Efficient operating room redesign through process improvement and optimal management of scheduled and emergent surgeries

This article is focused on the benefits of reducing variability and the role of operations research techniques in efficient operating room (OR) redesign through process improvement and optimal management of scheduled and emergent surgeries at hospitals. Issues at a participant hospital are studied which are presented in this article where in the authors develop a three step OR redesign model to address them. Firstly, the process bottlenecks affecting OR performance were identified with the help of a discrete event simulation (DES) model. Once the DES model focusing on the 'as-is' operations of the OR was built and validated, it was used to evaluate various improvement strategies. Secondly, in order to efficiently deal with unscheduled surgeries, a simulated queuing model was used to determine the number of ORs to be reserved which would help in better managing natural variability. Finally, OR time (with the remaining ORs) was allocated for scheduled surgeries after accommodating various operational constraints including surgeon preferences with the help of a mixed integer programme (MIP) model. The empirical observations and results are presented as well.