Multi-objective optimization for simultaneous operating room and nursing unit scheduling

Po Sheng Chiang,Po Cheng Chiang,An Jen Chiang,Chien-Ping Chung,Angus Jeang

doi:10.1177/1847979019891022

Abstract

The managerial aspect of providing quality, cost-effective health services to hospital patients is becoming increasingly important. However, merely focusing on cost reduction and quality improvement may jeopardize personnel satisfaction. Therefore, a balanced approach based on multiple considerations is necessary. Operating rooms (ORs) account for almost 33% of a hospital’s budget, and nursing labor costs represent more than 40% of a hospital’s budget. The concerns around health-care quality, personnel motivation, staff satisfaction, patient length of stay, and patient flow rate are greatly influenced by these two units with regard to day-to-day operations management. A possible approach is to look into the related essential problems, such as the nursing staff time scheduling in nursing units, and the doctor time scheduling in ORs. After surgery in the OR, patients stay in the subsequent ward for a period of time. This causes loading interdependency between the anterior OR and the posterior ward nursing unit; as a result, an attempt to schedule these two departments simultaneously is necessary for operation efficiency enhancement, service quality improvement, hospital budget reduction, and personnel satisfaction. In order to achieve the multiple objectives describing the conflicting priorities and differing preferences within nursing units and ORs, a compromise programming is adopted in this study as a balancing tool for multi-objective optimization to realize improved OR and nursing unit scheduling.

Highlights

Health-care systems involve a great amount of material and human resources
The delivery of health care while enhancing the levels of quality service, patient gratification, and staff fulfillment is increasingly becoming a vital concern of administrators in health-care systems
Because patients are removed from the operating rooms (ORs) after their operations, and are cared for by nurses during the length of their stay in a subsequent ward, the resolution of the problems related to the connection between anterior doctor scheduling in ORs and service scheduling in posterior nurse units is the main concern of this study

Summary

Introduction

Health-care systems involve a great amount of material and human resources. managers must pay close attention to efficiency improvement and cost reduction in their health-care systems.[1,2,3,4,5] the delivery of health care while enhancing the levels of quality service, patient gratification, and staff fulfillment is increasingly becoming a vital concern of administrators in health-care systems. Performance measures, such as patient waiting time, OR utilization, and stability of occupancy level, are considered. Because patients are removed from the OR after their operations, and are cared for by nurses during the length of their stay in a subsequent ward, the resolution of the problems related to the connection between anterior doctor scheduling in ORs and service scheduling in posterior nurse units is the main concern of this study. The multiple objectives are the utilization of scheduled nursing levels in fulfilling patient demands, nurse preferences in satisfying their day off arrangements, and cost-effective nurse scheduling. They are discussed in the following paragraphs. Because the patient demand differs at different intervals of the day, evening and night shifts, the daily patient demands are distributed into shifts proportionally, expressed as:

W XS XF

Objective function

Findings

Discussion

Conclusion