Citation

El-Rifai O, Garaix T, Augusto V, Xie X. Health Care Manag. Sci. 2014; 18(3): 289-302.

Affiliation

ROGI - LIMOS UMR CNRS 6158, Center for Biomedical and Healthcare Engineering, Ecole Nationale Superieure des Mines de Saint Etienne, Saint Etienne, France.

Copyright

(Copyright © 2014, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s10729-014-9300-4

PMID

25270574

Abstract

Excessive waiting time in Emergency Departments (ED) can be both a cause of frustration and more importantly, a health concern for patients. Waiting time arises when the demand for work goes beyond the facility's service capacity. ED service capacity mainly depends on human resources and on beds available for patients. In this paper, we focus on human resources organization in an ED and seek to best balance between service quality and working conditions. More specifically, we address the personnel scheduling problem in order to optimize the shift distribution among employees and minimize the total expected patients' waiting time. The problem is also characterized by a multi-stage re-entrant service process. With an appropriate approximation of patients' waiting times, we first propose a stochastic mixed-integer programming model that is solved by a sample average approximation (SAA) approach. The resulting personnel schedules are then evaluated using a discrete-event simulation model. Numerical experiments are then performed with data from a French hospital to compare different personnel scheduling strategies.

Language: en