Markov decision process applied to the control of hospital elective admissions

Nunes, Luiz Guilherme Nadal; Carvalho, Solon; Rodrigues, Rita de Cássia Meneses

doi:10.1016/j.artmed.2009.07.003

Cited by 51 publications

(37 citation statements)

References 14 publications

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“…Also formulas (28) and (29) check the transposition in patient entrance to recovery room. Constraint (30) checks that for each patient the recovery phase begins after completion of the surgery and also awaking the patient in the operating room. Formula (31) ensures that the waking the patient time in operating room is shorter than the stabilization time of the patient's condition in recovery.…”

Section: Mathematical Model To Reschedule For the Remaining Patientsmentioning

confidence: 99%

“…Then, by taking into account the contribution of different types of surgeries, nursing workload distribution is obtained. Nunes et al (2009), using a Markov decision process, have modeled elective patients admission control and by using the value iteration algorithm, they have implemented hypothetical examples. Sciomachen et al (2005) have developed and tested four eventbased simulation models.…”

Section: Introductionmentioning

confidence: 99%

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Stochastic Reactive Scheduling Model for Operating Rooms Considering the Moral and Human Virtues

Gerami¹

2017

Appl Ecol Env Res

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Gerami -Saidi-Mehrabad: Stochastic reactive scheduling model for operating rooms considering the moral and human virtues - STOCHASTIC REACTIVE SCHEDULING MODEL FOR OPERATING ROOMS CONSIDERING THE MORAL AND HUMAN VIRTUESGERAMI, F. * -SAIDI-MEHRABAD, M. Science and Technology Narmak, Tehran, *Corresponding author e-mail: geramifarzad@yahoo.com (phone: +98-31-3651-8673; fax: +98-31-3651-6098) (Received 18 th Aug 2016; accepted 15 th Nov 2016) Abstract. This study focuses on the issue of reactive scheduling for the operating room under the uncertain, arrival non-elective patients (emergency or urgent). For this a reactive rescheduling algorithm was proposed and also for steps of algorithm, several stochastic mixed integer programming models were developed. In these models, all duration, such as length of stay in the waiting room, the length of stay in the recovery room, surgery time, operating room preparation time, patient preparation time after anesthesia, patient awake time before transferring to the recovery room and operating room cleaning time are stochastic. The fact that this model is a chance-constraint problem, it looks very complex. In addition to financial goals (overtime, idle time), the important approach in this research is moral and humanitarian objectives such as patient satisfaction, justice, individual freedom, patient rights and medical ethics. In mathematical schedule models, we consider three level of patient's priority (F p 1 , F p 2 , F p 3 ). Based on these moral and human dimensions, the decision maker can prioritize patients. Restrictions on parts before (waiting room) and after (PACU) the operation room are also included in the mathematical models. For the evaluation of the proposed model the actual data related to the surgical center of a first-class hospital has been used. Keywords: humanitarian objectives, operating room, surgeries rescheduling, stochastic mixed integer programming, chance-constraint problems Department of Industrial Engineering, Iran University of IntroductionA large share of the costs and revenues of a hospital is related to operating rooms. Therefore, increasing productivity within the operating rooms has a significant impact on the ultimate performance of a hospital. Improved performance in operating rooms also increases economic indicators, rate of services and patients' satisfaction.Operating room scheduling problem is a special mode of the optimization problem. A lot of researches have been done on the optimization. Hajnal et al. (2007), Kaur (2007) and Tolner (2008) are tree good example. Operating room scheduling problem has some special features that have complicated the problem. Some of these features are: ethical and human relationship between the surgeon, patient and nurse;  human factor (surgeon, patient and nurse) satisfaction;  patient rights prism;  the principles of medical ethics; and  justice. For this reason, recently, attention has been given to research in the field of operating room planning and scheduling. Researches related ...

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Section: Mathematical Model To Reschedule For the Remaining Patientsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Stochastic Reactive Scheduling Model for Operating Rooms Considering the Moral and Human Virtues

Gerami¹

2017

Appl Ecol Env Res

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show abstract

“…We discuss in detail a variety of different applications (Fakih (2006), Kurt et al 130 (2011), Shechter et al (2008), Alagoz et al (2007), Alterovitz et al (2008), Nunes et al (2017) and Sloan (2007)) . As mentioned in the above, the main novelty of this paper, logically consistent aggregation of evidence from different measurements in a non-contradictory way and without a need to resort to empirical estimates still stands.…”

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confidence: 99%

Integrated testing strategies can be optimal for chemical risk classification

Rašeta

Pitchford

Cussens

et al. 2017

Mathematical Biosciences

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“…Randomness exists in for example the number of (emergency) patient arrivals and the number of patient transitions after being treated at a particular stage of their care process. Several papers have focused on tactical planning problems that span multiple departments and resources in healthcare [192,286,374] and other industries [211]. In [261], the literature and various applications is reviews and it is concluded that existing approaches to develop tactical resource and admission plans in the OR/MS literature are myopic, focus on developing long-term cyclical plans, or are not able to provide a solution for real-life instances.…”

Section: Introductionmentioning

confidence: 99%

“…Similar approaches for evaluation of resource requirements are taken in [113,192,251,512]. In order to calculate optimal static, elective patient admission plans for multiple resources and multiple patient groups with various care processes, [374] models the patient process as a Markov Decision Process (MDP). Their experiments show that alternative methods to solve the model should be developed, as the MDP approach is not yet suitable for realistically sized instances.…”

Section: Introductionmentioning

confidence: 99%

Integrated decision making in healthcare : an operations research and management science perspective

Hulshof¹

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Markov decision process applied to the control of hospital elective admissions

Cited by 51 publications

References 14 publications

Stochastic Reactive Scheduling Model for Operating Rooms Considering the Moral and Human Virtues

Stochastic Reactive Scheduling Model for Operating Rooms Considering the Moral and Human Virtues

Integrated testing strategies can be optimal for chemical risk classification

Integrated decision making in healthcare : an operations research and management science perspective

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