Integral multidisciplinary rehabilitation treatment planning

Abstract

This paper presents a methodology to plan treatments for rehabilitation outpatients. These patients require a series of treatments by therapists from various disciplines. In current practice, when treatments are planned, a lack of coordination between the different disciplines, along with a failure to plan the entire treatment plan at once, often occurs. This situation jeopardizes both the quality of care and the logistical performance.The multidisciplinary nature of the rehabilitation process complicates planning and control. An integral treatment planning methodology, based on an integer linear programming (ILP) formulation, ensures continuity of the rehabilitation process while simultaneously controlling seven performance indicators including access times, combination appointments, and therapist utilization. We apply our approach to the rehabilitation outpatient clinic of the Academic Medical Center (AMC) in Amsterdam, the Netherlands. Based on the results of this case, we are convinced that our approach can be valuable for decision-making support in resource capacity planning and control at many rehabilitation

Organizing integrated processes in cancer care

“…Scheduling the appointments is challenging, as patients prefer to combine several treatments on one day, while they have fixed therapists for every discipline. In the organization of these treatment pathways challenges are, amongst others, the continuity of the care process, a simultaneous start for all disciplines and a short access time [40].…”

“…[40] present a methodology to plan appointment series for rehabilitation outpatients. The scheduling of the radiotherapy care pathway is considered in [156] and [320], where operating hours of treatment machines and shift hours of machine operators are varied [156] or different arrival distributions and oncologist productivity are considered [320].…”

“…Used methods include mathematical programming [17,40], heuristics [82,235], simulation [82,153,156,235,320], stochastic programming [236], constraint programing [125], genetic algorithms [17], and agent-based models [305,306].…”

“…An example of an open-shop can be found in rehabilitation treatment, where patients need an appointment with a physician, physiotherapist, and psychologist, in an arbitrary sequence, as long as these appointments are planned on the same day 2.4. Type of system [117] or in the same week [40].…”

“…When a fixed capacity is reserved for such a one-stop-shop, rapid diagnostics, or carousel program, the maximum number of patients to be admitted is restricted [262]. An important objective in flow-shop planning is therefore to maximize the possible number of patients treated [40,146,313].…”