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The allocation of surgeries to operating rooms (ORs) is a challenging combinatorial optimization problem. There is also significant uncertainty in the duration of surgical procedures, which further complicates assignment decisions. In this article, we present stochastic optimization models for the assignment of surgeries to ORs on a given day of surgery.(More)
O perating room (OR) scheduling is an important operational problem for most hospitals. In this study, we present a novel two-stage stochastic mixed-integer programming model to minimize total expected operating cost given that scheduling decisions are made before the resolution of uncertainty in surgery durations. We use this model to quantify the benefit(More)
Uncertainty in the duration of surgical procedures can cause long patient wait times, poor utilization of resources, and high overtime costs. We compare several heuristics for scheduling an Outpatient Procedure Center. First, a discrete event simulation model is used to evaluate how 12 different sequencing and patient appointment time setting heuristics(More)
Creation of an Outpatient Procedure Center (OPC) is a complicated endeavor, requiring a detailed understanding of the resources available and the procedures to be performed. Miscalculation of resource allocation or patient flow through the area can result in the waste of expensive resources, patient dissatisfaction, and health care provider inefficiency.(More)
Surgical services require the coordination of many activities, including patient check-in and surgical preparation, surgery, and recovery after surgery. Each of these activities requires the availability of resources including staff, operating rooms, and intake and recovery beds. Furthermore, each of these activities has substantial uncertainty in their(More)
This pilot project was designed to determine the feasibility and effectiveness of an adaptation of the chronic care model applied to uninsured patients in a free medical clinic staffed by volunteer physicians. Of the 149 enrolled patients, 117 had hypertension, 91 had diabetes, and 51 had hyperlipidemia. Patients were enrolled in a chronic disease registry(More)
Patient appointment booking, sequencing, and scheduling decisions are challenging for outpatient procedure centers due to uncertainty in procedure times and patient attendance. We formulate a model based on a two-stage stochastic mixed integer program for optimizing booking and appointment times in the presence of uncertainty. The objective is to maximize(More)
At Mayo Clinic, care teams are being evaluated as a means to improve health care staff productivity and patient service. Traditional care in outpatient practices has health care staff working independently of each other with little coordination. Initial feedback by participating practices support the value of care teams. Our research focuses on a(More)
Increasing healthcare costs are driving the need for optimizing care delivery processes. Due to the complexity associated with healthcare processes, discrete event simulation is the most popularly used decision support tool in assessing trade-offs between multiple objectives of healthcare systems. However in situations where there is little or no structure(More)
In this paper we use simulation to evaluate the effect of shorter red cell shelf life on blood supplies at the Mayo Clinic and compare these results to previous work. Results show that a reduced maximum shelf life of 28 days is supportable under current conditions but that a maximum shelf life of 21 days or less will likely result in unacceptably high(More)