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The objective is to minimize the time patient stays in hospital
for surgery. The important considerations involved are:

Length of stay caused by the delay in

meeting surgery demand.

“UNMET” demand (or equivalent to being

postponed for particular amount of days).

Penalty due to undersupply.

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• I: Set of Room types.
• J: Set of Medical specialities.
• D: Set of Days.
• i: Index for Room type.
• j: Index for speciality.
• k, l : Indices for days.
• s: amount of staffed hours per day.
• ai: Number of operating rooms of type i.
• ejk: Emergency patient’s surgery demand for speciality j on day k (hours).
• ojk: Non-Emergency patient’s surgery demand for speciality j on day k (hours).
• cjk: The maximum number of operating rooms that speciality j can utilise on
day k (hours).
• ρkl: Number of days delayed if the surgery is postponed from day k to day l.
• Θ: The equivalent number of days delayed if some surgery demand is not met
in the model.
• β : Penalty rate for undersupply of OR hours to a speciality.

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• xijk: Number of Operating Rooms of type i allocated to speciality j
on day k.
• yjk: Amount of Emergency OR’s staffed hours allocated to speciality j
on day k.
• zjkl: Speciality j’s non-emergency demand postponed from day k to
day l.
• ujk: Speciality j’s unmet non-emergency demand on day k.
• bjk: Amount of idle time of the OR allocated to speciality j on day k.
• h: Total amount of idle time of all non-emergency OR’s.
• pj: oversupply of OR hours to speciality j relative to its desired level.
• qj: Undersupply of OR hours to speciality j relative to its desired
level.

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Minimize
∑ ∑ (ρkl ∑ zjkl) + θ∑ ∑ ujk + β∑qj
kϵD lϵD jϵJ jϵJ kϵD jϵJ

Total Penalty caused by Undersupply of

OR hours for each speciality.

Unmet non-emergency demand on day k.

Patients length of stay caused by the delay in meeting

surgery demand within specified day.

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 ∑ xijk = ai For all i,k
jϵJ

 s ∑ xijk ≥ ∑ zilk For all j,k

iϵI iϵI

 s ∑ xijk – bjk + ujk = Ojk For all j,k

iϵI

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h = ∑ ∑ bjk
jϵJ kϵD

 ∑x ≤cijk jk For all j,k

iϵI
h, pj, qj, x bjk, yjk, zjkl, ujk ≥ 0
ijk,

Xijk is an integer.
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 h∑ ojk
∑ bjk -
kϵD
kϵD = pj – qj
∑ ∑ ojk
jϵJ kϵD

For all j

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 Number of operating theatres types, i: 2
 Number of staffed hours, s: 8 hrs
 Delay for Unmet demand, θ : 1 day
 Number of Operating days, D: 5
 Number of specialities, J: 2
 Penalty rate, β : 0.1
 Maximum no. of Operating Rooms for Speciality 1, ci1: 3
 Maximum no. of Operating Rooms for Speciality 2, ci2: 3
 No. of Operating Rooms of type 1, a1: 3
 No. of Operating Rooms of type 2, a2: 2

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DAY SPECIALITY 1 SPECIALITY 2
MON 20 10
TUE 18 11
WED 22 9
THR 19 12
FRI 21 13

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• Optimized length of stay: 144.00 hours.
• Rooms allocated to each Speciality on each
day:

DAY SPECIALITY 1 SPECIALITY 2

TYPE 1 TYPE 2 TYPE 1 TYPE 2
MON 2 2 1 0
TUE 1 0 3 1
WED 3 1 0 1
THR 0 1 2 2
FRI 2 2 1 0
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 ∑ xijk = ai For all i,k
jϵJ

 s ∑ xijk ≥ ejk – yjk + ∑ zilk For all j,k

iϵI iϵI

 s ∑ xijk – (ejk – yjk + ∑zjlk) – bjk +

iϵI lϵD

∑ zjkl + ujk = Ojk For all j,k

lϵD

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h = ∑ ∑ bjk
jϵJ kϵD

 ∑yjk ≤ s For all k

jϵJ

 ∑ xijk ≤ cjk For all j,k

iϵI

 yjk ≤ ejk for all j,k

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 h∑ ojk
kϵD = pj – qj For all j.
∑ bjk - ∑ ∑ ojk
kϵD jϵJ kϵD

h, pj, qj, xijk, bjk, yjk, zjkl, ujk ≥ 0

Xijk is an integer.

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 ∑ xijk = ai For all j,k
jϵJ

 s ∑ xijk ≥ ejk – yjk + ∑ zilk For all j,k

iϵI iϵI

 s ∑ xijk – (ejk – yjk + ∑zjlk) – bjk +

iϵI lϵD

∑ zjkl + ujk = Ojk For all j,k

lϵD

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h = ∑ ∑ bjk
jϵJ kϵD

 ∑yjk ≤ s For all k

jϵJ

 ∑ xijk ≤ cjk For all j,k

iϵI

 yjk ≤ ejk For all j,k

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 h∑ ojk
kϵD = pj – qj For all j.
∑ bjk -
kϵD ∑ ∑ ojk
jϵJ kϵD

ojk + ∑ zijk – ujk ≤ POC hours For all j,k

i ϵI

h, pj, qj, x bjk, yjk, zjkl, ujk ≥ 0

ijk,

Xijk is an integer.
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Here working of operation theatre department
has been modeled using ARENA.
• Inter arrival time of patients is seen to follow
Exponential Random distribution with a mean
of 45 minutes.
• All operations are assumed to follow Uniform
distribution with minimum of 1 hour and
maximum of 3 hours.

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Dinh-Nguyen Pham,Andreas Klinkert “Surgical Case Scheduling as generalized job
shop scheduling problem”, European Journal of operation Research 185 (2008),
pp1011-1025.

Aida Jebali,Atidel B. Hadj Alouane,Pierre Ladet “Operating rooms scheduling”,

Int.J.Production Economics 99(2006), pp 52-62.

Bo Zhang, PavanKumar Murali, Maged Dessouky, and David Belson. “A Mixed Integer
Programming Approach For Allocating Operating Room Capacity”, Daniel J. Epstein
Department of Industrial and Systems Engineering, University of Southern
California,2006.

Brecht Cardoen, Erik Demeulemeester, “Optimizing a multiple objective surgical case

sequencing problem”, Int. J. Production Economics 119 (2009), pp 354-366.

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H.Fei, N.Meskens, “A planning and scheduling problem for an
operating theatre using an open scheduling strategy”, Computers
& Industrial Engineering 78(2009), pp 144-54.

AlainGuinet, Sondes Chaabane, “Operating Theatre Planning”,

Int.J.Production Economics 85 (2003) 69–81.

Vincent Augusto, Xiaolan Xie, “Operating theatre scheduling with

patient recovery in both operating rooms and recovery beds.”,
Computers & Industrial Engineering 45 (2009), pp 112-124.

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Brian R Hunt, “A Guide to MATLAB - For Beginners and
Experienced Users”, Cambridge University Press, 2006.

Stephan J Chapman, “MATLAB Programming for

beginners”, Bookware Companion Series, 2008.

Brian D Hahn, “Essential MATLAB for scientists and

Engineers”, Elsevier, 2006.

David J Anto, “A guide to optimization using CPLEX”, Dave

guide series, 2008.

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