The advanced scheduling of patients for elective surgeries is challenging when the operating room capacity usage by these procedures is uncertain. We study the application of some revenue management concepts and techniques to operating rooms for several surgical procedures performed in a multi-tier reimbursement system. Our approach focuses on booking requests for elective procedures, under the assumption that each request uses a random amount of time. We create and use a modified version of Belobaba's well-known EMSRb algorithm (Belobaba 1989) to decide on near-optimal protection levels for various classes of patients. Under the random resource utilization assumption, we decide, for each planning horizon, how much time to reserve for satisfying the demand coming from each class of patients, based on the type of surgical procedure requested and the patient's reimbursement level. In order to cope with the increasing demand for healthcare, and in particular, for surgery, a surgical suite is required to efficiently and effectively balance a high utilization of the operating room (OR) with the need for maintaining or improving the quality of care. Two factors affect the efficient use of existing resources: the challenges imposed by the increasing demand for healthcare, and the variability in both demand and service time. In an OR setting, this translates in both an uncertain number of patients in need for surgery, as well as inherent variability in the surgery times across types of surgeries, surgeons and patients. When managing demand for a relatively fixed and perishable capacity, revenue management (RM) techniques prove very successful. One of the pillars of revenue management objective is the optimal allocation of capacity to various demand classes, and two of the important questions that RM studies refer to how many requests to accept from discount customers and how much capacity to reserve for customers that are willing to pay full price in order to maximize revenues (profits) over a planning horizon. After its success in the airline industry in the 1970s, numerous efforts and research studies tried to adapt RM approaches to the needs of other industries, ranging from oil and gas pipelines to healthcare to made-toorder manufacturing (Phillips 2005) . In the OR setting, where available surgery time is relatively limited and perishable, one can apply capacity-based revenue management to better manage demand from the various patients. In this context, the specific managerial decision that we address is how much OR capacity should the scheduling department reserve or protect in advance, over the planning horizon, for various patient classes, where a class can be defined as a combination of patient reimbursement level and the type of surgery requested. Because of the inherent variability in the service rendered, each accepted and scheduled request for surgery uses up a va-2444 978-1-4244-9865-9/10/$26.00 ©2010 IEEE
In a similar vein, REF study protection levels for hospital operating rooms when nested solutions are allowed.
A revenue management approach for managing operating room capacity
Proceedings of the 2010 Winter Simulation Conference
Proceedings of the 2010 Winter Simulation Conference
Computer Science