Bouzon Nagem Assad Daniel, Spiegel Thaís
Departamento de Engenharia Industrial, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Department of Organization Engineering, Business Administration and Statistics, Universidad Politécnica de Madrid, Madrid, Spain.
Health Syst (Basingstoke). 2019 Nov 3;9(1):2-30. doi: 10.1080/20476965.2019.1680260. eCollection 2020.
Sizing and allocating health-care professionals are a critical problem in the management of emergency departments (EDs) managed by a public company in Rio de Janeiro (Brazil). An efficient ED configuration that is cost and time effective must be developed by this company for hospital managers. In this paper, the problem of health-care professional configurations in EDs is modelled to minimise the total labour cost while satisfying patient queues and waiting times as defined by the actual ED capacity and current clinical protocols. To solve this issue, mixed integer linear programming (MILP) that allocates health-care professionals and specifies the amount of professionals who must be hired is proposed. To consider the uncertainties in this environment and evaluate their impacts, a discrete-event simulation model is developed to reflect patient flow. An optimisation and simulation approach is used to search for efficiency leads for different ED configurations. These configurations change depending on the shift and the day of the week.
在巴西里约热内卢一家上市公司管理的急诊科中，医疗保健专业人员的规模确定和分配是一个关键问题。该公司必须为医院管理人员制定一种高效且具有成本效益和时间效益的急诊科配置。本文对急诊科医疗保健专业人员配置问题进行建模，以在满足由实际急诊科容量和当前临床方案所定义的患者队列和等待时间的同时，使总劳动力成本最小化。为解决此问题，提出了用于分配医疗保健专业人员并确定必须雇佣的专业人员数量的混合整数线性规划（MILP）。为考虑该环境中的不确定性并评估其影响，开发了一个离散事件模拟模型来反映患者流量。采用一种优化和模拟方法来寻找不同急诊科配置的效率提升点。这些配置会根据班次和一周中的日期而变化。
