In the last two decades, the western world witnessed a continuous rise in the health expenditure. Meanwhile, complaints from patients on excessive waiting times are also increasing. In the past, many researchers have tried to devise appointment scheduling rules to provide trade-offs between maximizing patients’ satisfaction and minimizing the costs of the health providers. For instance, this challenge appears appointment scheduling problems (ASP).
Commonly used methods in ASP include analytical methods, simulation studies, and combination of simulation with heuristic approaches. Analytical methods (e.g., queuing theory and mathematical programming) face challenges of fully capturing the complexities of systems and usually make strong assumptions for tractability of problems. These methods simplify the whole system to a single-stage unit and ignore the actual system factors such as the presence of multiple stages and/or resource constraints. Simulation studies, conversely, are able to model most complexities of the actual system, but they typically lack an optimization strategy to deliver optimal appointment schedules. Also, heuristic approaches normally are based on intuitive rules and do not perform well as standalone methods.
In order to reach an optimal schedule while considering complexities in actual health care systems, this thesis proposes efficient and effective methods that yield (near) optimal appointment schedules by integrating mathematical programming, a tabu search optimization algorithm and discrete event simulation. The proposed methodologies address the challenges and complexities of scheduling in real world multistage healthcare units in the presence of stochastic service durations, a mix of patient types, patients with heterogeneous service sequence, and resource constraints.
Moreover, the proposed methodology is capable of finding the optimum considering simultaneously multiple performance criteria. A Pareto front (a set of optimal solutions) for the performance criteria can be obtained using the proposed methods. Healthcare management can use the Pareto front to choose the appropriate policy based on different conditions and priorities.
In addition, the proposed method has been applied to two case studies of Operating Rooms departments in two major Canadian hospitals. The comparison of actual schedules and the ones yielded by the proposed method indicates that proposed method can improve the appointment scheduling in realistic clinical settings.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:MWU.1993/21710 |
| Date | 02 1900 |
| Creators | Saremi, Alireza |
| Contributors | ElMekkawy, Tarek (Manufacturing Engineering) Wang, Gary (Mechanical & Manufacturing Eng), Xue, Deyi (University of Calgary) Peng, Qingjin (Mechanical & Manufacturing Engineering) Annakkage, Udaya (Electrical Engineering) |
| Publisher | Elsevier |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Detected Language | English |
Page generated in 0.002 seconds