A model evaluating effect of disaster warning issuance conditions on “cry wolf syndrome” in the case of a landslide

This study proposes a model that clarifies how disaster warning issuance conditions affect “cry wolf” syndrome. The disaster assumed in this study is landslide caused by heavy rainfall. Local authorities that issue disaster warnings are thought to tend to avoid the situation where casualty occurs without the issuance to residents of a disaster warning. As a result, the issuance conditions may be relaxed. Under this circumstance, however, the residents are thought to tend to ignore disaster warnings, since such warnings are inaccurate. Thus may emerge the “cry wolf” syndrome. In this study, a simulation model that expresses the behaviors of the local authority and the residents has been developed. For the purpose of demonstrating the model, numerical experiments were then carried out. In the numerical experiments, the effects of optimal issuance conditions for disaster warnings on the cost incurred by the resident were evaluated by using assumed parameters for the model.     

A stochastic programming model for scheduling call centers with global Service Level Agreements

We consider the issue of call center scheduling in an environment where arrivals rates are highly variable, aggregate volumes are uncertain, and the call center is subject to a global service level constraint. This paper is motivated by work with a provider of outsourced technical support services where call volumes exhibit significant variability and uncertainty. The outsourcing contract specifies a Service Level Agreement that must be satisfied over an extended period of a week or month. We formulate the problem as a mixed-integer stochastic program. Our model has two distinctive features. Firstly, we combine the server sizing and staff scheduling steps into a single optimization program. Secondly, we explicitly recognize the uncertainty in period-by-period arrival rates. We show that the stochastic formulation, in general, calculates a higher cost optimal schedule than a model which ignores variability, but that the expected cost of this schedule is lower. We conduct extensive experimentation to compare the solutions of the stochastic program with the deterministic programs, based on mean valued arrivals. We find that, in general, the stochastic model provides a significant reduction in the expected cost of operation. The stochastic model also allows the manager to make informed risk management decisions by evaluating the probability that the Service Level Agreement will be achieved.     

Managing the overflow of intensive care patients

Many hospitals in the Netherlands are confronted with capacity problems at their intensive care units (ICUs) resulting in cancelling operations, overloading the staff with extra patients, or rejecting emergency patients. In practice, the last option is a common choice because for legal reasons, as well as for hospital logistics, rejecting emergency patients has minimal consequences for the hospital. As a result, emergency patients occasionally have to be transported to hospitals far away. In this work, we propose a cooperative solution for the ICU capacity problem. In our model, several hospitals in a region jointly reserve a small number of beds for regional emergency patients. We present a mathematical method for computing the number of regional beds for any given acceptance rate. The analytic approach is inspired by overflow models in telecommunication systems with multiple streams of telephone calls. Simulation studies show that our model is quite accurate. We conclude that cooperation between hospitals helps to achieve a high acceptance level with a smaller number of beds resulting in improved service for all patients.     

Workforce routing and scheduling for electricity network maintenance with downtime minimization

We investigate a combined routing and scheduling problem for the maintenance of electricity networks. In electricity networks power lines must be regularly maintained to ensure a high quality of service. For safety reasons a power line must be physically disconnected from the network before maintenance work can be performed. After completing maintenance work the power line must be reconnected. Each maintenance job therefore consists of multiple tasks which must be performed at different locations in the network. The goal is to assign each task to a worker and to determine a schedule such that the downtimes of power lines and the travel effort of workers are minimized. For solving this problem, we combine a Large Neighborhood Search meta-heuristic with mathematical programming techniques. The method is evaluated on a large set of test instances which are derived from network data of a German electricity provider.     

Selecting and adapting weekly work schedules with working time accounts: A case of a retail clothing chain

A case of selection and adaptation of weekly work schedules is presented. Weekly work schedules in two franchises of an important retail clothing chain have to be established. Working time accounts are used: each week, an employee can owe the company a certain number of hours or vice versa. Nevertheless, over a certain threshold, the hours have to be paid for by the company and the account balance returns to zero. A minimum and desired level of capacity of employees is contemplated. Hierarchically, the planned capacity must attempt to reach the minimum level; then it must fit a desired level as much as possible. At present, the task of allocation and the final adjustment of schedules is done manually, which is difficult, ineffective and often inaccurate. The procedure proposed is divided into two phases. Firstly, a work schedule, selected from a list, is assigned to each worker; a mixed linear program, followed by a local optimization process, is used. In the second phase, the work schedules are modified according to predefined rules: if there is a surplus of capacity, work schedules are reduced, and if there is a shortage, work schedules are extended. The company considers the results to be satisfactory.     

