http://repub.eur.nl/res/aut/17101/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/37647/ 2012-01-01T00:00:00Z http://repub.eur.nl/res/pub/25666/ 2011-08-16T00:00:00Z This paper develops a two-stage planning procedure for master planning of elective and emergency patients while allocating at best the available hospital resources. Four types of resources are considered: operating theatre, beds in the medium and in the intensive care units, and nursing hours in the intensive care unit. A tactical plan is obtained by minimizing the deviations of the resources consumption to the target levels of resources utilization, following a goal programming approach. The MIP formulation to get this tactical plan is specifically designed to account for emergency care since it allows for the reservation of some capacity for emergency patients and possible capacity excess. To deal with the deviation between actually arriving elective patients and the average number of patients on which the tactical plan is based, we consider the possibility of planning a higher number of patients than the average to create operating slots in the tactical plan (slack planning). These operating slots are then filled in the operational plan following several flexibility rules. We consider three options for slack planning that lead to three different tactical plans on which we apply three flexibility rules to get finally nine alternative weekly schedules of elective patients. We then develop an algorithm to modify this schedule on a daily basis so as to account for emergency patients' arrivals. Scheduled elective patients may be cancelled and emergency patients may be sent to other hospitals. Cancellation rules for both types of patients rely on the possibility to exceed the available capacities. Several performance indicators are defined to assess patient service and hospital efficiency. Simulation results show a trade-off between hospital efficiency and patient service. http://repub.eur.nl/res/pub/14707/ 2008-01-01T00:00:00Z Cardiothoracic surgery planning involves different resources such as operating theatre time, beds, IC beds and nursing staff. In the daily practice of the Thorax Centre case study setting, the planning focuses on optimal use of operating theatre time, though the performance of the Thorax Centre as a whole is often more limited by other resources. For operating theatres a master surgical schedule is used to allocate operating theatre resources at tactical level for a longer period. Operational schedules at weekly level are derived from this master schedule. Within cardiothoracic surgery different categories of patients can be distinguished based on their requirement of resources. The mix of patients operated is, therefore, an important decision variable for the Thorax Centre to manage the use of these resources. In this paper we will consider the planning problem at the tactical level to generate a master surgical schedule that realises a given target of patient throughput and optimises an objective function for the utilisation of resources. The problem can be mathematically approached by mixed integer linear programming, which we already demonstrated in a previous paper. The specific topic of the current paper is to investigate the influence of using a stochastic instead of a deterministic length of stay. We will discuss the new mathematical model developed for this planning problem. The results obtained by the model indicate that we can generate master surgical schedules with a better performance on target utilization levels of resources by considering the stochastic length of stay. © 2008 The Author(s). http://repub.eur.nl/res/pub/36054/ 2007-08-01T00:00:00Z There is an increasing need to develop a platform for comparing hospital admission planning systems due to a shift in the service paradigm in the health sector. The current service concept of hospital admission planning aims at optimising the use of scarce hospital resources without paying much attention to the level of service offered to patients. As patients nowadays do not accept long waiting times for hospital admission, it becomes necessary to consider alternative admission service concepts. Waiting lists have also become a political issue, and alternative concepts have been advocated such as giving all patients an appointment for admission. A simulation model was built to examine the impacts of extreme admission service concepts in a simplified hospital setting. The alternative concepts considered are based on the 'zero waiting time' principle (immediate treatment), and the 'booked admissions' principle (using an appointment for admission). The results of these admission service concepts are compared with the results of the current concept, based on the 'maximising resource use' principle. The paper deals with the development of a framework and tool that allows evaluating different, somehow conflicting, hospital admission planning concepts and the usefulness of such framework and tool for more refined/real-life approaches to hospital admission planning.