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Heurísticas para a marcação de cirurgias eletivas num hospital público
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Este trabalho enquadra-se no âmbito de um projeto em curso com um hospital público, onde foi estudado o problema de marcação de cirurgias eletivas. A administração do hospital pretende atingir os objetivos e as metas definidas pelo Ministério da Saúde para a produção cirúrgica, de forma a assegurar um elevado nível de eficiência do serviço cirúrgico. Contudo, os hospitais não têm qualquer sistema de marcação de cirurgias eletivas e, por isso, o agendamento é realizado, muitas vezes, pelos cirurgiões, enfermeiros ou funcionários administrativos. Devido à grande quantidade de pacientes que um cirurgião pode ter em lista de espera, este pode lembrar-se mais facilmente de pacientes que consultou mais recentemente. Portanto, muitas vezes, as cirurgias são marcadas de forma pouco sistemática e não respeitando critérios de equidade, desrespeitando, assim, as metas do Ministério. Foram consideradas três versões para o problema e foram desenvolvidas heurísticas com o objetivo de encontrar rapidamente boas soluções para cada versão do problema. As heurísticas selecionam os pacientes a serem agendados em cada semana e definem uma sala, um dia e um turno para a realização da respetiva cirurgia, de acordo com uma das três perspetivas diferentes do problema. As heurísticas desenvolvidas foram testadas em quatro instâncias reais e os valores das soluções obtidas foram comparados com os valores das soluções obtidas através de modelos matemáticos, formulados em programação linear inteira mista. Através da comparação destes valores foi concluído que, para todas as versões e para todas as instâncias testadas, as soluções obtidas pelas heurísticas são de muito boa qualidade e o tempo computacional necessário para a sua execução é, em geral, bastante reduzido, mesmo considerando as instâncias com mais cirurgias em lista de espera. Para além do desenvolvimento e implementação das heurísticas, foi criada uma interface de fácil utilização para o hospital, que possibilita a leitura da lista de espera e propõe uma agenda cirúrgica semanal. As heurísticas executadas através da interface são um bom meio para obter um sistema de marcação de cirurgias eletivas, tornando o processo de marcação mais automatizado e sistemático.
This work is part of an ongoing project with a public hospital, where the problem of scheduling elective surgeries is studied. The administration of the hospital aims to achieve the objectives and targets set by the Ministry of Health for surgical production, to ensure a surgical service with a high level of efficiency. However, hospitals do not have any elective surgeries scheduling system, so scheduling is often performed by surgeons, nurses or administrative staff. Due to the large number of patients that a surgeon may have on the waiting list, surgeons can remember more easily those patients consulted more recently. Often the surgeries are unsystematically scheduled and without respecting equity criteria, thus disregarding the Ministry’s goals. We consider three versions of the problem and heuristics have been developed in order to quickly find good solutions for each version of the problem. The heuristics select patients to be scheduled in each week and define a room, a day and a shift for the respective surgery in accordance with one of three different perspectives of the problem. The heuristics developed were tested in four real instances and the values of the solutions were compared with the values of the solutions obtained using mathematical models formulated in mixed integer linear programming. By comparing these values, we concluded that, for all versions and for all instances tested, the solutions obtained by the heuristics are of very good quality and the computational time required for its implementation is generally quite low, even considering the instances with more surgeries on the waiting list. In addition to the development and implementation of heuristics, a user-friendly interface for the hospital was created, which allows reading the waiting list and proposes a weekly surgical schedule. Executing heuristics through the interface is a good way to get an elective surgery scheduling system, making it a more automated and systematic scheduling process.
This work is part of an ongoing project with a public hospital, where the problem of scheduling elective surgeries is studied. The administration of the hospital aims to achieve the objectives and targets set by the Ministry of Health for surgical production, to ensure a surgical service with a high level of efficiency. However, hospitals do not have any elective surgeries scheduling system, so scheduling is often performed by surgeons, nurses or administrative staff. Due to the large number of patients that a surgeon may have on the waiting list, surgeons can remember more easily those patients consulted more recently. Often the surgeries are unsystematically scheduled and without respecting equity criteria, thus disregarding the Ministry’s goals. We consider three versions of the problem and heuristics have been developed in order to quickly find good solutions for each version of the problem. The heuristics select patients to be scheduled in each week and define a room, a day and a shift for the respective surgery in accordance with one of three different perspectives of the problem. The heuristics developed were tested in four real instances and the values of the solutions were compared with the values of the solutions obtained using mathematical models formulated in mixed integer linear programming. By comparing these values, we concluded that, for all versions and for all instances tested, the solutions obtained by the heuristics are of very good quality and the computational time required for its implementation is generally quite low, even considering the instances with more surgeries on the waiting list. In addition to the development and implementation of heuristics, a user-friendly interface for the hospital was created, which allows reading the waiting list and proposes a weekly surgical schedule. Executing heuristics through the interface is a good way to get an elective surgery scheduling system, making it a more automated and systematic scheduling process.
Descrição
Tese de mestrado, Estatística e Investigação Operacional (Investigação Operacional) Universidade de Lisboa, Faculdade de Ciências, 2016
Palavras-chave
Gestão de serviço de saúde Marcação de cirurgias eletivas Heurísticas Pesquisa local Interface Teses de mestrado - 2016