Master chemotherapy planning and clinicians rostering in a hospital outpatient cancer centre

Central European Journal of Operations Research - In the past years, the number of patients in need of chemotherapy treatments has been constantly increasing. Chemotherapy treatments must be...     

A cardinality-constrained robust model for the assignment problem in Home Care services

Home Care includes medical, paramedical and social services which are delivered to patients at their domicile rather than in hospital. Managing human and material resources in Home Care services is a difficult task, as the provider has to deal with peculiar constraints (e.g., the continuity of care, which imposes that a patient is always cared for by the same nurse) and to manage the high variability of patients’ demands. One of the main issues encountered in planning Home Care services under continuity of care requirement is the nurse-to-patient assignment. Despite the importance of this topic, the problem is only marginally addressed in the literature, where continuity of care is usually treated as a soft-constraint rather than as a hard one. Uncertainty is another relevant feature of nurse-to-patient assignment problem, and it is usually managed adopting stochastic programming or analytical policies. However, both these approaches proved to be limited, even if they improve the quality of the assignments upon those actually provided in practice. In this paper, we develop a cardinality-constrained robust assignment model, which allows exploiting the potentialities of a mathematical programming model without the necessity of generating scenarios. The developed model is tested on real-life instances related to a relevant Home Care provider operating in Italy, in order to evaluate its capability of reducing the costs related to nurses’ overtimes.     

Supporting decision making to improve the performance of an Italian Emergency Medical Service

An Emergency Medical Service (EMS) plays a fundamental role in providing good quality health care services to citizens, as it provides the first answer in distressing situations. Early response, one of the key factors in a successful treatment of an injury, is strongly influenced by the performance of ambulances, which are sent to rescue the patient. Here we report the research carried on by the authors on the ambulance location and management in the Milano area (Italy), as a part of a wider research project in collaboration with the EMS of Milano and funded by Regione Lombardia. The question posed by the EMS managers was clear and, at the same time, tricky: could decision making tools be applied, based on the currently available data, to provide suggestions for decision makers? To answer such a question, three different studies have been carried on: first the evaluation of the current EMS system performance through statistical analysis; then the study of operational policies which can improve the system performance through a simulation model; and finally the definition of an alternative set of posts through an optimization model. This paper describes the methodologies underlying such studies and reports on how their main findings were crucial to help the EMS in changing its organization model.     

Combining very large scale and ILP based neighborhoods for a two-level location problem

In this paper we tackle a generalization of the Single Source Capacitated Facility Location Problem in which two sets of facilities, called intermediate level and upper level facilities, have to be located; the dimensioning of the intermediate set, the assignment of clients to intermediate level facilities, and of intermediate level facilities to upper level facilities, must be optimized, as well. Such problem arises, for instance, in telecommunication network design: in fact, in hierarchical networks the traffic arising at client nodes often have to be routed through different kinds of facility nodes, which provide different services. We propose a heuristic approach, based on very large scale neighborhood search to tackle the problem, in which both ad hoc algorithms and general purpose solvers are applied to explore the search space. We report on experimental results using datasets from the capacitated location literature. Such results show that the approach is promising and that Integer Linear Programming based neighborhoods are significantly effective.