Optimal schedule of home care visits for a health care center

The provision of home health care services is becoming an important research area, mainly because in Portugal the population is ageing. Home care visits are organized taking into account the medical treatments and general support that elder/sick people need at home. This health service can be provided by nurse teams from Health Care Centers. Usually, the visits are manually planned and without computer support. The main goal of this work is to carry out the automatic schedule of home care visits, of one Portuguese Health Care Center, in order to minimize the time spent in all home care visits and, consequently, reduce the costs involved. The developed algorithms were coded in MatLab Software and the problem was efficiently solved, obtaining several schedule solutions of home care visits for the presented data. Solutions found by genetic and particle swarm algorithms lead to significant time reductions for both nurse teams and patients.This work has been supported by COMPETE: POCI-01-0145- FEDER-007043 and FCT - Fundru;ao para a Ciencia e Tecnologia within the Project Scope: UID/CEC/00319/2013.info:eu-repo/semantics/publishedVersio

A descriptive retrospective study of time consumption in home care services: how do employees use their working time?

BACKGROUND: Home care services in Norway are provided for free, and municipalities are responsible for their provision to all those in need of them, in accordance with the Act on Municipal Health and Care Services. The costs of home care services are increasing. Many municipalities are now working to find the best cost-effective solutions to ensure that home care services are of sufficient quality but still affordable. This paper describes how nurses and health workers spend their working time, with a hypothesis that driving time and time required to document details of the care given are underestimated in weekly planning schedules. METHODS: This article sets out a descriptive retrospective study of day-schedules and driving routes for staff working in home care services. Data were analyzed using GIS. RESULTS: The driving time was between 18% and 26% of working time in municipality A, and between 21% and 23% in municipality B. Visiting time varied between 44% and 62% in municipality A, and 40% and 56% in municipality B. Other tasks, including the legally-required documentation of the care given, varied between 19% and 32% in municipality A and 21% and 38% in municipality B. Overall, 22% of the driving routes in municipality A, and 14% in municipality B, took more time than expected. In municipality A, 22% of the day-schedules underestimated overtime; this figure was 14% in municipality B. CONCLUSIONS: In home care services, time taken for driving and to write statutory documentation seems to have been underestimated. Better planning and organization of driving routes would reduce driving time and allow more time for other necessary work

Gestión logística de sistemas de hospitalización domiciliaria: una revisión crítica de modelos y métodos

RESUMEN: Los servicios de Hospitalización Domiciliaria (HD) se basan en una red de distribución, en la cual los pacientes son hospitalizados en sus casas y los prestadores de servicios de salud deben entregar cuidados médicos coordinados a los pacientes. La demanda de estos servicios está creciendo rápidamente y los gobiernos y proveedores de servicios de salud enfrentan el reto de tomar un conjunto de decisiones complejas en un sector con un componente logístico importante. En este artículo se presenta una revisión crítica de los modelos y métodos utilizados para darle soporte a las decisiones logísticas en HD. Para esto se presenta primero un marco de referencia, con el objetivo de identificar las oportunidades de investigación en el campo. Con base en dicho marco, se presenta la revisión de la literatura y la identificación de brechas en la investigación. En particular, se hace énfasis en la necesidad de desarrollar e implementar metodologías más integradas para dar soporte a las decisiones estratégicas y tácticas y de considerar puntos clave de los sistemas reales.ABSTRACT: Home Health Care (HHC) services are based on a delivery network in which patients are hospitalized at their homes and health care providers must deliver coordinated medical care to patients. Demand for HHC services is rapidly growing and governments and health care providers face the challenge to make a set of complex decisions in a medical service business that has an important component of logistics problems. The objective of this paper is to provide a critical review of models and methods used to support logistics decisions in HHC. For this purpose, a reference framework is proposed first in order to identify research perspectives in the field. Based on this framework, a literature review is presented and research gaps are identified. In particular, the literature review reveals that more emphasizes is needed to develop and implement more integrated methodologies to support decisions at tactical and strategic planning levels and to consider key features from real systems

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

The sustainable home health care process based on multi-criteria decision-dupport

