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ECONOMICS, EDUCATION, AND POLICY

Improving Operating Room Efficiency by Applying Bin-Packing and Portfolio Techniques to Surgical Case Scheduling

Mark Van Houdenhoven, MSc^*, Jeroen M. van Oostrum, MSc^*, Erwin W. Hans, PhD, Gerhard Wullink, PhD^*, and Geert Kazemier, MD, PhD^*

From the Departments of *Operating Rooms, and Anesthesiology, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Operational Methods for Production and Logistics, School of Management and Governance, University of Twente, Enschede, The Netherlands; and Department of Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands.

Address correspondence and reprint requests to Jeroen van Oostrum, MSc, Department of Operating Rooms, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. Address e-mail to j.vanoostrum{at}erasmusmc.nl.

Abstract

BACKGROUND: An operating room (OR) department has adopted an efficient business model and subsequently investigated how efficiency could be further improved. The aim of this study is to show the efficiency improvement of lowering organizational barriers and applying advanced mathematical techniques.

METHODS: We applied advanced mathematical algorithms in combination with scenarios that model relaxation of various organizational barriers using prospectively collected data. The setting is the main inpatient OR department of a university hospital, which sets its surgical case schedules 2 wk in advance using a block planning method. The main outcome measures are the number of freed OR blocks and OR utilization.

RESULTS: Lowering organizational barriers and applying mathematical algorithms can yield a 4.5% point increase in OR utilization (95% confidence interval 4.0%–5.0%). This is obtained by reducing the total required OR time.

CONCLUSIONS: Efficient OR departments can further improve their efficiency. The paper shows that a radical cultural change that comprises the use of mathematical algorithms and lowering organizational barriers improves OR utilization.

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