By Paola Ramgren | Ivey Research Office | December 15, 2023
Mehmet Begen, Ivey Business School
HEALTHCARE HARMONY: MEHMET’S QUEST FOR SMOOTHER RECOVERY
Balancing the delicate interplay of surgeries and resources for efficient patient care.
In their paper "Surgery Scheduling and Perioperative Care: Smoothing and Visualizing Elective Surgery and Recovery Patient Flow," recently published by Analytics, Mehmet A. Begen in collaboration with John S. F Lyons (Western University) and Peter C. Bell (Ivey) address the surge of patients following surgery in the Post Anesthesia Care Unit.
UNLOCKING THE PUZZLE: THE BATTLE AGAINST SURGICAL GRIDLOCK
Mehmet A. Begen and his team were tasked with the mission to unravel the complexities of patient congestion within the Post Anesthesia Care Unit (PACU) at a partner hospital. This crucial unit serves as the recovery space for patients emerging from anesthesia-induced procedures, a critical step before their journey home. The challenge? Balancing the influx of post-surgery patients with the limited resources, beds, nurses, and staff available in the Post Anesthesia Care Unit.
The team's primary focus was to organize a seamless scheduling strategy to avoid a sudden surge of patients from the operating rooms and simultaneously into the PACU. By strategically spreading out (the end times of) surgeries, they aimed to ease the strain on the hospital’s resources.
The stakes are high, as hospital backlogs can lead to drastic measures, like surgery delays or cancellations. In some instances, the lack of space in the PACU or other units force hospitals to stop or postpone surgeries until the patient flow is manageable. It is a delicate balance of resources and patient care, where their goal was to disperse surgery end times, ensuring a smoother, more efficient flow that prevents overwhelming surges in the critical post-anesthesia phase.
UNLOCKING EFFICIENCY: SCHEDULING SOLUTIONS
When the research team delved into the elaborate world of surgery scheduling at the partner hospital's PACU, they found valuable insights that promised to reshape healthcare workflow. As they navigated through the highs and troughs of surgical activity, the team identified significant peak times when numerous surgeries concluded together within a short period of time, placing a considerable strain on the Post Anesthesia Care Unit.
Recognizing the varying duration of different surgeries, the team created a model to optimize the scheduling system with an objective to smooth the inflow of patients to the PACU. This model aims to alleviate the impact of high peaks in patient inflow to the PACU, creating a more seamless workflow. In addition to ensuring availability of sufficient beds and resources, fostering an environment where nurses and staff could deliver higher quality services without the relentless pressure of time constraints. Their approach not only elevates patient care but also enhances the overall work environment by acknowledging that for nurses to manage, for instance, 12 patients at the same time is inherently more stressful than managing 8.
Their model also promotes to maintain a consistent number of staff and nurses throughout the day, which plays a crucial role in addressing 'high transit' peaks and results in a more balanced patient flow during the day. This also makes staff scheduling easier with more balanced workloads and fewer number of resources needed.
Mehmet's team successfully transformed theoretical insights into practical solutions, demonstrating the power of strategic scheduling in revolutionizing healthcare operations.
THE RIPPLE EFFECT OF OPTIMIZED SCHEDULING IN HEALTHCARE
In the intricate world of healthcare, the impact of scheduling reaches far beyond individual units—it's about orchestrating a seamless synergy across the entire hospital. While initiatives within specific units aim to fine-tune scheduling, Mehmet A. Begen emphasizes the need for a holistic approach. Hospitals must capture the overarching picture that spans various departments, recognizing the interconnectedness that can significantly affect scheduling dynamics with a system-wide view, and only local solutions can make things worse.
Consider this: a patient's journey through the hospital, from preparation for the operating rooms to the Post Anesthesia Care Unit and beyond. Each step is a crucial puzzle piece for healthcare delivery. Only by examining the entire spectrum of scheduling, from the initial steps in the operating room journey to the final phases of care, can hospitals truly create an optimal workflow.
Mehmet and his team's insights underscore the transformative power of holistic scheduling solutions, paving the way for a future where every aspect of patient care flows seamlessly.
THE BACKGROUND
In the sphere of industrial engineering, Mehmet A. Begen's journey began at the Middle East Technical University (METU), where he embarked on his undergraduate studies. Focused on optimization and mathematical modeling, Mehmet's early academic pursuits sparked an interest in scheduling. This initial curiosity evolved into a dedicated exploration of the topic in his postgraduate years, with a Master's in Management Science and a PhD in Management Science from University of British Columbia (UBC). Driven by a passion for the subject, Mehmet's overarching goal has consistently revolved around improving productivity through effective scheduling. This commitment is particularly evident in this recent publication where he collaborated with his then PhD student John Lyons and Professor Emeritus Peter Bell.
The spark for Mehmet's deep dive into this publication was through a personal connection with a surgeon at the partner hospital. The surgeon, faced with challenges in the Post Anesthesia Care Unit, reached out to Mehmet for innovative solutions. This collaboration marked the beginning of Mehmet's impactful journey in addressing critical issues within healthcare scheduling, showcasing the intersection of academic expertise and real-world problem-solving.
CHARTING MEHMET’S FUTURE: THE ROAD AHEAD
Mehmet is currently engaged in research focused on scheduling and optimization problems.
One of the projects that Mehmet is actively working on is the combined appointment and advance scheduling. This complex problem encompasses multiple job classes, priorities, and incorporates machine learning. An illustrative example is the scheduling of patients with varying priority classes (e.g., those requiring immediate attention versus those can be scheduled for a later date) for diagnostic tests or surgeries, each requiring different types and lengths of services.
Another project that Mehmet is undertaking pertains to the order acceptance and resource planning problem. This research holds broad applications across diverse industries such as healthcare, logistics, and manufacturing. The primary objective is to determine the optimal number of resources required and devise a production schedule under uncertainty, where processing times are inherently not fully known.
In a broader sense, Mehmet's research interests revolve around the practical applications of optimization and analytics, especially scheduling. For more on his research and other publications check out http://www.ivey.uwo.ca/faculty/MBegen