Hospitals must schedule elective surgeries while preserving sufficient capacity for unpredictable emergency demand. Excessive emergency protection leads to underutilized operating rooms and longer elective waiting times, whereas insufficient protection causes cancellations, overtime, and delays in emergency care. The main research issue is therefore how hospitals can jointly configure supply-side and demand-side flexibility to manage this uncertainty.
Supply-side flexibility concerns how operating rooms and surgical teams are shared or preferentially allocated to emergency cases. Demand-side flexibility concerns whether selected elective patients can accept bounded changes in their surgery dates. The research examines when these two forms of flexibility should be used separately or jointly and how their effectiveness depends on emergency-demand variability, capacity pressure, patient flexibility, and operational preferences. Simulation and stochastic optimization are used to compare alternative policies in terms of operating-room utilization, elective waiting and cancellations, emergency delays, overtime, and tail-risk exposure. The aim is to develop implementable policies that improve both operational efficiency and service reliability without requiring hospitals to maintain large amounts of dedicated emergency capacity.
