Modeling of Multi-Level Planning of Shifting Bottleneck Resources Integrated with Downstream Wards in a Hospital

Featured Application The proposed model in this research is significant for hospitals for effective and efficient planning and scheduling of their resources. It has practical significance in a hospital where the whole system's performance is affected by one bottleneck (i.e., either the operating room, ICU, or ward), and this bottleneck keeps changing in different planning horizons. Planning and scheduling critical resources in hospitals is significant for better service and profit generation. The current research investigates an integrated planning and scheduling problem at different levels of operating rooms, intensive care units, and wards. The theory of constraints is applied to make plans and schedules for operating rooms based on the capacity constraints of the operating room itself and downstream wards. A mixed integer linear programming model is developed considering shifting bottleneck resources among the operating room, intensive care unit, and hospital wards to maximize the utilization of resources at all levels of planning. Different sizes of planning and scheduling problems of the hospital, including small, medium, and large sizes, are created with variable arrivals and surgery durations and solved using a CPLEX solver for validating the developed models. Later, the application of the proposed models in the real world to develop planning systems for hospitals is discussed, and future extensions are suggested.