Scheduling physiotherapy treatment in an inpatient setting
Scheduling physiotherapy treatment in an inpatient setting
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DOI：
10.1016/j.orhc.2012.08.001
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发表时间：
2012-12-01
影响因子：
2.1
通讯作者：
Wood, R. M.
中科院分区：
文献类型：
--
作者：
Griffiths, J. D.;Williams, J. E.;Wood, R. M.
虽然医疗保健的许多领域都受益于专门构建的自动化调度程序（例如护理名册，医生的手术和手术室），但物理治疗已经有点落后了。这是一个令人关切的问题，因为住院理疗是综合医院和专科康复单位许多治疗方案的重要组成部分。这项研究旨在帮助解决这个问题，详细介绍了一个计算机程序，已被引入到时间表物理治疗在一个主要的神经康复单位在卡迪夫，英国。目的是显示如何自动调度可以提供一个更有效和更高效的替代手动调度。虽然调度程序无疑会有所不同，从单位到单位，本文概述了什么被认为是一些最重要的目标和限制，除了一个适应性强的方法，可以用来达到一个高质量的解决方案，在及时的方式。这里考虑的调度问题制定为一个多目标组合优化问题，由于许多竞争的目标和约束和显着的尺寸的解决方案空间。一个近似的解决方案是寻求通过一个三阶段的局部搜索为基础的方法。第一阶段是构造一个有效的、高质量的初始解。第二阶段是通过应用一系列基于最速下降的算法来改进一些更重要的软约束。像硬约束一样，这些“适度”约束表示离散的违规次数，而不是对目标函数的贡献。这使得他们的解决方案更有针对性。第三阶段则是使用模拟退火和禁忌搜索优化（剩余的）软约束。结果是有利的典型的时间表质量（由约束违反测量），大大优于前“手”的方法。自推出以来，员工花在时间表创建上的时间已从每周8小时减少到不到2小时，从而为临床工作腾出了治疗师的时间。(C)2012爱思唯尔有限公司保留所有权利。
Whilst many areas of healthcare have benefitted from purpose-built automated scheduling programs (e.g. nursing rosters, doctor's surgeries, and operating theatres), physiotherapy has been somewhat left behind. This is a matter of concern, since inpatient physiotherapy is an important part of many treatment programmes in general hospitals and specialist rehabilitation units. This study seeks to help address this deficiency by detailing a computer program that has been introduced to timetable physiotherapy treatment at a major neurological rehabilitation unit in Cardiff, UK.The aim is to show how automated scheduling can provide a far more effective and efficient alternative to manual scheduling by hand. Whilst the scheduling procedure will undoubtedly differ from unit to unit, this paper outlines what are thought to be some of the most important objectives and constraints in addition to an adaptable methodology that can be employed to arrive at a good-quality solution in a timely fashion. The scheduling problem considered here is formulated as a multi-objective combinatorial optimisation problem due to the many competing objectives and constraints and the significant size of the solution space. An approximate solution is sought by means of a three stage local search based approach. The first stage is to construct a valid and good quality initial solution. The second stage is to improve this with respect to some of the more important soft constraints by applying a series of steepest descent based algorithms. Like hard constraints, these 'moderate' constraints represent a discrete number of violations rather than contributions to an objective function. This allows for a more targeted approach in their solution. The third stage is then the optimisation of the (remaining) soft constraints using simulated annealing and tabu search.Results are favourable with typical timetable quality (as measured by constraint violations), being considerably better than under the former 'by hand' approach. Since its introduction, employee time expended on timetable creation has been cut from eight hours per week to fewer than two, freeing up therapist time for clinical work. (C) 2012 Elsevier Ltd. All rights reserved.