A Capacity Allocation Planning Model for Integrated Care and Access Management

• 成果类型: Article
• 署名作者: Deglise-Hawkinson, Jivan; Helm, Jonathan E.; Huschka, Todd; Kaufman, David L.; Van Oyen, Mark P.
• 署名单位: Indiana University System; Indiana University Bloomington; Mayo Clinic; University of Michigan System; University of Michigan; University of Michigan System; University of Michigan
• 刊物名称: PRODUCTION AND OPERATIONS MANAGEMENT
• ISSN/ISSBN: 1059-1478
• DOI: 10.1111/poms.12941
• 发表日期: 2018
• 页码: 2270-2290
• 关键词: health-care; resource-allocation; patient; optimization; surgery; demand

摘要

The prevailing first-come-first-served approach to outpatient appointment scheduling ignores differing urgency levels, leading to unnecessarily long waits for urgent patients. In data from a partner healthcare organization, we found in some departments that urgent patients were inadvertently waiting longer for an appointment than non-urgent patients. This study develops a capacity allocation optimization methodology that reserves appointment slots based on urgency in a complicated, integrated care environment where multiple specialties serve multiple types of patients. This optimization reallocates network capacity to limit access delays (indirect waiting times) for initial and downstream appointments differentiated by urgency. We formulate this problem as a queueing network optimization and approximate it via deterministic linear optimization to simultaneously smooth workloads and guarantee access delay targets. In a case study of our industry partner we demonstrate the ability to (i) reduce urgent patient mean access delay by 27% with only a 7% increase in mean access delay for non-urgent patients, and (ii) increase throughput by 31% with the same service levels and over-time.