Scheduling Elective Surgeries in Multiple Operating Rooms

Abstract

This thesis focuses on the problem of designing appointment schedules in a surgery center with multiple operating rooms. The conditions under which overlapping surgeries in the surgeons’ schedule (i.e. parallel surgery processing) at the lowest cost are investigated with respect to three components of the total cost: waiting time, idle time, and overtime. A simulation optimization method is developed to find the near-optimal appointment schedules for elective surgical procedures in the presence of uncertain surgery durations. The analysis is performed in three steps. First, three near-optimal operating room schedules are found for different cost configurations based on the secondary data of surgery durations obtained from the Canadian Institute for Health Information. Second, these near-optimal appointment schedules are used to test a parallel scheduling policy where each surgeon has overlapping surgeries scheduled in two operating rooms for the entire session (480 minutes) and only attends the critical portions of surgeries in the two operating rooms. Lastly, another parallel scheduling policy is tested where each surgeon has overlapping surgeries scheduled for half of the session duration (240 minutes) and only has surgeries scheduled in one operating room for the remaining time. These two policies are tested using simulation with scenarios for parallelizable portions of surgeries varying from 0.1 to 0.9 at 0.1 increments and three cost configurations. In the simulated scenarios, the total cost is calculated as the weighted sum of patient waiting time, surgeon idle time, surgeon overtime, operating room idle time, and operating room overtime. Out of the nine scenarios for each policy and each cost configuration, the parallelizable portion of surgeries that result in the lowest total cost is identified. The results from both policies indicate that implementing parallel scheduling policies for surgery types with higher parallelizable portions results in surgeons remaining idle for longer periods during the session. This idle time cost is justified by a decrease in other cost components for surgeries with parallelizable portions 50% or less; however, the total cost is higher for surgeries with parallelizable portions over 50%. In addition, it has been observed that overlapping surgeries with lower parallelizable portions is more expensive than overlapping those over with 50%. Therefore, it is concluded that the surgery types that allow parallel surgery scheduling policies to be implemented at the lowest cost have 50% of their duration parallelizable.