Abstract
This study examines how operating room capacity management (ORCM) policies can enhance access to surgical services and improve societal welfare by reducing cancellations and improving resource utilisation. Using a discrete event simulation (DES) model, we evaluated three ORCM policies—dedicated, flexible, and hybrid—across different hospital sizes, focusing on their intersection with elective scheduling strategies. The analysis incorporated the perspectives of both hospital managers prioritising resource efficiency and patients concerned with surgery cancellations. Results indicate that the effectiveness of each policy depends on the specific circumstances of the hospital (e.g., hospital size and the adopted scheduling strategy), with the hybrid policy generally outperforming the others. Sensitivity analysis showed that incorporating comprehensive elective surgery scheduling—addressing pre- and post-surgery resource availability, as well as the unpredictability of emergency arrivals—substantially reduced cancellations and improved ORCM outcomes. This research highlights the critical role of selecting an appropriate ORCM policy and optimising elective scheduling to ensure sustainable surgical operations, minimise disruptions from emergencies, and improve patient care. Our findings provide actionable insights for hospital managers to refine their strategies, balancing patient needs and operational efficiency in the context of sustainable healthcare delivery.