Decentralized and Dynamic Home Health Care Resource Scheduling Using an Agent-Based Model

The purpose of this thesis is to design an agent-based scheduling system, simulated in a dynamic environment that will reduce home healthcare service costs. The study focuses on situations where a health care agency needs to assign home visits among a group of independent healthcare practitioners. Each practitioner has different skill sets, time constraints, and cost structures, given the nature, time and location of each home visit. Each expects reasonable payment commensurate with their skill levels as well as the costs incurred. The healthcare agency in turn needs all planned visits performed by qualified practitioners while minimizing overall service costs. Decisions about scheduling are made both before and during the scheduling period, requiring the health care agency to respond to unexpected situations based on the latest scheduling information. This problem is examined in a multi-agent system environment where practitioners are modeled as self-interested agents. The study first analyzes the problem for insights into the combinatorial nature of such a problem occurring in a centralized environment, then discusses the decentralized and dynamic challenges. An iterated bidding mechanism is designed as the negotiation protocol for the system. The effectiveness of this system is evaluated through a computational study, with results showing the proposed multi-agent scheduling system is able to compute high quality schedules in the decentralized home healthcare environment. Following this, the system is also implemented in a simulation model that can accommodate unexpected situations. We presents different simulation scenarios which illustrate the process of how the system dynamically schedules incoming visits, and cost reduction can be observed from the results

Dynamically accepting and scheduling patients for home healthcare

Importance of home healthcare is growing rapidly since populations of developed and even developing countries are getting older quickly and the number of hospitals, retirement homes, and medical staff do not increase at the same rate. We present Scenario Based Approach (SBA) for the Home Healthcare Nurse Scheduling Problem. In this problem, arrivals of patients are dynamic and acceptance and appointment time decisions have to be made as soon as patients arrive. The primary objective is to maximise the average number of daily visits. For the sake of service continuity, patients have to be visited at the same days and times each week during their service horizon. SBA is basically a simulation procedure based on generating several scenarios and scheduling new customers with a simple but fast heuristic. Then results are analysed to decide whether to accept the new patient and at which appointment day/time. First, two different versions of SBA, Daily and Weekly SBA are developed and analysed for a single nurse. We compare Daily SBA to two greedy heuristics from the literature, distance and capacity based, and computational studies show that Daily SBA makes significant improvements compared to these other two methods for a single nurse. Next, we extend SBA for a multi-nurse case. SBA is compared to a greedy heuristic under different conditions such as same depot case where nurses start their visits from and return to same place, clustered service area, and nurses with different qualification level. SBA gives superior results under all experiment conditions compared to the greedy heuristic

Operator Assignment and Routing Problems in Home Health Care Services

Human resource planning in Home Health Care (HHC) services is a critical activity on which the quality of the delivered care depends. From the admission of the patient, the service organization has to decide the home operators who will follow the patients during their stay as well as the detailed care delivery plan. The robust resource planning is crucial for operations in the HHC structure, to avoid process inefficiencies, treatment delays and low quality of service. Many of HHC providers pursue the objective of continuity of care which is maintaining the same (principal) operator throughout the time the patient stays in the system. This paper proposes a two–stage approach for assignment and routing decisions in HHC organizations. The main goal is to analyze the interaction between the assignment and routing processes in a single district. All the proposed cases are applied on a instance generated from real data obtained by an Italian HHC provider

Operator assignment and routing problems in home health care services

Human resource planning in Home Health Care (HHC) services is a critical activity on which the quality of the delivered care depends. From the admission of the patient, the service organization has to decide the home operators who will follow the patients during their stay as well as the detailed care delivery plan. The robust resource planning is crucial for operations in the HHC structure, to avoid process inefficiencies, treatment delays and low quality of service. Many of HHC providers pursue the objective of continuity of care which is maintaining the same (principal) operator throughout the time the patient stays in the system. This paper proposes a two–stage approach for assignment and routing decisions in HHC organizations. The main goal is to analyze the interaction between the assignment and routing processes in a single district. All the proposed cases are applied on a instance generated from real data obtained by an Italian HHC provider