Operating Room Scheduling and Adaptive Control Using a Priority First Fit Decreasing Heuristic

Operating room (OR) scheduling is a critical factor affecting overall hospital performance. We examine OR scheduling from two perspectives. In the first perspective we propose a scheme for OR block scheduling that uses a heuristic developed for a three-machine flow shop where the three phases of the peri-operative process (pre-op, OR, and post-op) correspond to the three-machine flow shop. This approach facilitates a hospital-as-a-system perspective. The second perspective used to examine OR scheduling is adaptive control of the OR slate. Recognizing that there are many factors affecting OR throughput performance, especially preemptions from emergent and urgent cases, adaptive control of the OR slate is necessary. To realistically improve performance, adaptive control of the OR slate should incorporate constraints on how surgeries can be rescheduled. We examine the benefits from adaptive control of the OR slate that uses a priority first fit decreasing (PFFD) heuristic while incorporating constraints on OR slate rescheduling. The PFFD heuristic is a priority-driven variation of the classic FFD heuristic used in bin packing problems. We develop a scheme for OR block scheduling and our PFFD heuristic. We then demonstrate our PFFD heuristic in a simulation-based case study, and subsequently run a simulation using 1000 instances to test the performance of our PFFD heuristic in OR slate scheduling and OR slate adaptive control showing improvements in performance relative to the frequently used first-come-first-served rule