ITEM METADATA RECORD
Title: Data-driven operations management at a large university hospital.
Other Titles: Datagedreven operations management in een groot universitair ziekenhuis.
Authors: Samudra, Michael
Issue Date: 21-Dec-2016
Table of Contents: Doctoral Committee iii
Acknowledgments v
Abstract ix
1 Introduction 1
2 Literature review 7
2.1 Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
2.2 Search method and other reviews . . . . . . . . . . . . . . . . . 8
2.2.1 Search method . . . . . . . . . . . . . . . . . . . . . . 8
2.2.2 Other reviews . . . . . . . . . . . . . . . . . . . . . . . 10
2.3 Descriptive fields . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.3.1 Patient characteristics . . . . . . . . . . . . . . . . . . . 14
2.3.2 Performance measures . . . . . . . . . . . . . . . . . . 18
2.3.3 Decision delineation . . . . . . . . . . . . . . . . . . . 25
2.3.4 Up- and downstream facilities . . . . . . . . . . . . . . 30
2.3.5 Uncertainty . . . . . . . . . . . . . . . . . . . . . . . . 33
2.3.6 Operations research methodology . . . . . . . . . . . . 37
2.3.7 Testing phase . . . . . . . . . . . . . . . . . . . . . . . 41
2.3.8 Relations between classification fields . . . . . . . . . . 43
2.4 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
3 Hospital setting and model 49
3.1 Hospital setting . . . . . . . . . . . . . . . . . . . . . . . . . . 49
3.1.1 Patient arrivals . . . . . . . . . . . . . . . . . . . . . . 50
3.1.2 Non-electives . . . . . . . . . . . . . . . . . . . . . . . 53
3.1.3 Surgery duration . . . . . . . . . . . . . . . . . . . . . 56
3.1.4 Capacity allocation . . . . . . . . . . . . . . . . . . . . 61
3.1.5 Rescheduling . . . . . . . . . . . . . . . . . . . . . . . 64
3.2 Model . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
3.2.1 Model assumptions and validation . . . . . . . . . . . . 70
3.2.2 Simplifications . . . . . . . . . . . . . . . . . . . . . . 72
3.2.3 Details on the used DES model . . . . . . . . . . . . . 74
3.3 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
4 One-step strategy 79
4.1 Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80
4.1.1 Factor 1: First come, first served . . . . . . . . . . . . . 81
4.1.2 Factor 2: DT interval . . . . . . . . . . . . . . . . . . . 82
4.1.3 Factor 3: Next day . . . . . . . . . . . . . . . . . . . . 82
4.2 Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
4.2.1 OR-related performance measures . . . . . . . . . . . . 84
4.2.2 Percentage of patients served within their DT . . . . . . 85
4.2.3 Patient waiting time . . . . . . . . . . . . . . . . . . . 89
4.2.4 Weighted DT cost . . . . . . . . . . . . . . . . . . . . 89
4.2.5 Discipline-specific insights . . . . . . . . . . . . . . . . 94
4.3 Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
4.4 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
5 Two-step strategy 99
5.1 Factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
5.1.1 Factor 1: Protection levels . . . . . . . . . . . . . . . . 101
5.1.2 Factor 2: Within-week scheduling step . . . . . . . . . 102
5.1.3 Factor 3: Push . . . . . . . . . . . . . . . . . . . . . . 103
5.2 Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 104
5.2.1 OR-related performance measures . . . . . . . . . . . . 104
5.2.2 Percentage of patients served within DT . . . . . . . . . 105
5.2.3 Patient waiting time . . . . . . . . . . . . . . . . . . . 108
5.2.4 Weighted DT cost . . . . . . . . . . . . . . . . . . . . 109
5.2.5 Discipline-specific insights . . . . . . . . . . . . . . . . 112
5.3 Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
5.3.1 Performing the second stage on Thursday instead of Friday114
5.3.2 Comparison with the one-step strategy . . . . . . . . . . 115
5.4 Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
6 Discussion 119
6.1 Three points on the literature . . . . . . . . . . . . . . . . . . . 119
6.1.1 Clarifying the target group: Researchers or practitioners 120
6.1.2 Clarifying the objective . . . . . . . . . . . . . . . . . . 123
6.1.3 Clarifying the problem: Setting- and method-specific
assumptions . . . . . . . . . . . . . . . . . . . . . . . . 125
6.2 Limitations and future work . . . . . . . . . . . . . . . . . . . 129
7 Conclusion 133
Appendices 139
A Surgery durations 141
B Surgeon estimation error 149
List of figures 151
List of tables 155
Doctoral Dissertations from the Faculty of Business and Economics 191
Publication status: published
KU Leuven publication type: TH
Appears in Collections:Research Center for Operations Management, Leuven

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