A simulation optimization approach for planning and scheduling in operating rooms for elective and urgent surgeries

Improving operating room efficiency has become one of the most important goals for health care providers given growing expenditures in managing hospital operations. Effective appointment schedules, which minimize the cost of patient waiting time and operating room idle time and overtime, play an important role in terms of improving efficiency. The variability inherent in surgical procedure times and random arrival of urgent cases significantly complicates the scheduling process. In this study, we compare several strategies for scheduling outpatient surgical procedures in the presence of urgent arrivals. First, a simulation optimization approach is used to find heuristic solutions for a surgery scheduling problem with a heterogeneous set of elective and urgent procedures in a multiple operating room setting. Second, a discrete-event simulation model is used to numerically evaluate how different sequencing and allocation policies perform for multiple surgery procedure types. Historical surgery procedure data for a hospital providing day surgeries over a two-year period from the Canadian Institute for Health Information (CIHI) database will be used to provide empirical support for the input parameters of the model.