A Mixed Integer Linear Programming Appro
A Mixed Integer Linear Programming Appro
Abstract— the problem studied in this paper is to allocate and the MILP model is more efficient than the CP model in terms
to sequence the elective operation on operating rooms (ORs). We of computational times.
develop a mixed integer linear programming (MILP) model to
solve this problem. Decisions in this model include the allocation This paper is organized as follows. In the next section, we
of operations to material resources and human resources, the propose a literature review of the OR scheduling and we
starting time of them and the starting time for each surgeon. To identify our contribution. A MILP model and a CP model are
show the efficiency of this model, we decide to compare it with a proposed in section 3. Section 4 compares the computational
constraints programming (CP) approach. The performance of performance of the two proposed models. Finally, the paper
these models is tested using a benchmark of the literature. The ends with concluding remarks and future research prospects in
results indicate the efficiency of the MILP model compared with section 5.
the CP model in terms of computational time.
Many paper focus on the ORs and recovery room when A MILP model is then formulated as follows:
discussing OT scheduling problem. Furthermore, induction
task is always performed in the OR. The contribution of the
paper is to separate the induction and the operation task to obj = min (max (SBo+pbo-Δo)) (1.1)
improve the use of the ORs. With the new structure of the OT,
the goal is to perform the induction task in induction room
while the OR is prepared for another operation. ∑Oo=1 po×ORo,r≤ RATr r ϵ {1..R} (1.2)
A MILP model is proposed to minimize the Makespan of
the OT. To show the efficiency of the MILP model, we
develop a CP model and we compare the results of the MILP ∑o=1Os po×SURo,s≤ RATSs s ϵ {1..S} (1.3)
with the CP model. Here are the notations used for the two
proposed models.
∑r=1R OR o,r = 1 o ϵ {1..O} (1.4)
TABLE I. NOTATIONS
∑o=1O∑tp=1Type∑r=1R ORo,r × pretp,r =O (1.10) SOp≥ SOo + pIro + po + tr +Δo – M × (3- θo,p,r –ORo,r –
ORp,r) o,p ϵ {1..O}, o≠p, rϵ {1..R} (1.26)
αo,p,b + αp,o,b ≥ RBo,b + RBp,b -1 o,p ϵ {1..O}, o<p, b ϵ SOo, SIo, SBo, Ss ≥ 0 o ϵ {1..O}, s ϵ {1..S} (34)
{1..B} (1.19)
The criterion obj to optimize is the maximum completion
time for operation in the OT. In order to obtain the most
yo,p,s + yp,o,s ≤ SURo,s o,p ϵ {1..O}, o<p, s ϵ {1..S} balanced operation schedule with smaller amount of opening
(1.20) hours in the OT on the day, we employ the Makespan of the
OT. Constraints (1.4) ensure that an operation can be assigned
to an OR only if it is opened and each operation is assigned to
exactly one OR, respectively. Constraints sets (1.2) - (1.3)
yo,p,s + yp,o,s ≤ SURo,s o,p ϵ {1..O}, o<p, s ϵ {1..S} impose a daily operating time limit on each OR and surgeon.
(1.21) Constraints (1.5) – (1.6) ensure that each operation should be
assigned to at most one induction bed and one recovery bed.
Constraints (1.7) impose the minimal number of nurses who
yo,p,s + yp,o,s ≥ SURo,s + SURp,s -1 o,p ϵ {1..O}, o<p, s ϵ can participate in one operation. Constraints (1.8) and (1.9)
{1..S} (1.22) ensure that a nurse does not overlap between operating rooms
during the day. Constraints (1.10) are related to OR
accessibility and verify that the operations happen in an
SIo + pIo = SOo oϵ {1..O} (1.23) appropriate OR.
A precedence relation exists between two operations if and
only if they are assigned to the same OR (resp. induction beds,
SOo+ pIro+ po + Δo = SBo o ϵ {1..O} (1.24) recovery beds, surgeons). This is enforced by constraints (1.11)
- (1.22). The set of the constraints (1.23) and (1.24) define the
precedence constraints. Constraints (1.25) and (1.27) ensure ∑o=1O∑τ=tmin(t+ po+ pIro+ Δo+ tr -1, T) ORo,r,τ ≤ 1r ϵ {1..R}, t ϵ
that an induction bed and a recovery bed cannot be occupied by {1..T} (2.4)
more than one patient in the same time. The constraints (1.26)
imply that an OR cannot be occupied by more than one patient.
