A simulation of variability-oriented sequencing rules on block surgical scheduling

Abstract

Surgery scheduling has received considerable attention in recent years. Block schedules, in which surgeon groups utilize the OR for whatever surgeries they have scheduled for the day, present additional challenges to schedulers. While mean operation times are often used as the primary factor in scheduling strategies, the variability of these operations is not. Recent research suggests that sequencing surgeries based on their variation may decrease the number of late surgery starts. This article builds upon this emerging methodology of variability-oriented sequencing rules for block schedules. Discrete event simulation was used to examine the effectiveness of different sequencing algorithms in reducing the number of behind schedule surgeries and their magnitude. The number and magnitude of tardy surgeries and the patient waiting time were significantly improved by an average of 40% with the proposed scheduling strategies. Additional simulations explored several variations of the variability-based scheduling methodology.