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Flexible hospital-wide elective patient scheduling

Gartner, Daniel and Padman, Rema 2019. Flexible hospital-wide elective patient scheduling. Journal of the Operational Research Society 10.1080/01605682.2019.1590509
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Abstract

In this paper, we build on and extend Gartner and Kolisch (2014)’s hospital-wide patient scheduling problem. Their contribution margin maximizing model decides on the patients' discharge date and therefore the length of stay. Decisions such as the allocation of scarce hospital resources along the clinical pathways are taken. Our extensions which are modeled as a mathematical program include admission decisions and flexible patient-to-specialty assignments to account for multi-morbid patients. Another flexibility extension is that one out of multiple surgical teams can be assigned to each patient. Furthermore, we consider overtime availability of human resources such as residents and nurses. Finally, we include these extensions in the rolling-horizon approach and account for lognormal distributed recovery times and remaining resource capacity for elective patients. Our computational study on real-world instances reveals that, if overtime flexibility is allowed, up to 5% increase in contribution margin can be achieved by reducing length of stay by up to 30%. At the same time, allowing for overtime can reduce waiting times by up to 33%. Our model can be applied in and generalized towards other patient scheduling problems, for example in cancer care where patients may follow defined cancer pathways.

Item Type: Article
Date Type: Publication
Status: In Press
Schools: Mathematics
Subjects: R Medicine > R Medicine (General)
Publisher: Palgrave Macmillan / Taylor & Francis
ISSN: 0160-5682
Date of First Compliant Deposit: 4 March 2019
Date of Acceptance: 1 March 2019
Last Modified: 20 Oct 2019 18:27
URI: http://orca.cf.ac.uk/id/eprint/120111

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