Hospital planning automation & optimization

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Sponsor

A large University Hospital

Project

Develop an application to automate and optimize the scheduling of Postgraduate Doctors.

Context

In addition to their usual missions of an hospital, University Hospitals are also in charge of the training of the Postgraduate Doctors (PGs, i.e. young graduated doctors who qualify for a specialization, for 3-5 extra years).  PGs are critical resources to guarantee smooth functioning of the department, as most departments are understaffed for specialists.  In return, the departments commit to training PGs by giving them access to the widest range of different activities during their internship (their training is mainly based on “learning by doing”).

Every 6 weeks, an assignment schedule for the PGs is drawn up manually by the Postgraduates themselves. This raises several issues:

  1. Quality and time: Mastering all constraints at stake to create a valid and robust schedule requires experience. As the turnover of PGs is quite high, the quality and duration of the planning process is highly variable.
  2. Fairness: As the schedule is made by the PGs for the PGs, it is often subject to criticism. Indeed, some tasks are more interesting or valued than others. Moreover, individual preferences related to on-call duties, holidays and days off must also be integrated in the planning …

As there was no standard planning software able to conciliate the functional needs of a hospital with individual educational preferences, N-SIDE developed a bespoke scheduling tool.

Solution

N-SIDE has developed a light and flexible planning software using common office components (MS Access as GUI and DB). Such architecture makes it easy to deploy, run and share results by non-computer literate users and does not require any specific hardware investment.
The core of the application is a tailormade Mixed Integer Mathematical Program that optimizes Postgraduates activity scheduling with respect to all business-specific constraints, such as:

  • workforce demand for each activity and half-day
  • skills and seniority
  • educational preferences
  • on-call duties
  • legal framework (compensatory rest …)
  • time off (external training and clinics, holidays, sick leaves …)
  • planning history for preferences, on call duties …

Benefits

After roll-out of the planning software, the following benefits were quickly highlighted by both the hospital management and the Postgraduate Doctors as well:

  1. Time savings : schedules are generated in a few clicks, replacing the cumbersome and time consuming manual  process. Time saved by PGs on planning is now better valued in medical care or training purposes.
  2. Perceived fairness and acceptability: a Postgraduate’s job is demanding and requires sacrifices. However, PGs are more prone to accept tough schedules if they can observe that  these are based on objective data and that everybody is treated the same way.
  3. Improved operations management: thanks to the optimization feature, Postgraduate assignments now match the functional needs of the hospital. Furthermore, as drawing up schedules is now much easier, it has become possible to plan surgery hours much further in advance. Agility has also improved since schedules can quickly be adapted when someone is absent.
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