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Scheduling of Physicians with Time‐Varying Productivity Levels in Emergency Departments

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  • Farzad Zaerpour
  • Marco Bijvank
  • Huiyin Ouyang
  • Zhankun Sun

Abstract

Emergency department (ED) overcrowding and long patient wait times have become a worldwide problem. We propose a novel approach to assigning physicians to shifts such that ED wait times are reduced without adding new physicians. In particular, we extend the physician rostering problem (PRP) by including heterogeneity among emergency physicians in terms of their productivity (measured by the number of new patients seen in 1 hour) and by considering the stochastic nature of patient arrivals and physician productivity. We formulate the PRP as a two‐stage stochastic program and solve it with a sample average approximation and the L‐shaped method. To formulate the problem, we perform a data analysis to investigate the major drivers of physician productivity using patient visit data from our partner ED, and we find that the individual physician, shift hour, and shift type (e.g., day or night) are the determining factors of ED productivity. A simulation study calibrated using real data shows that the new scheduling method can reduce patient wait times by as much as 13% compared to the current scheduling system at our study ED. We also demonstrate how to incorporate physician preference in scheduling through physician clustering based on productivity. Our simulation results show that EDs can receive almost the full benefit of the new scheduling method even when the number of clusters is small.

Suggested Citation

  • Farzad Zaerpour & Marco Bijvank & Huiyin Ouyang & Zhankun Sun, 2022. "Scheduling of Physicians with Time‐Varying Productivity Levels in Emergency Departments," Production and Operations Management, Production and Operations Management Society, vol. 31(2), pages 645-667, February.
  • Handle: RePEc:bla:popmgt:v:31:y:2022:i:2:p:645-667
    DOI: 10.1111/poms.13571
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    References listed on IDEAS

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    1. Jens Brunner & Günther Edenharter, 2011. "Long term staff scheduling of physicians with different experience levels in hospitals using column generation," Health Care Management Science, Springer, vol. 14(2), pages 189-202, June.
    2. Hummy Song & Anita L. Tucker & Karen L. Murrell & David R. Vinsonc, 2018. "Closing the Productivity Gap: Improving Worker Productivity Through Public Relative Performance Feedback and Validation of Best Practices," Management Science, INFORMS, vol. 64(6), pages 2628-2649, June.
    3. Yichuan Ding & Eric Park & Mahesh Nagarajan & Eric Grafstein, 2019. "Patient Prioritization in Emergency Department Triage Systems: An Empirical Study of the Canadian Triage and Acuity Scale (CTAS)," Manufacturing & Service Operations Management, INFORMS, vol. 21(4), pages 723-741, October.
    4. Robert J. Batt & Christian Terwiesch, 2017. "Early Task Initiation and Other Load-Adaptive Mechanisms in the Emergency Department," Management Science, INFORMS, vol. 63(11), pages 3531-3551, November.
    5. David C. Chan, 2018. "The Efficiency of Slacking off: Evidence From the Emergency Department," Econometrica, Econometric Society, vol. 86(3), pages 997-1030, May.
    6. Gnanlet, Adelina & Gilland, Wendell G., 2014. "Impact of productivity on cross-training configurations and optimal staffing decisions in hospitals," European Journal of Operational Research, Elsevier, vol. 238(1), pages 254-269.
    7. Van den Bergh, Jorne & Beliën, Jeroen & De Bruecker, Philippe & Demeulemeester, Erik & De Boeck, Liesje, 2013. "Personnel scheduling: A literature review," European Journal of Operational Research, Elsevier, vol. 226(3), pages 367-385.
    8. Jens Brunner & Jonathan Bard & Rainer Kolisch, 2009. "Flexible shift scheduling of physicians," Health Care Management Science, Springer, vol. 12(3), pages 285-305, September.
    9. Hummy Song & Anita L. Tucker & Karen L. Murrell, 2015. "The Diseconomies of Queue Pooling: An Empirical Investigation of Emergency Department Length of Stay," Management Science, INFORMS, vol. 61(12), pages 3032-3053, December.
    10. Song‐Hee Kim & Ward Whitt, 2014. "Choosing arrival process models for service systems: Tests of a nonhomogeneous Poisson process," Naval Research Logistics (NRL), John Wiley & Sons, vol. 61(1), pages 66-90, February.
    11. John Goodale & Gary Thompson, 2004. "A Comparison of Heuristics for Assigning Individual Employees to Labor Tour Schedules," Annals of Operations Research, Springer, vol. 128(1), pages 47-63, April.
    12. Erhard, Melanie & Schoenfelder, Jan & Fügener, Andreas & Brunner, Jens O., 2018. "State of the art in physician scheduling," European Journal of Operational Research, Elsevier, vol. 265(1), pages 1-18.
    13. Huguette Beaulieu & Jacques Ferland & Bernard Gendron & Philippe Michelon, 2000. "A mathematical programming approach for scheduling physicians in the emergency room," Health Care Management Science, Springer, vol. 3(3), pages 193-200, June.
    14. Louis-Martin Rousseau & Gilles Pesant & Michel Gendreau, 2002. "A General Approach to the Physician Rostering Problem," Annals of Operations Research, Springer, vol. 115(1), pages 193-205, September.
    15. Defraeye, Mieke & Van Nieuwenhuyse, Inneke, 2016. "Staffing and scheduling under nonstationary demand for service: A literature review," Omega, Elsevier, vol. 58(C), pages 4-25.
    16. Omar EL-Rifai & Thierry Garaix & Vincent Augusto & Xiaolan Xie, 2015. "A stochastic optimization model for shift scheduling in emergency departments," Health Care Management Science, Springer, vol. 18(3), pages 289-302, September.
    17. Jillian A. Berry Jaeker & Anita L. Tucker, 2017. "Past the Point of Speeding Up: The Negative Effects of Workload Saturation on Efficiency and Patient Severity," Management Science, INFORMS, vol. 63(4), pages 1042-1062, April.
    18. A Gunawan & H C Lau, 2013. "Master physician scheduling problem," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 64(3), pages 410-425, March.
    19. Jens Brunner & Jonathan Bard & Rainer Kolisch, 2011. "Midterm scheduling of physicians with flexible shifts using branch and price," IISE Transactions, Taylor & Francis Journals, vol. 43(2), pages 84-109.
    20. Ludwig Kuntz & Sandra Sülz, 2013. "Treatment speed and high load in the Emergency Department—does staff quality matter?," Health Care Management Science, Springer, vol. 16(4), pages 366-376, December.
    21. Stolletz, Raik & Brunner, Jens O., 2012. "Fair optimization of fortnightly physician schedules with flexible shifts," European Journal of Operational Research, Elsevier, vol. 219(3), pages 622-629.
    22. Diwas S. Kc & Christian Terwiesch, 2009. "Impact of Workload on Service Time and Patient Safety: An Econometric Analysis of Hospital Operations," Management Science, INFORMS, vol. 55(9), pages 1486-1498, September.
    23. Thompson, Gary M. & Goodale, John C., 2006. "Variable employee productivity in workforce scheduling," European Journal of Operational Research, Elsevier, vol. 170(2), pages 376-390, April.
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