Implications of Non-Operating Room Anesthesia Policy for Operating Room Efficiency

Abstract

This thesis focuses on examining the use of Non-Operating Room Anesthesia (NORA) policy in Operating Room (OR) scheduling. A NORA policy involves a practice whereby the administration of anesthesia stage is performed outside the OR. The goal of the thesis is to determine whether NORA policy can improve OR efficiency measured by the performance of total costs, which consists of a weighted sum of patient waiting time, OR overtime and idle time. A simulation optimization method is adopted to find near-optimal schedules for elective surgeries in an outpatient setting. The results of a traditional OR scheduling model, where all stages of the surgery are performed in the OR, will be compared to the results of a NORA OR model where the initial anesthesia stage is performed outside of the OR. Two cases are considered for the NORA model given the decrease on mean durations: (1) a model with the same number of surgery appointments and shorter session length and (2) a models with the same session length and more surgery appointments. . The impact of a NORA policy on OR performance is further analyzed by considering scenarios that capture Surgery duration variability and mean surgery durations which are two traits for surgeries that have been shown to impact OR performance. This thesis aims to investigate how a NORA policy performs when standard deviations and mean surgery durations change. The results show that NORA policy can improve OR efficiency in all settings.