Operating Rooms Scheduling for Elective Surgeries in a Hospital Affected by War-Related Incidents

Abstract

Hospital scheduling presents huge challenges for the healthcare industry. Various studies have been conducted in many different countries with focus on both elective and non-elective surgeries. There are important variables and factors that need to be taken into considerations. Different methods and approaches have also been used to examine hospital scheduling. Notwithstanding the continuous changes in modern healthcare services and, in particular, hospital operations, consistent reviews and further studies are still required. The importance of hospital scheduling, particularly, has become more critical as the trade-off between limited resources and overwhelming demand is becoming more evident. This situation is even more pressing in a volatile country where shootings and bombings in public areas happened. Hospital scheduling for elective surgeries in volatile country such as Iraq is therefore often interrupted by non-elective surgeries due to war-related incidents. Hence, this paper intends to address this issue by proposing a hospital scheduling model with focus on neuro-surgery department. The aim of the model is to maximize utilization of operating room while concurrently minimizing idle time of surgery. The study focused on neurosurgery department in Al-Shahid Ghazi Al-Hariri hospital in Baghdad, Iraq. In doing so, a Mixed-integer linear programming (MILP) model is formulated where interruptions of non-elective surgery are incorporated into the main elective surgery based model. Computational experiment is then carried out to test the model. The result indicates that the model is feasible and can be solved in reasonable times. Nonetheless, its feasibility is further tested as the problems size and the computation times is getting bigger and longer. Application of heuristic methods is the way forward to ensure better practicality of the proposed model. In the end, the potential benefit of this study and the proposed model is discussed.

Immediate and long-term impact of the COVID-19 pandemic on delivery of surgical services

“…Although the seasonal disruption of surgical care and the occasional cancellation of surgery is not new to most healthcare systems, the current pandemic has unprecedented implications for surgical services and patients with surgical conditions. Surgical capacity may experience extreme challenges in war zones, or in the case of mass casualty events from terror or during civilian accidents or natural disasters, with numbers exceeding the surgical capacity (such as operating theatres, number of surgeons and anaesthesia staff). In the current pandemic, rather than mobilizing surgical resources for surgical conditions in need, the current demand for ventilators, hospital space and personnel is depriving surgical capacity to a point where essential surgical delivery is strained in multiple regions, irrespective of their economic classification.…”

Programación multiobjetivo de quirófanos considerando el bienestar del cliente interno y externo

“…Se han desarrollado 5 casos para la ejecución del modelo; 4 de estos casos propuestos se enfocan en la eficiencia de las funciones objetivos, cada uno de estos presenta una variación en su función objetivo modificando la prioridad de las distintas funciones; el último caso propuesto se basa en el balance de estas. Se plantean 6 medidas de desempeño para evaluar los casos desarrollados, las tres primeras medidas (Cercanía Óptimo FObj_MaxPrf (Guido y Conforti, 2017), Cercanía Óptimo FObj_MinOcio (Ali, Lamsali, y Othman, 2019), Cercanía Óptimo FObj_Max (Zhang et al, 2019)) miden la cercanía porcentual entre las distintas funciones objetivo y su valor ideal, la cuarta medida (Índice de preferencia total) mide el nivel de cirugías prioritarias programadas, la quinta medida (Promedio médicos programados por día) mide la utilización del personal médico y está relacionada con la función objetivo FObj_MinOcio, por último la sexta medida de desempeño mide el número total de pacientes atendidos en el periodo de planeación y se relacionada con la función objetivo FObj_MaxCli .…”

“…El modelo matemático desarrollado considera 3 objetivos; los cuales fueron escogidos por su predominación en la literatura: I) Maximizar la prioridad de los pacientes (FObj_MaxPrf) (Guido y Conforti, 2017); II) Minimizar la ociosidad (FObj_MinOcio) (Ali et al, 2019); III) Maximizar el número de pacientes (FObj_MaxCli) (Zhang et al, 2019).…”

“…Entre las aplicaciones de metodologías empleadas a la programación por compromisos se encontraron enfoques de toma de decisión difusos (Khodaei et al, 2018;Miao et al, 2020), técnicas de correlación de coeficientes (Canales et al, 2020), distancia de la función objetivo en valores nadir (Amiri et al, 2011) y programación de compromiso con restricciones de azar (Abdelaziz et al, 2007). Igualmente, dentro de la literatura consultada se evidencian funciones de desempeño como: maximizar el mayor número cirugías preferenciales programadas (Guido y Conforti, 2017);minimización de los tiempos ociosos (Ali, Lamsali, y Othman, 2019) y (Erekat et al, 2019) este objetivo busca asignar el menor número posible de médicos tal que la demanda de cirugías obligue al uso eficiente de los mismo reduciendo los tiempos ociosos entre cirugías consecutivas, lo cual garantiza el bienestar entre los médicos de tal modo que los días que estos son programados tienen el mayor número de cirugías según su capacidad quedando libre los otros días, por otro lado se encuentra la maximización del número de clientes atendidos, esta medida de desempeño se enfoca en la satisfacción de pacientes y el uso de los quirófanos, para ello se busca maximizar la cantidad de cirugías programadas en el horizonte de tiempo planeado, lo cual indirectamente mejora la utilización de los recursos disponibles (quirófanos y médicos) (Zhang et al, 2019).…”

"Immediate and Long-Term Impacts of COVID-19 on Surgical Services and Patient"

“…In addition, the effect of the stacking up of operations and the fallout of the pandemic will need to be analyzed. Guidance is urgently needed on how to deliver surgical services safely and effectively in the face of pressures placed by the COVID-19 pandemic [17][18][19].…”