Demand Driven Healthcare Scheduling using Flexible Shifts and Monte-Carlo Simulat

描述（由申请人提供）：护士和医疗技术人员的短缺正在加速。通过安排工作人员以精确满足每小时的医疗服务需求，可以减少短缺。想想银行柜员的调度，在需求高峰期会安排更多的员工。目前根据需求进行调度的尝试是相对原始的：允许少量量化的固定班次，例如：7点到3点，10点到6点，3点到11点，7点到7点，7点到7点等等。预先确定的固定班次是调度过程的刚性输入参数，工人被分配到班次。在这个创新中，固定的换挡被灵活的换挡参数所取代；具体来说，就是一系列与员工生活方式相协调的上班时间和轮班时间。这些参数成为调度算法的弹性输入。在任何特定的一天分配给工人的实际班次都是为了让足够的工人满足每小时的需求而计算的。第一阶段的研究成功地确定了工人友好、灵活的轮班安排的有效性，并发现可能节省4%的成本。4%可以显著减少目前的劳动力短缺，相当于每年节省35亿美元的医疗费用。尽管有许多关于灵活轮班调度的科学研究，但由于研究中使用的技术的复杂性，缺乏实际的商业应用。在第二阶段，将采用简单但功能强大的蒙特卡罗模拟技术。假设可以开发蒙特卡罗模拟，使用对工人友好的灵活轮班参数来精确满足每小时的医疗服务需求。具体目标是找到一个目标函数，量化满足每小时需求的目标和蒙特卡罗过程在模拟期间使用的一组移位扰动。该商业化产品将是Acme Express Inc.的医疗人员调度软件DOCS Scheduler的一个新模块，该软件已经在市场上销售。当前的DOCS调度器是为受薪（医生）员工设计的，采用固定班次。使用灵活的轮班是一种完全不同的创新，主要针对轮班工人，如护士和医疗技术人员。一个可以节省4%医疗保健人员成本的新模块将成为Acme Express， Inc.不断变化的市场竞争优势。

DESCRIPTION (provided by applicant): The shortage of nurses and medical technologists is accelerating. Shortages can be reduced by scheduling staff to precisely meet the hour-by-hour demand for medical service. 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, 10am-6pm, 3pm-11pm, 7am-7pm, 7pm-7am, etc. is allowed. The pre-determined fixed shifts are rigid input parameters for the scheduling process and workers are assigned to the shifts. In this innovation, fixed shifts are replaced with flexible shift parameters; specifically, a range of start times and shift durations that are harmonious with worker lifestyles. These parameters become elastic inputs for 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 the hour-by-hour demand. Phase I research successfully determined the efficacy of worker-friendly, flexible shift scheduling and found savings of 4 percent are possible. Four percent can cut the current worker shortfall significantly and corresponds to annual savings of $3.5 billion in healthcare costs. Despite many scientific studies of flexible shift scheduling, there is a dearth of practical commercial applications primarily due to the complexity of technologies employed in the research. In Phase II, a simple but powerful technology, Monte-Carlo simulation, will be employed. The hypothesis is that a Monte-Carlo simulation can be developed that uses worker-friendly, flexible shift parameters to precisely meet the hour-by-hour demand for medical service. The Specific Aim is to find an objective function that quantifies the goal of meeting hour-by-hour demand and a set of shift perturbations for the Monte-Carlo process to use during the simulation. The commercialized product will be a new module for DOCS Scheduler, Acme Express Inc.'s healthcare staff scheduling software that is already in the marketplace. The current DOCS Scheduler was designed for salaried (physicians) staff and uses fixed shifts. Using flexible shifts is an entirely different innovation and focuses on shift workers like nurses and medical technicians. A new module that saves 4 percent in healthcare staffing costs will be a market-changing, competitive advantage for Acme Express, Inc. 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, with similar estimates for medical technologists. Phase I found that healthcare worker shortage can be reduced by 4 percent 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. In Phase II, Acme Express, Inc. will employ a simple but powerful technology, Monte-Carlo Simulation, to automatically build the staff schedule, minimize periods of overstaffing, and significantly reduce healthcare labor costs.