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Improving Patient Access to Chemotherapy Treatment at Duke Cancer Institute

Author

Listed:
  • Jonathan C. Woodall

    (Duke Medicine, Durham, North Carolina 27710)

  • Tracy Gosselin

    (Duke Cancer Institute, Durham, North Carolina 27710)

  • Amy Boswell

    (Duke Cancer Institute, Durham, North Carolina 27710)

  • Michael Murr

    (Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, North Carolina 27695)

  • Brian T. Denton

    (Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, Michigan 48109)

Abstract

This paper describes how we applied simulation and optimization in combination to improve patient flow within the Duke Cancer Institute, a large cancer center. We first developed a discrete-event simulation model to predict patient waiting time and resource utilization throughout various parts of the center, including the outpatient clinic, radiology, the pharmacy, laboratory services, and the oncology treatment facility. Simulation model studies showed that nurse unavailability during oncology treatment causes a serious bottleneck in patient flow. Next, we developed a mixed-integer programming model to relieve the bottleneck by optimizing weekly and monthly scheduling of different types of nurses. Finally, we developed a novel simulation-optimization model to further relieve the bottleneck by optimizing the starting times of nurse shifts. Our paper summarizes our main findings and the resulting recommendations that Duke Cancer Institute implemented.

Suggested Citation

  • Jonathan C. Woodall & Tracy Gosselin & Amy Boswell & Michael Murr & Brian T. Denton, 2013. "Improving Patient Access to Chemotherapy Treatment at Duke Cancer Institute," Interfaces, INFORMS, vol. 43(5), pages 449-461, October.
    • Handle: RePEc:inm:orinte:v:43:y:2013:i:5:p:449-461
    DOI: 10.1287/inte.2013.0695
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    References listed on IDEAS

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    1. Pablo Santibáñez & Vincent Chow & John French & Martin Puterman & Scott Tyldesley, 2009. "Reducing patient wait times and improving resource utilization at British Columbia Cancer Agency’s ambulatory care unit through simulation," Health Care Management Science, Springer, vol. 12(4), pages 392-407, December.
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    Cited by:

    1. Hadid, Majed & Elomri, Adel & Mekkawy, Tarek El & Jouini, Oualid & Kerbache, Laoucine & Hamad, Anas, 2022. "Operations management of outpatient chemotherapy process: An optimization-oriented comprehensive review," Operations Research Perspectives, Elsevier, vol. 9(C).
    2. Majed Hadid & Adel Elomri & Regina Padmanabhan & Laoucine Kerbache & Oualid Jouini & Abdelfatteh El Omri & Amir Nounou & Anas Hamad, 2022. "Clustering and Stochastic Simulation Optimization for Outpatient Chemotherapy Appointment Planning and Scheduling," IJERPH, MDPI, vol. 19(23), pages 1-34, November.
    3. Alireza F. Hesaraki & Nico P. Dellaert & Ton Kok, 2023. "Online scheduling using a fixed template: the case of outpatient chemotherapy drug administration," Health Care Management Science, Springer, vol. 26(1), pages 117-137, March.
    4. Alireza F. Hesaraki & Nico P. Dellaert & Ton Kok, 2020. "Integrating nurse assignment in outpatient chemotherapy appointment scheduling," OR Spectrum: Quantitative Approaches in Management, Springer;Gesellschaft für Operations Research e.V., vol. 42(4), pages 935-963, December.
    5. Shahab Sadri & Arsalan Paleshi & Lihui Bai & Monica Gentili, 2024. "A Simulation Study for a Safe Reopening and Operation of the Trager Institute Optimal Aging Clinic During the COVID-19 Pandemic," Interfaces, INFORMS, vol. 54(2), pages 188-204, March.
    6. Kibaek Kim & Sanjay Mehrotra, 2015. "A Two-Stage Stochastic Integer Programming Approach to Integrated Staffing and Scheduling with Application to Nurse Management," Operations Research, INFORMS, vol. 63(6), pages 1431-1451, December.
    7. Menel Benzaid & Nadia Lahrichi & Louis-Martin Rousseau, 2020. "Chemotherapy appointment scheduling and daily outpatient–nurse assignment," Health Care Management Science, Springer, vol. 23(1), pages 34-50, March.
    8. David Scheinker & Margaret L. Brandeau, 2020. "Implementing Analytics Projects in a Hospital: Successes, Failures, and Opportunities," Interfaces, INFORMS, vol. 50(3), pages 176-189, May.
    9. Bohui Liang & Ayten Turkcan & Mehmet Erkan Ceyhan & Keith Stuart, 2015. "Improvement of chemotherapy patient flow and scheduling in an outpatient oncology clinic," International Journal of Production Research, Taylor & Francis Journals, vol. 53(24), pages 7177-7190, December.
    10. M. Heshmat & A. Eltawil, 2021. "Solving operational problems in outpatient chemotherapy clinics using mathematical programming and simulation," Annals of Operations Research, Springer, vol. 298(1), pages 289-306, March.
    11. Guillaume Lamé & Oualid Jouini & Julie Stal-Le Cardinal, 2016. "Outpatient Chemotherapy Planning: a Literature Review with Insights from a Case Study," Post-Print hal-01324488, HAL.

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