How to Schedule Elective Surgical Cases into Specific Operating Rooms to Maximize the Efficiency of Use of Operating Room Time

Dexter, Franklin; Traub, Rodney D.

doi:10.1097/00000539-200204000-00030

Cited by 250 publications

(155 citation statements)

References 19 publications

(34 reference statements)

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“…23,24,26 The cases would be scheduled into the service-specific time with the most unscheduled time. 6,[27][28][29] The implication is that when determining a maximum wait, we can consider only those cases scheduled into the surgeon's block time and consider that block time always full.…”

Section: Appendixmentioning

confidence: 99%

Monitoring changes in individual surgeon’s workloads using anesthesia data

Dexter

Masursky²,

Ledolter

et al. 2012

Can J Anesth/J Can Anesth

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Purpose We investigated whether changes in the number of cases performed by surgeons can be used as an appropriate surrogate for anesthesia departments' billed units. Methods We used both number of cases performed and the American Society of Anesthesiologists' Relative Value Guide TM (ASA RVG) units to assess all operating room anesthetics of an anesthesia group for two sets of 13 fourweek periods. The units correspond to Canadian basic units and time units. Results Although the number of ASA RVG units is an economically important variable that quantifies perioperative workload, the number of cases is a suitable surrogate for ASA RVG units when used to monitor individual surgeons. The pooled mean Pearson correlation coefficient between the two variables was r = 0.95, with 95% confidence interval 0.94 to 0.96. In addition, there were essentially none to very weak pairwise correlations among surgeons. Conclusions Informal hospital analyses of relative changes in a surgeon's caseload over one year using anesthesia workload data or anesthesia billing data will generally give equivalent results. The principal importance of our findings is that they can be used by anesthesiologists, specifically department heads, in their role as part of operating room committees. Such committees institute plans to revise the caseload of one or a few surgeons, and they then evaluate the results of those plans. The findings of this study are applicable to all anesthesia groups and may be especially valuable to the heads of anesthesiology departments who do not have the data to repeat our analyses. RésuméObjectif Nous avons cherche´a`savoir si les changements dans le nombre de patients ope´re´s par les chirurgiens pouvaient se refle´ter fide`lement dans les unite´s de facturation des de´partements d'anesthe´sie.

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Section: Appendixmentioning

confidence: 99%

Monitoring changes in individual surgeon’s workloads using anesthesia data

Dexter

Masursky²,

Ledolter

et al. 2012

Can J Anesth/J Can Anesth

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“…As for the objective, much research has aimed at maximizing operating room utilization, due to its high operational cost (see Dexter and Traub [2002], Ozkarahan [2000], Dexter et al [1999). However, showed that, at hospitals with fixed or nearly fixed annual budgets, allocating operating room time based on utilization can adversely affect the hospital financially, and suggested considering not only operating room time but also the resulting use of hospital beds.…”

Section: Literature Reviewmentioning

confidence: 99%

A mixed integer programming approach for allocating operating room capacity

Zhang

Murali

Dessouky

et al. 2009

Journal of the Operational Research Society

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We have developed a methodology for allocating operating room capacity to specialties. Our methodology consists of a finite-horizon mixed integer programming (MIP) model which determines a weekly operating room allocation template that minimizes inpatients' cost measured as their length of stay. A number of patient type priority (e.g., emergency over non-emergency patient) and clinical constraints (e.g., maximum number of hours allocated to each specialty, surgeon and staff availability) are included in the formulation. The optimal solution from the analytical model is inputted into a simulation model that captures some of the randomness of the processes (e.g., surgery time, demand, arrival time, and no-show rate of the outpatients) and non-linearities (e.g., the MIP assumes proportional allocation of demand satisfaction (output) with room allocation (input)). The simulation model outputs the average length of stay for each specialty and the room utilization. On a case example of a Los Angeles County Hospital, we show how the hospital length of stay pertaining to surgery can be reduced.

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“…However, their work, which adds single RQ cases to existing schedules at different points in the evolution of the schedules, fails to capture the potential effect of the block release on scheduling decisions made after the RQ case has been added. Other related papers consider methods for placing RQ, or add-on, cases into existing schedules, but the decisions are limited to the day before and the day of surgery, thus eliminating the role of the block release date (Dexter, Macario, & Traub, 1999;Dexter & Traub, 2002;Gerchak, Gupta, & Henig, 1996).…”

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confidence: 99%

A stochastic dynamic program for the single-day surgery scheduling problem

Herring

Herrmann

2011

IIE Transactions on Healthcare Systems Engineering

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The scheduling of individual surgical patients has received extensive treatment in the literature, but this paper is the first to propose a model that simultaneously captures the roles of block schedules, block release dates, and request queue policies in the dynamic evolution of the schedule for a single day in an operating room suite. The model is formulated as a stochastic dynamic program and theoretical results are obtained for a single room version. These results demonstrate that optimal request queue decisions for a single room follow a threshold policy that preserves a desired amount of operating room space for the remaining demand from the room's allocated surgical specialty. An algorithm for determining the optimal thresholds is presented, followed by computational results.

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How to Schedule Elective Surgical Cases into Specific Operating Rooms to Maximize the Efficiency of Use of Operating Room Time

Abstract: We showed how elective cases should be scheduled to maximize the efficiency of use of operating room time. The analysis applies to surgical suites at which surgeons and patients have access to operating room time every workday.

Cited by 250 publications

References 19 publications

Monitoring changes in individual surgeon’s workloads using anesthesia data

Monitoring changes in individual surgeon’s workloads using anesthesia data

A mixed integer programming approach for allocating operating room capacity

A stochastic dynamic program for the single-day surgery scheduling problem

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