The management of non-elective patients: shared vs. dedicated policies

Abstract The approaches for the management of elective and non-elective surgery can be classified with respect to the choice of sharing or not the operating theater. The dedicated operating room policy consists in reserving, each day, one or more operating rooms to perform only non-elective surgeries. Conversely, the shared operating room policy allows to perform elective and non-elective surgeries in the same operating room session. Furthermore, hybrid policies are defined providing, each day, both dedicated and shared operating rooms. The issue of adopting one of these policies is debated in the literature and they all could be the best policy depending on the scenario and the operative conditions. In this paper we propose a hybrid and flexible model to deal with the surgery process scheduling of both elective and non-elective patients, in which new online and offline optimization algorithms are introduced, taking into account both patient- and facility-centered objectives. The aim of this paper is to provide a detailed comparison among different policies taking into account several scenarios and operative conditions in such a way to consider the characteristics of the operating theater and those of the patients it serves.