Kaiser Permanente Oakland Medical Center Optimizes Operating Room Block Schedule for New Hospital

In July 2014, Kaiser Permanente, a major integrated healthcare delivery consortium, opened a new hospital, replacing an existing hospital, adjacent to its headquarters in Oakland, California. Hospital staff needed to devise a new operating room schedule. In developing the schedule, the key decisions the staff would have to make were the type of block (i.e., a combination of surgery types that can be performed in the same operating room on the same day) to assign to each operating room on each day of the planning horizon. We report on the development and implementation of an integer programming model to generate a near-optimal block schedule. The approach differs from many in the literature because it considers both direct nursing costs and patient-related costs, and can accommodate a variety of practical constraints. Kaiser Permanente Oakland implemented the proposed schedule and continues to use it with minor modifications in response to subsequent growth and changes in patient demand patterns. Three major benefits of the schedule are that it: (1) satisfies almost all of the monthly block requirements in only four weeks, thereby releasing capacity to reduce the surgical backlog; (2) eliminates days with excess admissions, which would have required additional nursing staff; and (3) reduces the number of surgeries canceled due to an insufficient number of available beds.