整合上下游資源產能限制之手術室排程研究

Operation Room Scheduling with Consideration of Upstream and Downstream Capacity Constraints

林妤蒨(Yu-Chien Lin)

指導教授 ： 黃奎隆

國立臺灣大學/工學院/工業工程學研究所/碩士(2012年)

https://doi.org/10.6342/NTU.2012.03038

摘要

手術室作業為醫院中最重要的流程之一，有效配置與管理支持手術室作業的醫療資源，可顯著提升手術室使用效率與其所能為醫院帶來的經濟效益。於手術室排程問題（Scheduling Problem）中需要考量眾多醫療資源，應如何進行整體性之規劃、如何進行資源產能的最佳化配置是相當複雜的議題，加以手術室的上、下游資源產能限制會顯著影響該手術室排程效率的表現，使得手術室排程規劃變得更加困難。

本研究同時考量醫院手術室的上游資源與下游資源的產能限制，以手術室套件與資源組合的概念進行資源整合與規劃，目標是最小化手術作業流程的固定成本、超時工作成本以及手術室產能閒置成本，以最有效率的方式進行醫療資源配置，改善醫院手術室排程效率，降低醫療資源超時使用成本以及手術室閒置對醫院的利潤損失。本研究建立一個確定性的混整數線性規劃模型，此模型不限於特定科別或醫療機構，並提出一啟發式解法以增進大型案例的求解效率，幫助醫院進行多日且多間的手術室主排程規劃；並針對八種問題情境進行混整數線性規劃模型與啟發式解法之綜合比較與討論，找出兩者分別適用時機以及不同情境面臨的問題。

關鍵字

手術室 ； 排程問題 ； 上下游 ； 資源產能限制 ； 混整數線性規劃

並列摘要

The surgical operation is one of the most important processes in a hospital. In order to increase the utilization rate of medical resources and the economic benefit of the hospital, the manager of operation rooms (ORs) should efficiently allocate and manage the medical resources. Numerous medical resources are included in an OR scheduling problem. Moreover, upstream and downstream capacity constraints also significantly affect the performance of OR schedule. Therefore, it is a very complicated issue to conduct the scheduling problem and find the optimal strategy of resources allocation.

The objective of this research is to minimize the fixed cost and the overtime cost of surgical operations as well as the idle cost of ORs. Based on the concept of OR suites and modes, a deterministic mixed integer linear programming (MILP) model is formulated in order to integrate medical resources and plan the schedule of ORs. This general model does not limit to particular surgical departments or organizations. In addition, a heuristic method is constructed to increase the efficiency of solving large-scale problems which may include a large number of surgical jobs, several ORs and types of medical resource in a longer planning horizon.

This research compares the performances of the MILP model and the heuristic method in eight scenarios. According to the comparison results, there are some differences among these scenarios, and the suitable methods for each scenario are discussed. Our results show that the proposed method can provide an efficient OR schedule and medical resources allocation strategy so that the total cost of the hospital decreases and the quality of medical service increases.

並列關鍵字

Operation room ； Scheduling problem ； Upstream and downstream ； Resource capacity constraint ； Mixed integer linear programming

參考文獻

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