A Study Of Operating Room Scheduling Problem Under Uncertainty Perturbations

In recent years,with the aging of society’s population,people’s demand for medical services has been increasing,while the limited resources of hospitals and the existence of uncertainties have brought great challenges to medical service scheduling.How to achieve rational utilization of medical resources,optimize patient surgery time,reduce the phenomenon of unreasonable surgery resource allocation,and improve the efficiency of resource utilization has begun to become a hot topic of concern for scholars at home and abroad.The uncertainty of patient surgery duration has been a pain point and difficulty affecting the existence of medical resource scheduling,which will not only affect the original surgery scheduling plan,but also affect the service level of hospitals and increase the difficulty of medical resource allocation.A scientific and reasonable surgery scheduling plan should minimize the impact of uncertainties and should also take into account factors such as patient preferences,patient waiting time,and physician scheduling as much as possible.Based on this,this paper incorporates patient waiting time and patient preference into the scheduling problem,fully considers patients’ uncertain surgery length,ensures that hospitals can efficiently meet patients’ needs,minimize hospital costs and maximize medical resource utilization when surgery length fluctuates,and provides medical services to patients at a high level of service,specifically by:Constructing a short-term robust surgery scheduling model based on constraint violation probability.Minimize the total cost of operating room management including surgery scheduling cost,patient waiting cost,and operating room overtime cost based on different waiting time weights of patients considering the uncertainty of patient surgery length.A short-term robust surgical scheduling model in a certain daily waiting queue is established using robust discrete optimization,and the relationship between robustness and objective function values is balanced by introducing robust coefficients,which are transformed into a mixed integer linear programming model by pairwise theory,and the reliability of the robust solution is further obtained by calculating the upper limit of the constraint violation probability.The numerical experimental results show that as the robustness coefficient increases,the total operating room cost,operating room timeout,and patient waiting time increase accordingly,but the service level of the model also gradually improves.Meanwhile,this paper also conducts sensitivity analysis to study the relationship between the probability of constraint violation and the total cost of the operating room under different perturbation ratios.An elective surgery scheduling model based on the service level constraint is constructed.Considering patients’ preferences for surgery time and attending physicians,a block strategy scheduling for the operating room is performed,and an adjustable robust optimization method is applied to study the problem of scheduling the operating room for patient preferences and joint physician scheduling under the service level constraint,with the goal of minimizing the total operating room scheduling cost,in response to the uncertainty of patients’ surgery length.Meanwhile,the model combines opportunity constraints with robust optimization to give an elective surgery scheduling model based on adjustable robust optimization with a guaranteed service quality level of the surgery scheduling system.The model weighs the relationship between robustness and objective function values by adjusting the robustness coefficients to give an iterative algorithm that can find the optimal robustness coefficients to satisfy a preset service level.Finally,numerical calculations are performed to verify the validity of this model,and the results show that the model can effectively cope with fluctuations in patient surgery length and that the total OR scheduling cost increases only slightly as patient preference gradually increases.This study combines short-term surgery scheduling and elective surgery schedule to form a rolling planning scheme that can cope with various uncertainties.Efficient allocation of OR resources within the constraints of limited medical resources,the multi-constrained,multi-resource,and highly complex surgical scheduling problem considered in this paper is more in line with reality and thus provides a theoretical basis for surgical scheduling.The results of the study enlighten hospital managers to be able to choose different robustness factors according to their own degree of risk preference and the guaranteed probability of the model to achieve a trade-off between robustness and economy.