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patients to operating room, it is not necessary to check the speciality of the operating room. Any patient can be
assigned to any available operating room.
Modified Block Scheduling Strategy: This is the combination of block and open strategy to use the
advantages of both strategies. There are two ways to modify block strategy and apply it as modified block
strategy (Fei et al, 2009). The first one is to reserve some operating room and to keep open for others. The
second way is to release unused blocks for the remaining surgeries.
2. Advantage and Disadvantage of Different Scheduling Strategies

Each scheduling strategy has its advantages and disadvantages. Table 1 shows the comparison of these
scheduling strategies.
Table 1. Advantages and disadvantages of different scheduling strategy

Strategy Advantage Disadvantage

Block - In real life, block scheduling strategy is applied more often - In this strategy, the operating room is allocated to
Strategy in many hospitals because the complexity of this strategy is some specific surgeon, and if there is no surgical
lower than open strategy (Zhu et al, 2019). case for that surgeon on the day or the cancellation
- Surgeons’ preference is to centralize all the surgeries at a occurs, other surgeons cannot be assigned to that
specific time of workday. So, applying this strategy is time block/operating room.
suitable for surgeons because working time is fixed in this
strategy (Zhu et al, 2019).
- This strategy reduces the time required for preparation and
cleaning time between surgeries which also reduces the
patient waiting time (Gür & Eren, 2018).
Open - It is a more flexible strategy because there is no pre- - A bad design of open system can cause a high loss
Strategy allocated time block. rate.
- With the comparison of block scheduling strategy, the - This strategy is not popular in real life because it
open strategy has better utilization of operating room (Zhu et causes inconvenience, and also surgeons cannot
al, 2019). centralize their work.
- May have to face inconvenience when they have
to deal with emergency cases because patients have
priority to choose time (Zhu et al, 2019).
- This strategy may cause long waiting time
because of dynamic patient arrival (Zhu et al, 2019).
Modified - This strategy is more convenient for operation room No disadvantage reported in the literature.
Block management because it can assign other operations to
Strategy perform in the operation room to prevent the loss of late
cancellations (Agnetis et al, 2014).
- Capable to solve the problems mentioned for block and
open strategy.
Although there are some limitations, block strategy is applied in many hospitals, for example, many
hospitals in Europe adopt this strategy (Penn et al, 2017). In many hospitals, the block strategy is implemented
due to surgeons’ preferences (Zhu et al, 2019). Open strategy is flexible but may cause low utilization or delay.
For all these reasons, open strategy is not mostly adopted in real life because this strategy is not popular among
surgeons (Zhu et al, 2019). Many studies reported on block and open scheduling strategy but modified block

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Artificial Intelligence in the 4th Industrial Revolution