Tactical Decision Making for Selective Expansion of Operating Room Resources Incorporating Financial Criteria and Uncertainty in Subspecialties?? Future Workloads
- 1 May 2005
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Anesthesia & Analgesia
- Vol. 100 (5), 1425-1432
- https://doi.org/10.1213/01.ane.0000149898.45044.3d
Abstract
We considered the allocation of operating room (OR) time at facilities where the strategic decision had been made to increase the number of ORs. Allocation occurs in two stages: a long-term tactical stage followed by short-term operational stage. Tactical decisions, approximately 1 yr in advance, determine what specialized equipment and expertise will be needed. Tactical decisions are based on estimates of future OR workload for each subspecialty or surgeon. We show that groups of surgeons can be excluded from consideration at this tactical stage (e.g., surgeons who need intensive care beds or those with below average contribution margins per OR hour). Lower and upper limits are estimated for the future demand of OR time by the remaining surgeons. Thus, initial OR allocations can be accomplished with only partial information on future OR workload. Once the new ORs open, operational decision-making based on OR efficiency is used to fill the OR time and adjust staffing. Surgeons who were not allocated additional time at the tactical stage are provided increased OR time through operational adjustments based on their actual workload. In a case study from a tertiary hospital, future demand estimates were needed for only 15% of surgeons, illustrating the practicality of these methods for use in tactical OR allocation decisions.Keywords
This publication has 17 references indexed in Scilit:
- Market Capture of Inpatient Perioperative Services Using DEAHealth Care Management Science, 2004
- Data Envelopment Analysis to Determine by How Much Hospitals Can Increase Elective Inpatient Surgical Workload for Each SpecialtyAnesthesia & Analgesia, 2004
- Optimization of operating room allocation using linear programming techniquesJournal of the American College of Surgeons, 2003
- Sensitivity Analysis and Uncertainty in Linear ProgrammingInforms Journal on Applied Analytics, 2003
- How to Release Allocated Operating Room Time to Increase Efficiency: Predicting Which Surgical Service Will Have the Most Underutilized Operating Room TimeAnesthesia & Analgesia, 2003
- Use of Linear Programming to Estimate Impact of Changes in a Hospital's Operating Room Time Allocation on Perioperative Variable CostsAnesthesiology, 2002
- Calculating a Potential Increase in Hospital Margin for Elective Surgery by Changing Operating Room Time Allocations or Increasing Nursing Staffing to Permit Completion of More Cases: A Case StudyAnesthesia & Analgesia, 2002
- Scheduling Surgical Cases into Overflow Block Time— Computer Simulation of the Effects of Scheduling Strategies on Operating Room Labor CostsAnesthesia & Analgesia, 2000
- Which Algorithm for Scheduling Add-on Elective Cases Maximizes Operating Room Utilization?Anesthesiology, 1999
- Surgical Subspecialty Block Utilization and Capacity PlanningAnesthesiology, 1999