Fewer intensive care unit refusals and a higher capacity utilization by using a cyclic surgical case schedule.
OBJECTIVE
Mounting health care costs force hospital managers to maximize utilization of scarce resources and simultaneously improve access to hospital services. This article assesses the benefits of a cyclic case scheduling approach that exploits a master surgical schedule (MSS). An MSS maximizes operating room (OR) capacity and simultaneously levels the outflow of patients toward the intensive care unit (ICU) to reduce surgery cancellation.


METHODS
Relevant data for Erasmus MC have been electronically collected since 1994. These data are used to construct an MSS that consisted of a set of surgical case types scheduled for a period or cycle. This cycle was executed repetitively. During such a cycle, surgical cases for each surgical department were scheduled on a specific day and OR. The experiments were performed for the Erasmus University Medical Center and for a virtual hospital.


RESULTS
Unused OR capacity can be reduced by up to 6.3% for a cycle length of 4 weeks, with simultaneous optimal leveling of the ICU workload.


CONCLUSIONS
Our findings show that the proposed cyclic OR planning policy may benefit OR utilization and reduce surgical case cancellation and peak demands on the ICU.
Van Houdenhoven
Mark
M
Department of Operating Rooms, Erasmus University Medical Center, The Netherlands.
van Oostrum
Jeroen M
JM
Wullink
Gerhard
G
Hans
Erwin
E
Hurink
Johann L
JL
Bakker
Jan
J
Kazemier
Geert
G
D001071:Appointments and Schedules; D001509:Bed Occupancy / Q000706:statistics & numerical data*; D017598:Efficiency, Organizational; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D009426:Netherlands; D009873:Operating Rooms