The increase in life expectancy has led to a growing demand for Home Health Care (HHC) services. However, some problems can arise in the management of these services, leading to high computational complexity and time-consuming to obtain an exact and/or optimal solution. This study intends to contribute to an automatic multi-criteria decision-support system that allows the optimization of several objective functions simultaneously, which are often conflicting, such as costs related to travel (distance and/or time) and available resources (health professionals and vehicles) to visit the patients. In this work, the HHC scheduling and routing problem is formulated as a multi objective approach, aiming to minimize the travel distance, the travel time and the number of vehicles, taking into account specific constraints, such as the needs of patients, allocation variables, the health professionals and the transport availability. Thus, the multi-objective genetic algorithm, based on the NSGA-II, is applied to a real-world problem of HHC visits from a Health Unit in Bragança (Portugal), to identify and examine the different compromises between the objectives using a Pareto-based approach to operational planning. Moreover, this work provides several efficient end-user solutions, which were standardized and evaluated in terms of the proposed policy and compared with current practice. The outcomes demonstrate the significance of a multi-criteria approach to HHC services.The authors are grateful to the Foundation for Science and Technology (FCT, Portugal) for financial support through national funds FCT/MCTES (PIDDAC) to CeDRI (UIDB/05757/2020 and UIDP/05757/2020), SusTEC (LA/P/0007/2021) and ALGORITMI Research Centre / LASI (UIDB/00319/2020). Filipe Alves thanks the FCT for supporting its research with the Ph.D. grant SFRH/BD/143745/2019.info:eu-repo/semantics/publishedVersio

Modelling home care organisations from an operations management perspective

Home Care (HC) service consists of providing care to patients in their homes. During the last decade, the HC service industry experienced significant growth in many European countries. This growth stems from several factors, such as governmental pressure to reduce healthcare costs, demographic changes related to population ageing, social changes, an increase in the number of patients that suffer from chronic illnesses, and the development of new home-based services and technologies. This study proposes a framework that will enable HC service providers to better understand HC operations and their management. The study identifies the main processes and decisions that relate to the field of HC operations management. Hence, an IDEF0 (Integrated Definition for Function Modelling) activity-based model describes the most relevant clinical, logistical and organisational processes associated with HC operations. A hierarchical framework for operations management decisions is also proposed. This analysis is derived from data that was collected by nine HC service providers, which are located in France and Italy, and focuses on the manner in which operations are run, as well as associated constraints, inputs and outputs. The most challenging research areas in the field of HC operations management are also discussed

Modelling and (re-)planning periodic home social care services with loyalty and non-loyalty features

This work was partially supported by the Fundacao para a Ciencia e a Tecnologia (Portuguese Foundation for Science and Technology) through the project UID/MAT/00297/2019 (Centro de Matematica e Aplicacees).The aging population alongside little availability of informal care are two of the several factors leading to an increased need for assisted living support. In this work, we tackle a home social care service problem, motivated by two real case studies where a new loyalty scheme must be considered: within a week, patient-caregiver loyalty should be pursued but, between weeks, the caregivers must rotate among patients (non-loyalty). In addition, a common situation in this kind of service is also addressed: the need of a constant re-planning caused by the leaving of patients and the arrival of new ones. This new plan should be such that minimum disturbance is caused to the visiting hours of current patients, the caregivers’ travelling time between visits is minimized, and the workload is balanced among caregivers. A multi-objective optimization approach based on mixed-integer models is developed. Results on the two real case studies show that both institutions can efficiently re-plan their activities without much disturbance on the visits of their patients, and with a patient-caregiver loyalty scheme suiting their needs.authorsversionpublishe

Home care routing and scheduling problem with teams’ synchronization

Funding Information: This work is funded by Portuguese funds through the FCT - Fundação para a Ciência e a Tecnologia , I.P., under the scope of the projects UIDB/00297/2020 (Center for Mathematics and Applications), UIDB/00097/2020 (CEGIST), and the PhD scholarship grant SFRH/BD/148773/2019 . Publisher Copyright: © 2023 The AuthorsThe demand for home care (HC) services has steadily been growing for two main types of services: healthcare and social care. If, for the former, caregivers' skills are of utter importance, in the latter caregivers are not distinguishable in terms of skills. This work focuses social care and models caregivers' synchronization as a means of improving human resources management. Moreover, in social care services, several visits need to be performed in the same day since patients are frequently alone and need assistance throughout the day. Depending on the patient's autonomy, some tasks have to be performed by two caregivers (e.g. assist bedridden patients). Therefore, adequate decision support tools are crucial for assisting managers (often social workers) when designing operational plans and to efficiently assign caregivers to tasks. This paper advances the literature by 1) considering teams of one caregiver that can synchronize to perform tasks requiring two caregivers (instead of having teams of two caregivers), 2) simultaneously modelling daily continuity of care and teams' synchronization, and 3) associating dynamic time windows to teams' synchronizations introducing scheduling flexibility while minimize service and travel times. These concepts are embedded into a daily routing and scheduling MIP model, deciding on the number of caregivers and on the number and type of teams to serve all patient tasks. The main HC features of the problem, synchronization and continuity of care, are evaluated by comparing the proposed planning with the current situation of a home social care service provider in Portugal. The results show that synchronization is the feature that most increases efficiency with respect to the current situation. It evidences a surplus in working time capacity by proposing plans where all requests can be served with a smaller number of caregivers. Consequently, new patients from long waiting lists can now be served by the “available” caregivers.publishersversionpublishe