Quantitative methods of physician scheduling at hospitals

Masteroppgave i industriell økonomi og informasjonsledelse 2010 – Universitetet i Agder, GrimstadStaff scheduling at hospitals is a widely studied area within the fields of operation research and management science because of the cost pressure on hospitals. There is an interest to find procedures on how to run a hospital more economically and efficient. Many of the studies about staff scheduling at hospital have been done about nurses, which work under common labor law restrictions. The goal of nurse scheduling is to minimize the staffing cost and maximizing their preferences. While the operation rooms are the engine of the hospitals, the physicians are the fueling for the hospitals. Without the physicians the patients would not be treated well and the hospital would not earn money. This thesis studies the physician scheduling problem, which has not been studied so widely as the nurse scheduling problem. A limited number of literatures about this theme have been studied to answer the main research question: How can we categorize physician scheduling at hospitals? Studying the physician rostering problem on the search for efficiency and cost savings is an intricate process. One can read a lot about this theme develop a lot of models; and shape and test different hypotheses. However, to increase efficiency it is wise to make a plan of information to consider. The categories searched for within this literature review are the level of experience, the planning period, the field of specialty, the type of shifts, whether cyclic or acyclic schedules are used and also which models and methods are used to solve this problem. Level of experience was first divided between residents - that are still under education, and physicians - which are fully licensed. Physicians are medical trained doctors that provide medical treatment rather than surgical treatment in hospitals. After medical school, they have accomplished between three to seven years of residential internship before they obtain their license. The residents are still under education and must therefore participate in a number of assorted activities and patient treatments during their resident period to acquire their license. This situation for resident makes scheduling unique as they are in a learning period and staffing the hospital at the same time. The planning period is a category that is divided in three levels; short-term which lasts up to a month, midterm which lasts from one month up to six months and a long-term that lasts from six months up to one year. The field of specialty is divided between the specialties of the physicians. In the numerous departments at a hospital, the work is distinctive from one another. A normal workday in a department that is only open during the day can be quite different from a workday in an emergency department. Working in a hospital is unlike other type of jobs. A hospital or at least different departments in a hospital are open all day long, every day of the year. As a result, the hospital must be staffed all the time. The need for staffing varies during the day, the day of week; and during the different seasons, due to the fluctuation of the demands. An example for a solution is a variety of broad types of shifts. Scheduling these shift types can be made cyclic or acyclic. Qualitative method has been used in this master’s thesis. The research question is a typically quantitative method starting with “how”. And to answer it, this thesis builds on a definite number of case studies. These case studies are limited to concern only about physician and resident scheduling problem written in English. These cases are primarily scientific articles and conference handouts. The cases are read - and interesting information is registered in a case study database. The findings have shown different use of planning period after the level of experience. Few studies have been done with short-term planning period; physicians are mostly scheduled for a midterm planning period, whereas residents are mostly scheduled with a long-term planning period. Most studies have scheduled physicians and residents for a day, evening and night shift, often in a combination with some kind of on-call shift. The field of specialty that is most studied is within emergency medicine. As the work in an emergency department is stressful, it is a complex task to make good schedules that satisfies the physicians and residents working there. Exact approaches are the most used modeling technique used for physician scheduling

New Methods for Resolving Conflicting Requests with Examples from Medical Residency Scheduling

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138246/1/poms12728.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138246/2/poms12728-sup-0001-SupInfo.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138246/3/poms12728_am.pd

Resource Planning in Engineering Services Firms

We develop a model to enable engineering professional services firms to improve the management of their competitive resources, i.e., skilled engineers, to be better able to respond to customer demand. The model was informed by semistructured interviews with senior executives from engineering, information technology (IT) services and technical consulting firms. As a result, we capture many of the complexities associated with the resource planning process in the professional engineering services sector. In the resulting model, the key attributes of supply, demand, and operations constraints are identified. Based on information obtained from the interviews, a number of test firms are created.We then use these test firms to study the impact of various resource planning policies on firm performance. These policies include the skill mix and profile of skilled employees, limits on the number of concurrent projects to which an employee can be assigned, and policies governing employee cross-training and hiring. The impact of these policies is evaluated in terms of business metrics, such as the project completion rate and net revenue. Finally, our model is extended to capture a multiphase rolling planning horizon, where projects may span multiple phases with the goal of ensuring consistency in employee assignment to projects

