Heuristics for balancing Operating Room and post-anesthesia resources under uncertainty

The post-anesthesia care unit (PACU) is a shared resource in the hospital where patients recover from surgery. It is fed by a set of operating rooms (OR¿s) often spanning several surgical services. It is insufficient to determine the best surgery schedule for any single OR without considering available PACU capacity. We model this as a two-stage process where the first stage is surgery and the second, post-anesthesia recovery. An interesting aspect of the second-stage process is that it begins as soon as the first stage has concluded even if a PACU bed is not available. In this case, the OR continues to house the recovering patient until a PACU bed is available. We analyze the structure of the problem, evaluate several heuristics based on competing performance measures for surgical suite efficiency, and present results of numerical experiments and insights that can be derived from them.