A Three Steps Approach for Surgery Planning of Elective and Urgent Patients

摘要

This paper considers the problem of surgery planning with elective and urgent patients. The proposed solutions follows three steps: 1) scheduling of elective patients: given the ordered waiting lists of elective patients, schedule them in the available Operation Rooms (ORs); 2) scheduling of urgent patients: one day in advance, schedule the urgent patients in the remaining time after the step 1; and 3) sequencing of the surgeries: the elective and urgent patients scheduled in each OR are sequenced. In the first step, the elective patients are scheduled for a target Elective Surgery Time (EST) in the ORs, trying to respect the order of the patients on the waiting list. In the second one, the urgent patients are scheduled in the remaining time ensuring that an urgent patient does not wait more than 48 hours. Finally, in the third step, the surgeries assigned to each OR (elective and urgent) are sequenced in such a way that the maximum time that an emergency patient should wait is minimized. Using real data from the Orthopedic Department of the "Lozano Blesa" hospital in Zaragoza, the scheduling obtained by the three steps approach are analyzed by simulations. The influence of different EST, i.e., different reservation policies of the ORs are analyzed in terms of performance and quality of the surgical service.