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OPTIMIZE OR−SCHEDULE TO REDUCE NUMBER OF REQUIRED BEDS Theresia van Essen, Joël Bosch
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Reduce number of required beds: Less admissions Reduce length of stay Level bed utilization 9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 2/26 CONTEXT
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9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 3/26 BED UTILIZATION PatientLOSOption 1Option 2 13MondayTuesday 23 Wednesday 32ThursdayWednesday
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9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 4/26 BED UTILIZATION PatientLOSOption 1Option 2 13MondayTuesday 23 Wednesday 32ThursdayWednesday
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9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 5/26 BED UTILIZATION PatientLOSOption 1Option 2 13MondayTuesday 23 Wednesday 32ThursdayWednesday
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9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 6/26 BED UTILIZATION PatientLOSOption 1Option 2 13MondayTuesday 23 Wednesday 32ThursdayWednesday
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9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 7/26 BED UTILIZATION PatientLOSOption 1Option 2 13MondayTuesday 23 Wednesday 32ThursdayWednesday
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Beliën and Demeulemeester (2007) Stochastic length of stay Optimization Minimize sum required beds Van Oostrum et al. (2008) Mean length of stay Optimization Vanberkel et al. (2011) Stochastic length of stay Evaluation 9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 8/26 RELEVANT LITERATURE
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Generate OR blocks Maximize OR utilization Satisfy overtime probability Assign OR blocks to OR-day Minimize number beds Satisfy OR availability Satisfy surgeon availability Satisfy capacity instrument sets 9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 9/26 MODEL
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Blocks are assigned to one specialist Maximize sum of expected duration Sum expected duration plus slack is less than capacity Solve with Column Generation 9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 10/26 GENERATE OR BLOCKS 08:00 16:00
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Planning horizon Days with OR and surgeon availability OR blocks Number of patients of each type Required instruments Probability distribution LOS 9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 11/26 ASSIGN OR BLOCKS TO OR-DAY INPUT LOS12345 Probability0.100.300.400.150.05
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9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 12/26 ASSIGN OR BLOCKS TO OR-DAY DISTRIBUTION BEDS 1 0.8 0.6 0.4 0.2
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Simulated Annealing Swap two OR blocks from two different days If swap is feasible, determine number required beds Better solution: accept Worse solution: accept with probability 9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 13/26 ASSIGN OR BLOCKS TO OR-DAY MODEL
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9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 14/26 ASSIGN OR BLOCKS TO OR-DAY MODEL OR 1OR 2 Day 112 Day 234
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9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 15/26 ASSIGN OR BLOCKS TO OR-DAY MODEL OR 1OR 2 Day 142 Day 231
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Assignment of OR blocks to OR-days Number required beds per day 9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 16/26 ASSIGN OR BLOCKS TO OR-DAY OUTPUT
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9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 17/26 RESULT HAGAZIEKENHUIS ORTHOPEDICS
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9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 18/26 RESULT HAGAZIEKENHUIS ORTHOPEDICS
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9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 19/26 RESULT HAGAZIEKENHUIS ORTHOPEDICS
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Applicable to surgical wards Applicable to nonsurgical wards No OR blocks, but individual patients Emergency patients can be incorporated Add distribution of emergency patients per day 9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 20/26 APPLICATIONS
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Number beds can be reduced Even when OR utilization increases Costs can be reduced Information for nurse rostering provided Develop iterative approach Close wards during weekend 9-11-2011Optimize OR-Schedule to Reduce Number of Required Beds 21/26 CONCLUSIONS & FUTURE RESEARCH
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Questions? j.t.vanessen@utwente.nl
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