title: Optimizing perioperative decision making: improved information for clinical workflow planning.
abstract: Perioperative care is complex and involves multiple interconnected subsystems. Delayed starts, prolonged cases and overtime are common. Surgical procedures account for 40-70% of hospital revenues and 30-40% of total costs. Most planning and scheduling in healthcare is done without modern planning tools, which have potential for improving access by assisting in operations planning support. We identified key planning scenarios of interest to perioperative leaders, in order to examine the feasibility of applying combinatorial optimization software solving some of those planning issues in the operative setting. Perioperative leaders desire a broad range of tools for planning and assessing alternate solutions. Our modeled solutions generated feasible solutions that varied as expected, based on resource and policy assumptions and found better utilization of scarce resources. Combinatorial optimization modeling can effectively evaluate alternatives to support key decisions for planning clinical workflow and improving care efficiency and satisfaction.
authors.affiliation: VA HSR&D Center on Implementing Evidence-based Practice, Indianapolis VAMC, Indianapolis, IN, USA.
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Doebbeling
authors.forename: Matthew M
authors.initials: MM
authors.lastname: Burton
authors.forename: Eric A
authors.initials: EA
authors.lastname: Wiebke
authors.forename: Spencer
authors.initials: S
authors.lastname: Miller
authors.forename: Laurence
authors.initials: L
authors.lastname: Baxter
authors.forename: Donald
authors.initials: D
authors.lastname: Miller
authors.forename: Jorge
authors.initials: J
authors.lastname: Alvarez
authors.forename: Joseph
authors.initials: J
authors.lastname: Pekny
mesh_terms: D003657:Decision Making; D003697:Delphi Technique; D017598:Efficiency, Organizational; D006801:Humans; D007407:Interviews as Topic; D017146:Models, Organizational; D009870:Operating Room Information Systems; D009873:Operating Rooms / Q000458:organization & administration*; D019990:Perioperative Care; D057188:Workflow