Optimal sequencing of urgent surgical cases

Optimal sequencing of urgent cases (i.e., selecting which urgent case shoul d be performed first and which second) may enhance patient safety, increase patient satisfaction with timeliness of surgery, and minimize surgeons' co mplaints. Before determining the optimal sequence of urgent cases, an opera ting room (OR) suite must identify the primary scheduling objective to be s atisfied when prioritizing pending urgent cases. These scheduling objective s may include: 1) perform the cases in the sequence that minimizes the aver age length of time each surgeon and patient waits; 2) perform the cases in the order that they were submitted; or 3) perform the cases based on medica l priority, as prioritized by an OR director, or surgeons discussing the ca ses among themselves. We provide mathematical structure which can be used t o program a computerized surgical services information system to assist in optimizing the sequence of urgent cases. We use an example to illustrate th at the optimal sequence varies depending on the scheduling objective chosen .