A compact optimization model for the tail assignment problem

This paper investigates a new model for the so-called Tail Assignment Problem, which consists in assigning a well-identified airplane to each flight leg of a given flight schedule, in order to minimize total cost (cost of operating the flights and possible maintenance costs) while complying with a number of operational constraints. The mathematical programming formulation proposed is compact (i.e., involves a number of $0?1$ decision variables and constraints polynomial in the problem size parameters) and is shown to be of significantly reduced dimension as compared with previously known compact models. Computational experiments on series of realistic problem instances (obtained by random sampling from real-world data set) are reported. It is shown that with the proposed model, current state-of-the art MIP solvers can efficiently solve to exact optimality large instances representing 30-day flight schedules with typically up to 40 airplanes and 1500 flight legs connecting as many as 21 airports. The model also includes the main existing types of maintenance constraints, and extensive computational experiments are reported on problem instances of size typical of practical applications.     

A stochastic appointment scheduling system on multiple resources with dynamic call-in sequence and patient no-shows for an outpatient clinic

This research focuses on the stochastic assignment system motivated by outpatient clinics, especially the physical therapy in rehabilitation service. The aim of this research is to develop a stochastic overbooking model to enhance the service quality as well as to increase the utilization of multiple resources, like therapy equipment in a physical therapy room, with the consideration of patients’ call-in sequence. The schedule for a single-service period includes a fixed number of blocks of equal length. When patients call, they are assigned to an appointment time for that block, and an existing appointment is not allowed to be changed. In each visit, a patient might require more than one resource and a probability of no-show. Two estimation methods were proposed for the expected waiting and overtime cost with multiple resources: Convolution Estimation Method and Joint Cumulative Estimation Method for the upper and lower bound value; respectively. A numerical example based on a physical therapy room was used to show that this stochastic model was able to schedule patients for better profitability compared with traditional appointment systems based on four prioritization rules. The workload in each appointment slot was more balanced albeit more patients were assigned to the first slot to fill up the empty room.     

Optimizing specimen collection for processing in clinical testing laboratories

We study the logistics of specimen collection for a clinical testing laboratory that serves sites dispersed in an urban area. The specimens that accumulate at the customer sites throughout the working day are transported to the laboratory for processing. The problem is to construct and schedule a series of tours to collect the accumulated specimens from the sites throughout the day. Two hierarchical objectives are considered: (i) maximizing the amount of specimens processed by the next morning, and (ii) minimizing the daily transportation cost. We show that the problem is NP-hard and formulate a linear Mixed Integer Programming (MIP) model to solve the bicriteria problem in two levels. We characterize properties of optimal solutions and develop a heuristic approach based on solving the MIP model with additional constraints that seeks for feasible solutions with specific characteristics. To evaluate the performance of this approach, we provide an upper bounding scheme on the daily processed amount, and develop two relaxed MIP models to generate lower bounds on the daily transportation cost. The effectiveness of the proposed solution approach is evaluated using realistic problem instances. Insights on key problem parameters and their effects on the solutions are extracted by further experiments.     

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.     

Mathematical programming accelerates implementation of agro-industrial sugarcane complex

With the current demand for Brazilian sugarcane, the importance to investors of a faster implementation of agro-industrial complexes has been increasing. Estimates suggest that a 4-year implementation may enhance financial value creation by 10% when compared to the usual 6-year implementation. Given a desired production and a target implementation horizon, the quadratic programming model presented in this paper offers a feasible plantation schedule with minimum deviation from the plan. The model was used as an important tool in two business plans.     

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.     

The roster quality staffing problem – A methodology for improving the roster quality by modifying the personnel structure

Quantitative decision support on personnel planning is often restricted to either rostering or staffing. There exist some approaches in which aspects at the staffing level and the rostering level are treated in a sequential way. Obviously, such practice risks producing suboptimal solutions at both decision levels. These arguments justify an integrated approach towards improving the overall quality of personnel planning. This contribution constitutes (1) the introduction of the roster quality staffing problem and (2) a three-step methodology that enables assessing the appropriateness of a personnel structure for achieving high quality rosters, while relying on an existing rostering algorithm. Based on the rostering assessment result, specific modifications to the personnel structure can be suggested at the staffing level. The approach is demonstrated by means of two different hospital cases, which have it that they are subject to complex rostering constraints. Experimental results show that the three-step methodology indeed points out alternative personnel structures that better comply with the rostering requirements. The roster analysis approach and the corresponding staffing recommendations integrate personnel planning needs at operational and tactical levels.     

The optimal allocation of server time slots over different classes of patients

We present a model for assigning server time slots to different classes of patients. The objective is to minimize the total expected weighted waiting time of a patient (where different patient classes may be assigned different weights). A bulk service queueing model is used to obtain the expected waiting time of a patient of a particular class, given a feasible allocation of service time slots. Using the output of the bulk service queueing models as the input of an optimization procedure, the optimal allocation scheme may be identified. For problems with a large number of patient classes and/or a large number of feasible allocation schemes, a step-wise heuristic is developed. A common example of such a system is the allocation of operating room time slots over different medical disciplines in a hospital.     

