A Computational Approach to Patient Flow Logistics in Hospitals

Scheduling decisions in hospitals are often taken in a decentralized way. This means that different specialized hospital units decide autonomously on e.g. patient admissions and schedules of shared resources. Decision support in such a setting requires methods and techniques that are different from the majority of existing literature in which centralized models are assumed. The design and analysis of such methods and techniques is the focus of this thesis. Specifically, we develop computational models to provide dynamic decision support for hospital resource management, the prediction of future resource occupancy and the application thereof. Hospital resource management targets the efficient deployment of resources like operating rooms and beds. Allocating resources to hospital units is a major managerial issue as the relationship between resources, utilization and patient flow of different patient groups is complex. The issues are further complicated by the fact that patient arrivals are dynamic and treatment processes are stochastic. Our approach to providing decision support combines techniques from multi-agent systems and computational intelligence (CI). This combination of techniques allows to properly consider the dynamics of the problem while reflecting the distributed decision making practice in hospitals. Multi-agent techniques are used to model multiple hospital care units and their decision policies, multiple patient groups with stochastic treatment processes and uncertain resource availability due to overlapping patient treatment processes. The agent-based model closely resembles the real-world situation. Optimization and learning techniques from CI allow for designing and evaluating improved (adaptive) decision policies for the agent-based model, which can then be implemented easily in hospital practice. In order to gain insight into the functioning of this complex and dynamic problem setting, we developed an agent-based model for the hospital care units with their patients. To assess the applicability of this agent-based model, we developed an extensive simulation. Several experiments demonstrate the functionality of the simulation and show that it is an accurate representation of the real world. The simulation is used to study decision support in resource management and patient admission control. To further improve the quality of decision support, we study the prediction of future hospital resource usage. Using prediction, the future impact of taking a certain decision can be taken into account. In the problem setting at hand for instance, predicting the resource utilization resulting from an admission decision is important to prevent future bottlenecks that may cause the blocking of patient flow and increase patient waiting times. The methods we investigate for the task of prediction are forward simulation and supervised learning using neural networks. In an extensive analysis we study the underlying probability distributions of resource occupancy and investigate, by stochastic techniques, how to obtain accurate and precise prediction outcomes. To optimize resource allocation decisions we consider multiple criteria that are important in the hospital problem setting. We use three conflicting objectives in the optimization: maximal patient throughput, minimal resource costs and minimal usage of back-up capacity. All criteria can be taken into account by finding decision policies that have the best trade-off between the criteria. We derived various decision policies that partly allow for adaptive resource allocations. The design of the policies allows the policies to be easily understandable for hospital experts. Moreover, we present a bed exchange mechanism that enables a realistic implementation of these adaptive policies in practice. In our optimization approach, the parameters of the different decision policies are determined using a multiobjective evolutionary algorithm (MOEA). Specifically, the MOEA optimizes the output of the simulation (i.e. the three optimization criteria) as a function of the policy parameters. Our results on resource management show that the benchmark allocations obtained from a case study are considerably improved by the optimized decision policies. Furthermore, our results show that using adaptive policies can lead to better results and that further improvements may be obtained by integrating prediction into a decision policy

Multi-agent stochastic simulation of occupants in buildings

One of the principle causes for deviations between predicted and simulated performance of buildings relates to the stochastic nature of their occupants: their presence, activities whilst present, activity dependent behaviours and the consequent implications for their perceived comfort. A growing research community is active in the development and validation of stochastic models addressing these issues; and considerable progress has been made. Specifically models in the areas of presence, activities while present, shading devices, window openings and lighting usage. One key outstanding challenge relates to the integration of these prototype models with building simulation in a coherent and generalizable way; meaning that emerging models can be integrated with a range of building simulation software. This thesis describes our proof of concept platform that integrates stochastic occupancy models within a multi agent simulation platform, which communicates directly with building simulation software. The tool is called Nottingham Multi-Agent Stochastic Simulation (No-MASS). No-MASS is tested with a building performance simulation solver to demonstrate the effectiveness of the integrated stochastic models on a residential building and a non-residential building. To account for diversity between occupants No-MASS makes use of archetypical behaviours within the stochastic models of windows, shades and activities. Thus providing designers with means to evaluate the performance of their designs in response to the range of expected behaviours and to evaluate the robustness of their design solutions; which is not possible using current simplistic deterministic representations. A methodology for including rule based models is built into No-MASS, this allows for testing what-if scenarios with building performance simulation and provides a pragmatic basis for the modelling of the behaviours for which there is insufficient data to develop stochastic models. A Belief-Desire-Intention model is used to develop a set of goals and plans that an agent must follow to influence the environment based on their beliefs about current environmental conditions. Recommendations for the future development of stochastic models are presented based on the sensitivity analysis of the plans. A social interactions framework is developed within No-MASS to resolve conflicts between competing agents.This framework resolves situations where each agent may have different desires, for example one may wish to have a window open and another closed based on the outputs of the stochastic models. A votes casting system determines the agent choice, the most votes becomes the action acted on. No-MASS employs agent machine learning techniques that allow them to learn how to respond to the processes taking place within a building and agents can choose a strategy without the need for context specific rules. Employing these complementary techniques to support the comprehensive simulation of occupants presence and behaviour, integrated within a single platform that can readily interface with a range of building (and urban) energy simulation programs is the key contribution to knowledge from this thesis. Nevertheless, there is significant scope to extend this work to further reduce the performance gap between simulated and real world buildings

