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The encyclopedia · Engineering & Operations · Operational decision · 2014–2017

Kaiser optimized the operating-room schedule for a new hospital

Kaiser's new Oakland hospital needed an OR timetable; an integer program scheduled surgical blocks, cutting the backlog and excess admission days.

Kaiser Permanente

the move

Kaiser opened a new hospital next to its Oakland headquarters in July 2014 and needed a schedule for a completely new set of operating rooms.

The key decision was which block, a combination of surgery types that can run in the same room on the same day, to assign to each operating room each day.

The fix was an integer-programming model that generates a near-optimal block schedule, considering both direct nursing costs and patient-related costs.

It satisfied almost all monthly block requirements in just four weeks, freeing capacity to reduce the surgical backlog; it eliminated the days that would have needed extra nursing staff; and it reduced surgeries cancelled for lack of a bed.

why it works

  • Operating-room blocks are a hard assignment problem with many practical constraints.
  • Optimizing both nursing cost and patient cost beats scheduling for throughput alone.
  • A near-optimal schedule soaked up backlog instead of deferring it.
  • Fewer excess-admission days avoided additional nurse hiring.
the payoffAssign surgical blocks to rooms and days to match capacityneat

what transfers

A hospital schedule is a constrained assignment problem, not a judgment call. Model the block mix in each room each day and you free capacity, avoid extra staff and reduce cancellations.

what came after

Kaiser implemented the schedule and continues to use it with minor updates as demand patterns change, steadily reducing the surgical backlog.

references

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