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Improving operational effectiveness of tactical master plans for emergency and elective patients under stochastic demand and capacitated resources

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  • Adan, Ivo
  • Bekkers, Jos
  • Dellaert, Nico
  • Jeunet, Jully
  • Vissers, Jan

Abstract

This paper develops a two-stage planning procedure for master planning of elective and emergency patients while allocating at best the available hospital resources. Four types of resources are considered: operating theatre, beds in the medium and in the intensive care units, and nursing hours in the intensive care unit. A tactical plan is obtained by minimizing the deviations of the resources consumption to the target levels of resources utilization, following a goal programming approach. The MIP formulation to get this tactical plan is specifically designed to account for emergency care since it allows for the reservation of some capacity for emergency patients and possible capacity excess. To deal with the deviation between actually arriving elective patients and the average number of patients on which the tactical plan is based, we consider the possibility of planning a higher number of patients than the average to create operating slots in the tactical plan (slack planning). These operating slots are then filled in the operational plan following several flexibility rules. We consider three options for slack planning that lead to three different tactical plans on which we apply three flexibility rules to get finally nine alternative weekly schedules of elective patients. We then develop an algorithm to modify this schedule on a daily basis so as to account for emergency patients' arrivals. Scheduled elective patients may be cancelled and emergency patients may be sent to other hospitals. Cancellation rules for both types of patients rely on the possibility to exceed the available capacities. Several performance indicators are defined to assess patient service and hospital efficiency. Simulation results show a trade-off between hospital efficiency and patient service.

Suggested Citation

  • Adan, Ivo & Bekkers, Jos & Dellaert, Nico & Jeunet, Jully & Vissers, Jan, 2011. "Improving operational effectiveness of tactical master plans for emergency and elective patients under stochastic demand and capacitated resources," European Journal of Operational Research, Elsevier, vol. 213(1), pages 290-308, August.
    • Handle: RePEc:eee:ejores:v:213:y:2011:i:1:p:290-308
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    1. Oddoye, J.P. & Jones, D.F. & Tamiz, M. & Schmidt, P., 2009. "Combining simulation and goal programming for healthcare planning in a medical assessment unit," European Journal of Operational Research, Elsevier, vol. 193(1), pages 250-261, February.
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    Cited by:

    1. 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.
    2. Arne Schulz, 2023. "The balanced maximally diverse grouping problem with integer attribute values," Journal of Combinatorial Optimization, Springer, vol. 45(5), pages 1-27, July.
    3. Aisha Tayyab & Saif Ullah & Mohammed Fazle Baki, 2023. "An Outer Approximation Method for Scheduling Elective Surgeries with Sequence Dependent Setup Times to Multiple Operating Rooms," Mathematics, MDPI, vol. 11(11), pages 1-15, May.
    4. Michael Samudra & Carla Van Riet & Erik Demeulemeester & Brecht Cardoen & Nancy Vansteenkiste & Frank E. Rademakers, 2016. "Scheduling operating rooms: achievements, challenges and pitfalls," Journal of Scheduling, Springer, vol. 19(5), pages 493-525, October.
    5. Fattahi, Mohammad & Keyvanshokooh, Esmaeil & Kannan, Devika & Govindan, Kannan, 2023. "Resource planning strategies for healthcare systems during a pandemic," European Journal of Operational Research, Elsevier, vol. 304(1), pages 192-206.
    6. Duma, Davide & Aringhieri, Roberto, 2019. "The management of non-elective patients: shared vs. dedicated policies," Omega, Elsevier, vol. 83(C), pages 199-212.
    7. Zhang, Jian & Dridi, Mahjoub & El Moudni, Abdellah, 2019. "A two-level optimization model for elective surgery scheduling with downstream capacity constraints," European Journal of Operational Research, Elsevier, vol. 276(2), pages 602-613.
    8. Jie Bai & Andreas Fügener & Jan Schoenfelder & Jens O. Brunner, 2018. "Operations research in intensive care unit management: a literature review," Health Care Management Science, Springer, vol. 21(1), pages 1-24, March.
    9. Loïc Deklerck & Babak Akbarzadeh & Broos Maenhout, 2022. "Constructing and evaluating a master surgery schedule using a service-level approach," Operational Research, Springer, vol. 22(4), pages 3663-3711, September.
    10. Wang, Yu & Tang, Jiafu & Fung, Richard Y.K., 2014. "A column-generation-based heuristic algorithm for solving operating theater planning problem under stochastic demand and surgery cancellation risk," International Journal of Production Economics, Elsevier, vol. 158(C), pages 28-36.
    11. Aida Jebali & Ali Diabat, 2015. "A stochastic model for operating room planning under capacity constraints," International Journal of Production Research, Taylor & Francis Journals, vol. 53(24), pages 7252-7270, December.
    12. Ana Batista & Jorge Vera & David Pozo, 2020. "Multi-objective admission planning problem: a two-stage stochastic approach," Health Care Management Science, Springer, vol. 23(1), pages 51-65, March.
    13. Bernardetta Addis & Giuliana Carello & Andrea Grosso & Elena Tànfani, 2016. "Operating room scheduling and rescheduling: a rolling horizon approach," Flexible Services and Manufacturing Journal, Springer, vol. 28(1), pages 206-232, June.
    14. ShuJie Liao & Haiting Tu & Cheng Hu & Wulin Pan & Jianwu Xiong & Dongyang Yu & Lei Jing & Wei Pan, 2019. "Fuzzy multi-objective medical service organization selection model considering limited resources and stochastic demand in emergency management," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-15, March.
    15. Bovim, Thomas Reiten & Christiansen, Marielle & Gullhav, Anders N. & Range, Troels Martin & Hellemo, Lars, 2020. "Stochastic master surgery scheduling," European Journal of Operational Research, Elsevier, vol. 285(2), pages 695-711.
    16. 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.
    17. Omolbanin Mashkani & Andreas T. Ernst & Dhananjay Thiruvady & Hanyu Gu, 2023. "Minimizing patients total clinical condition deterioration in operating theatre departments," Annals of Operations Research, Springer, vol. 328(1), pages 821-857, September.
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    19. John Bowers, 2013. "Balancing operating theatre and bed capacity in a cardiothoracic centre," Health Care Management Science, Springer, vol. 16(3), pages 236-244, September.
    20. Koppka, Lisa & Wiesche, Lara & Schacht, Matthias & Werners, Brigitte, 2018. "Optimal distribution of operating hours over operating rooms using probabilities," European Journal of Operational Research, Elsevier, vol. 267(3), pages 1156-1171.

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