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2012 | Buch

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Handbook of Healthcare System Scheduling

herausgegeben von: Randolph Hall

Verlag: Springer US

Buchreihe : International Series in Operations Research & Management Science

Enthalten in: Springer Professional "Wirtschaft+Technik" , Springer Professional "Wirtschaft"

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Über dieses Buch

This edited volume captures and communicates the best thinking on how to improve healthcare by improving the delivery of services -- providing care when and where it is needed most -- through application of state-of-the-art scheduling systems. Over 12 chapters, the authors cover aspects of setting appointments, allocating healthcare resources, and planning to ensure that capacity matches needs for care.

A central theme of the book is increasing healthcare efficiency so that both the cost of care is reduced and more patients have access to care. This can be accomplished through reduction of idle time, lessening the time needed to provide services and matching resources to the needs where they can have the greatest possible impact on health. Within their chapters, authors address:

(1) Use of scheduling to improve healthcare efficiency.

(2) Objectives, constraints and mathematical formulations.

(3) Key methods and techniques for creating schedules.

(4) Recent developments that improve the available problem solving methods.

(5) Actual applications, demonstrating how the methods can be used.

(6) Future directions in which the field of research is heading.

Collectively, the chapters provide a comprehensive state-of-the-art review of models and methods for scheduling the delivery of patient care for all parts of the healthcare system.

Chapter topics include setting appointments for ambulatory care and outpatient procedures, surgical scheduling, nurse scheduling, bed management and allocation, medical supply logistics and routing and scheduling for home healthcare.

Inhaltsverzeichnis

Frontmatter

Chapter 1. Matching Healthcare Resources to Patient Needs

Abstract

Healthcare scheduling entails matching health care resources (providers, rooms, equipment, supplies, organs, devices and instruments) to patient needs, when and where they need them. Effective scheduling reduces waste, reduces patient waiting and improves health outcomes. Scheduling methods rely on operations research techniques, including forecasting, mathematical modeling and optimization, queue models and stochastic processes. These techniques are used in many ways, including setting appointments, scheduling staff, planning surgeries and managing the flow of patients through health care systems.

Randolph Hall

Chapter 2. Capacity Planning

Abstract

In this chapter, we discuss some of the modeling methods available for use by health care organizations in determining the level of resources to make available for the delivery of a service or a set of services. We focus mainly on the insights available from different forms of queuing model but discuss also the role of simulation modeling. We then outline the challenges faced in populating capacity planning models with appropriate parameter estimates before closing with some remarks on the non-technical, cultural barriers to effective capacity planning.

Martin Utley, Dave Worthington

Chapter 3. Nurse Scheduling

Abstract

The cost of health care is increasing dramatically every year in the United States. For instance, according to the Towers Perrin healthcare survey, healthcare costs increased an average of 6% in 2008 compared to 2007 (Perrin 2008). Cost of developing new technologies and treatments, rising personnel income, America’s aging population, and a relatively increased demand for health care are some of the reasons for this rapid growth. The Centers for Medicare and Medicaid Services estimated that by 2018, the cost of health care will be more than 4.3 trillion dollars, which is 20.3% of the total GDP (Foundation 2009).

Gino J. Lim, Arezou Mobasher, Laleh Kardar, Murray J. Cote

Chapter 4. Patient Appointments in Ambulatory Care

Abstract

Outpatient appointment system design is a complex problem because it involves multiple stakeholders, sequential booking process, random arrivals, no-shows, varying degrees of urgency of different patients’ needs, service time variability, and patient and provider preferences. Clinics use a two-step process to manage appointments. In the first step, which we refer to as the clinic profile setup problem, service providers’ daily clinic time is divided into appointment slots. In the second step, which we refer to as the appointment booking problem, physicians’ offices decide which available slots to book for each incoming request for an appointment. In this chapter, we present formulations of mathematical models of key problems in the area of appointment system design. We also discuss the challenges and complexities of solving such problems. In addition, summaries of prior research, particularly advanced models related to the examples shown in this chapter are also presented.

Diwakar Gupta, Wen-Ya Wang

Chapter 5. Operating Theatre Planning and Scheduling

Abstract

In this chapter we present a number of approaches to operating theatre planning and scheduling. We organize these approaches hierarchically, which serves to illustrate the breadth of problems confronted by researchers. At each hierarchical planning level we describe common problems, solution approaches and results from studies at partner hospitals.

Erwin W. Hans, Peter T. Vanberkel

Chapter 6. Appointment Planning and Scheduling in Outpatient Procedure Centers

Abstract

This chapter provides a summary of the planning and scheduling decisions for outpatient procedure centers. A summary and background of outpatient procedure centers and their operations is provided along with the challenges faced by managers. Planning and scheduling decisions are discussed and categorized as either long-or short-term decisions. Examples and results are drawn from the literature along with important factors that influence planning and scheduling decisions. A summary of open challenges for the operations research community is presented.

Bjorn Berg, Brian T. Denton

Chapter 7. Human and Artificial Scheduling System for Operating Rooms

Abstract

Operating theatres experience dynamic situations that result from unanticipated developments in scheduled cases, arrival of emergency cases and the scheduling decisions made during the day by the operating room coordinator (ORC). The task of the ORC is to ensure that operating rooms (ORs) finish on time and that all scheduled cases as well as the emergency cases are completed. At the end of each day, however, ORs may finish too early or too late because cases have experienced delays or been canceled. Delays or cancelations add to the patient’s inherent anxiety associated with surgery and engenders anger and frustration. They have been shown to be an important determinant of patient dissatisfaction across the continuum of preoperative-operative-postoperative care. Recent research (Stepaniak et al. (2009) Anesth Analg 108:1249–1256) addresses how the risk attitude of an ORC affects the quality of the scheduling decision making. In this chapter you will learn about the interaction between the personality of both a human and an artificial OR scheduler, learn about the effects on the decision the OR scheduler makes and the quality of the resulting OR schedule. Therefore, we formalize risk attitudes in heuristics developed to solve the real-time scheduling problems ORCs face during the day.

