Ameliyathane ve yeniden kullanilabilir tibbi cihazlarin stokastik planlamasi: Simülasyon optimizasyonu yaklaşimi

Health care expenditures are expected to grow every year, and more than $40 \%$ of a hospital's total expenses and revenues are generated by surgical surgeries. One of the major resources required during surgeries are reusable medical devices (RMDs). RMDs are surgical instruments utilized during surgeries which have to be reprocessed by thorough cleaning followed by high-level disinfection or sterilization after each use. RMDs have to be planned with operating rooms (ORs) concurrently since insufficient RMDs may cause delays in surgery starting times. However, management of RMD sterilization stage is nontrivial. First, RMDs are sent to sterilization service at different times due to different finishing times of surgeries during a day. Second, the decision of how to load the sterilization machines, i.e., how to batch RMDs, is a complicated one. Lastly, time spent during sterilization has to be considered during scheduling of ORs since an surgery cannot start without the required number of RMDs. In this thesis, we study the integrated scheduling of ORs and sterilization of RMDs under stochastic surgery durations. We propose a simulation optimization approach to tackle with this problem, and through numerical studies show that our approach could lead to significant ($15 \%$ on average) cost savings in compare to deterministic approaches for a hospital