Efficient management of operating room (OR) schedules is of particular interest as this service is the largest cost and revenue center in a hospital and can substantially impact its staffing and finances. A major problem associated with developing OR schedules for elective surgeries is the uncertainty inherent in the duration of surgical services which can disrupt a daily plan. Another problem is the impact of facilities and resources upstream and downstream to the operating room, which affect the performance of the overall system. Using a manufacturing system analytical approach, the peri-operative process is modeled as a transfer line with three machines and two buffers using a discrete time Markov chain. Model predictive control is then applied to control the pace of patient release into the OR rooms. With this model and empirical studies of OR and recovery duration, guidance can be given to OR managers on how to dynamically schedule and reschedule patients throughout an operating room’s day that minimizes cost for a given workload.

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