Research On Surgical Operation Resource Scheduling And Collaborative Optimization In Hospital Group

As China deepens the reform of the medical and health system,the decline in revenue of public hospitals affected by policies has become an inevitable trend.Faced with the current situation of insufficient investment by the state,how to optimize processes and improve hospitalization turnover has become an urgent problem for large public hospitals.The majority of inpatients in large public hospitals are surgical patients.Arranging surgical schedules rationally and improving the utilization rate of operating rooms and corresponding departments is of great significance for large public hospitals to improve patient management ability,enhance operational level,and improve the economic performance of hospitals.Based on this,this article aims at the current unbalanced and unreasonable allocation of limited medical resources,taking the distribution and scheduling of surgical resources in large hospitals as the research object,with the goal of improving the optimal allocation and efficient use of surgical resources,and assigning surgical resources.Scheduling and surgical scheduling are the key research issues.Research on surgical resource allocation and surgical scheduling modeling and algorithm design for large public hospitals is carried out.Specifically,it mainly contains the following aspects.(1)The surgical resource allocation method between departments in hospital group considers the long-term decision-making of hospital surgical resource optimization and studies the multi-objective surgical resource allocation at the hospital department level.The optimization of hospital surgical resources requires the determination of the number of patients to be treated by each department.The total number of hospital beds and the number of extra beds are under the control of medical management agencies,and the operating room capacity is limited.Under the circumstances of insufficient investment by the state and the gradual payment of medical insurance payment policy to single-disease payers,hospital revenues are gradually restricted,how large-scale public hospitals can reasonably arrange patient admission policies among departments,and ensure that the normal economic revenue,public welfare and fairness of large-scale public hospitals is a problem.In this thesis,surgical disease grouping is defined as a standard product type by single disease and DRG,and the hospital is modeled as a production system.The model aims at maximizing economic benefits;on the other hand,in order to implement hierarchical medical care,give full play to the role of high-quality medical resources in large hospitals and maximize the output of medical technology,the government and medical institutions’ management departments require tertiary hospitals to focus on the third and fourth levels surgeries.So the maximization of medical technology output is another goal of the model.First,the first objective function is solved by an integer linear programming model to obtain the best economic benefit value;then this economic benefit value is inserted into the model as a constraint to optimize the next objective function,that is,the medical technology output.The results of numerical calculations show that the allocation of hospital surgical resources through multi-objective functions results in improved hospital operations and medical technology output.(2)To address the contradiction between the surgical needs of patients and the scarcity of resources between surgeries,the problem of block scheduling in operating rooms of hospital group was studied.In this section aims to maximize the number of surgical operations.The determination of the operating period of each operating room,doctors ensure that each section of the patient for treatment every day,while achieving a reasonable allocation of the operating room.This section presents the design of scheduling model in work cycle and uses a linear programming algorithm to perform simulations based on the model.It verified that the scheduling model can meet the different requirements of different hospital entities such as different surgical requirements and different surgical resource allocation.The model flexibly completes the allocation of resources such as operating rooms and hospital teams,and is in line with the actual hospital surgical resource allocation requirements.It effectively increases the overall demand for surgery within the hospital group,reduces the overtime and extra costs of operating rooms in large hospitals,and increases the number of secondary hospital operations and the utilization of surgical resources.(3)Aiming at the diversity and correlation of hospital surgery-related resources in hospital gruop,the issue of surgical scheduling with uncertain surgical duration under full resource constraints was studied.By analyzing the time of each element of the surgical procedure,it can be seen as several stages of operation room preparation,surgery,and post-anesthesia recovery of the patient in the recovery room.In the above several stages,resource allocation and utilization are required,and all constraints are integrated,including human resources,housing facilities,equipment materials and surgical instruments.Reuse of resources: reuse of disinfection equipment,reuse of consumables,disposable consumables,special materials,etc.The patient’s self-discipline: whether it is a carrier of the infectious disease,the state of the patient’s surgery on the day,and the patient’s surgical urgency.Random factors: blood supply,rapid pathological time,specialist outs,etc.By analyzing the characteristics of medical resource scheduling in hospital surgery under the model of medical linkage,in order to reduce the influence of surgical time cost uncertainty on surgical scheduling,the resource constraint issues such as operating room,anesthesia recovery bed,and surgical instruments are also considered.A hybrid full-constrained surgical scheduling algorithm based on robustness optimization method and genetic algorithm is proposed.The corresponding numerical simulation is given and the validity and efficiency of the proposed model and algorithm are verified.(4)In the two phases naming surgery to rehabilitation,the two-stage surgery optimization approach from the operating room to the specialized ICU is considered.In order to improve the patient satisfaction and the operating efficiency of hospital group,the scheduling of the surgery is optimized,and the medical team schedules and elective surgery are fully considered.With characteristics such as nature and patient type,aiming at minimizing the overall time for all surgical patients from starting surgery to transferring from ICU,a two-stage mixed flow shop model based on operating room to ICU was constructed and proposed and an improved EDA Algorithm is carried out.Finally,the actual operation of thoracic surgery in People’s Hospital of Jiangsu Province was used to verify the effectiveness of the proposed model and algorithm.Studies have shown that the numerical results obtained based on the model and algorithm in this thesis are better than the overall time from the start of surgery to the transfer from the ICU in the actual schedule,which can effectively shorten the completion time of the surgery and improve the utilization efficiency of medical resources.The research work in this thesis provides a new solution to the problem of surgical resource optimization in hospital group.It considers surgical research methods in layers,and fully considers the distribution of operating room capacity,the distribution of major operations,and the sequence distribution of patients from three levels: strategic level,tactical level,and operational level in order to achieve the optimization of the performance index.The optimization plans for maximizing economic benefits,maximizing patient satisfaction,and maximizing resource utilization were considered separately,and in-depth research was conducted on four aspects of surgical resource scheduling to obtain corresponding research results.At the same time,with the in-depth study,the future research work is looked forward to.In the future research,we can consider the allocation of operating room capacity based on the needs of the department’s human resource capabilities,consider the management of surgical resources in medical associated Hospital,consider the surgical scheduling problem in the case of equipment resource uncertainty,and consider the patient preparation in the upper operating room stage,which is a three stage modeling issue naming preparation stage,surgical stage and surgical intensive care room stage.