Comparing Policies for Case Scheduling Within 1 Day of Surgery by Markov Chain Models

Anesthesia and Analgesia
Pengyi ShiRichard H Epstein

Abstract

In previous studies, hospitals' operating room (OR) schedules were influenced markedly by decisions made within a few days of surgery. At an academic hospital, 46% of ORs had their last case scheduled or changed within 1 working day of surgery, and a private hospital had 64%. Many of these changes were for patients who were admitted before surgery (i.e., inpatient cases). In this study, we investigate the impact on OR productivity of how cases are scheduled within 1 working day before the day of surgery. We consider the case-scheduling choice between 2 ORs. We compare 3 scheduling policies: Best Fit Descending, Worst Fit Descending, and Worst Fit Ascending. "Descending" strategies consider new cases from longest to shortest, whereas "Ascending" considers new cases from shortest to longest. Best Fit schedules each new case into the OR with sufficient but the least remaining underutilized OR time for the case. Worst Fit does the same but with the most remaining time. For our application, Best Fit chooses a later start time, whereas Worst Fit chooses an earlier start time. In our computational model, cases are of 2 possible durations, brief or long. Case cancellation is incorporated explicitly, and the number of new cases to sched...Continue Reading

References

Mar 21, 1998·Journal of Medical Systems·D P StrumG Bashein
Apr 23, 2003·AORN Journal·Franklin Dexter, Richard H Epstein
May 26, 2005·Anesthesiology·Franklin DexterJohannes Ledolter
Jun 25, 2005·Anesthesia and Analgesia·Ronald D Miller, Neal H Cohen
Jul 23, 2005·Anesthesia and Analgesia·Franklin DexterJohannes Ledolter
Nov 21, 2008·Anesthesia and Analgesia·David L ReichRonald A Kahn
Nov 21, 2008·Anesthesia and Analgesia·Danielle MasurskyNancy A Nussmeier
Mar 21, 2009·Anesthesia and Analgesia·Pieter S StepaniakGuus de Vries
Sep 19, 2009·Anesthesia and Analgesia·Franklin DexterJohannes Ledolter
Dec 2, 2011·Journal of Graduate Medical Education·Ruth E Wachtel, Franklin Dexter
Sep 27, 2012·Anesthesia and Analgesia·Franklin DexterRichard H Epstein
Mar 29, 2013·International Journal of Health Care Quality Assurance·Juha-Matti LehtonenTeemu Moilanen
May 28, 2013·Anesthesia and Analgesia·Pieter S Stepaniak, Franklin Dexter

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Citations

Feb 27, 2017·Journal of Clinical Anesthesia·Franklin Dexter, Richard H Epstein
Mar 30, 2018·Anesthesia and Analgesia·Richard H Epstein, Franklin Dexter
Aug 12, 2018·Journal of Medical Systems·Steven D BoggsUNKNOWN Association of Anesthesia Clinical Directors
Nov 20, 2019·Journal of Medical Systems·Mitchell H TsaiRichard S Zubarik
Jun 20, 2017·Journal of Clinical Anesthesia·Richard H Epstein, Franklin Dexter

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