Demand Driven Healthcare Scheduling using Flexible Shifts and Monte Carlo Simulat

描述(申请人提供)：医护人员的短缺正在加速。寿命更长、老龄化的人口要求更多的医疗服务，而医疗工作者的退休和高流动率正在减少工人队伍。可以减少或消除短缺，方法是只安排满足每小时医疗服务需求所需的工作人员数量，并使用弹性班次来做到这一点。想想银行出纳员的调度，在需求高峰时安排更多的工作人员。目前根据需求进行调度的尝试相对原始：允许少量量化的固定班次，例如：上午7点到3点、8点到4点、10点到6点、3点到11点、7点到7点、7点到7点等。预定的固定班次是调度过程的输入参数，工人被分配到班次。调度员的目标是安排足够的上午、下午和晚上的班次，以满足全天对医疗服务的预期需求。在我们的创新中，固定的班次被灵活的班次参数取代；具体地说，成为调度算法的输入的一系列开始时间和班次长度。在任何一天分配给工人的实际班次是根据目标计算的，即有足够的工人来满足每小时对医疗服务的需求。第一阶段将确定弹性轮班制满足医疗服务需求的效果，并评估可能的效率。第二阶段将开发一种算法，使用灵活的轮班和蒙特卡洛模拟来自动化这一过程。文献表明，通过使用灵活的班次可以实现2%-15%的FTE效率，对应于每年17亿至80亿美元的社会经济影响。商业化的产品将是DOCS Scheduler的一个新模块，DOCS Scheduler是我们的调度软件，目前正被120个医疗保健组织使用。我们目前的产品计划采用固定班次。增加灵活的班次排班模块将提供2-15%的FTE效率，这将是一项改变市场的竞争优势。公共卫生相关性：随着人口老龄化和寿命的延长，再加上医护人员的退休和高流动率，加剧了医护人员的短缺。2008年美国护士短缺20万人，预计到2014年将短缺100万人。通过使用与员工生活方式相协调的灵活班次来精确地根据医疗服务需求安排员工，可以显著减少甚至可能消除医护人员短缺，并提高医护人员的士气。

DESCRIPTION (provided by applicant): The shortage of healthcare workers is accelerating. An longer-living, ageing population is demanding more medical service while healthcare worker retirements and high turnover is decreasing the worker pool. Shortages can be reduced or eliminated by scheduling only the number of staff needed to meet the hour-by-hour demand for medical service and using flexible shifts to do so. Think of bank teller scheduling, where more staff are scheduled at peak demand. Current attempts to schedule to demand are relatively primitive: a small number of quantized fixed shifts, for example: 7am-3pm, 8am-4pm, 10am-6pm, 3pm-11pm, 7am- 7pm, 7pm-7am, etc. is allowed. The pre-determined fixed shifts are input parameters to the scheduling process and workers are assigned to the shifts. The scheduler's objective is to fill enough morning, afternoon and evening shifts to meet expected demand for medical service throughout the day. In our innovation, fixed shifts are replaced with flexible shift parameters; specifically, a range of start times and shift lengths which become inputs to the scheduling algorithm. The actual shift assigned to a worker on any particular day is computed with the objective to have just enough workers to meet hour-by-hour demand for medical service. Phase I will determine the efficacy of flexible shift scheduling to meet demand for medical service and estimate the possible efficiency. Phase II will develop an algorithm that automates the process using flexible shifts and Monte-Carlo simulation. The literature indicates 2-15% FTE efficiencies are possible by using flexible shifts, corresponding to an annual societal economic impact of $1.7 billion to $8 billion. The commercialized product will be a new module for DOCS Scheduler, our scheduling software that currently is being used by 120 healthcare organizations. Our current product schedules using fixed shifts. The addition of a flexible shift scheduler module providing FTE efficiencies of 2-15% would be a market-changing competitive advantage. PUBLIC HEALTH RELEVANCE: An ageing population with increasing lifespan, coupled with healthcare worker retirements and high turnover, is exacerbating the shortage of healthcare workers. The USA nurse shortage of 200,000 workers in 2008 is estimated to be 1,000,000 by 2014. Healthcare worker shortages can be significantly reduced, possibly eliminated, and healthcare worker morale improved, by using flexible shifts that are harmonious with worker lifestyles to schedule staff precisely according to demand for medical service.