Improving the efficiency of the operating room environment with an optimization and machine learning model.

The operating room is a major cost and revenue center for most hospitals. Thus, more effective operating room management and scheduling can provide significant benefits. In many hospitals, the post-anesthesia care unit (PACU), where patients recover after their surgical procedures, is a bottleneck....

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Publicado en:Health Care Management Science Vol. 22; no. 4; pp. 756 - 768
Autores principales: Fairley, Michael, Scheinker, David, Brandeau, Margaret L.
Formato: Journal Article
Publicado: Springer Nature Dec2019
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
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        atl: Improving the efficiency of the operating room environment with an optimization and machine learning model.
      aug:
        au:
          Fairley, Michael
          Scheinker, David
          Brandeau, Margaret L.
        affil: Department of Management Science and Engineering, Stanford University, 94305, Stanford, CA, USA
      sug:
        subj:
          Operating Rooms Administration
          Personnel Staffing and Scheduling Administration
          Organizational Efficiency
          Post Anesthesia Care Units Administration
          Program Evaluation
          Hospitals, Pediatric
          Operating Rooms Economics
          Post Anesthesia Care Units Economics
          California
          Computer Simulation
      ab: The operating room is a major cost and revenue center for most hospitals. Thus, more effective operating room management and scheduling can provide significant benefits. In many hospitals, the post-anesthesia care unit (PACU), where patients recover after their surgical procedures, is a bottleneck. If the PACU reaches capacity, patients must wait in the operating room until the PACU has available space, leading to delays and possible cancellations for subsequent operating room procedures. We develop a generalizable optimization and machine learning approach to sequence operating room procedures to minimize delays caused by PACU unavailability. Specifically, we use machine learning to estimate the required PACU time for each type of surgical procedure, we develop and solve two integer programming models to schedule procedures in the operating rooms to minimize maximum PACU occupancy, and we use discrete event simulation to compare our optimized schedule to the existing schedule. Using data from Lucile Packard Children's Hospital Stanford, we show that the scheduling system can significantly reduce operating room delays caused by PACU congestion while still keeping operating room utilization high: simulation of the second half of 2016 shows that our model could have reduced total PACU holds by 76% without decreasing operating room utilization. We are currently working on implementing the scheduling system at the hospital.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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