论文标题
广泛适用算法的设计和实施,用于优化日内外科计划
The Design and Implementation of a Broadly Applicable Algorithm for Optimizing Intra-Day Surgical Scheduling
论文作者
论文摘要
手术调度优化是一个积极的研究领域。但是,很少实施优化手术调度的算法并看到持续使用。如果算法允许外科医生的自主权,即仅需要有限的计划集中式,并且在有限的技术基础设施中,则更有可能实施算法。为了使算法看到持续使用,必须与医院容量,患者量和调度习惯的变化兼容。为了实现这些目标,我们开发了床(手术的更好的选修日)算法,这是一种贪婪的启发式,用于平滑几天的单位特异性手术入院。我们在一个大型儿科学术医学中心的EMR中实施了床。 床的使用与入院次数的差异降低有关。床在Tableau的仪表板中免费提供,这是一家商业软件,由许多医院使用。床很容易实现,可用于大多数医院可用的有限工具,不需要减少外科医生的自主权或集中调度,并且与医院容量或患者量的变化兼容。我们提出了一个一般的算法框架,该框架是基于特定的目标和约束选择得出的。我们认为,该框架生成的算法保留了许多床的理想特征,同时与广泛的目标和约束兼容。
Surgical scheduling optimization is an active area of research. However, few algorithms to optimize surgical scheduling are implemented and see sustained use. An algorithm is more likely to be implemented, if it allows for surgeon autonomy, i.e., requires only limited scheduling centralization, and functions in the limited technical infrastructure of widely used electronic medical records (EMRs). In order for an algorithm to see sustained use, it must be compatible with changes to hospital capacity, patient volumes, and scheduling practices. To meet these objectives, we developed the BEDS (better elective day of surgery) algorithm, a greedy heuristic for smoothing unit-specific surgical admissions across days. We implemented BEDS in the EMR of a large pediatric academic medical center. The use of BEDS was associated with a reduction in the variability in the number of admissions. BEDS is freely available as a dashboard in Tableau, a commercial software used by numerous hospitals. BEDS is readily implementable with the limited tools available to most hospitals, does not require reductions to surgeon autonomy or centralized scheduling, and is compatible with changes to hospital capacity or patient volumes. We present a general algorithmic framework from which BEDS is derived based on a particular choice of objectives and constraints. We argue that algorithms generated by this framework retain many of the desirable characteristics of BEDS while being compatible with a wide range of objectives and constraints.