Fewer intensive care unit refusals and a higher capacity utilization by using a cyclic surgical case schedule Mark Van Houdenhoven MSc a,b , Jeroen M. van Oostrum MSc a,b, ⁎ , Gerhard Wullink PhD a,b , Erwin Hans PhD c , Johann L. Hurink PhD d , Jan Bakker MD, PhD b , Geert Kazemier MD, PhD a,e a Department of Operating Rooms, Erasmus University Medical Center, The Netherlands b Department of Intensive Care, Erasmus University Medical Center, 3000 CA, Rotterdam, The Netherlands c Department of Operational Methods for Production and Logistics, School of Management and Governance, University of Twente, 7500 AE, Enschede, The Netherlands d Department of Electrical Engineering, Mathematics and Computer Science, University of Twente, 7500 AE, Enschede, The Netherlands e Department of Surgery, Erasmus University Medical Center, 3000 CA, Rotterdam, The Netherlands Keywords: Intensive care unit; Master surgical schedule; Surgical case; Health care efficiency Abstract Purpose: Mounting health care costs force hospital managers to maximize utilization of scarce resources and simultaneously improve access to hospital services. This article assesses the benefits of a cyclic case scheduling approach that exploits a master surgical schedule (MSS). An MSS maximizes operating room (OR) capacity and simultaneously levels the outflow of patients toward the intensive care unit (ICU) to reduce surgery cancellation. Materials and Methods: Relevant data for Erasmus MC have been electronically collected since 1994. These data are used to construct an MSS that consisted of a set of surgical case types scheduled for a period or cycle. This cycle was executed repetitively. During such a cycle, surgical cases for each surgical department were scheduled on a specific day and OR. The experiments were performed for the Erasmus University Medical Center and for a virtual hospital. Results: Unused OR capacity can be reduced by up to 6.3% for a cycle length of 4 weeks, with simultaneous optimal leveling of the ICU workload. Conclusions: Our findings show that the proposed cyclic OR planning policy may benefit OR utilization and reduce surgical case cancellation and peak demands on the ICU. © 2008 Elsevier Inc. All rights reserved. 1. Introduction Mounting health care costs force hospital managers to maximize utilization of scarce resources and simultaneously improve access to hospital services. Efforts are therefore directed at developing planning methods that may deal with these seemingly conflicting objectives [1]. ⁎ Corresponding author. Department of Operating Rooms, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands. Fax: +31 10 463 4035. E-mail address: j.vanoostrum@erasmusmc.nl (J.M. van Oostrum). 0883-9441/$ – see front matter © 2008 Elsevier Inc. All rights reserved. doi:10.1016/j.jcrc.2007.07.002 Journal of Critical Care (2008) 23, 222–226