An operating room scheduling strategy to maximize the use of operating room block time: Computer simulation of patient scheduling and survey of patients' preferences for surgical waiting time

Determining the appropriate amount of block time to allocate to surgeons an d selecting the days on which to schedule elective cases can maximize opera ting room (OR) use. We used computer simulation to model OR scheduling. Inp uts in the computer model included different methods to determine when a pa tient will have surgery (on-line bin-packing algorithms), case durations, l engths of time patients wait for surgery (2 wk is the median longest length of time that the outpatients [n = 367] sun eyed considered acceptable), ho urs of block time each day, and number of blocks each week. For block time to be allocated to maximize OR utilization, two parameters must be specifie d: the method used to decide on what day a patient will have surgery and th e average length of time patients wait to have surgery. OR utilization depe nds greatly on, and increases as, the average length of time patients wait for surgery increases. Implications: Operating room utilization can be maxi mized by allocating block time for the elective cases based on expected tot al hours of elective cases, scheduling patients into the first available da te provided open block time is available within 4 wk, and otherwise schedul ing patients in "overflow" time outside of the block time.