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Minimizing the waiting time for emergency surgery

机译:尽量缩短紧急手术的等待时间

摘要

Hospitals aim to deliver the highest quality of care. One key priority is to schedule emergency surgeries as quickly as possible, because postponing them generally increases a patient’s risk of complications and even death. In this paper, we consider the case that emergency surgeries are scheduled in one of the elective Operating Rooms (ORs). In this situation, emergency patients are operated once an going elective surgery has finished. We denote these completion times of the elective surgeries by ‘break-in-moments’ (BIMs). The waiting time for emergency surgeries can be reduced by spreading these BIMs as evenly as possible over the day. This can be achieved by sequencing the surgeries in their assigned OR, such that the maximum interval between two consecutive BIMs is minimized. In this paper, we discuss several exact and heuristic solution methods for this new type of scheduling problem. However, in practice, emergency surgeries arising throughout the day and the uncertainty of the durations of elective surgeries, may disrupt the initial schedule. As a result, the completion times of the elective surgeries, and therefore, the BIMs change, leading also to a change of the maximum distance between two BIMs. To estimate this effect and investigate the robustness of the created schedules, we conduct a simulation study. Computational results show that the best approaches reduce the waiting time of emergency surgeries by approximately 10%.
机译:医院旨在提供最高质量的护理。一个关键优先事项是尽快安排紧急手术,因为推迟紧急手术通常会增加患者发生并发症甚至死亡的风险。在本文中,我们考虑将紧急手术安排在其中一个选修手术室(OR)中的情况。在这种情况下,一旦进行了择期手术,便会对急诊病人进行手术。我们用“瞬间中断”(BIM)表示选修手术的完成时间。通过在一天中尽可能均匀地分布这些BIM,可以减少紧急手术的等待时间。这可以通过对手术按其指定的OR进行排序来实现,以使两个连续BIM之间的最大间隔最小。在本文中,我们讨论了针对这种新型调度问题的几种精确且启发式的求解方法。但是,实际上,全天发生的紧急手术以及选修手术持续时间的不确定性可能会破坏初始计划。结果,选择性外科手术的完成时间以及因此的BIM改变了,这也导致了两个BIM之间的最大距离的改变。为了评估这种影响并调查所创建计划的鲁棒性,我们进行了模拟研究。计算结果表明,最佳方法可将紧急手术的等待时间减少约10%。

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