Solution methods for the tray optimization problem

In order to perform medical surgeries, hospitals keep large inventories of surgical in- struments. These instruments need to be sterilized before each surgery. Typically the instruments are kept in trays. Multiple trays may be required for a single surgery, while a single tray may contain instruments that are required for multiple surgical procedures. The tray optimization problem (TOP) consists of three main decisions: (i) the assignment of instruments to trays, (ii) the assignment of trays to surgeries, and (iii) the number of trays to keep in inventory. The TOP decisions have to be made such that total operating costs are minimized and such that for every surgery sufficient instruments are available. This paper presents and evaluates several exact and heuristic solution methods for the TOP. We compare solution methods on computation time and solution quality. Moreover, we conduct simulations to evaluate the performance of the solutions in the long run. The novel methods that are provided are the first methods that are capable of solving instances of realistic size. The most promising method consists of a highly scalable advanced greedy algorithm. Our results indicate that the outcomes of this method are, on average, very close to the outcomes of the other methods investigated, while it may be easily applied by (large) hospitals. The findings are robust with respect to fluctuations in long term OR schedules

Scheduling non-urgent patient transportation while maximizing emergency coverage

Many ambulance providers operate both advanced life support (ALS) and basic life support (BLS) ambulances. Typically, only an ALS ambulance can respond to an emergency call, whereas non-urgent patient transportation requests can be served by either an ALS or a BLS ambulance. The total capacity of BLS ambulances is usually not enough to fulfill all non-urgent transportation requests. The remaining transportation requests then have to be performed by ALS ambulances, which reduces the coverage for emergency calls. We present a model that determines the routes for BLS ambulances while maximizing the remaining coverage by ALS ambulances. Different from the classical dial-a-ride problem, only one patient can be transported at a time, and not all requests are known in advance. Throughout the day, new requests arrive, and we present an online model to deal with these requests

Scheduling non-urgent patient transportation while maximizing emergency coverage

Many ambulance providers operate both advanced life support (ALS) and basic life support (BLS) ambulances. Typically, only an ALS ambulance can respond to an emergency call, whereas non-urgent patient transportation requests can either be served by an ALS or a BLS ambulance. The total capacity of BLS ambulances is usually not enough to fulfill all non-urgent transportation requests. The remaining transportation requests then have to be performed by ALS ambulances, which reduces the coverage for emergency calls. We present a model that determines the routes for BLS ambulances while maximizing the remaining coverage by ALS ambulances. Different from the classical Dial-A-Ride Problem, only one patient can be transported at a time and not all request are known in advance. Throughout the day, new requests arrive and we present an online model to deal with these requests

Comparing population and incident data for optimal air ambulance base locations in Norway

Background: Helicopter emergency medical services are important in many health care systems. Norway has a nationwide physician manned air ambulance service servicing a country with large geographical variations in population density and incident frequencies. The aim of the study was to compare optimal air ambulance base locations using both population and incident data. Methods: We used municipality population and incident data for Norway from 2015. The 428 municipalities had a median (5-95 percentile) of 4675 (940-36,264) inhabitants and 10 (2-38) incidents. Optimal helicopter base locations were estimated using the Maximal Covering Location Problem (MCLP) optimization model, exploring the number and location of bases needed to cover various fractions of the population for time thresholds 30 and 45 min, in green field scenarios and conditioned on the existing base structure. Results: The existing bases covered 96.90% of the population and 91.86% of the incidents for time threshold 45 min. Correlation between municipality population and incident frequencies was -0.0027, and optimal base locations varied markedly between the two data types, particularly when lowering the target time. The optimal solution using population density data put focus on the greater Oslo area, where one third of Norwegians live, while using incident data put focus on low population high incident areas, such as northern Norway and winter sport resorts. Conclusion: Using population density data as a proxy for incident frequency is not recommended, as the two data types lead to different optimal base locations. Lowering the target time increases the sensitivity to choice of data

Comparison of static ambulance location models

Over the years, several ambulance location models have been discussed in the literature. Most of these models have been further developed to take more complicated situations into account. However, the existing standard models have never been compared computationally according to the criteria used in practice. In this paper, we compare several ambulance location models on coverage and response time criteria. In addition to four standard ambulance location models from the literature, we also present two models that focus on average and expected response times. The computational results show that the Maximum Expected Covering Location Problem (MEXCLP) and the Expected Response Time Model (ERTM) perform the best over all considered criteria. However, as the computation times for ERTM are long, we advice to use the MEXCLP except when response times are more important than coverage