Constraints (1.28) verify that a nurse cannot participate in more ∑o=1Os∑τ=tmin(t+ po+ ts -1, T) SURo,s,τ ≤ 1s ϵ {1..S}, t ϵ {1..T}
than one operation at the same time. Constraints (1.30) ensure (2.5)
that a surgeon cannot operate more than one patient at the same
time. Constraints (1.25) – (1.30) make sure that two operations
do not overlap in time if their assigned resource (OR or
surgeon or nurse) is the same. Observe that the constraints ∑o=1O∑τ=tmin(t+ pIo -1, T) IBo,Ib,τ ≤ 1Ib ϵ {1..IB}, t ϵ {1..T}
(1.26) are inutile if the operating room r is not assigned to o (2.6)
and p, respectively, since then θo,p,r + ORo,r + ORp,r ≤ 1 and
hence M (3 - θo,p,r –ORo,r – ORp) is greater than the left-hand
side because of a very large value of M. If the operating room r ∑o=1O∑τ=tmin(t+ pbo- Δ -1, T)
o RBo,b,τ ≤ 1b ϵ {1..B}, t ϵ {1..T}
is assigned to o and p then the constraints (1.15) are necessary, (2.7)
depending on whether θo,p,r =1 or θo,p,r =0. For instance θo,p,r =1,
constraints (1.15) say that the operation p starts after the
completion time of operation o with a minimum time tr ∑r=1R∑t=1T ORo,r,t = 1 o ϵ {1..O} (2.8)
(cleaning time of OR). The M parameter used is an upper
bound on the surgery completion time, this value is sufficient
to keep the constraints (1.25) - (1.31) inutile when necessary. ∑Ib=1IB∑t=1T IBo,Ib,t ≤ 1 o ϵ {1..O} (2.9)
Constraints (1.29) ensure that operation of a surgeon cannot be
started before his or her arrival to the surgical suite. Constraints
(1.19) ensure that the starting time of each operation cannot be
more than the daily regular availability. Constraints (1.31) and ∑b=1B∑t=1T RBo,b,t ≤ 1 o ϵ {1..O} (2.10)
(1.32) ensure that each surgeon operates during the interval of
time in which he/she is available. Finally, the constraints (1.33)
and (1.34) express the variables’ domain. ∑nr=1NR∑t=1T NURo,nr,t ≥ NM o ϵ {1..O} (2.11)
B. a CP model
This section presents the CP model we build for solving the ∑t=1min(t+ pIo-1, T) ∑Ib=1IB (t+ pIo) × IBo,Ib,t ≤ ∑t=1T∑r=1R t ×
elective scheduling problem. In this model, time has a discrete ORo,r,t o ϵ {1..O} (2.12)
representation as a set of time periods available for scheduling,
{1…T}. This representation of time is used in the literature
such as [4] and [12] when they solve the scheduling problem ∑t=1min(t+ po+ pIro+ Δo -1, T) ∑r=1R (t+ po+ pIro+ Δo) × ORo,r,t ≤
with the CP mechanism. Let SA(s,t,r) represents the matrix ∑t=1T∑b=1B t × RBo,b,t o ϵ {1..O} (2.13)
surgeons availability. Each surgeon s expresses her/ his
availability in time slot t in preference room r ϵ Rs; which
represents the set of preference room of surgeons. Before ∑o=1Os∑τ=tmin(t+ p -1, T)
o ORo,r,τ ≤ SA(s,t,r) s ϵ {1..S}, t ϵ
formulating the problem, we define the set of binary variables: {1..T}, r ϵ Rs (2.14)
∑o=1O∑t=1T po× ORo,r,t ≤ RATr r ϵ {1..R} (2.2) ∑o=1O∑t=1T (t+ pbo ) × RBo,b,t≤ T bϵ {1..B} (2.18)
Instances O R S IB B To test the two strategies, we use the problem instance n°3
N° where there are four ORs, six induction beds, six recovery beds
Inst.1 9 4 6 6 6 and four nurses. The problem instance includes 13 operations
Inst.2 11 4 6 6 6 performed by six surgeons over single day. In strategy 1, the
Inst.3 13 4 6 6 6 Makespan is 525 minutes and in the second the Makespan is
Inst.4 15 4 6 6 6 450 minutes. We notice that in the first strategy we have 45
Inst.5 11 6 9 9 9
minutes overtime and with the new structure the Makespan is
Inst.6 13 6 9 9 9
reduced and all operations are scheduled in a regular time of number of planned operations in the planning day and
OT. maximize the occupancy rate of the ORs.
Fig. 1. Charge of ORs in these two strategies In this paper, we study the daily scheduling problem in a
deterministic context. In the future work, it is necessary to take
into accounts the urgent operations and to evaluate the
robustness of the MILP model. Other suggestion for future
research is to extend the proposed models by including other
human resources such as the porters and the anesthetists.
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