Overview on agent-based social modelling and the use of formal languages

Transdisciplinary Models and Applications investigates a variety of programming languages used in validating and verifying models in order to assist in their eventual implementation. This book will explore different methods of evaluating and formalizing simulation models, enabling computer and industrial engineers, mathematicians, and students working with computer simulations to thoroughly understand the progression from simulation to product, improving the overall effectiveness of modeling systems.Postprint (author's final draft

Agents for educational games and simulations

This book consists mainly of revised papers that were presented at the Agents for Educational Games and Simulation (AEGS) workshop held on May 2, 2011, as part of the Autonomous Agents and MultiAgent Systems (AAMAS) conference in Taipei, Taiwan. The 12 full papers presented were carefully reviewed and selected from various submissions. The papers are organized topical sections on middleware applications, dialogues and learning, adaption and convergence, and agent applications

Principles and Concepts of Agent-Based Modelling for Developing Geospatial Simulations

The aim of this paper is to outline fundamental concepts and principles of the Agent-Based Modelling (ABM) paradigm, with particular reference to the development of geospatial simulations. The paper begins with a brief definition of modelling, followed by a classification of model types, and a comment regarding a shift (in certain circumstances) towards modelling systems at the individual-level. In particular, automata approaches (e.g. Cellular Automata, CA, and ABM) have been particularly popular, with ABM moving to the fore. A definition of agents and agent-based models is given; identifying their advantages and disadvantages, especially in relation to geospatial modelling. The potential use of agent-based models is discussed, and how-to instructions for developing an agent-based model are provided. Types of simulation / modelling systems available for ABM are defined, supplemented with criteria to consider before choosing a particular system for a modelling endeavour. Information pertaining to a selection of simulation / modelling systems (Swarm, MASON, Repast, StarLogo, NetLogo, OBEUS, AgentSheets and AnyLogic) is provided, categorised by their licensing policy (open source, shareware / freeware and proprietary systems). The evaluation (i.e. verification, calibration, validation and analysis) of agent-based models and their output is examined, and noteworthy applications are discussed.Geographical Information Systems (GIS) are a particularly useful medium for representing model input and output of a geospatial nature. However, GIS are not well suited to dynamic modelling (e.g. ABM). In particular, problems of representing time and change within GIS are highlighted. Consequently, this paper explores the opportunity of linking (through coupling or integration / embedding) a GIS with a simulation / modelling system purposely built, and therefore better suited to supporting the requirements of ABM. This paper concludes with a synthesis of the discussion that has proceeded. The aim of this paper is to outline fundamental concepts and principles of the Agent-Based Modelling (ABM) paradigm, with particular reference to the development of geospatial simulations. The paper begins with a brief definition of modelling, followed by a classification of model types, and a comment regarding a shift (in certain circumstances) towards modelling systems at the individual-level. In particular, automata approaches (e.g. Cellular Automata, CA, and ABM) have been particularly popular, with ABM moving to the fore. A definition of agents and agent-based models is given; identifying their advantages and disadvantages, especially in relation to geospatial modelling. The potential use of agent-based models is discussed, and how-to instructions for developing an agent-based model are provided. Types of simulation / modelling systems available for ABM are defined, supplemented with criteria to consider before choosing a particular system for a modelling endeavour. Information pertaining to a selection of simulation / modelling systems (Swarm, MASON, Repast, StarLogo, NetLogo, OBEUS, AgentSheets and AnyLogic) is provided, categorised by their licensing policy (open source, shareware / freeware and proprietary systems). The evaluation (i.e. verification, calibration, validation and analysis) of agent-based models and their output is examined, and noteworthy applications are discussed.Geographical Information Systems (GIS) are a particularly useful medium for representing model input and output of a geospatial nature. However, GIS are not well suited to dynamic modelling (e.g. ABM). In particular, problems of representing time and change within GIS are highlighted. Consequently, this paper explores the opportunity of linking (through coupling or integration / embedding) a GIS with a simulation / modelling system purposely built, and therefore better suited to supporting the requirements of ABM. This paper concludes with a synthesis of the discussion that has proceeded

Model checking learning agent systems using Promela with embedded C code and abstraction

As autonomous systems become more prevalent, methods for their verification will become more widely used. Model checking is a formal verification technique that can help ensure the safety of autonomous systems, but in most cases it cannot be applied by novices, or in its straight \off-the-shelf" form. In order to be more widely applicable it is crucial that more sophisticated techniques are used, and are presented in a way that is reproducible by engineers and verifiers alike. In this paper we demonstrate in detail two techniques that are used to increase the power of model checking using the model checker SPIN. The first of these is the use of embedded C code within Promela specifications, in order to accurately re ect robot movement. The second is to use abstraction together with a simulation relation to allow us to verify multiple environments simultaneously. We apply these techniques to a fairly simple system in which a robot moves about a fixed circular environment and learns to avoid obstacles. The learning algorithm is inspired by the way that insects learn to avoid obstacles in response to pain signals received from their antennae. Crucially, we prove that our abstraction is sound for our example system { a step that is often omitted but is vital if formal verification is to be widely accepted as a useful and meaningful approach