Minimizing the waiting time for emergency surgery

Hospitals aim to deliver the highest quality of care. One key priority is to schedule emergency surgeries as quickly as possible, because postponing them generally increases a patient's risk of complications. In this paper, we consider the case that emergency surgeries are scheduled in one of the elective Operating Rooms (ORs). In this situation, emergency patients are operated once an ongoing elective surgery has finished. We denote these completion times of the elective surgeries by 'break-in-moments' (BIMs). The waiting time for emergency surgeries can be reduced by spreading these BIMs as evenly as possible over the day. This can be achieved by sequencing the surgeries in their assigned OR, such that the maximum interval between two consecutive BIMs is minimized. In this paper, we discuss several exact and heuristic solution methods for this new type of scheduling problem. However, in practice, emergency surgeries arising throughout the day and the uncertainty of the durations of elective surgeries, may disrupt the initial schedule. As a result, the completion times of the elective surgeries, and therefore, the BIMs change, leading also to a change of the maximum distance between two BIMs. To estimate this effect and investigate the robustness of the created schedules, we conduct a simulation study. Computational results show that the 'Fixed Goal Values' algorithm reduces the waiting time of emergency surgeries by approximately 10% when compared to the schedule used at the Erasmus Medical Centre. (C) 2012 Elsevier Ltd. All rights reserved.