AMELİYATHANELERİN ÇİZELGELENMESİ, BİR KARIŞIK TAMSAYILI PROGRAMLAMA YAKLAŞIMI

Year 2015, Issue: 2, 7 - 28, 25.11.2015

Bülent Çekiç

Abstract

Bu çalışma ameliyathane faaliyetlerinin, bunları kullanan cerrahi servisler arasında nasıl dengeli dağıtılabileceğine ilişkin en uygun (optimal) çözümler bulmayı amaçlamaktadır. Bu doğrultuda, karışık tamsayılı programlama yöntemi kullanılarak bir sayısal model geliştirilmiştir. Bu modelin amaç fonksiyonu hazırlık maliyetlerini minimize ederek, model verisinde yer alan ameliyathanelerin, cerrahi servislere haftalık olarak dengeli dağıtımını yapmaktadır. Modelin senaryolar geliştirilerek varılan sonuçları, mevcut kullanım şartlarına göre, ameliyathanelerin kullanımının daha dengeli dağılımını yapmakta, daha az hazırlık maliyetli ve daha esnek kullanım olanaklarını ortaya koymaktadır.

Keywords

Çizelgeleme, Ameliyathanelerin Çizelgelenmesi, Karışık Tamsayılı Programlama

A MIXED INTEGER PROGRAMMING APPROACH FOR SCHEDULING OF OPERATING ROOMS

Abstract

This study aims to find an optimal solution to the balanced distribution of surgical services to operating rooms. For that matter, a mixed integer programming model is developed. The objective function of the model aims to minimize setup costs and provides a weekly balanced distribution of operating rooms to surgical services. Operating-room-allocation is expected to create bottlenecks in cases of emergencies. In order to exhibit the effects of emergencies and the changes in operating room assignments, some scenarios have been developed and the model is solved for all these cases. The results have revealed that the current allocation of the operating rooms to the surgeries takes time and brings about setup costs to overcome the emergencies. When some of the surgical services are allowed to use at least one of the operating rooms freely, it is observed that the costs are reduced. The usage of all operating rooms without any constraining allocations by the surgical services, makes the total setup cost zero. However, in this case, there occur operating-room-renewing costs which are not explicitly included into the model. The actual data about the allocation of the operating rooms are obtained from a public hospital. The results show that the alternative scenarios exhibit more balanced operation distributions and a flexible operating room usage with less time and setup costs.

Keywords

Scheduling, Operating Room Scheduling, Mixed Integer Programming (MIP)

References

• • ASUNAKUTLU, T., (2004), Türkiye’de Yataklı Tedavi Kurumlarında Kalite Yönetimi, Sağlık Bakanlığı Proje Raporu, Ankara.
• • BAKER, K.R., (1994), Elements Of Sequencing and Scheduling, Dartmounth College, Hannover.
• • BELIËN, J., DEMEULEMEESTER, E., CARDOEN, B., (2009), A decision support system for cyclic master surgery scheduling with multiple objectives, Journal of Scheduling, 12 (2), 147-161.
• • BLAKE, J. T., DONALD, J., (2002), Mount Sinai hospital uses integer programming to allocate operating room time, Interfaces, 32 (2), 63-73.
• • BLAKE, J. T., DEXTER, F., DONALD, J., (2002), Operating room managers’ use of integer programming for assigning block time to surgical groups: A case study, Anesthesia & Analgesia, 94 (1), 143-148.
• • CARDOEN, B., DEMEULEMEESTER, E., BELIËN, J., (2010), Operating room planning and scheduling: A literature review, European Journal of Operational Research, 201(3), 921-932.
• • FRIES, B. E., (1976), Bibliography of Operations Research in Health Care Systems, Operations Research, 24 (9), 801-815.
• • FRIES, B. E., (1979), Bibliography of Operations Research in Health Care Systems: An Update, Operations Research, 27 (2), 408-419.
• • GERCHAK, Y., GUPTA D., HENING M., (1996), Reservation Planning for Elective Surgery Under Uncertain Demand for Emergency Surgery, Management Science, 42 (3), 321-334.
• • GUERRIERO, F., GUIDO, R., (2011), Operational research in the management of the operating theatre: A survey, Health Care Management Science, 14 (1), 89-114.
• • KUSTERS, R. J., GROTT, P. M. A., (1996), Modelling Resource Availability in General Hospitals: Design and Implementation of a Decision Support Model, European Journal of Operational Research, 88, 428-445.
• • MASSEY JR, F. J., (1951), The Kolmogorov-Smirnov test for goodness of fit, Journal of the American Statistical Association, 46 (253), 68-78.
• • NAHMIAS, S., (2001), Production and Operations Analysis, 4th Edt., New York: McGraw Hill.
• • OĞULATA, N. S., EROL R., (2003), A Hierarchical Multiple Criteria Mathematical Programming Approach for Scheduling General Surgery Operations in Large Hospitals, Journal of Medical Systems, 27 (3), 259-270.
• • ÖZCAN, C., (1997), Devlet Hastanelerinde TKY'nin Uygulanabilirliği, Sağlık Hizmetlerinde Toplam Kalite Yönetimi ve Performans Ölçümü, M. Çoruh (Ed.), Ankara: Haberal Eğitim Vakfı.
• • ÖZGÜLBAŞ, N., (1995), Hastanelerde Finansal Yönetim: Sorunlar ve Çözüm Önerileri, Yüksek Lisans Tezi, Hacettepe Üniversitesi Sağlık Bilimleri Enstitüsü, Ankara.
• • ÖZKARAHAN, İ., (2000), Allocation of surgeries to operating rooms by goal programming, Journal of Medical Systems, 24 (6), 339-378.
• • PINEDO, M., (1995), Scheduling: Theory, Algorithms and Systems, New Jersey: Prentice-Hall.
• • SILVER, E.A., PYKE, D. F., PETERSON, R., (1998), Inventory Management and Production Planning and Scheduling, 3rd Edt., New York: John Wiley & Sons.
• • ZHANG, B., MURALI, P., DESSOUKY, M. M., BELSON, D., (2009), A mixed integer programming approach for allocating operating room capacity, Journal of the Operational Research Society, 60 (5), 663-673.