West China Hospital of Sichuan University, Chengdu 610041, China.
School of Economics and Management, Sichuan Tourism University, Chengdu 610100, China.
J Healthc Eng. 2019 Aug 26;2019:5647078. doi: 10.1155/2019/5647078. eCollection 2019.
In China, emergency room residents (EMRs) generally face high working intensity. It is particularly important to arrange the working shifts of EMRs in a scientific way to balance their work and rest time. However, in existing studies, most of the scheduling models are based on the individual doctor or nurse as a unit, less considering the actuality of operation and management of emergency department (ED) in large public hospitals in China. Besides, the depiction of the hard and soft constraints of EMR scheduling in China is insufficient. So in order to obtain the scientific and reasonable scheduling shifts, this paper considers various management rules in a hospital, physicians' personal preferences, and the time requirements of their personal learning and living and takes the minimum deviation variables from the soft constraints as the objective function to construct a mixed integer programming model with the doctor group as the scheduling unit. The analytic hierarchy process (AHP) is used to determine the weights of deviation variables. Then, IBM ILOG CPLEX 12.8 is used to solve the model. The feasibility and effectiveness of the scheduling method are verified by the actual case from West China Hospital of Sichuan University. The scheduling results can meet the EMRs' flexible work plans and the preferences of the doctor teams for the shifts and rest days. Compared with the current manual scheduling, the proposed method can greatly improve the efficiency and rationality of shift scheduling. In addition, the proposed scheduling method also provides a reference for EMR scheduling in other China's high-grade large public hospitals.
在中国,急诊室住院医师(EMR)普遍面临高强度的工作。科学安排 EMR 的轮班时间,平衡他们的工作和休息时间尤为重要。然而,在现有的研究中,大多数调度模型都是以个体医生或护士为单位,较少考虑中国大型公立医院急诊科的实际运营和管理情况。此外,对 EMR 调度的硬约束和软约束的描述不足。因此,为了获得科学合理的轮班安排,本文考虑了医院的各种管理规则、医生的个人偏好以及他们个人学习和生活的时间要求,并以最小偏离变量作为目标函数,从软约束中构建一个以医生组为调度单元的混合整数规划模型。层次分析法(AHP)用于确定偏差变量的权重。然后,使用 IBM ILOG CPLEX 12.8 来求解模型。通过来自四川大学华西医院的实际案例验证了调度方法的可行性和有效性。调度结果可以满足 EMR 灵活的工作计划以及医生团队对轮班和休息日的偏好。与当前的手动调度相比,该方法可以大大提高轮班调度的效率和合理性。此外,该调度方法还为中国其他高级大型公立医院的 EMR 调度提供了参考。