P. S. Stepaniak, R. A. C. van der Velden, J. van de Klundert, A. P. M. Wagelmans

Chapter 8. Bed Assignment and Bed Management

Abstract

Beds are a critical resource for serving patients in hospitals, but also provide a place where patients queue for needed care. Bed requirements result from medical needs along with the hospital’s effectiveness at reducing average length of stay and hospitalization rates. Hospitals can reduce the need for beds by reducing the unproductive portion of the patient’s stay (e.g., waiting for a test) and by reducing the portion of time when beds are unoccupied. Hospitals must also synchronize discharges with admissions to minimize time of day and day of week variations in bed occupancy levels. Finally, beds must be managed as part of the overall hospital system so that shortages do not cause delays or cancellations in the emergency department or surgery.

Randolph Hall

Chapter 9. Queuing Networks in Health Care Systems

Abstract

Over the last decades, the concept of patient flow has received an increased amount of attention. Health care professionals have become aware that in order to analyze the performance of a single health care facility, its relationship with other health care facilities should also be taken into account. A natural choice for analysis of networks of health care facilities is queuing theory. With a queuing network a fast and flexible analysis is provided that discovers bottlenecks and allows for the evaluation of alternative set-ups of the network. In this chapter we describe how queuing theory, and networks of queues in particular, can be invoked to model, study, analyze, and solve health care problems. We describe important theoretical queuing results, give a review of the literature on the topic, discuss in detail two examples of how a health care problem is analyzed using a queuing network, and suggest directions for future research.

Maartje E. Zonderland, Richard J. Boucherie

Chapter 10. Medical Supply Logistics

Abstract

This chapter focuses on medical supply logistics from the perspective of materials management and technology. It covers the structure of the medical supply chain and illustrates many of the issues that make the management of medical supply chains unique, complex, and challenging. Then, a review of inventory management practices and current research for medical supplies is provided. As an example, the management of blood supply is illustrated. Finally, key technological enablers such as electronic data exchange, automatic data capture technologies, and their importance within medical logistics are discussed. Future areas for research are suggested.

Manuel D. Rossetti, Nebil Buyurgan, Edward Pohl

Chapter 11. Operations Research Applications in Home Healthcare

Abstract

The home health care industry is an important component of health care systems that have the potential to lower the system-wide costs of delivering care, and free capacity in overcrowded acute care settings such as hospitals. Demand is doubling, but resources are scarce. A nursing shortage and near-zero profit margins hinder the ability of home care agencies to meet the increasing patient demand. The effective utilization of resources is vital to the continued availability of home care services. There is tremendous opportunity for the operations research community to address the challenges faced by home care agencies to improve their ability to meet as much patient demand as possible. This chapter describes tactical and operational planning problems arising in home health care, and discusses alternative configurations of home health supply chains. Formulations for home health nurse districting, home health nurse routing and scheduling, and home health supply chain problems are presented, and the relevant literature is reviewed. Recent developments in remote monitoring technologies that could change the home health care landscape are discussed, and future research directions are proposed.

Ashlea Bennett Milburn

Chapter 12. A Framework for Healthcare Planning and Control

Abstract

Rising expenditures spur health care organizations to organize their processes more efficiently and effectively. Unfortunately, health care planning and control lags behind manufacturing planning and control. We analyze the existing planning and control concepts or frameworks for health care operations management and find that they do not address various important planning and control problems. We conclude that they only focus on hospitals and are too narrow, focusing on a single managerial area, such as resource capacity planning, or ignoring hierarchical levels. We propose a modern framework for health care planning and control that integrates all managerial areas in health care delivery operations and all hierarchical levels of control, to ensure completeness and coherence of responsibilities for every managerial area. The framework can be used to structure the various planning and control functions and their interaction. It is applicable to an individual department, an entire health care organization, and to a complete supply chain of cure and care providers. The framework can be used to identify and position various types of managerial problems, to demarcate the scope of organization interventions and to facilitate a dialogue between clinical staff and managers.

Erwin W. Hans, Mark van Houdenhoven, Peter J. H. Hulshof

Backmatter

Titel: Handbook of Healthcare System Scheduling
herausgegeben von: Randolph Hall
Verlag: Springer US
Electronic ISBN: 978-1-4614-1734-7
Print ISBN: 978-1-4614-1733-0
DOI: https://doi.org/10.1007/978-1-4614-1734-7

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Über dieses Buch

Inhaltsverzeichnis

Frontmatter

Chapter 1. Matching Healthcare Resources to Patient Needs

Chapter 2. Capacity Planning

Chapter 3. Nurse Scheduling

Chapter 4. Patient Appointments in Ambulatory Care

Chapter 5. Operating Theatre Planning and Scheduling

Chapter 6. Appointment Planning and Scheduling in Outpatient Procedure Centers

Chapter 7. Human and Artificial Scheduling System for Operating Rooms

Chapter 8. Bed Assignment and Bed Management

Chapter 9. Queuing Networks in Health Care Systems

Chapter 10. Medical Supply Logistics

Chapter 11. Operations Research Applications in Home Healthcare

Chapter 12. A Framework for Healthcare Planning and Control

Backmatter

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