يك رو يكرد دو مرحله اي براي برنامه ريزي اتاق عمل و زمان بندي اعمال جراحي انتخابي و اورژانسي - مطالعه موردي: بيمارستان عيسي بن مريم

A two-step Approach to Operating Room Planning an‎d Scheduling for Elective an‎d Emergency Surgeries - Case Study: Isa Ibn Maryam Hospital

مديريت

The increasing deman‎d for medical services an‎d the high share of operating rooms in hospital costs an‎d income have made this department one of the vital an‎d strategic units of medical centers. The existence of different specialized services an‎d surgeons with patients, different deman‎ds an‎d preferences, an‎d different capacities for operating rooms an‎d inpatient departments necessitate efficient planning an‎d scheduling of activities for efficient use of resources. The complexity of the surgical planning an‎d scheduling process, especially in the presence of resource constraints an‎d unpredictable arrival of emergency patients, doubles the need to develop scientific an‎d efficient models. The aim of this research is to design an‎d implement an integrated multi-level framework for operating room planning an‎d scheduling that can simultaneously cover strategic, tactical, an‎d operational decisions an‎d is consistent with the actual conditions of the hospital. The proposed model includes four decision-making levels: At the strategic level, the CAP model allocates the weekly capacity of operating rooms to specialized services in order to maximize the use of the rooms. At the tactical level, the SSP model adjusts the weekly schedule of surgeons with the aim of balancing the workload an‎d bed occupancy. At the offline operational level, the DSSP model performs the daily scheduling of surgeons an‎d elective an‎d non-urgent emergency surgeries with the goals of minimizing overtime an‎d diversifying the services assigned to the operating rooms. Then, the ESSH preventive algorithm increases the system’s readiness to accept urgent emergency patients by creating targeted buffers on the daily schedule. At the online operational level, the DRSP reactive model, in the face of urgent emergency arrival, reschedules the schedule to allow for rapid surgery an‎d maintain overall schedule stability. The models were implemented an‎d eva‎luated using real data from Issa bin Maryam Hospital. The results showed that the proposed framework was able to perform well in all stages an‎d increase the efficiency of the operating rooms, reduce idle times an‎d overtime, improve workload balance, an‎d enhance the capacity to respond to emergency patients. Specifically, the CAP model achieved 78.125% utilization of weekly capacity an‎d reduced unemployment to 21.875%, the SSP model reduced the maximum number of beds occupied per day by 18% an‎d improved the stan‎dard deviation by 9.8%, an‎d the DSSP model improved the average completion time by 11.26% an‎d the variety of specialized services by 52.83%. The ESSH model, by creating targeted buffers, was able to ensure the response to urgent emergency surgery within the allowed time limit, an‎d the DRSP model, by limiting rescheduling, maintained an‎d stabilized the initial schedule. In addition to providing a new approach to operating room management, this research has the potential to be implemented in a real-world environment an‎d can be used as an effective decision-making tool for hospital managers.

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الهام معظم

149265