THE ROUTING OF HOME HEALTH CARE TEAM FOR THE ELDERLY: A CASE STUDY IN METROPOLITAN MUNICIPALITY

TÜİK verilerine göre ülkemizde son on yılda yaşlı nüfus oranının %28.07 arttığı görülmektedir. Bu durumu ele alan belediyeler zor durumdaki vatandaşlarına destek olmayı amaçlamaktadır. Bunun için evde temizlik ve bakım hizmetleri, ev içi bakım-onarım hizmetleri, cami temizlik hizmetleri gibi toplumun ihtiyaç ve beklentilerine yönelik önemli adımlar atmışlardır. Bu çalışmada araç rotalama problemi ele alınmıştır. Ankara Büyükşehir Belediyesi Yaşlı Hizmet Merkezi’nde evde temizlik ve kişisel bakım, bakım-onarım ve cami temizlik hizmetlerinde toplam kat edilen mesafenin en küçüklenmesi amaçlanmıştır. Çalışmada 05.10.2018 tarihinde temizlik ve kişisel bakım hizmetinde 25 ekibin 123 adrese, bakım-onarım hizmetinde 1 ekibin 6 adrese ve cami temizlik hizmetinde 3 ekibin 18 adrese yani toplamda 29 ekibin 147 adrese verdiği hizmetler ele alınmıştır. Problemin çözümünde tamsayılı programlama modeli kullanılmıştır. Sonuç olarak ekipler için minimum kat edilen mesafeler hesaplanmış ve mevcut durum ile karşılaştırılmıştır. %9 oranında bir iyileşme sağlanmıştır. Bu çalışma, evde bakım hizmetlerinde araç rotalarının oluşturulmasıyla uygun kararları almasına yardımcı olacaktır.According to Turkey's statistical agency data, our country has increased 28.07% of the elderly population over the past decade. Municipalities addressing this situation aim to support their citizens in distress. For this purpose, they have taken important steps towards the needs and expectations of the society such as cleaning and maintenance services at home, home maintenance services, mosque cleaning services.In this study, vehicle routing problem is discussed. In Ankara Metropolitan Municipality Elderly Service Center, it is aimed to minimize the total distance traveled in house cleaning and personal care, maintenancerepair and mosque cleaning services. In the study, cleaning and personal care services on 05.10.2018, 29 teams to address 147 services are considered which in 25 teams to 123 addresses, maintenance and repair services 1 team 6 address and mosque cleaning service 3 teams 18 address. An integer programming model is used to solve the problem. As a result; The minimum distance travelled for the teams is calculated. The results are compared with the current situation and an improvement of 9% was achieved. This study will help to make appropriate decisions by creating vehicle routes in home care service

Implementación de un prototipo de soporte de decisiones logísticas de ruteo en atención médica domiciliaria en Medellín, Colombia

RESUMEN : El incremento de la población y de la expectativa de vida en Colombia han generado un aumento en las necesidades de prestación de servicios de salud, así como del desarrollo de nuevas herramientas para responder a dichos incrementos. Teniendo en cuenta estas necesidades en temas específicos de salud, la Atención Médica Domiciliaria (HHC por sus siglas en inglés Home Health Care) es un servicio que asigna personal médico asistencial capacitado a los hogares de los pacientes, según sus condiciones y necesidades, con el fin de aplicar procedimientos médicos teniendo siempre como base el cumplimiento de una prescripción establecida. Esto implica tomar decisiones relativas a la asignación y secuenciación del personal teniendo en cuenta las características del servicio, y asegurando que los pacientes sean atendidos en las condiciones definidas dentro de sus propios hogares. Dichas decisiones han sido estudiadas haciendo uso de métodos matemáticos para el problema de ruteo de vehículos, así como de asignación y secuenciación de personal médico asistencial. El problema radica en el uso adecuado del personal disponible con diferentes fines ya sean de maximizar el número de pacientes atendidos por profesional o haciendo uso de la distancia más corta dentro del trazado del recorrido. Algunas de las condiciones que deben considerarse son el tipo de personal, el tipo de paciente, la distancia de recorrido, entre otras, con el objetivo de diseñar la mejor ruta para tener un buen servicio y cumplir con dichas condiciones. Con el objetivo de dar soporte a la toma de decisiones logísticas de ruteo en HHC en el contexto de Medellín, Antioquia, en este trabajo se presenta un prototipo computacional que, basado en métodos aproximados, permite mejorar las métricas de desempeño del sistema, y agiliza el proceso de toma de decisiones en asignación y secuenciación de personal médico asistencial en el marco de HHC

O problema de roteamento e escalonamento de profissionais de saúde: The home healthcare routing and scheduling problem

