Leveling ICU Bed Occupancy Using a Quota System: An Applied Heuristic for Operating Theater Managers

The operating theater, as well as the intensive care unit, are both one of the most expensive departments within a hospital but also one of the largest revenue drivers. Extensive planning on multiple strategic levels is necessary, to guarantee patient safety, workload leveling as well as profitability of a hospital. Patients are scheduled for each department individually but also jointly across departments when resources are shared. In research, many papers focus on optimizing the utilization of each department individually but also on the patient flow from one department to the other. However, few papers focus on the development of scheduling heuristics that can be used by operating theater managers without knowledge of mathematical optimization. We present an operating theater quota system for elective intensive care patients that minimizes the expected maximum bed demand in the intensive care unit. We develop a heuristic that can be easily understood and applied by operating theater managers. We use multiple instances to show that the heuristic can achieve near-optimal results by comparing the heuristic with an optimal approach.