Surgery planning and bed allocation with application to a military hospital’s orthopaedic department

Abstract

Based on the needs of a military hospital, this work presents an integrated surgery scheduling and post-surgical bed planning problem for a standard hospital setting. The setting gives rise to a general healthcare modelling problem with a number of innovations with respect to the literature. The model includes multiple postsurgical recovery trajectories involving possible stays at the Intensive Care Unit (ICU) or Semi-Intensive (SICU) and allows the decision maker to assign a bed allocation plan that considers the maximum length of stays in these postoperative units. The approach is designed to ensure a seamless patient flow, avoiding surgery cancellations due to insufficient downstream resources, and enables tactical planning that considers the long-term balance between demand and surgery provision across all specialties. To validate the model and investigate the sensitivity with respect to model parameters and the availability of resources, we use a series of experiments that were based on the actual operation of the hospital partner. The results shows the performance that the model can tackle a general hospital setting and provide decision support for surgical provision while taking into account the whole patient trajectory, as well as both upstream and downstream resources.