• A closer view at the patient surgery planning and scheduling problem: A literature review

      Samudra, Michael; Demeulemeester, Erik; Cardoen, Brecht (Review of Business and Economic Literature, 2013)
    • A two-step patient scheduling procedure

      Samudra, Michael; Demeulemeester, Erik; Cardoen, Brecht (2013)
    • Due time driven patient scheduling

      Samudra, Michael; Demeulemeester, Erik; Cardoen, Brecht (2012)
      The purpose of the study was to examine the psychometric properties of the Coach-Athlete Relationship Questionnaire (CART-Q), an instrument that was originally developed and validated for British athletes (Jowett & Ntoumanis, 2004), with a sample of Belgian, Dutch speaking athletes. The CART-Q was designed to measure Closeness, Commitment, and Complementarity (3Cs). Study 1 focused on assessing the factorial validity of the 11-item CART-Q with a sample of 401 Belgian, Dutch speaking athletes employing Confirmatory Factory Analysis (CFA). Analysis pointed to a three-dimensional factor structure with satisfactory internal consistency scores. Study 2 cross-validated the factorial structure of the 11- item CART-Q with an independent sample of 400 Belgian, Dutch speaking athletes and examined its predictive validity. The three-dimensional factor structure was upheld with satisfactory internal consistency scores. The predictive validity of the Belgian CART-Q was demonstrated when the 3Cs of the CART-Q were associated with satisfaction variables in a conceptually coherent manner. Overall, results supported the multidimensional nature of the coach-athlete relationship with Belgian athletes, as reflected in the 3Cs.
    • Due time driven surgery scheduling

      Samudra, Michael; Demeulemeester, Erik; Cardoen, Brecht; Vansteenkiste, N.; Rademakers, Frank (Health Care Management Science, 2017)
      In many hospitals there are patients who receive surgery later than what is medically indicated. In one of Europe's largest hospitals, the University Hospital Leuven, this is the case for approximately every third patient. Serving patients late cannot always be avoided as a highly utilized OR department will sometimes suffer capacity shortage, occasionally leading to unavoidable delays in patient care. Nevertheless, serving patients late is a problem as it exposes them to an increased health risk and hence should be avoided whenever possible. In order to improve the current situation, the delay in patient scheduling had to be quantified and the responsible mechanism, the scheduling process, had to be better understood. Drawing from this understanding, we implemented and tested realistic patient scheduling methods in a discrete event simulation model. We found that it is important to model non-elective arrivals and to include elective rescheduling decisions made on surgery day itself. Rescheduling ensures that OR related performance measures, such as overtime, will only loosely depend on the chosen patient scheduling method. We also found that capacity considerations should guide actions performed before the surgery day such as patient scheduling and patient replanning. This is the case as those scheduling strategies that ensure that OR capacity is efficiently used will also result in a high number of patients served within their medically indicated time limit. An efficient use of OR capacity can be achieved, for instance, by serving patients first come, first served. As applying first come, first served might not always be possible in a real setting, we found it is important to allow for patient replanning.
    • How to schedule patients within their due time

      Samudra, Michael; Cardoen, Brecht; Demeulemeester, Erik (2012)
    • Implications of switching from a to-day to a to-week patient scheduling strategy, an application at the UZ Leuven

      Samudra, Michael; Demeulemeester, Erik; Cardoen, Brecht (2013)
      In most hospitals there are some patients who receive surgery later than required. As their health condition can potentially quickly worsen, they are exposed to a health risk. In order to improve the current situation, the lateness of patients has to be, firstly, quantified and, secondly, the responsible mechanism has to be understood, namely the patient scheduling process. We analyzed the percentage of patients being served late in Belgium’s largest hospital, the UZ Leuven. At the hospital, an elective patient is associated with one of five due time intervals within which the patient has to be served. We analyzed the lateness of patients across disciplines using all data from 2012 and 22 ORs. We tried to understand many of the different aspects related to the scheduling process, which knowledge we then included into a simulation model. We investigated from the data: patient arrival patterns, the relation between estimated and realized surgery durations, rescheduling mechanisms and the allocation patterns of emergencies. We also used the model to investigate the effects of switching from the current scheduling practice of assigning surgeries directly to slots (OR and day) to a two-step procedure, where patients are scheduled to a surgery week first and only in a second step to slots. Our results suggest that in case of the two-step procedure it is very important to allow patients with shorter due times to break into the already fixed weekly schedule. Additionally, it is important that in the second step of the scheduling procedure, in the within week scheduling, the due time is considered. We conclude that improving patient scheduling can help to decrease the amount of patients served too late. As a next step, we try to develop a sound scheduling schema, which allows to further decrease the number of patients served to late.
    • Operating room planning and scheduling

      Demeulemeester, Erik; Beliën, Jeroen; Cardoen, Brecht; Samudra, Michael (2013)
    • Scheduling operating rooms: Achievements, challenges and pitfalls

      Samudra, Michael; Van Riet, Carla; Demeulemeester, Erik; Cardoen, Brecht; Vansteenkiste, Nancy; Rademakers, Frank (Journal of Scheduling, 2016)
      In hospitals, the operating room (OR) is a particularly expensive facility and thus efficient scheduling is imperative. This can be greatly supported by using advanced methods that are discussed in the academic literature. In order to help researchers and practitioners to select new relevant articles, we classify the recent OR planning and scheduling literature into tables regarding patient type, used performance measures, decisions made, OR up- and downstream facilities, uncertainty, research methodology and testing phase. Based on these classifications, we identify trends and promising topics. Additionally, we recognize three common pitfalls that hamper the adoption of research results by stakeholders: the lack of a clear choice of authors on whether to target researchers (contributing advanced methods) or practitioners (providing managerial insights), the use of ill-fitted performance measures in models and the failure to understandably report on the hospital setting and method-related assumptions. We provide specific guidelines that help to avoid these pitfalls. First, we show how to build up an article based on the choice of the target group (i.e., researchers or practitioners). Making a clear distinction between target groups impacts the problem setting, the research task, the reported findings, and the conclusions. Second, we discuss points that need to be considered by researchers when deciding on the used performance measures. Third, we list the assumptions that need to be included in articles in order to enable readers to decide whether the presented research is relevant to them.