A mixed-integer goal programming model for nursing service budgeting

This paper presents a mixed-integer goal programming model for expense budgeting in a hospital nursing department. The model incorporates several different objectives based upon such considerations as cost containment and providing appropriate nursing hours for delivering quality nursing care. Also considered are possible trade-offs among full-time, part-time and overtime nurses on weekdays as well as weekends. The budget includes vacation, sick leave, holiday, and seniority policies of a hospital and various constraints on a hospital nursing service imposed by nursing unions. The results are based upon data from a study hospital and indicate that the model is practical for budgeting in a hospital nursing department.     

A real options approach to labour shifts planning under different service level targets

Firms that experience uncertainty in demand as well as challenging service levels face, among other things, the problem of managing employee shift numbers. Decisions regarding shift numbers often involve significant expansions or reductions in capacity, in response to changes in demand. In this paper, we quantify the impact of treating shifts in workforce expansion as investments, while considering required service level improvements. The decision to increase shifts, whether by employing temporary workers or hiring permanent employees, is one that involves significant risks. Traditional theories typically consider reversible investments, and thus do not capture the idiosyncrasies involved in shift management, in which costs are not fully reversible. In our study, by using real options theory, we quantify managers’ ability to consider this irreversibility, aiming to enable them to make shift decisions under conditions of uncertainty with the maximum level of flexibility. Our model aims to help managers make more accurate decisions with regard to shift expansion under service level targets, and to defer commitment until future uncertainties can be at least partially resolved. Overall, our investigation contributes to studies on the time required to introduce labour shift changes, while keeping the value of service level improvements in mind.     

Planning annualised hours with a finite set of weekly working hours and cross-trained workers

Annualising working hours (i.e., the possibility of irregularly distributing the total number of working hours over a year) permits companies to adapt capacity to fluctuations in demand, thus reducing overtime, temporary workers and inventory costs. Since annual hours can lead to a worsening of the staff’s working conditions, many laws and collective bargaining agreements contain constraints that affect the distribution of working time. This paper proposes a MILP model to solve an annualised working hours planning problem in which workers are considered to be cross-trained, and in which the number of weekly working hours must belong to a previously agreed finite set. A computational experiment demonstrates the effectiveness of the model.     

Joint spare parts inventory and reliability decisions under a service constraint

Reliability and inventory levels of spare parts are major factors that determine the service level for the maintenance of machines provided by original equipment manufacturers (OEMs). In general, decisions on reliability and stock levels are made separately in practice, and academic literature offers little guidance on how to jointly make these two decisions. In order to fill in the gap in the literature and provide guidance to OEMs, we jointly model reliability and inventory problems. We consider three different service measures: aggregate fill rate, average downtime per system per year and expected total number of long downs in a year. Our models minimize the sum of holding and emergency shipment costs subject to a limited reliability improvement budget and a target service level. We develop an algorithm that considers reliability and inventory decisions simultaneously, test our solution approach on real-life and randomly generated data sets and compare the results with an approach that considers reliability and inventory decisions sequentially. Numerical results show substantial benefits of integrating reliability and inventory decisions.     

Equipment scheduling problem under disruptions in mail processing and distribution centres

This paper addresses the production and workforce scheduling problem under disruptions in United States Postal Service mail processing facilities. These facilities contain a large variety of equipment and employ a non-homogeneous workforce that work on shifts of various lengths and start times. Disruptions such as demand fluctuation and absenteeism happen and may significantly change demand and the size of workforce. How to adjust production plans and workforce schedules through the use of overtime and flexible employees in the face of these disruptions to meet the service commitment is a challenging problem yet to be solved. This problem is modelled as a large-scale integer program, which contains equipment scheduling, shift scheduling and overtime management, and break assignment modules. Problems of realistic size are solved efficiently through an LP-based decomposition algorithm. Comprehensive experiments have been designed to investigate the effects of the use of overtime, the control of absenteeism, and the importance of integrating equipment and workforce scheduling simultaneously. The model integrates seamlessly with other research studies and provides the necessary and critical tools to manage the resources in a facility on a routine basis.     

The optimality of myopic stocking policies for systems with decreasing purchasing prices

This paper studies the stocking/replenishment decisions for inventory systems where the purchasing price of an item decreases overtime. In a periodic review setting with stochastic demands, we model the purchasing prices of successive periods as a stochastic and decreasing sequence. To minimize the expected total discounted costs (purchasing, inventory holding and shortage penalty) for systems with backlogging and lost sales, we derive conditions, regarding the cost parameters, under which myopic stocking policies are optimal.     

The Balance of Care Project: Modelling the Allocation of Health and Personal Social Services

The Balance of Care model was designed to predict from aggregate health and personal social service plans the care which will be received by different types of potential client. Planners can use the model to assess the implications of various competing strategies and hence choose the one which will yield a pattern of care closest to that desired. In order to predict the pattern of care inherent in a service strategy it is necessary to establish the priorities governing the allocation of services to clients. This paper concentrates on the structure of the model and the techniques developed to deduce priorities from the past behaviour of the health and personal social service system. Applications of the model are described more fully elsewhere.     

