Programma 19 oktober 2012

Choir 1.jpgCHOIR seminar
Improving healthcare operations starts here

Date: Friday October 19, 2012

Time: 10:45 - 12:00

Welcome and coffee from 10:30

Location: University of Twente, Citadel H327 (building 9 on the campus map)

Cost: Free (registration not required)

Talks

Maartje Zonderland

Variations in the patient care process at the emergency department:

Development and implications of an observational instrument

Egbert van der Veen

Self-Rostering: An iterative improvement heuristic to support feasible schedule creation

Abstracts

Variations in the patient care process at the emergency department:

Development and implications of an observational instrument

Maartje Zonderland

Zonderland Zorglogistiek

Center for Healthcare Operations Improvement & Research, University of Twente

In this talk we discuss the development and implications of an observational instrument, designed to evaluate treatment routines at an Emergency Department (ED). The instrument divides all different types of activities a doctor can perform at an ED into eight categories. In 2010, a pilot study with the instrument was carried out at the ED of Leiden University Medical Center. All physician activities were registered on a minute-to-minute base by an independent observer. Ten doctors were observed during a total of ± 36 hours in which 42 patients were seen. Although emergency physicians were observed for a shorter period of time than internists, they saw more patients. Emergency physicians tended to have more patient contact time than internists, but both groups dedicated most of their time to documentation and had little communication with emergency department nurses. The average LOS of internal patients was significantly higher than for the patients of emergency physicians. By protocol, patients at the Emergency Department (ED) who are seen by emergency physicians are treated one by one, resulting in a more or less serial treatment routine. Physicians from other departments tend to see more patients at the same time (parallel treatment routine), and thus occupy more treatment rooms simultaneously. We suspect that the parallel treatment routine is related to a longer patient LOS and suboptimal ED logistics. In a succeeding study we will mathematically compare the advantages and disadvantages of serial and parallel treatment routines at the ED.

Self-Rostering: An iterative improvement heuristic to support feasible schedule creation

Egbert van der Veen

ORTEC

Center for Healthcare Operations Improvement & Research, University of Twente

Self-rostering is receiving more and more attention from both theory and practice. With self-rostering, employees propose the schedule they prefer to work during a given planning horizon. These schedules serve as input to create feasible schedules. We present an approach to support creating feasible schedules, where every employee's proposed schedule is preserved as much as possible and where the burden is divided ‘fair’ among the employees.

Our approach is flexible and easily extendable, since the checking of labor rules is isolated from the actual algorithm, which makes it easy to incorporate additional labor rules. Moreover, our approach enables the user to make a trade-off between transparency of the algorithm's choices versus a higher quality resulting schedule. We discuss results and indicate how the user can control the performance of the algorithm using various model parameters.

About the CHOIR seminar

The CHOIR seminar is a new monthly healthcare operations research platform where theory meets practice.

The next CHOIR activity will be the symposium ‘Quality-driven efficiency in healthcare’ on Friday November 23, see www.utwente.nl/choir for information and registration.