Scheduling cardiac procedures: A knowledge-based approach

Decisions pertaining to the planning and scheduling of critical resources such as operating rooms (OR's) are among the most critical day-to-day problems faced by hospitals. These decisions impact not only the quality of care to patients but also the crucial relationship between the hospital and the physicians who practice there. OR scheduling is typically carried out by highly experienced staff who understand the idiosyncrasies of the particular environment. Due to the complexity of the problem and the dynamic nature of the environment, the effectiveness of general-purpose scheduling systems has been limited in such domains. In this paper, we describe the scheduling problem in a large cardiac center and present a knowledge-based approach for solving the problem. Our system-development efforts were based on an in-depth study of the scheduling problem using a protocol analysis technique. This paper presents a description of the scheduling problem at the cardiac center in the form of a case study and derives a system architecture that integrates principles of opportunistic planning and reason maintenance. The opportunism in our approach allows for incremental schedule construction, while the reason maintenance mechanism ensures that the system keeps track of reasons for scheduling decisions and revises the schedule whenever conflicts or new opportunities for schedule improvement arise.