Problema de Roteamento e Escalonamento de Profissionais de Saúde consiste em determinar a melhor rota para profissionais de saúde para atendimento domiciliar. Existem diversas variantes deste problema que diferem nas restrições e funções objetivo. Este artigo apresenta uma revisão da literatura, com o objetivo de identificar os problemas de roteamento utilizados pelos autores, os diferentes tipos de função objetivo, e as técnicas de solução utilizadas

Diseño de un sistema aplicativo para la programación de personal y rutas del servicio domiciliario del HUSI

El trabajo de grado a continuación trata de la problemática presentada en el sector de la salud como resultado de la baja capacidad instalada de los establecimientos de salud. Como solución alternativa a este problema existe un servicio que permite extender la capacidad de las instituciones, conocido como Servicio de Hospitalización Domiciliaria (SHD). Éste ha permitido hacer un control y seguimiento periódico a pacientes en sus hogares, sin llegar a ocupar recursos dentro del hospital. En Colombia, el Hospital Universitario San Ignacio (HUSI) ha venido implementando esta nueva modalidad bajo el nombre de Extensión Hospitalaria dirigido por la oficina de Alta Temprana. Sin embargo, el HUSI ha tenido inconvenientes en el SHD dada la complejidad relacionada con asignación de recursos, movilidad y programación de rutas y horarios. El proceso de asignación de citas se ejecuta de manera manual y la programación se realiza a criterio del jefe de enfermería disponible. Por lo tanto, se diseñó un sistema aplicativo utilizando la meta-heurística Tabú, que permite la programación semiautomática del servicio de hospitalización domiciliaria logrando el aumento de cobertura de demanda del HUSI. Lo anterior logró mejorar el desempeño del SHD, incrementando el porcentaje de admitidos al programa de Extensión Hospitalaria en 30% y la eficiencia del servicio aumentando en un número de 5 a 6 pacientes atendidos por día.Currently, there are certain inefficiencies in health sector, many as a result of the low installed capacity of health settings. As an alternative solution to this problem, there is a service that allows extending the capacity of institutions known as Home Health Care Service (Servicio de Hospitalización Domiciliaria SHD, in Spanish). This has allowed periodic controlling and monitoring of patients in their homes, without ever occupying resources within the hospital. In Colombia, the Hospital Universitario San Ignacio (HUSI), located at the Pontificia Universidad Javeriana, has been implementing this new modality under the name of Extensión Hospitalaria directed by the Early Discharge Unit (Oficina de Alta Temprana, in Spanish). However, the HUSI has had problems in the SHD given the complexity related to resource assignment, a Healthcare Routing and Scheduling Problem (HHCRSP). Nowadays, the process of assigning appointments is carried out manually, rostering and scheduling are done under the criteria of the available nursing manager. Therefore, we designed an application system using Tabú Search metaheuristic, which allows the semiautomatic scheduling of the Home Healthcare Service, increasing HUSI demand coverage. The above enabled the improvement of the SHD performance, increasing the percentage of patients included into the Hospital Extension program in 30% which is equivalent to 5 to 6 additional patients attended per day.Ingeniero (a) IndustrialPregrad

Optimización de las operaciones de programación y ruteo de personal especializado en servicios médicos domiciliarios

48 Páginas.Los servicios médicos domiciliarios surgen de la necesidad de los hospitales de realizar el cuidado de pacientes que por condiciones especiales requieren hospitalización y/o atención en sus hogares. La prestación de este servicio implica la programación del personal especializado y de las rutas de visitas a pacientes, generando un impacto tanto en calidad de los servicios de salud como en costos de personal y transporte para los hospitales. Este trabajo presenta una descripción de las características del personal médico y las restricciones del problema, con el propósito de determinar herramientas que permitan al tomador de decisiones en entidades médicas domiciliarias realizar una eficiente programación de personal y asignación de rutas de visitas a pacientes (Home Health Care Routing and Scheduling Problem, HHCRSP), considerando múltiples tipos de personal, múltiples puntos de inicio y fin de rutas y ventanas de tiempo duras para un horizonte de planeación, esto considerando la incertidumbre en la operación.

Modeling and analysis of a home care routing problem

This thesis proposes the Home Care Routing Problem with Time Windows (HCRPTW) which is an extension to the well-known Vehicle Routing Problem with Time Windows (VRPTW). Different than VRPTW, we solve the routing problem of the health care personnel of a Home Health Care (HHC) service provider when the patients require different types of services. In this problem, the patients may request different types of care which can be provided by two types of personnel: nurses and health care aides. Each patient must be visited exactly once even if her servicing requires both personnel and is associated with a strict time window during which the service must be provided. In order to solve this problem, we present the 0-1 mixed integer programming formulation of the problem. The problem can be modeled with three different objective functions which are to minimize the total distance travelled, to minimize the total number of personnel and to minimize the total number of vehicles. We randomly generate a set of instances based on Solomon’s benchmark problems for the VRPTW and solve them using IBM ILOG CPLEX. We also study Crew Constrained Home Care Routing Problem with Time Windows (CC-HCRPTW) which is another extension of HCRPTW where the number of each type of personnel is limited

