A disruption-restoration-based MILP model for elective surgical scheduling in a children's hospital using scenarios

TL;DR

This paper presents a MILP model for scheduling elective pediatric surgeries that accounts for disruptions like emergencies and no-shows, using scenarios and backup plans to ensure timely patient care.

Contribution

It introduces a scenario-based MILP approach with backup schedules to handle disruptions in pediatric surgical scheduling, a novel application in this context.

Findings

Effective disruption management in pediatric surgery scheduling.

Balanced handling of urgent and non-urgent cases.

Maintains timely care despite uncertainties.

Abstract

We consider the problem of scheduling elective surgeries in a Children's Hospital, where disruptions due to emergencies and no-shows may arise. We account for two features that occur in many pediatric settings: i) that it is not uncommon for pediatric patients to fall ill on the very day of their operation and, consequentially, to be unable to undergo surgery and ii) that operating rooms normally reserved for elective surgeries can be used to treat emergency cases. Elective surgeries are scheduled taking into account the time spent on the waiting list and the patient's priority, which considers the severity of their condition and their surgical deadline, generating a nominal schedule. This schedule is optimized in conjunction with a series of back-up schedules: in fact, back-up schedules shall be available in advance so as to guarantee that the operating rooms activity immediately recovers in case of a disruption. We propose an Integer Linear Programming-based approach for the problem. As there is no consolidated data on the features of both emergencies and no show, we enumerate a representative subset of the possible emergency and no-show scenarios and for each of them a back-up plan is designed. The approach reschedules patients in a way that minimizes disruption with respect to the nominal schedule and applies an as-soon-as-possible policy in case of emergencies to ensure that all patients receive timely care. The approach shows to be effective in managing disruptions, ensuring that the waiting list is managed properly, with a balanced mix of urgent and less urgent patients. Therefore, the approach provides an effective solution for scheduling patients in a pediatric hospital, taking into account the unique features of such facilities.