Operations Research for Hospital Efficiency and Effectiveness

医院效率和效果的运筹学

• 批准号: RGPIN-2015-06056
• 负责人: Verter, Vedat
• 金额: $ 3.42万
• 依托单位: McGill University
• 依托单位国家: 加拿大
• 项目类别: Discovery Grants Program - Individual
• 财政年份: 2019
• 资助国家: 加拿大
• 起止时间: 2019-01-01 至 2020-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=689546
• 关键词: Operations; Research; Hospital; Efficiency; Effectiveness

The overarching objective of this research program is to improve the state of the art in operations research and management science for hospital management. In this context, efficiency refers to the utilization of the variety of resources that are required for running a hospital e.g., physicians, nurses, allied health professionals, technicians, orderlies, staff; and effectiveness refers to the overall performance of the hospital system in terms of the cost, quality of care, access to care and health outcomes. The improvement of efficiency and effectiveness involve multiple stakeholders, multiple objectives, a variety of constraints and hence, a number of difficult trade offs. This constitutes a hotbed of challenging problems many of which are currently being tackled by hospital administrators based on experience and intuition. Operations research and industrial engineering constitute methodology domains from which we can benefit in improving the current practice of hospital management by developing solid analytical frameworks, decision support tools and managerial insights. ***During the period of this grant, we will investigate three specific issues concerning hospital efficiency and effectiveness: (i) integration of hospital discharge processes with community-based care, (ii) tactical management of the inpatient capacity in a hospital, and (iii) operational management of inpatient wards. Although the clinical context, including the type of hospital and the patient's disease condition, would have an impact on the specifics of the resulting mathematical models, our intent is to strive for the development of a generic modeling framework that would enable us to derive generally applicable managerial insights. In light of the time-dependent nature of the problems we plan to study, simulation, stochastic dynamic programming and Markov decision processes constitute the modeling toolkit we plan to dwell on. We will develop approximate dynamic programming algorithms or adopt decomposition methods and meta-heuristic frameworks for solving the arising large-scale mathematical formulations.***The specific problems we plan to investigate include the transitioning of mentally ill patients from acute care facility to housing units with varying levels of supervision (under (i)), the impact of off-service ward assignments on the hospital's overall performance (under (ii)), and the development of real-time simulation based optimization methods for the operation of surgical wards (under (iii)). Our partners for these three streams of research are the Douglas Hospital, Montreal General Hospital and Jewish General Hospital (JGH), respectively. In particular, the third research stream on operational decisions will be carried out utilizing the real-time location system (RTLS) that is now installed at two surgical wards of JGH, thanks to a CFI grant to the applicant. **

该研究计划的总体目标是提高医院管理中运筹学和管理科学的最新水平。在这种情况下，效率是指对运营医院所需的各种资源的利用，例如医生、护士、专职医疗专业人员、技术人员、勤务人员、工作人员；有效性是指医院系统在成本、护理质量、获得护理的机会和健康结果方面的整体绩效。效率和有效性的提高涉及多个利益相关者、多个目标、各种约束，因此需要进行许多困难的权衡。这构成了具有挑战性的问题的温床，其中许多问题目前正在由医院管理人员根据经验和直觉来解决。运筹学和工业工程构成了方法论领域，我们可以通过开发可靠的分析框架、决策支持工具和管理见解来改善当前的医院管理实践。 ***在这笔赠款期间，我们将调查有关医院效率和效益的三个具体问题：（i）出院流程与社区护理的整合，（ii）医院住院容量的战术管理，以及（iii）住院病房的运营管理。尽管临床背景（包括医院类型和患者的疾病状况）会对所得数学模型的细节产生影响，但我们的目的是努力开发通用模型框架，使我们能够得出普遍适用的管理见解。鉴于我们计划研究的问题的时间依赖性，模拟、随机动态规划和马尔可夫决策过程构成了我们计划深入研究的建模工具包。我们将开发近似动态规划算法或采用分解方法和元启发式框架来解决出现的大规模数学公式。***我们计划研究的具体问题包括精神病患者从急症护理机构过渡到不同监管级别的住房单元（第(i)项下）、停业病房分配对医院整体绩效的影响（第(ii)项下）以及发展 基于实时模拟的外科病房操作优化方法（第（iii）项下）。我们这三个研究领域的合作伙伴分别是道格拉斯医院、蒙特利尔综合医院和犹太综合医院 (JGH)。特别是，由于 CFI 向申请人提供资助，有关运营决策的第三个研究将利用现已安装在 JGH 两个外科病房的实时定位系统 (RTLS) 进行。 **