How to schedule elective surgical cases into specific operating rooms to maximize the efficiency of use of operating room time

被引:196
作者
Dexter, F [1 ]
Traub, RD
机构
[1] Univ Iowa, Dept Anesthesia, Div Management Consulting, Iowa City, IA 52242 USA
[2] N Dakota State Univ, Coll Business Adm, Fargo, ND 58105 USA
关键词
D O I
10.1097/00000539-200204000-00030
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
We considered elective case scheduling at hospitals and surgical centers at which surgeons and patients choose the day of surgery, cases are not turned away, and anesthesia and nursing staffing are adjusted to maximize the efficiency of use of operating room (OR) time. We investigated scheduling a new case into an OR by using two patient-scheduling rules: Earliest Start Time or Latest Start Time. By using several scenarios, we showed that the use of Earliest Start Time is rational economically at such facilities. Specifically, it maximizes OR efficiency when a service has nearly filled its regularly scheduled hours of OR time. However, Latest Start Time will perform better at balancing workload among services' OR time. We then used historical case duration data from two facilities in computer simulations to investigate the effect of errors in predicting case durations on the performance of these two heuristics. The achievable incremental reduction in overtime by having perfect information on case duration versus using historical case durations was only a few minutes per OR. The differences between Earliest Start Time and Latest Start Time were also only a few minutes per OR. We conclude that for facilities at which the goals are, in order of importance, safety, patient and surgeon access to OR time, and then efficiency, few restrictions need to be placed on patient scheduling to achieve an efficient use of OR time.
引用
收藏
页码:933 / 942
页数:10
相关论文
共 21 条
[1]   BOUNDS ON EXPECTED PROJECT TARDINESS [J].
BIRGE, JR ;
MADDOX, MJ .
OPERATIONS RESEARCH, 1995, 43 (05) :838-850
[2]   Statistical method for predicting when patients should be ready on the day of surgery [J].
Dexter, F ;
Traub, RD .
ANESTHESIOLOGY, 2000, 93 (04) :1107-1114
[3]  
Dexter F, 2000, AANA J, V68, P31
[4]   Which algorithm for scheduling add-on elective cases maximizes operating room utilization? Use of bin packing algorithms and fuzzy constraints in operating room management [J].
Dexter, F ;
Macario, A ;
Traub, RD .
ANESTHESIOLOGY, 1999, 91 (05) :1491-1500
[5]   Comparison of statistical methods to predict the time to complete a series of surgical cases [J].
Dexter, F ;
Traub, RD ;
Qian, F .
JOURNAL OF CLINICAL MONITORING AND COMPUTING, 1999, 15 (01) :45-51
[6]   Statistical method to evaluate management strategies to decrease variability in operating room utilization: Application of linear statistical modeling and Monte Carlo simulation to operating room management [J].
Dexter, F ;
Macario, A ;
Lubarsky, DA ;
Burns, DD .
ANESTHESIOLOGY, 1999, 91 (01) :262-274
[7]   An operating room scheduling strategy to maximize the use of operating room block time: Computer simulation of patient scheduling and survey of patients' preferences for surgical waiting time [J].
Dexter, F ;
Macario, A ;
Traub, RD ;
Hopwood, M ;
Lubarsky, DA .
ANESTHESIA AND ANALGESIA, 1999, 89 (01) :7-20
[8]   A strategy for deciding operating room assignments for second-shift anesthetists [J].
Dexter, F ;
Macario, A ;
O'Neill, L .
ANESTHESIA AND ANALGESIA, 1999, 89 (04) :920-924
[9]  
Dexter F, 2001, ANESTH ANALG, V92, P1493
[10]   Scheduling a delay between different surgeons' cases in the same operating room on the same day using upper prediction bounds for case durations [J].
Dexter, F ;
Traub, RD ;
Lebowitz, P .
ANESTHESIA AND ANALGESIA, 2001, 92 (04) :943-946