ImproveOR .: Ferramentas de apoio à decisão para melhoria da gestão do bloco operatório

Surgical activity is recognized as generating a high portion of hospitals’ funding, as having substantial

impacts in other areas of hospital provision, and as being a social concern for which populations are quite

sensitive. In line with this, governments and hospital managers in many countries have recognized the

scope for improving efficiency and quality in operating rooms (ORs) management, while emphasizing the

relevance for guaranteeing responsive services and acceptable levels of waiting times. In Portugal,

successive governments have developed special programmes to tackle high waiting times and lists, with the

current System for Management of Patients Waiting for Surgery (SIGIC) having two main goals: 90.4% of

surgical patients to be operated within the maximum guaranteed response time according to the priority 

level; and an average waiting time below 120 days. Nevertheless, despite SIGIC and other policies to

pressure has been put in ORs as there has been an upward trend in the demand for surgical care (e.g.

46.6% increase between 2006 and 2015 [ACSS16]).

Activity in ORs is especially complex as it involves highly specialized medical staff, a wide range of hospital

equipment and material, many interrelated and complex processes (with up and downstream implications

and dependencies between human and material resources), as well as it entails a high level of variability

and uncertainty. Although optimization models based on mathematical programming have a key role in

assisting hospital managers, surgeons and other stakeholders in surgical planning and scheduling decisions,

there is still relatively little literature in the area. Models are not designed to respect multiple surgical

contexts, and have not accounted for surgeons’ preferences and views. This is especially problematic

because surgeons and other stakeholders do not make use of such models if those do not consider their

 perspectives.

A multidisciplinary team of researchers (from CEG-IST, CMAFCIO, CIDEHUS, CHLN and HESE) will collaborate

in developing decision support tools for improved OR management to fill this gap. Namely, it combines

optimization approaches (based on multi-objective mathematical programming models) to assist resource

capacity planning decisions with structuring participatory approaches (informed by problem structuring

methods and multicriteria value measurement tools) to capture surgeons and other stakeholders’ views

and preferences. Developed models are designed and applied to data from two Portuguese hospitals,

showing the extent to which one can simultaneously maximize surgeons’ (and other stakeholders’)

satisfaction, maximize OR utilization, maximize hospitals’ income/production, and fulfil the SIGIC goals,

 providing key information on how to improve efficiency, quality and access in OR management.