Kemoterapi randevularının hemşireler arasındaki iş yükü dengesi gözetilerek belirsizlik altında çizelgelenmesi

Belirsizlik varken ayaktan kemoterapi randevularının çizelgelenmesi esnasında hemşirelerin iş yükünü dengelemek zor bir problemdir. Bu çalışmada, hastaların randevu vakitlerinin belirlenmesini ve hemşirelerin kendi aralarındaki iş yükü dengesini bozmadan hastaların koltuklara ve hemşirelere atanmasını sağlayan iki aşamalı stokastik karışık tamsayılı programlama modeli tasarlanmıştır. Çalışmada pre-medikasyon ve infüzyon sürelerindeki belirsizlik dikkate alınmıştır. Modelin amaç fonksiyonu, hastaların bekleme süreleri ve hemşirelerin fazla mesai sürelerinin ağırlıklandırılmış toplamının beklenen değerini enküçüklemektedir. Büyük bir hastanenin ayaktan kemoterapi ünitesinden elde edilmiş veriler kullanılarak bilgisayısal deneyler yapılmıştır. Çalışmada gözetilen iki rakip ölçüt arasındaki denge incelenmiştir. Klinikte bulunan koltuk ve hemşire sayısı ile performans ölçütleri arasındaki ilişki irdelenmiştir. Stokastik çözüm değeri hesaplanarak, belirsizliği dikkate alarak çözüm bulmanın faydası ölçülmüştür.

Anahtar Kelimeler:

Kemoterapi çizelgeleme, Stokastik programlama, Sağlık hizmeti operasyonları

Chemotherapy appointment scheduling under uncertainty by considering workload balance among nurses

Balancing nurse workload while scheduling outpatient chemotherapy appointments under uncertainty is a challenging problem. In this study, a two-stage stochastic mixed-integer programming model is proposed for setting appointment times of patients and assigning patients to chairs and nurses without distorting the workload balance among nurses. The uncertainty in pre-medication and infusion durations is considered. The objective function of the model minimizes the expected weighted sum of patient waiting time and nurse overtime. Computational experiments are conducted based on data from an outpatient chemotherapy unit of a large hospital. The trade-off between the two competing criteria of the study is investigated. The relationship between the numbers of chairs and nurses in the clinic with the performance measures is examined. The benefit of considering uncertainty is assessed by calculating the value of stochastic solution.

Keywords:

Chemotherapy scheduling, Stochastic programming, Healthcare operations,

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