Optimization methods for physician scheduling

Abstract

This thesis considers three physician scheduling problems in health care systems. Specifically, we focus on improvements to current physician scheduling practices through the use of mathematical modeling. In the first part of the thesis, we present a physician shift scheduling problem focusing on maximizing continuity of care (i.e., ensuring that patients are familiar with their treating physicians, and vice versa). We develop an objective scoring method for measuring the continuity of a physician schedule and combine it with a mixed integer programming model. We apply our methods to the problem faced in the pediatric intensive care unit at Children's Healthcare of Atlanta at Egleston, and show that our schedule generation approach outperforms manual methods for schedule construction, both with regards to solution time and continuity. The next topic presented in this thesis focuses on two scheduling problems: (i) the assignment of residents to rotations over a one-year period, and given that assignment, (ii) the scheduling of residents' night and weekend shifts. We present an integer programming model for the assignment of residents to rotations such that residents of the same type receive similar educational experiences. We allow for flexible input of parameters and varying groups of residents and rotations without needing to alter the model constraints. We present a simple model for scheduling 1st-year residents to night and weekend shifts. We apply these approaches to problems faced in the Department of Surgery Residency Program at Emory University School of Medicine. Rotation assignment is made more efficient through automated schedule generation, and the shift scheduling model allows us to highlight infeasibilities that occur when shift lengths exceed a certain value, and we discuss the impact of duty hour restrictions under limitations of current scheduling practices. The final topic of this thesis focuses on the assignment of physicians to various tasks while promoting equity of assignments and maximizing space utilization. We present an integer programming model to solve this problem, and we apply this model to the physician scheduling problem faced in the Department of Gynecology and Obstetrics at Emory University Hospital and generate high quality solutions very quickly.