Stochastic online appointment scheduling of multi-step sequential procedures in nuclear medicine

Abstract

The increased demand for medical diagnosis procedures has been recognized as one of the contributors to the rise of health care costs in the U.S. in the last few years. Nuclear medicine is a subspecialty of radiology that uses advanced technology and radiopharmaceuticals for the diagnosis and treatment of medical conditions. Procedures in nuclear medicine require the use of radiopharmaceuticals, are multi-step, and have to be performed under strict time window constraints. These characteristics make the scheduling of patients and resources in nuclear medicine challenging. In this work, we derive a stochastic online scheduling algorithm for patient and resource scheduling in nuclear medicine departments which take into account the time constraints imposed by the decay of the radiopharmaceuticals and the stochastic nature of the system when scheduling patients. We report on a computational study of the new methodology applied to a real clinic. We use both patient and clinic performance measures in our study. The results show that the new method schedules about 600 more patients per year on average than a scheduling policy that was used in practice by improving the way limited resources are managed at the clinic. The new methodology finds the best start time and resources to be used for each appointment. Furthermore, the new method decreases patient waiting time for an appointment by about two days on average.

Organizing timely treatment in multi-disciplinary care

“…As the planning of the drug preparation by the pharmacy and the drug injection by the nurses should be well-coordinated, an integrated perspective is required in planning the chemotherapy appointments [96]. Other examples of multi-disciplinary outpatient and day care clinics can be found in cancer diagnostics [71], neurology [75], nuclear medicine [135] and ophthalmology [110].…”

Organizing integrated processes in cancer care

“…As the planning of the drug preparation by the pharmacy and the drug injection by the nurses should be well-coordinated, an integrated perspective is required in planning the chemotherapy appointments [169]. Other examples of multidisciplinary outpatient and day care clinics can be found in cancer diagnostics [108], neurology [113], nuclear medicine [236] and ophthalmology [181].…”

“…Hierarchical level 181,197,236,254,265,273,313], heuristics [67,76,143,148,181,198,241,277,313], simulation [15], genetic algorithms [16,68,69,148,197,241], local search methods [66], and data mining [15,68]. For online planning, we found 21 papers.…”

“…Used methods include mathematical programming [17,40], heuristics [82,235], simulation [82,153,156,235,320], stochastic programming [236], constraint programing [125], genetic algorithms [17], and agent-based models [305,306].…”

Harmony Search Approach for Patient Scheduling in Emergency Laboratories

“…The proposed approach allocates the resource capacity to patient groups and finds the optimal resource openings hours. Pérez et al, (2013) have presented a stochastic online scheduling algorithm for patient and resource scheduling in nuclear medicine departments which take into account the time constraints imposed by the decay of the radiopharmaceuticals and the stochastic nature of the system when scheduling patients. Ceschia and Schaerf (2011) have firstly developed a multi-neighborhood local search procedure to solve the patient admission scheduling problem.…”