Integrated surgery planning and bed allocation with multiple routes of post-surgical care, with application to a military hospital’s orthopaedic department

Abstract

This paper presents an integrated surgery scheduling and post-surgical bed planning problem for a standard hospital setting. The setting gives rise to a general healthcare modelling problem with a number of innovations with respect to the literature. The model includes multiple post-surgical recovery trajectories involving possible stays at the intensive (ICU) or semi-intensive care unit (SICU) and allows the decision maker to assign a bed allocation plan that considers the maximum length of stays at both SICU and ICU. The approach is designed to ensure a seamless patient flow, avoiding surgery cancellations due to insufficient downstream resources, and enables tactical planning that considers the long-term balance between demand and surgery provision across all specialties. To validate the model and investigate the sensitivity with respect to model parameters and the availability of resources, we use a series of experiments that were based on the actual operation of a military hospital’s orthopaedic department. The results illustrate the demand pressures, as an optimised allocation with the current demand and resources results in an occupation of 96.5%. We also show that increases in demand should be matched by a similar percentage increase in operating theatre capacity in order to keep the occupation below 100%.

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ORCID for Edilson F. Arruda: orcid.org/0000-0002-9835-352X

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