Assigning patients to nurses in neonatal intensive care

An intensive care nursery provides health care for critically ill newborn infants. During a typical shift, infants range from those needing only occasional care to those requiring constant attention. At the beginning of each shift, the head nurse groups the patients for assignment to staff nurses. Typically each nurse cares for one group of infants throughout the shift. The large variation in infant conditions along with several complicating side constraints makes it difficult to develop balanced nurse work loads. We develop a mathematical programming approach for achieving better workload balance. We first develop a detailed neonatal acuity system that quantifies the nursing workload of each patient. We then develop an integer linear program that assigns patients to nurses while balancing nurse workloads. Because this model is computationally intractable, we develop a heuristic that exploits the fact that most nurseries are divided into a number of physical zones. We use ten case studies taken from a major university hospital to benchmark the performance of this heuristic. We also perform a designed experiment using randomly generated problems that examines the effect of nursery parameters on heuristic performance.     

Generalized Nonlinear Variational-Like Inequalities

This study investigates how to dynamically allocate resources with a given budget for advertising through Web portals using keyword-activated banner ads on the Internet. Identifying the factors that affect the potential number of banner ad clickthroughs in each portal, we show that the process of budget allocation between the two types of portals (generic vs specialized) that leads to the largest banner clicksthrough in the long run is an optimal control problem. Using techniques of dynamic programming, we find analytical solutions for the optimal budgeting decisions. Our analysis shows that an advertisers optimal portal budgeting depends nonlinearly on the number of visitors who type the same trigger keyword and the average clicksthrough rates, as well as on the advertiser and ad effectiveness. Further, we find that the maximal number of banner clickthroughs from both portals, at time t, depends on the remaining budget until the end of the planning period. The analytical results have useful managerial insight. One of the interesting features of our solution shows that, while a large visitor base may favor the generic portal, other parameters may affect it unfavorably: e.g., lower clickthrough rates of keyword banners from a more heterogeneous audience. Using a specificaction that is consistent with empirical observations, we show that, in the long run, an advertiser must always spend more ad money at the specialized portal.     

考虑老年人感知满意度的社区居家养老护理人员调度策略研究

近年来,随着人口老龄化进程不断加快,社区居家养老模式越来越受到社会各界的高度关注。为了向社区居家养老服务中心护理人员调度提供决策支持,研究考虑老年人感知满意度的护理人员调度问题。以社区居家养老预约服务为背景,首先融合前景理论和模糊理论分别从老年人等待时间、老年人对护理人员偏好和老年人对服务价格偏好三个方面建立老年人感知满意度函数;其次确定主要目标为最大化老年人综合感知满意度,次要目标为最小化社区居家养老服务中心运营成本的优化调度问题,并且构建了相应的混合整数非线性规划数学模型;最后综合应用遗传算法和模拟植物生长算法(PGSA)对该模型进行求解,其中遗传算法用于求解护理人员的服务顺序,PGSA用于求解护理人员调度方案,并且利用MATLAB软件进行仿真,同时引入粒子群算法与PGSA进行计算对比,发现PGSA在性能参数和计算时间方面都有明显的优势。通过算例验证分析,结果表明该模型在考虑老年人感知满意度的基础上,能够获得最优的护理人员调度方案,证明了上述优化模型和算法的可行性和有效性。     

Modelling the requirement for supplementary nurses in an intensive care unit

The intensive care unit (ICU) of a hospital is an essential yet costly resource. Consequently, intensive care modelling has become increasingly prevalent in recent years in attempts to increase efficiency and reduce costs. Previous models have usually assumed that the numbers of beds available are restricted; when all beds are occupied, any additional patients are referred elsewhere or elective surgeries are cancelled. In this study, activities at the ICU at a large teaching hospital were modelled using data relating to all admissions to the ICU during the year 2000—a total of 1084 admissions. The unit is unusual in that the majority of patients referred for intensive care therapy are admitted. Bed numbers are increased when necessary to cope with demand. However, nurses are a restricted resource. In order to maintain the required nurse:patient ratio of at least one:one, supplementary nurses are employed during busy periods. Supplementary nurse costs are substantial and so nurse utilization must be closely monitored. The development of a model that calculates the required number of supplementary nurses per shift, and also encapsulates the time-dependent nature of elective surgery admissions and complex duration-of-stay profiles, is presented in this paper. In particular, the model is used to determine the number of rostered nurses that are required to minimize overall nursing staff costs.     

A Network Optimization Model for Budget Planning in Multi-Objective Hierarchical Systems

This paper presents a planning/budgeting scheme for hierarchical systems. A multi-objective network optimization model for multilayer budget allocation is suggested. The network presents the hierarchical structure of the system. The budget allocations are the flows in the network. Each component in the system (arc in the network) has lower and upper bounds. The model maximizes the additive utility function of the system, expressed as a weighted summation over the preferences of the system's components in the various levels. The preferences are evaluated by using a multigoal approach, utilizing the Analytical Hierarchy Process (AHP). Finally, the model is conceptually compared with other known budgeting procedures and models, such as ZBB, PBBS and cost benefit analyses.     

