Collaborative Operating Room Planning and Scheduling
Bibliographic record
Abstract
Operating rooms (ORs) play a substantial role in hospital profitability, and their optimal utilization is conducive to containing the cost of surgical service delivery, shortening surgical patient wait times, and increasing patient admissions. We extend the OR planning and scheduling problem from a single independent hospital to a coalition of multiple hospitals in a strategic network, where a pool of patients, surgeons, and ORs are collaboratively planned. To solve the resulting mixed-integer dual resource constrained model, we develop a novel logic-based Benders’ decomposition approach that employs an allocation master problem, sequencing sub-problems for each hospital-day, and novel multistrategy Benders’ feasibility and optimality cuts. We investigate various patient-to-surgeon allocation flexibilities, as well as the impact of surgeon schedule tightness. Using real data obtained from the General Surgery Departments of the University Health Network (UHN) hospitals, consisting of Toronto General Hospital, Toronto Western Hospital, and Princess Margret Cancer Centre in Toronto, Ontario, Canada (who already engage in some collaborative resource sharing), we find that on average, collaborative OR scheduling with traditional patient-to-surgeon allocation flexibility results in 6% cost-savings, while flexible patient-to-surgeon allocation flexibility increases cost-savings to 40%, and surgeon schedule tightness can impact costs by 15%. The collective impact of our collaboration and patient flexibility results in between 45% and 63% savings per surgery. We also use a game theoretic approach to fairly redistribute the payoff acquired from a coalition of hospitals and to empirically show coalitional stability among hospitals. Data and the online supplement are available at https://doi.org/10.1287/ijoc.2017.0745 .
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".