Planning the delivery of home social services: a mathematical programming-based approach to support routing and scheduling assignments

The increased average lifespan, together with low birth rates, are transforming the European Union's age pyramid. Currently, we are experiencing a transition towards a much older population structure. Given that the institutions that provide care to these population groups are limited by budgetary constraints, it is imperative to optimize several processes, among which route planning and staff scheduling stand out. This dissertation aims to develop a mathematical programming model to support the planning of routes and human resources for providers of Home Social Services. Beyond general Vehicle Routing Problems assumptions, the proposed model also considers the following features: i) working time regulations, ii) mandatory breaks, iii) users' autonomy, and iii) meals' distribution. The present model, implemented using GAMS software, focuses simultaneously on two objective functions: minimization of operating costs, and maximization of equity through the minimization of differences in teams' working times. Chebyshev's method was chosen to solve the developed multiobjective model. The model was built based on a Portuguese Private Institution of Social Solidarity. Through the application of the model, significant improvements are obtained when compared to the current planning of the partner institution, such as it is the case of an improved workload distribution between caregivers and routes that will result in lower costs for the institution. This model is fully enforceable to other institutions that provide services similar or equal to the institution used as a reference.O aumento da esperança média de vida, juntamente com baixas taxas de natalidade, estão a transformar a pirâmide etária da União Europeia. Atualmente, estamos a vivenciar uma transição direcionada para uma estrutura populacional muito mais envelhecida. Dado que as instituições que prestam cuidados a esta fração se encontram limitadas por restrições orçamentais, torna-se imperativo otimizar vários processos, dos quais se destacam planeamento de rotas e escalonamento de funcionárias. Esta dissertação visa introduzir um modelo de programação matemática com a finalidade de apoiar o planeamento de rotas e recursos humanos para prestadores de Serviços de Apoio Domiciliário. O modelo assenta, além dos pressupostos de um "Vehicle Routing Problem", nos seguintes: i) regulações de tempo de trabalho, ii) pausas obrigatórias, iii) autonomia dos utentes, e iv) distribuição de refeições. O modelo, desenvolvido através de software GAMS, foca-se em duas funções objetivo, simultaneamente: minimização dos custos operacionais, e maximização da equidade, através da minimização das diferenças nos tempos de trabalho das equipas. O método de Chebyshev foi o escolhido para desenvolver o modelo multiobjetivo. O modelo foi construído tendo por base uma Instituição Particular de Solidariedade Social em Portugal. Através da aplicação do modelo, obtêm-se melhorias significativas, quando comparado com o atual planeamento da instituição parceira, como é o caso de uma melhor distribuição da carga de trabalho entre as funcionárias e das rotas que resultam da redução dos custos operacionais da instituição. Este modelo é totalmente extensível a outras instituições que prestem serviços semelhantes ou iguais à instituição utilizada como referência

DEVELOPING AN OPTIMAL MODEL FOR INFANT HOME VISITATION

The United States, Great Britain, Denmark, Canada and many other countries have accepted home visitation (HV) as a promising strategy for interventions for infants after births and for their mothers. Prior HV studies have focused on theoretical foundations, evaluations of programs, cost/benefit analysis and cost estimation by using hospital/payer/insurance data to prove its effectiveness and high cost. As governments and private organizations continue to fund HVs, it is an opportune time to develop and formulate operations research (OR) models of HV coverage, quality and cost so they might be used in program implementation as done for adult home healthcare (HHC) and home care (HC). This dissertation introduces a new modeling approach and proposes a solution methodology which helps to determine the schedules of follow-up nursing care providers (NCP) to visit discharged patients in order to minimize total follow-up cost at the planning and operational level, and to improve the quality of care. The model improves the quality of treatment of infants and mothers during pregnancy, after birth and discharge from the hospital by maximizing the quality of assignment of the right NCP with the right skill, nurse type and years of experience to the right patient with the specific health need. The modeling approach is based on a mixed-interger programming (MIP) formulation that represents the dynamics of the system comprising aspects such as visit schedules and total program’s cost while satisfying a variety of requirements modeled as constraints. The model is tested and validated with real life data. Computational results for the formulation for real life instances of the problem with the Nurse Family Partnership Program (NFP) obtained using IBM CPLEX optimization Studio version 12.6.1 are presented. The intent is to enhance the administrative and deployment process of HV programs, minimize risks, allow planners to explore the best scenarios under different conditions related to cost, treatment and coverage requirements, and highlight the best course of action when assigning NCPs to clients. Results show significant cost savings and enhanced quality treatment in several cases studied and tested. Finally, the study identifies and presents fertile avenues for future research for this field