论文标题
手术室和麻醉师调度问题的随机优化方法
Stochastic Optimization Approaches for an Operating Room and Anesthesiologist Scheduling Problem
论文作者
论文摘要
我们建议在不确定性下进行组合分配,分配,测序和调度问题,包括多个操作室(OR),麻醉师和手术以及解决此类问题的方法。具体而言,给定的一组ORS,定期麻醉师,召唤麻醉师和手术,我们的方法同时解决了以下决策问题:(1)分配问题,一个分配问题,决定要打开哪些OR,以及在哪个呼叫的麻醉学家中呼吁进行的分配问题,(2)分配一个分配问题,(2)分配序列和序列序列,并分配序列序列和序列序列,并分配序列序列和肛门序列,或者是一个或者序列的序列序列和肛门序列,或确定手术的顺序及其在每个OR中的计划开始时间。为了解决每次手术持续时间的不确定性,我们提出并分析具有风险中性和避免风险的目标的随机编程(SP)和分配强大的优化(DRO)模型。我们使用样品平均近似值获得了SP模型的近乎最佳解决方案,并提出了一种计算有效的列和构件生成方法来解决我们的DRO模型。此外,我们得出了破坏对称性的约束,以提高模型的可溶性。使用现实世界,公开可用的手术数据和纽约卫生系统的案例研究,我们进行了广泛的计算实验,以经验和理论上比较了所提出的方法,证明可以在哪里获得重大的绩效改善。此外,我们得出了与实践相关的几种管理见解。
We propose combined allocation, assignment, sequencing, and scheduling problems under uncertainty involving multiple operation rooms (ORs), anesthesiologists, and surgeries, as well as methodologies for solving such problems. Specifically, given sets of ORs, regular anesthesiologists, on-call anesthesiologists, and surgeries, our methodologies solve the following decision-making problems simultaneously: (1) an allocation problem that decides which ORs to open and which on-call anesthesiologists to call in, (2) an assignment problem that assigns an OR and an anesthesiologist to each surgery, and (3) a sequencing and scheduling problem that determines the order of surgeries and their scheduled start times in each OR. To address uncertainty of each surgery's duration, we propose and analyze stochastic programming (SP) and distributionally robust optimization (DRO) models with both risk-neutral and risk-averse objectives. We obtain near-optimal solutions of our SP models using sample average approximation and propose a computationally efficient column-and-constraint generation method to solve our DRO models. In addition, we derive symmetry-breaking constraints that improve the models' solvability. Using real-world, publicly available surgery data and a case study from a health system in New York, we conduct extensive computational experiments comparing the proposed methodologies empirically and theoretically, demonstrating where significant performance improvements can be gained. Additionally, we derive several managerial insights relevant to practice.