 2020: a Literature Review," SN Operations Research Forum, Springer, vol. 3(1), pages 1-42, March.
    3. Thomas Schneider, A.J. & Theresia van Essen, J. & Carlier, Mijke & Hans, Erwin W., 2020. "Scheduling surgery groups considering multiple downstream resources," European Journal of Operational Research, Elsevier, vol. 282(2), pages 741-752.
    4. Şeyda Gür & Mehmet Pınarbaşı & Hacı Mehmet Alakaş & Tamer Eren, 2023. "Operating room scheduling with surgical team: a new approach with constraint programming and goal programming," Central European Journal of Operations Research, Springer;Slovak Society for Operations Research;Hungarian Operational Research Society;Czech Society for Operations Research;Österr. Gesellschaft für Operations Research (ÖGOR);Slovenian Society Informatika - Section for Operational Research;Croatian Operational Research Society, vol. 31(4), pages 1061-1085, December.
    5. McRae, Sebastian & Brunner, Jens O., 2020. "Assessing the impact of uncertainty and the level of aggregation in case mix planning," Omega, Elsevier, vol. 97(C).

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