A multiobjective ϵ-constraint based approach for the robust master surgical schedule under multiple uncertainties

The efficient scheduling of elective surgeries in hospitals is critical for ensuring patient satisfaction, cost-effectiveness, and overall operational efficiency. However, operating theater (OT) managers face complex and competing scheduling problems due to numerous sources of uncertainty and the im...

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Published in:European journal of operational research Vol. 320; no. 3; pp. 682 - 698
Main Authors: Makboul, Salma, Olteanu, Alexandru-Liviu, Sevaux, Marc
Format: Journal Article
Language:English
Published: Elsevier B.V 01.02.2025
Elsevier
Subjects:
Computer Science
Downstream resource constraint
Multiobjective optimization
Operating rooms planning
Operations Research
OR in health services
Robust optimization
Operating rooms planning
Robust optimization
Downstream resource constraint
Multiobjective optimization
OR in health services
ISSN:0377-2217, 1872-6860
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Abstract The efficient scheduling of elective surgeries in hospitals is critical for ensuring patient satisfaction, cost-effectiveness, and overall operational efficiency. However, operating theater (OT) managers face complex and competing scheduling problems due to numerous sources of uncertainty and the impact of the proposed schedule on downstream recovery units, such as the intensive care unit (ICU). To address these challenges, this study develops a multiobjective robust planning model for the weekly Master Surgical Schedule (MSS) under multiple uncertainties. The model takes into account patient priority, assignment cost and workload balancing, while also considering the constraints of the OT, surgeon availabilities, downstream resources, and the uncertainty of surgery duration and patients’ length of stay (LOS) in the ICU. To evaluate the robust solutions, a Monte Carlo simulation is used to calculate the risk of constraint violations, and an adapted ϵ-constraint algorithm is used for the four-objective problem to compute the Pareto front and calculate the hypervolume for every degree of uncertainty. This provides a comprehensive decision tool for OT decision makers and allows for the comparison of various scenarios in terms of the number of scheduled patients, canceled patients, and the utilization rate of the OT. •We present a multiobjective robust model for the weekly Master Surgical Schedule.•We model uncertainty of surgery duration and LOS using polyhedral uncertainty sets.•The ϵ-constraint algorithm computes the Pareto front.•Monte Carlo simulation assesses risks from surgery duration and LOS uncertainties.•We compare robust and deterministic models using several metrics.
AbstractList The efficient scheduling of elective surgeries in hospitals is critical for ensuring patient satisfaction, cost-effectiveness, and overall operational efficiency. However, operating theater (OT) managers face complex and competing scheduling problems due to numerous sources of uncertainty and the impact of the proposed schedule on downstream recovery units, such as the intensive care unit (ICU). To address these challenges, this study develops a multiobjective robust planning model for the weekly Master Surgical Schedule (MSS) under multiple uncertainties. The model takes into account patient priority, assignment cost and workload balancing, while also considering the constraints of the OT, surgeon availabilities, downstream resources, and the uncertainty of surgery duration and patients’ length of stay (LOS) in the ICU. To evaluate the robust solutions, a Monte Carlo simulation is used to calculate the risk of constraint violations, and an adapted -constraint algorithm is used for the four-objective problem to compute the Pareto front and calculate the hypervolume for every degree of uncertainty. This provides a comprehensive decision tool for OT decision makers and allows for the comparison of various scenarios in terms of the number of scheduled patients, canceled patients, and the utilization rate of the OT.
The efficient scheduling of elective surgeries in hospitals is critical for ensuring patient satisfaction, cost-effectiveness, and overall operational efficiency. However, operating theater (OT) managers face complex and competing scheduling problems due to numerous sources of uncertainty and the impact of the proposed schedule on downstream recovery units, such as the intensive care unit (ICU). To address these challenges, this study develops a multiobjective robust planning model for the weekly Master Surgical Schedule (MSS) under multiple uncertainties. The model takes into account patient priority, assignment cost and workload balancing, while also considering the constraints of the OT, surgeon availabilities, downstream resources, and the uncertainty of surgery duration and patients’ length of stay (LOS) in the ICU. To evaluate the robust solutions, a Monte Carlo simulation is used to calculate the risk of constraint violations, and an adapted ϵ-constraint algorithm is used for the four-objective problem to compute the Pareto front and calculate the hypervolume for every degree of uncertainty. This provides a comprehensive decision tool for OT decision makers and allows for the comparison of various scenarios in terms of the number of scheduled patients, canceled patients, and the utilization rate of the OT. •We present a multiobjective robust model for the weekly Master Surgical Schedule.•We model uncertainty of surgery duration and LOS using polyhedral uncertainty sets.•The ϵ-constraint algorithm computes the Pareto front.•Monte Carlo simulation assesses risks from surgery duration and LOS uncertainties.•We compare robust and deterministic models using several metrics.
Author Sevaux, Marc
Makboul, Salma
Olteanu, Alexandru-Liviu
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  givenname: Salma
  orcidid: 0000-0002-6423-2367
  surname: Makboul
  fullname: Makboul, Salma
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  givenname: Alexandru-Liviu
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  givenname: Marc
  orcidid: 0000-0003-3855-9072
  surname: Sevaux
  fullname: Sevaux, Marc
  email: marc.sevaux@univ-ubs.fr
  organization: Université Bretagne-Sud, Lab-STICC, UMR 6285, CNRS, Lorient, France
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Issue 3
Keywords Operating rooms planning
Robust optimization
Downstream resource constraint
Multiobjective optimization
OR in health services
Language English
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Snippet The efficient scheduling of elective surgeries in hospitals is critical for ensuring patient satisfaction, cost-effectiveness, and overall operational...
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SubjectTerms Computer Science
Downstream resource constraint
Multiobjective optimization
Operating rooms planning
Operations Research
OR in health services
Robust optimization
Title A multiobjective ϵ-constraint based approach for the robust master surgical schedule under multiple uncertainties
URI https://dx.doi.org/10.1016/j.ejor.2024.08.022
https://hal.science/hal-04677534
Volume 320
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