Scheduling of surgeries subject to stochastic surgery and length of stay with respect to limited capacities in hospitals

考虑到医院容量有限，随机手术和住院时间的手术安排

• 批准号: 328158686
• 负责人: Dr. Svenja Schoonover
• 金额: --
• 依托单位: Institut für Produktionswirtschaft
• 依托单位国家: 德国
• 项目类别: Research Fellowships
• 财政年份: 2016
• 资助国家: 德国
• 起止时间: 2015-12-31 至 2018-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/328158686?language=en
• 关键词: Scheduling; surgeries; subject; stochastic; surgery

Surgeries are measures to improve the quality of life. In some cases, the procedures are even life-saving. Surgeries require many resources, including surgeons, anesthesiologists, nurses, tools and devices, an operating room and a bed in a care unit directly following the surgery. If one resource is not available, the surgery must be postponed, reducing the health care service level. Therefore, a surgery scheduling approach should take limited resources and stochasticity into account. This leads to shorter waiting times for surgeries (by higher utilization of operating rooms) and to a better nurse-patient ratio in the care units (by more leveled utilization of the care units). Current research considers fixed, repeating surgery schedules, but not individual plans for varying demand of surgeries. Therefore, the objective of this research project is to develop a mathematical decision model for surgery scheduling subject to stochastic surgery and bed occupancy times, limited operating rooms and care units, and staff capacities. The goal of this model is to maximize the utilization of operating rooms, to level the utilization in the care units, and the economic, and therefore sustainable, use of the hospital resources. In the course of the project, the distribution of surgery times and the length of stay subject to the procedures is determined, and the correlation between the duration of the surgery and the length of stay in the wards is investigated. The mathematical decision model is developed using the insights from this data analysis (that is, the expected value and the standard deviation per procedure and, if applicable, the correlation between surgery time and length of stay). The result of the model is a surgery and bed occupancy plan for a given demand of procedures subject to the limited resources. Furthermore, we will analyze buffer times in the surgery schedule and its positive effects on robustness of the plan and its negative effects on the idle time. The model will utilize real hospital data. The provided data are surgery times and lengths of stay for the complete years 2014-2016 for three different disciplines at the Hanover Medical School in Germany. The variability of surgery times differs for the selected disciplines: eye surgery has very low variability, heart surgery has a medium variability, and accident surgery is highly variable. In addition, we have bypass surgery data from the Vanderbilt Medical Center for 2015-2017.This research project extends the assumptions of prevailing methods by the consideration of the stochasticity of durations and limited bed capacities with varying surgery demands. That way, it will contribute to the improvement of the health care service level.

surgery是提高生活质量的措施。在某些情况下，这些程序甚至可以挽救生命。外科手术需要许多资源，包括外科医生，麻醉师，护士，工具和设备，手术室和手术后直接在护理单元中的床。如果一个资源不可用，手术必须推迟，降低医疗服务水平。因此，手术调度方法应考虑有限的资源和随机性。这导致手术等待时间缩短（通过提高手术室的利用率），并改善护理单位的护士-患者比例（通过提高护理单位的利用率）。目前的研究考虑固定的，重复的手术时间表，但不是针对不同手术需求的个人计划。因此，本研究项目的目标是开发一个数学决策模型，手术调度受随机手术和床位占用时间，有限的手术室和护理单位，和工作人员的能力。这种模式的目标是最大限度地利用手术室，使护理单位的利用率水平，经济，因此可持续地利用医院资源。在项目实施过程中，确定了手术次数和住院时间的分布，并调查了手术持续时间和住院时间之间的相关性。使用来自该数据分析的见解（即，每个手术的预期值和标准差，以及手术时间和住院时间之间的相关性（如适用））开发数学决策模型。该模型的结果是一个手术和床位占用计划的程序受到有限的资源给定的需求。 此外，我们将分析手术时间表中的缓冲时间及其对计划稳健性的积极影响和对空闲时间的负面影响。该模型将利用真实的医院数据。提供的数据是德国汉诺威医学院三个不同学科2014-2016年的手术时间和住院时间。手术时间的可变性因所选学科而异：眼科手术的可变性非常低，心脏手术的可变性中等，意外手术的可变性很高。此外，我们还获得了范德比尔特医学中心2015- 2017年的搭桥手术数据。本研究项目通过考虑手术时间的随机性和有限的床位容量以及不同的手术需求，扩展了主流方法的假设。这将有助于提高医疗服务水平。