Daily Scheduling Of Surgery And Nurse Assignment Problem Under Uncertainty

The operating room is the most resource-intensive and costliest place in the hospital.The establishment of the operating room is accompanied by high fixed costs.Research shows that operating room management costs account for about 40% of the hospital budget.Effective surgery scheduling can reduce the operating cost of the hospital,improve the satisfaction of the staff and patient,and it is very important for the hospital.The contents of surgery schedule include assigning operating rooms,nurses,doctors,anesthesiologists and determining the surgery sequence.In the actual schedule,the surgery schedule will be affected by many uncertain factors,such as the uncertainty about the duration of surgery,the uncertainty about the arrival of emergency patients and so on.According to the actual background of the hospital,the focus of the research is also different.This thesis mainly studies the following contents.Firstly,this thesis introduces the hot spots and methods of operating room scheduling.Through reading relevant literature on operating room management and field research in hospitals,the basic process of operating room operation was summarized.Combined with the medical environment in China,the constraints to be considered in surgery scheduling were summarized.This thesis summarizes the management of operating room from the aspects of optimization objective and research method and so on,which lays a foundation for the whole research work.Secondly,the study focused on the problem of daily operation schedule of joint nurse scheduling with uncertain surgery duration.The duration of operation was affected by patients' physical conditions,doctors' technical level and other factors,so the duration was uncertain.In practice,the scheduling of nurse resources has a certain impact on the surgical scheduling,and the constraint of nurse resources cannot be regarded as an indistinguishable constraint.Nurses are divided into circulating nurse and scrub nurse.In general,nurses who can play the circulating role can also play the role of scrub nurses,and vice versa.In addition,nurses also have department constraints,ability level constraints,shift constraints.In view of the duration uncertainty and related constraints of nurse assignment,a mixed integer programming model was established,and the two-stage sequential search genetic algorithm and Kelley algorithm were used to solve the problemFinally,on the basis of above,the staff-patient preference is further considered.We follow the following sorting principles.Firstly,give priority to special surgery,then give priority to the surgery which is on the operation day,finally give priority to the surgery whose hospital bed number is small.The bi-level programming model was established,the upper model allocates related resources,the lower model decides operation sequence,the upper model to minimize the operating costs,the lower model to maximize patient preferences.The objective functions of the upper and lower layers of the model are different and affect each other.Genetic algorithm and empirical heuristic algorithm are used to solve the problem.In this thesis,surgery scheduling and nurse scheduling are considered together,and the decision variable of nurse allocation is added on the basis of surgery scheduling.The results of calculation examples show that combined nurse scheduling can indeed have a certain impact on surgery scheduling results.In addition,the preference of doctors and patients is further taken into account to make the operation schedule closer to the actual operation situation of the operating room,which is of certain significance to optimize the operation management of the operating room in the hospital.