Simulation modelling for contracting hospital emergency services at the regional level

Hospital emergency services are closely connected to demographic issues and population changes. The methodology presented here helps to assess the effects of the forecasted demand changes on the next-year emergency unit workloads. The objective of the study is to estimate the expected volume of emergency hospital services, as measured by the number and costs of medical procedures provided to patients, to be contracted by the Polish National Health Fund (NFZ) branch at the regional level to cover the forecasted demand. A discrete-event simulation model was developed to elaborate the credible forecasts of the function components, the fundamental elements of the contract values granted by the NFZ for emergency departments for the following year. Emergency department-level data were drawn from the NFZ regional branch registry to perform a statistical analysis of emergency services provided to patients in 17 admission units and emergency wards in 2010. The model results indicate that the predicted increase in two age groups, i.e., the youngest children and the older population, will have different effects on the number and value of hospital emergency services to be considered in the contracting policy. There is potential for a discrete-event simulation to support strategic health policy decision making at the regional level. The value of this approach lies in providing estimates for the what-if scenarios related to the prognosis of changing acute demand.     

Locating specialized service capacity in a multi-hospital network

Multi-hospital systems have become very common in today’s healthcare environment. However, there has been limited published research examining the opportunities and challenges of pooling specialized services to a subset of hospitals in the network. Therefore, this paper considers how hospital networks with multiple locations can leverage pooling benefits when deciding where to position specialized services, such as magnetic resonance imaging (MRI), transplants, or neonatal intensive care. Specifically, we develop an optimization model to determine how many and which of a hospital network’s hospitals should be set up to deliver a specialized service. Importantly, this model takes into account both financial considerations and patient service levels. Computational results illustrate the value of optimally pooling resources across a subset of hospitals in the network versus two alternate approaches: (1) delivering the service at all locations and requiring each site to handle its own demand, or (2) locating the service at one hospital that handles all network demand.     

A branch-and-price approach for integrating nurse and surgery scheduling

A common problem at hospitals is the extreme variation in daily (even hourly) workload pressure for nurses. The operating room is considered to be the main engine and hence the main generator of variance in the hospital. The purpose of this paper is threefold. First of all, we present a concrete model that integrates both the nurse and the operating room scheduling process. Second, we show how the column generation technique approach, one of the most employed exact methods for solving nurse scheduling problems, can easily cope with this model extension. Third, by means of a large number of computational experiments we provide an idea of the cost saving opportunities and required solution times.     

Modelling activities at a neurological rehabilitation unit

A queuing model of a specialist neurological rehabilitation unit is studied. The application is to the Neurological Rehabilitation Centre at Rookwood Hospital (Cardiff, UK), the national rehabilitation unit for Wales. Due to high demand this 21-bed inpatient facility is nearly always at maximum occupancy, and with a significant bed-cost per day this makes it a prime candidate for mathematical modelling. Central to this study is the concept that treatment intensity has an effect on patient length of stay. The model is constructed in four stages. First, appropriate patient groups are determined based on a number of patient-related attributes. Second, a purpose-built scheduling program is used to deduce typical levels of treatment to patients of each group. These are then used to estimate the mean length of stay for each patient group. Finally, the queuing model is constructed. This consists of a number of disconnected homogeneous server queuing systems; one for each patient group. A Coxian phase-type distribution is fitted to the length of time from admission until discharge readiness and an exponential distribution models the remainder of time until discharge. Some hypothetical scenarios suggested by senior management are then considered and compared on the grounds of a number of performance measures and cost implications.     

Developing work schedules for an inter-city transit system with multiple driver types and fleet types

In developing work schedules, the job assignment flexibility exploits the variety of available skills, thus enabling the assignment of workers to perform different jobs. In this study, we investigate the problem of finding the mix of primary and secondary jobs in short term work schedules to meet, at minimum cost, the daily service requirements of an inter-city bus transit firm in Andra Pradesh India operating multiple fleet types. We formulate the problem as a set covering model with resource allocation constraints. We develop a branch-and-price procedure to solve the model. Computational results are provided.     

A column generation approach for solving the patient admission scheduling problem

This paper addresses the Patient Admission Scheduling (PAS) problem. The PAS problem entails assigning elective patients to beds, while satisfying a number of hard constraints and as many soft constraints as is possible, and arises at all planning levels for hospital management. There exist a few, different variants of this problem. In this paper we consider one such variant and propose an optimization-based heuristic building on branch-and-bound, column generation, and dynamic constraint aggregation to solve it. We achieve tighter lower bounds than previously reported in the literature and, in addition, we are able to produce new best known solutions for five out of twelve instances from a publicly available repository.     

Optimal response against bioterror attack on airport terminal

We consider a potential bioterror attack on an airport. After the attack is identified, the government is faced with the problem of how to allocate limited emergency resources (human resources, vaccines, etc.) efficiently. The government is assumed to make a one-time resource allocation decision. The optimal allocation problem is discussed and it is shown how available information on the number of infected passengers can be incorporated into the model. Estimation for parameters of the cost function (number of deaths after the epidemic is over) is provided based on known epidemic models. The models proposed in the paper are demonstrated with a case study using real airport data.