A sample-path approach to optimal position liquidation

We consider the problem of optimal position liquidation where the expected cash flow stream due to transactions is maximized in the presence of temporary or permanent market impact. A stochastic programming approach is used to construct trading strategies that differentiate decisions with respect to the observed market conditions, and can accommodate various types of trading constraints. As a scenario model, we use a collection of sample paths representing possible future realizations of state variable processes (price, trading volume etc.), and employ a heuristical technique of sample-path grouping, which can be viewed as a generalization of the standard nonanticipativity constraints.     

Cost-based decision-making in middleware virtualization environments

Middleware virtualization refers to the process of running applications on a set of resources (e.g., databases, application servers, other transactional service resources) such that the resource-to-application binding can be changed dynamically on the basis of applications’ resource requirements. Although virtualization is a rapidly growing area, little formal academic or industrial research provides guidelines for cost-optimal allocation strategies. In this work, we study this problem formally. We identify the problem and describe why existing schemes cannot be applied directly. We then formulate a mathematical model describing the business costs of virtualization. We develop runtime models of virtualization decision-making paradigms. We describe the cost implications of various runtime models and consider the cost effects of different managerial decisions and business factors, such as budget changes and changes in demand. Our results yield useful insights for managers in making virtualization decisions.     

The combined manpower planning and preventive maintenance strategies by aggregate planning for the service division of vending machines

This paper presents a mathematical model of aggregate planning for the service division of vending machines, which determines its workforce size and the preventive maintenance level that may affect the failure rate. The unique aspect of this problem is that it exhibits two types of failures requiring different repair and preventive maintenance. The practice is to divide the service division into two groups, within which there are hierarchies according to these types of failures, and in each group, there are full-time workers with annual contracts and temporary workers hired only during the peak season. A case study based on actual operational data demonstrates how effective the introduced model and the policy are in reducing the total cost and improving the quality of service, and thus enhancing the overall system performance of the service division. We perform sensitivity analysis on key parameters, which helps us change maintenance strategies under diverse operating situations.     

Dynamic multi-priority,multi-class patient scheduling with stochastic service times

Efficient patient scheduling has significant operational, clinical and economical benefits on health care systems by not only increasing the timely access of patients to care but also reducing costs. However, patient scheduling is complex due to, among other aspects, the existence of multiple priority levels, the presence of multiple service requirements, and its stochastic nature. Patient appointment (allocation) scheduling refers to the assignment of specific appointment start times to a set of patients scheduled for a particular day while advance patient scheduling refers to the assignment of future appointment days to patients. These two problems have generally been addressed separately despite each being highly dependent on the form of the other. This paper develops a framework that incorporates stochastic service times into the advance scheduling problem as a first step towards bridging these two problems. In this way, we not only take into account the waiting time until the day of service but also the idle time/overtime of medical resources on the day of service. We first extend the current literature by providing theoretical and numerical results for the case with multi-class, multi-priority patients and deterministic service times. We then adapt the model to incorporate stochastic service times and perform a comprehensive numerical analysis on a number of scenarios, including a practical application. Results suggest that the advance scheduling policies based on deterministic service times cannot be easily improved upon by incorporating stochastic service times, a finding that has important implications for practice and future research on the combined problem.     

Workforce staffing and scheduling: Hospital nursing specific models

Decisions relating to hospital nurse staffing and scheduling are among the most important decisions made in hospitals today. Staffing and scheduling choices must be made which will result in timely and high-quality care to patients. These choices are complicated by the requirement for round-the-clock staffing in many hospital nursing units, a severe nursing shortage, and an outcry from many quarters to cut costs of health care. In general, patients today are kept in hospitals only if they are in need of highly skilled nursing care. In this paper we present a review of some of the issues in health care currently influencing the hospital nurse staffing and scheduling environment. In addition, we review the literature that illustrates nurse manager's concerns, and approaches taken in the past by operations researchers to address those concerns. We present some data from a recent study of nurse managers in 31 hospitals that illustrates the complexity of the issues. We conclude with a discussion of future research directions in hospital nurse staffing and scheduling.     

Financial risk of project's cost

In this paper we will examine the effects of uncertainty of investment costs on the expected gain and budget allocation of a decision-maker. These effects are studied using the relationship between riskiness and stochastic dominance. Results and examples are provided for the case of budgeting one project. Furthermore, the problem of centralized vs. non-centralized budget allocation forn identically independent distributed projects is discussed.     

基于成本和加班时长的双目标家庭护理人员调度问题

人口老龄化程度的持续加重使得家庭医疗护理服务逐渐发展。本文针对家庭护理人员调度优化问题,考虑医患的技能匹配、加班费用、加班时长和工作量分配的均衡性等因素,设定最大技能偏差和工作时长,建立了最小化运营成本和最小化最大加班时长的双目标混合整数规划模型。设计了改进的NSGA-II和SPEA-II算法对问题进行求解,数值实验表明:最大加班时长越长,运营成本越小;最大技能偏差和医护人员早到惩罚对目标的影响明显;小规模算例中两算法均表现良好,大中型规模算例中改进SPEA-II的效率更高。