Novel heuristic and metaheuristic approaches to the automated scheduling of healthcare personnel

This thesis is concerned with automated personnel scheduling in healthcare organisations; in particular, nurse rostering. Over the past forty years the nurse rostering problem has received a large amount of research. This can be mostly attributed to its practical applications and the scientific challenges of solving such a complex problem. The benefits of automating the rostering process include reducing the planner’s workload and associated costs and being able to create higher quality and more flexible schedules. This has become more important recently in order to retain nurses and attract more people into the profession. Better quality rosters also reduce fatigue and stress due to overwork and poor scheduling and help to maximise the use of leisure time by satisfying more requests. A more contented workforce will lead to higher productivity, increased quality of patient service and a better level of healthcare. Basically stated, the nurse rostering problem requires the assignment of shifts to personnel to ensure that sufficient employees are present to perform the duties required. There are usually a number of constraints such as working regulations and legal requirements and a number of objectives such as maximising the nurses working preferences. When formulated mathematically this problem can be shown to belong to a class of problems which are considered intractable. The work presented in this thesis expands upon the research that has already been conducted to try and provide higher quality solutions to these challenging problems in shorter computation times. The thesis is broadly structured into three sections. 1) An investigation into a nurse rostering problem provided by an industrial collaborator. 2) A framework to aid research in nurse rostering. 3) The development of a number of advanced algorithms for solving highly complex, real world problems

A metaheuristics approach to the nurse rostering problem

Health care providers are affected by problems of personnel costs. Usually, the generation of rosters is a hand-made and time-consuming task and does not always comply with the legislation and the internal rules. The article presents an approach to roster generation for nursing technicians according to legal and internal restrictions and in a satisfactory period of time. It is also designed to give employees a higher level of satisfaction concerning their day off preferences and a fair distribution of unpopular shifts.The article’s proposal is to develop a hybrid system formed by a Tabu Search metaheuristic combined with a genetic algorithm. Experiments were carried out with artificial test cases based on real data. The results obtained were satisfactory, showing the feasibility of the solution in all tests performed.Key words: rostering problem, tabu search, genetic algorithm, hybrid systems

An Integrated Framework for Staffing and Shift Scheduling in Hospitals

Over the years, one of the main concerns confronting hospital management is optimising the staffing and scheduling decisions. Consequences of inappropriate staffing can adversely impact on hospital performance, patient experience and staff satisfaction alike. A comprehensive review of literature (more than 1300 journal articles) is presented in a new taxonomy of three dimensions; problem contextualisation, solution approach, evaluation perspective and uncertainty. Utilising Operations Research methods, solutions can provide a positive contribution in underpinning staffing and scheduling decisions. However, there are still opportunities to integrate decision levels; incorporate practitioners view in solution architectures; consider staff behaviour impact, and offer comprehensive applied frameworks. Practitioners’ perspectives have been collated using an extensive exploratory study in Irish hospitals. A preliminary questionnaire has indicated the need of effective staffing and scheduling decisions before semi-structured interviews have taken place with twenty-five managers (fourteen Directors and eleven head nurses) across eleven major acute Irish hospitals (about 50% of healthcare service deliverers). Thematic analysis has produced five key themes; demand for care, staffing and scheduling issues, organisational aspects, management concern, and technology-enabled. In addition to other factors that can contribute to the problem such as coordination, environment complexity, understaffing, variability and lack of decision support. A multi-method approach including data analytics, modelling and simulation, machine learning, and optimisation has been employed in order to deliver adequate staffing and shift scheduling framework. A comprehensive portfolio of critical factors regarding patients, staff and hospitals are included in the decision. The framework was piloted in the Emergency Department of one of the leading and busiest university hospitals in Dublin (Tallaght Hospital). Solutions resulted from the framework (i.e. new shifts, staff workload balance, increased demands) have showed significant improvement in all key performance measures (e.g. patient waiting time, staff utilisation). Management team of the hospital endorsed the solution framework and are currently discussing enablers to implement the recommendation

Novel heuristic and metaheuristic approaches to the automated scheduling of healthcare personnel

This thesis is concerned with automated personnel scheduling in healthcare organisations; in particular, nurse rostering. Over the past forty years the nurse rostering problem has received a large amount of research. This can be mostly attributed to its practical applications and the scientific challenges of solving such a complex problem. The benefits of automating the rostering process include reducing the planner’s workload and associated costs and being able to create higher quality and more flexible schedules. This has become more important recently in order to retain nurses and attract more people into the profession. Better quality rosters also reduce fatigue and stress due to overwork and poor scheduling and help to maximise the use of leisure time by satisfying more requests. A more contented workforce will lead to higher productivity, increased quality of patient service and a better level of healthcare. Basically stated, the nurse rostering problem requires the assignment of shifts to personnel to ensure that sufficient employees are present to perform the duties required. There are usually a number of constraints such as working regulations and legal requirements and a number of objectives such as maximising the nurses working preferences. When formulated mathematically this problem can be shown to belong to a class of problems which are considered intractable. The work presented in this thesis expands upon the research that has already been conducted to try and provide higher quality solutions to these challenging problems in shorter computation times. The thesis is broadly structured into three sections. 1) An investigation into a nurse rostering problem provided by an industrial collaborator. 2) A framework to aid research in nurse rostering. 3) The development of a number of advanced algorithms for solving highly complex, real world problems

