The distributed operating room (OR) scheduling problem aims to find an assignment of surgeries to ORs across collaborating hospitals that share their waiting lists and ORs. We propose a stochastic extension of this problem where surgery durations are considered to be uncertain. In order to obtain solutions for the challenging stochastic model, we use sample average approximation and develop two enhanced decomposition frameworks that use logic-based Benders (LBBD) optimality cuts and binary decision diagram based Benders cuts. Specifically, to the best of our knowledge, deriving LBBD optimality cuts in a stochastic programming context is new to the literature. Our computational experiments on a hospital data set illustrate that the stochastic formulation generates robust schedules and that our algorithms improve the computational efficiency. Summary of Contribution: We propose a new model for an important problem in healthcare scheduling, namely, stochastic distributed operating room scheduling, which is inspired by a current practice in Toronto, Ontario, Canada. We develop two decomposition methods that are computationally faster than solving the model directly via a state-of-the-art solver. We present both some theoretical results for our algorithms and numerical results for the evaluation of the model and algorithms. Compared with its deterministic counterpart in the literature, our model shows improvement in relevant evaluation metrics for the underlying scheduling problem. In addition, our algorithms exploit the structure of the model and improve its solvability. Those algorithms also have the potential to be used to tackle other planning and scheduling problems with a similar structure.

Operating rooms (ORs) play a substantial role in hospital profitability, and their optimal utilization is conducive to containing the cost of surgical service delivery, shortening surgical patient wait times, and increasing patient admissions. We extend the OR planning and scheduling problem from a single independent hospital to a coalition of multiple hospitals in a strategic network, where a pool of patients, surgeons, and ORs are collaboratively planned. To solve the resulting mixed-integer dual resource constrained model, we develop a novel logic-based Benders’ decomposition approach that employs an allocation master problem, sequencing sub-problems for each hospital-day, and novel multistrategy Benders’ feasibility and optimality cuts. We investigate various patient-to-surgeon allocation flexibilities, as well as the impact of surgeon schedule tightness. Using real data obtained from the General Surgery Departments of the University Health Network (UHN) hospitals, consisting of Toronto General Hospital, Toronto Western Hospital, and Princess Margret Cancer Centre in Toronto, Ontario, Canada (who already engage in some collaborative resource sharing), we find that on average, collaborative OR scheduling with traditional patient-to-surgeon allocation flexibility results in 6% cost-savings, while flexible patient-to-surgeon allocation flexibility increases cost-savings to 40%, and surgeon schedule tightness can impact costs by 15%. The collective impact of our collaboration and patient flexibility results in between 45% and 63% savings per surgery. We also use a game theoretic approach to fairly redistribute the payoff acquired from a coalition of hospitals and to empirically show coalitional stability among hospitals. Data and the online supplement are available at https://doi.org/10.1287/ijoc.2017.0745 .