Methods and analytical tools to optimize patient flow

在本建议中，我将重点介绍医疗保健系统中与患者流相关的应用程序。患者流问题可以描述为：患者一次到达一个系统，等待预约。这个预约通常定义了他们访问的开始时间（或他们治疗的开始日期）。一个病人可能有多个预约。每个病人都有一个事先不知道的档案。概要文件被定义为一组活动和每个活动的持续时间。一个或多个资源可以执行每个活动，并且一些活动具有优先级约束。每天可能会发生一个或多个活动：它们可以一个接一个地被安排（单个约会），也可以一次全部安排（多个约会）。这些活动通常与资源有关，必须对这些资源进行安排，以确保患者能够获得这些资源。由于缺乏对这些有限资源的协调，往往会造成患者延误和瓶颈。病人的到达时间、护理需求和服务时间通常是未知的。病人流动问题很难解决。文献分析表明：1)大多数研究集中在单资源调度上，认为需求是已知的；2)不确定性没有得到很好的整合和利用；3)患者和资源调度问题往往依次独立解决；当这两个问题结合在一起时，精确的方法已经达到了极限。虽然不可能同时解决这些问题，但我的研究项目旨在解决整个患者流动问题（为了一个有效和综合的卫生系统）。为了应对这些挑战，我的研究将分为三个主题：A)“部分”整合患者和资源调度的专用算法；B)寻找更有效的元启发式方法；C)寻找有效的方法来整合专用算法的解决方案。这些领域的项目旨在解决医疗保健系统中出现的实际问题，并开发创新的方法方法，以推进知识和促进科学。这项研究的目标之一是提供最先进的工具和良好的做法，可以被加拿大各地的医疗保健行业使用。这项研究将有利于医疗保健决策者（因此患者）通过减少等待时间和方便访问的病人。它应该能够缓解诊所和医院的拥挤。我目前的合作网络允许我有特权访问数据，在实践中遇到的挑战的知识和算法的验证领域。最后，参与这项研究的学生将获得与行业合作的经验。他们将获得在研究和实践方面的专业知识，这将对他们的职业生涯有很大的帮助。

In this proposal, I will focus on applications related to patient flow in the healthcare system. The patient flow problem can be described as follows: Patients arrive in the system one at a time and wait for an appointment. This appointment usually defines the start time of their visit (or the start day of their treatment). One patient may have multiple appointments. Each patient has a profile that is not known in advance. The profile is defined as a set of activities and a duration time for each activity. One or more resources may perform each activity, and some activities have precedence constraints. Each day one or more activities may occur: they may be scheduled one after the other (single appointment) or all at once (multiple appointments). The activities are often related to resources, which must be scheduled to ensure their availability to the patients. Patient delays and bottlenecks are often caused by a lack of coordination of these limited resources. The arrival times, care needs, and service times of the patients are usually unknown. Patient flow problems are difficult to solve. Analysis of the literature shows that: 1) Most research focuses on single-resource scheduling and considers that the demand is known; 2) Uncertainty is poorly integrated and exploited; 3) Patient and resource scheduling problems are often solved sequentially and independently; and 4) Exact approaches have reached their limits when both problems are integrated. While it is not always possible to address these issues simultaneously, my research program aims to work towards addressing the patient flow problem as a whole (for an effective and integrated health system). To address these challenges, my research will be divided into three themes: A) dedicated algorithms for "partially" integrated patient and resource scheduling; B) the search for approaches to more efficient metaheuristics; and C) the search for efficient methods to integrate the solutions of dedicated algorithms. The projects in these areas aim to both tackle practical problems arising in the healthcare system, and to develop innovative methodological approaches that will advance knowledge and contribute to science. One of the objectives of this research is to provide state-of-the-art tools and good practices that can be used by the healthcare industry all over Canada. This research will benefit healthcare decision makers (and therefore the patients) through wait time reduction and facilitated access for patients. It should be able to relieve congestion in clinics and hospitals. My current network of collaborations allows me to have a privileged access to the data, knowledge of the challenges encountered in practice and a validation field for the algorithms. Finally, students that will participate in this research will gain experience in collaborating with industry. They will acquire expertise in the both of research and practice that will be of great assistance in their careers.