A new dynamic integrated framework for surgical patients' prioritization considering risks and uncertainties

This study reviews current patients' prioritization systems and presents an innovative integrated three-step decisional framework in an attempt to overcome their limitations. In its first step, the proposed framework encompasses fuzzy logic, analytic hierarchy process (AHP) to formalize stakeholders' goals and objectives. In the second step, the assessments made on each patient's condition are integrated by data envelopment analysis (DEA) and compared among them by a min-max regret approach (MRA) to obtain a primary prioritization of patients. The third step uses the delay ratio, the risk criteria score, and a profile matrix to introduce dynamic aspects related to the evolution of patients' condition and changes in the patient's list to the prioritization process. This three-step framework not only considers the surgery team members' opinions but also considers the patient's opinions in the decision-making process. The new framework has been implemented in the Orthopedic Surgery Ward, Shohada University Hospital, Iran, showing very promising results and advantages. (C) 2016 Elsevier B.V. All rights reserved.