Intégration du facteur humain dans la gestion des ressources partagées appliquée à la programmation opératoire
(2010)
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- Authors
- Supervisors
- Fouad, Riane
- Abstract
- (en) In health care systems, the operating theatre is recognized as playing an important role, notably in terms of generated income and cost. It is a key activity in the chain of care creation and plays a fundamental part since it directly impacts the quality of care. Its management, and in particular its planning process, is thus a critical activity and has been the subject of many studies. Indeed, the planning process conditions the performance of the operating theatre both in terms of room utilization and overtime; therefore it directly affects the working costs. A survey of the relevant literature emphasizes three points: i) human resources are often neglected in this process; ii) the stochastic nature of the environment is rarely considered; iii) this process is usually decomposed in two sequential phases: a planning stage followed by a scheduling stage. Due to this decomposition the resulting solutions may turn out to be sub-optimal. The ensuing questions are: is it possible to integrate the planning and scheduling steps of the operating theatre planning process in an efficient way on real size instances? Can a cooperative dimension be brought to the planning process? Can the subsequent resolution methods be made robust to the randomness of the surgical activity? These are the research questions we address in this thesis. First, we show by means of a mixed-integer program (MIP) and a genetic algorithm (GA) that a single procedure completely covering the planning and scheduling of the surgical operations can be efficient for planning dedicated operating rooms (ORs). Next, adapting the only MIP to the context of versatile ORs is sufficient to schedule the latter efficiently, simply by treating the inherent symmetry of the problem when one assumes such ORs, as often encountered in the relevant literature. The solution approaches (MIP, GA and symmetric MIP) are also fitted so as to include a human factor in the decision-making process. The major actors of the operating theatre, i.e. the surgeons, are allowed to declare preferences for the allotted operating slots or to bet on these slots in an auction process. If some surgeons appeared to be displeased by the allocation of the slots, a negotiation protocol allows two of them to exchange one of their respective operations and to schedule it in the slot of the other negotiator. Finally, we develop a Markov process to assess how the stochastic nature of the operating theatre affects its performance. Notably, we can derive, from a certain level of overtime, the right ORs occupancy rate to apply while setting up the operating schedule so as to make the latter robust and to be sure to absorb the random events such as emergencies, unexpected long operations or lack of recovery beds. The work developed in this thesis answers the three research questions we stated initially, and represents valuable tools to help the operating theatre manager in his task.
- Affiliations
FUCaM Département des sciences de gestion
Citations
Roland, B. (2010). Intégration du facteur humain dans la gestion des ressources partagées appliquée à la programmation opératoire. https://hdl.handle.net/2078.5/130991