Designing the Liver Allocation Hierarchy: Incorporating Equity and Uncertainty

Liver transplantation is the only available therapy for any acute or chronic condition resulting in irreversible liver dysfunction. The liver allocation system in the U.S. is administered by the United Network for Organ Sharing (UNOS), a scientific and educational nonprofit organization. The main components of the organ procurement and transplant network are Organ Procurement Organizations (OPOs), which are collections of transplant centers responsible for maintaining local waiting lists, harvesting donated organs and carrying out transplants. Currently in the U.S., OPOs are grouped into 11 regions to facilitate organ allocation, and a three-tier mechanism is utilized that aims to reduce organ preservation time and transport distance to maintain organ quality, while giving sicker patients higher priority. Livers are scarce and perishable resources that rapidly lose viability, which makes their transport distance a crucial factor in transplant outcomes. When a liver becomes available, it is matched with patients on the waiting list according to a complex mechanism that gives priority to patients within the harvesting OPO and region. Transplants at the regional level accounted for more than 50% of all transplants since 2000.This dissertation focuses on the design of regions for liver allocation hierarchy, and includes optimization models that incorporate geographic equity as well as uncertainty throughout the analysis. We employ multi-objective optimization algorithms that involve solving parametric integer programs to balance two possibly conflicting objectives in the system: maximizing efficiency, as measured by the number of viability adjusted transplants, and maximizing geographic equity, as measured by the minimum rate of organ flow into individual OPOs from outside of their own local area. Our results show that efficiency improvements of up to 6% or equity gains of about 70% can be achieved when compared to the current performance of the system by redesigning the regional configuration for the national liver allocation hierarchy.We also introduce a stochastic programming framework to capture the uncertainty of the system by considering scenarios that correspond to different snapshots of the national waiting list and maximize the expected benefit from liver transplants under this stochastic view of the system. We explore many algorithmic and computational strategies including sampling methods, column generation strategies, branching and integer-solution generation procedures, to aid the solution process of the resulting large-scale integer programs. We also explore an OPO-based extension to our two-stage stochastic programming framework that lends itself to more extensive computational testing. The regional configurations obtained using these models are estimated to increase expected life-time gained per transplant operation by up to 7% when compared to the current system.This dissertation also focuses on the general question of designing efficient algorithms that combine column and cut generation to solve large-scale two-stage stochastic linear programs. We introduce a flexible method to combine column generation and the L-shaped method for two-stage stochastic linear programming. We explore the performance of various algorithm designs that employ stabilization subroutines for strengthening both column and cut generation to effectively avoid degeneracy. We study two-stage stochastic versions of the cutting stock and multi-commodity network flow problems to analyze the performances of algorithms in this context

Learning Dynamic Priority Scheduling Policies with Graph Attention Networks

The aim of this thesis is to develop novel graph attention network-based models to automatically learn scheduling policies for effectively solving resource optimization problems, covering both deterministic and stochastic environments. The policy learning methods utilize both imitation learning, when expert demonstrations are accessible at low cost, and reinforcement learning, when otherwise reward engineering is feasible. By parameterizing the learner with graph attention networks, the framework is computationally efficient and results in scalable resource optimization schedulers that adapt to various problem structures. This thesis addresses the problem of multi-robot task allocation (MRTA) under temporospatial constraints. Initially, robots with deterministic and homogeneous task performance are considered with the development of the RoboGNN scheduler. Then, I develop ScheduleNet, a novel heterogeneous graph attention network model, to efficiently reason about coordinating teams of heterogeneous robots. Next, I address problems under the more challenging stochastic setting in two parts. Part 1) Scheduling with stochastic and dynamic task completion times. The MRTA problem is extended by introducing human coworkers with dynamic learning curves and stochastic task execution. HybridNet, a hybrid network structure, has been developed that utilizes a heterogeneous graph-based encoder and a recurrent schedule propagator, to carry out fast schedule generation in multi-round settings. Part 2) Scheduling with stochastic and dynamic task arrival and completion times. With an application in failure-predictive plane maintenance, I develop a heterogeneous graph-based policy optimization (HetGPO) approach to enable learning robust scheduling policies in highly stochastic environments. Through extensive experiments, the proposed framework has been shown to outperform prior state-of-the-art algorithms in different applications. My research contributes several key innovations regarding designing graph-based learning algorithms in operations research.Ph.D

The New Hampshire, Vol. 75, No. 15 (Oct. 26, 1984)

The student publication of the University of New Hampshire

Phoenix 1993

https://commons.erau.edu/phoenix-yearbooks/1028/thumbnail.jp