Surgery Scheduling and Perioperative Care: Smoothing and Visualizing Elective Surgery and Recovery Patient Flow
Bibliographic record
Abstract
This paper addresses the practical problem of scheduling operating room (OR) elective surgeries to minimize the likelihood of surgical delays caused by the unavailability of capacity for patient recovery in a central post-anesthesia care unit (PACU). We segregate patients according to their patterns of flow through a multi-stage perioperative system and use characteristics of surgery type and surgeon booking times to predict time intervals for patient procedures and subsequent recoveries. Working with a hospital in which 50+ procedures are performed in 15+ ORs most weekdays, we develop a constraint programming (CP) model that takes the hospital’s elective surgery pre-schedule as input and produces a recommended alternate schedule designed to minimize the expected peak number of patients in the PACU over the course of the day. Our model was developed from the hospital’s data and evaluated through its application to daily schedules during a testing period. Schedules generated by our model indicated the potential to reduce the peak PACU load substantially, 20-30% during most days in our study period, or alternatively reduce average patient flow time by up to 15% given the same PACU peak load. We also developed tools for schedule visualization that can be used to aid management both before and after surgery day; plan PACU resources; propose critical schedule changes; identify the timing, location, and root causes of delay; and to discern the differences in surgical specialty case mixes and their potential impacts on the system. This work is especially timely given high surgical wait times in Ontario which even got worse due to the COVID-19 pandemic.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".