PHYSICIAN SCHEDULING IN WOMEN'S HOSPITAL

In this project, a physician scheduling problem arising from the operations of the Obstetrics and Gynecology Department at Hamad Women's Hospital in Qatar has been studied. The essence of the physician scheduling problem lies in assigning physicians with different experience levels to a set of predetermined shifts to achieve a set of clinical/non-clinical duties over a defined time horizon while considering a large set of conflicting rules and constraints including, and not limited, to hospital rules, physicians' requirements, shift coverage requirements, seniority-based workload rules, physicians' preferences, and workload balance aspects. The focus of this research project is to develop schedule for physicians (labor specialists and inpatient ward specialists) within Obstetrics and Gynecology Department at Hamad Women's Hospital for on-call shifts (evening shift and night shift) beside regular working shift (morning shift) while respecting all hard constraints, satisfying a wide range of soft constraints as far as possible, and most importantly balancing the workload among the physicians. Both labor specialists and inpatient ward specialists are the main service providers in this hospital, and therefore optimizing their work-shifts assignments would indirectly assist in providing a better service to female patients in Qatar and would result in meeting both the hospital and the physicians' satisfaction. In this work, the problem is formulated as mathematical programming model and solved by AIMMS optimization software. Optimal physicians' schedules were generated, and the proposed model was tested on real data provided from the Obstetrics and Gynecology Department in Qatar. A comparison between the resulting optimal schedules and the manual schedules used currently by the hospital was conducted. Then, a sensitivity analysis was performed in order to test the robustness of the obtained physicians' schedules of the proposed model. The proposed approach demonstrated that high quality schedules that satisfy all the constraints and mainly ensure balanced workload among the physicians can be generated with less time and effort required compared to the schedules prepared manually by the chief specialist in Women's Hospital

A shift scheduling model for employees with different seniority levels and an application in healthcare

This paper addresses the problem of scheduling medical residents that arises in different clinical settings of a hospital. The residents are grouped according to different seniority levels that are specified by the number of years spent in residency training. It is required from the residents to participate in the delivery of patient care services directly by working weekday and weekend day shifts in addition to their regular daytime work. A monthly shift schedule is prepared to determine the shift duties of each resident considering shift coverage requirements, seniority-based workload rules, and resident work preferences. Due to the large number of constraints often conflicting, a multi-objective programming model has been proposed to automate the schedule generation process. The model is implemented on a real case in the pulmonary unit of a local hospital for a 6-month period using sequential and weighted methods. The results indicate that high quality solutions can be obtained within a few seconds compared to the manually prepared schedules expending considerable effort and time. It is also shown that the employed weighting procedure based on seniority levels performs much better compared to the preemptive method in terms of computational burden. (C) 2008 Elsevier B.V. All rights reserved

Agendamento de atos médicos no Instituto Português de Reumatologia

Mestrado em Decisão Económica e EmpresarialEste trabalho foca-se no agendamento dos atos médicos que o IPR oferece para as várias especialidades, dando particular atenção à especialidade de reumatologia. O objetivo deste trabalho é ajustar o número de atos médicos, no sentido de chegar ao objetivo de atos médicos contratualizados e rentabilizar o tempo disponível dos médicos, tendo em conta restrições contextuais. Após uma recolha inicial de dados, foi delineado um modelo para se efetuar a distribuição dos atos médicos, de forma rápida, organizada e eficiente. O modelo vai ser estudado utilizando metodologias de otimização, nomeadamente programação linear, de modo a poderem ser testados dois cenários. O software utilizado foi o Premium Solver Pro. O modelo construído está focado na especialidade de reumatologia mas poderá ser adaptado a qualquer das outras especialidades oferecidas pelo IPR.This report will focus on the scheduling of medical appointments offered by the Portuguese Institute of Rheumatology. The Institute offers treatments on various specialties, but it gives special attention to the rheumatology specialty. The goal of this study is to adjust the number of appointments, in order to reach the objective number of medical acts that was contracted, and to profit from the available time of each physician, taking into account the contextual restrictions. After a primary data collection, a problem was identified to figure out how to distribute the appointments, in a fast, organized and efficient way. The problem will be studied using optimization methodologies, namely linear programing, in lieu of testing two scenarios. The software used is Premium Solver Pro. The model is focused on the rheumatology specialty but it can be adapted for any of the other specialties offered by IPR

A shift scheduling model for employees with different seniority levels and an application in healthcare

This paper addresses the problem of scheduling medical residents that arises in different clinical settings of a hospital. The residents are grouped according to different seniority levels that are specified by the number of years spent in residency training. It is required from the residents to participate in the delivery of patient care services directly by working weekday and weekend day shifts in addition to their regular daytime work. A monthly shift schedule is prepared to determine the shift duties of each resident considering shift coverage requirements, seniority-based workload rules, and resident work preferences. Due to the large number of constraints often conflicting, a multi-objective programming model has been proposed to automate the schedule generation process. The model is implemented on a real case in the pulmonary unit of a local hospital for a 6-month period using sequential and weighted methods. The results indicate that high quality solutions can be obtained within a few seconds compared to the manually prepared schedules expending considerable effort and time. It is also shown that the employed weighting procedure based on seniority levels performs much better compared to the preemptive method in terms of computational burden.OR in manpower planning OR in health services Multiple objective programming Shift scheduling Resident physicians Seniority