Demand Driven Healthcare Scheduling using Flexible Shifts and Monte Carlo Simulat

描述（由申请人提供）：医疗保健工作者的短缺正在加速。长寿、老龄化的人口需要更多的医疗服务，而医疗保健工作者的退休和高流动率正在减少工人的数量。可以通过只安排满足每小时医疗服务需求所需的工作人员人数和采用灵活的轮班制来减少或消除短缺。想想银行出纳员的调度，在高峰需求时安排更多的员工。目前，按需调度的尝试相对原始：允许少量量化的固定班次，例如：7am-3 pm、8am-4pm、10am-6pm、3 pm-11 pm、7am-7 pm、7 pm-7am等。预定的固定班次是调度过程的输入参数，并且工人被分配到班次。调度员的目标是填补足够的上午，下午和晚上的班次，以满足全天医疗服务的预期需求。在我们的创新中，固定班次被灵活的班次参数所取代;具体地说，开始时间和班次长度的范围成为调度算法的输入。在任何一天分配给工人的实际轮班数是以刚好有足够的工人来满足每小时的医疗服务需求为目标计算的。第一阶段将确定灵活轮班制对满足医疗服务需求的有效性，并估计可能的效率。第二阶段将开发一种算法，使用灵活的班次和蒙特-卡罗模拟使这一过程自动化。文献表明，通过使用灵活的轮班，2-15%的FTE效率是可能的，相当于每年17亿至80亿美元的社会经济影响。该商业化产品将成为DOCS排程软件的新模块，目前有120家医疗机构正在使用该软件。我们目前的产品时间表使用固定班次。增加灵活的轮班安排模块，提供2-15%的FTE效率将是一个改变市场的竞争优势。公共卫生相关性：人口老龄化、寿命延长，加上医护人员退休和高流动率，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年将达到100万人。通过使用与工人生活方式和谐的灵活轮班，根据医疗服务需求精确安排工作人员，可以显著减少甚至消除医疗工作人员短缺，提高医疗工作人员的士气。

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.