开放式心脏外科不确定情况下病人和外科医生手术室调度的稳健混合整数二元编程模型

Bahareh Rahmani Manshadi
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引用次数: 0

摘要

在医院中,外科病房既是成本中心,也是收入中心。在这个病房里,医院面临着需求增加、资源有限和成本上升等挑战。因此,所做的决策会对医院的绩效产生影响。因此,本文提出了一个稳健的混合整数二元编程模型,该模型有三个目标,即可用资源效率最大化、病人等待时间最小化和手术成本最小化。该模型将手术室分配给病人和外科医生,然后获得独立心脏病医院下游病房所需的床位容量。该模型包括医院、外科医生和病人的不同偏好:等待时间、病人取消、迟到、手术持续时间的不确定性、病人手术开始时间、每个工作日的加班时间、时间窗口、SICU 病床、规划期限以及外科医生、手术室和工作日的空闲时间。提出的模型采用稳健优化方法来解决随机问题。建议的模型是根据 Bertsimas 和 Sim 提出的随机编程方法制定的。在所提出的模型中,采用了滚动地平线法来重新安排取消后的节目。计算结果表明,滚动视距法缩短了等待时间,提高了吞吐量。结果表明,引入的模型在降低手术成本、减少病人等待时间、提高可用资源效率等方面都有所改善。这项研究是在伊朗 Shahid Rajaei 心脏医院进行的。
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A robust mixed-integer binary programming model for operating theater scheduling to the patient and the surgeon under uncertainty in an open-heart Surgery Department

In hospitals, the surgical ward is both a cost and revenue center. In this ward, hospitals face challenges such as increasing demand, limited resources, and rising costs. Consequently, the decisions made have an implications effect on the hospital's performance. Therefore, in this paper a robust mixed-integer binary programming model is proposed with three objectives of maximizing the efficiency of available resources, minimizing the patients waiting time, and minimizing surgery costs that are formulated utilizing the augmented epsilon constraint approach. This model allocates the operating room to the patient and the surgeon and then obtains the required bed capacity inside the downstream units for stand-alone cardiac hospitals. This model includes different preferences for hospital, surgeon, and patient: waiting time, patient cancellations, tardiness, uncertainties in surgery durations, the patient operation start times, the overtime per working day, time windows, SICU beds, planning horizon, and the idle times of the surgeons, operating theater, and working day. The proposed model is solved using robust optimization to deal with stochastic. The proposed model is formulated on the stochastic programming method proposed by Bertsimas and Sim. In the proposed model, a rolling horizon method is used to reschedule the program after cancellation. The computational results illustrate that the rolling horizon method reduces waiting time and increases throughput. The results illustrate that the benefit obtained from the introduced model has improvements in reducing the surgery costs, and patient waiting time, and increasing the efficiency of available resources. This study has been performed at Shahid Rajaei Heart Hospital in Iran.

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来源期刊
Perioperative Care and Operating Room Management
Perioperative Care and Operating Room Management Nursing-Medical and Surgical Nursing
CiteScore
1.30
自引率
0.00%
发文量
52
审稿时长
56 days
期刊介绍: The objective of this new online journal is to serve as a multidisciplinary, peer-reviewed source of information related to the administrative, economic, operational, safety, and quality aspects of the ambulatory and in-patient operating room and interventional procedural processes. The journal will provide high-quality information and research findings on operational and system-based approaches to ensure safe, coordinated, and high-value periprocedural care. With the current focus on value in health care it is essential that there is a venue for researchers to publish articles on quality improvement process initiatives, process flow modeling, information management, efficient design, cost improvement, use of novel technologies, and management.
期刊最新文献
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