Partially Flexible Operating Rooms for Elective and Emergency Surgeries

Yann B. Ferrand, Michael J. Magazine, Uday S. Rao

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


In hospitals, the management of operating rooms faces a trade-off between the need to be responsive to emergency surgeries and to conduct scheduled elective surgeries efficiently. Operating rooms can be configured as flexible and handle both electives and emergencies, or as dedicated to focus on either electives or emergencies. With flexible rooms, the prioritization of emergencies over scheduled electives can lead to schedule disruptions. Focused rooms can lead to imbalances between capacity and surgery workload. Whereas hospital administrators typically handle this trade-off by employing either flexible rooms (complete flexibility) or dedicated rooms (complete focus), we investigate whether a combination of flexible and dedicated rooms (partial flexibility) could be a preferable alternative. The ensuing question is what is the right combination of flexible and dedicated rooms? A versatile simulation model is developed to evaluate different resource allocation policies under various environmental parameters and performance metrics, including patient wait time, staff overtime, and operating room utilization. The main result is that partial flexibility configurations outperform both complete flexibility and complete focus policies by providing solutions with improved values of expected wait time for both emergency and elective patients.

Original languageEnglish (US)
Pages (from-to)819-847
Number of pages29
JournalDecision Sciences
Issue number5
StatePublished - Oct 1 2014
Externally publishedYes


  • Healthcare and Capacity Management

ASJC Scopus subject areas

  • Business, Management and Accounting(all)
  • Strategy and Management
  • Information Systems and Management
  • Management of Technology and Innovation


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