Robust Method For Surgical Scheduling With Non-operating Room Anesthesia

Surgical scheduling is one of the most important issues in medical scheduling.It is related to the operation of medical institutions and the turnover of patients.Medical institutions usually take the form of centralized scheduling,with unified scheduling and management by the operating services department.However,the procedure of surgery is complicated and uncertain,which brings obstacles to the centralized scheduling of surgery.Most domestic hospitals still lack scientific scheduling methods and technologies.Therefore,medical institutions are eager to seek more adaptive scheduling methods to optimize surgical scheduling based on the characteristics of surgical scheduling problems.In the surgical scheduling process,the Operating Room(OR)is the most important resource and also the bottleneck resource.Therefore,how to use the operating room more reasonably and efficiently is the key to the operation scheduling problem.In the practice of medical institutions,the surgical procedure of "Non-Operating Room Anesthesia(NORA)" comes along.It hopes to optimize the surgical procedure by separating the preoperative anesthesia stage from the operating room,but the relevant theoretical guidance relatively lacking.In this study,we consider the integrated surgical scheduling problem with both Anesthetic Rooms(ARs)and ORs in the presence of surgical duration uncertainty.It is our objective to device a robust scheduling mechanism.The novel perspective of this study is to isolate the anesthesia preoperative stage from an OR which to save OR time and improve its efficiency.To tackle this problem,we develop a two-stage,mixed-integer robust optimization model that minimizes the total costs.Some salient properties about the model are derived and a heuristic algorithm is developed to solve the problem effectively with the performance gap from the optimal solution within an ace of nearly 5%.Our numerical experiments reveal that with few opened ARs,it is effective to save OR times and improve the operational performance of ORs under the uncertainty of surgical duration.In addition,by leveraging data reported in the extant research in conjunction with simulated data,the effectiveness of the proposed algorithm is also verified under different degrees of the conservative parameter.Interestingly,it is demonstrated that our scheduling approach,while considering uncertainty,even outperforms the deterministic setting in terms of reducing surgery delay.We hope that this study will provide hospital managers with some theoretical references on Non-Operating Room Anesthesia(NORA)procedures.On the one hand,we give a robust scheduling method when considering the AR service capability and the uncertainty of the operation time.On the other hand,we also provide the hospital administrator with an evaluation reference for the uncertainty of the operation time.They can determine the degree of conservativeness of the uncertainty of surgical time according to surgeries and their own risk appetite.