Designing cyclic appointment schedules for outpatient clinics with scheduled and unscheduled patient arrivals

We present a methodology to design appointment systems for outpatient clinics and diagnostic facilities that offer both walk-in and scheduled service. The developed blueprint for the appointment schedule prescribes the number of appointments to plan per day and the moment on the day to schedule the appointments. The method consists of two models; one for the day process that governs scheduled and unscheduled arrivals on the day and one for the access process of scheduled arrivals. Appointment schedules that balance the waiting time at the facility for unscheduled patients and the access time for scheduled patients are calculated iteratively using the outcomes of the two models. Two methods to calculate appointment schedules, complete enumeration and a heuristic procedure, are compared in various numerical experiments. Furthermore, an appointment schedule for the CT-scan facility at the Academic Medical Center Amsterdam, The Netherlands, is developed to demonstrate the practical merits of the methodology. The method is of general nature and can therefore also be applied to scheduling problems in other sectors than health care.     

Visualization of Delay Uncertainty and its Impact on Train Trip Planning: A Design Study

Uncertainty about possible train delays has an impact on train trips, as the exact arrival time is unknown during trip planning. Delays can lead to missing a connecting train at the transfer station, or to coming too late to an appointment at the destination. Facing this uncertainty, the traveler may wish to use an earlier train or a different connection arriving well before the appointment. Currently, train trip planning is based on scheduled times of connections between two stations. Information about approximate delays is only available shortly before train departure. Although several visualization approaches can show temporal uncertainty, we are not aware of any visual design specifically supporting trip planning, which can show delay uncertainty and its impact on the connections. We propose and evaluate a visual design which extends train trip planning with delay uncertainty. It shows the scheduled train connections together with their expected train delays as well as their impacts on both the arrival time, and the potential of missing a transfer. The visualization also includes information about alternative connections in case of these critical transfers. In this way the user is able to judge which train connection is suitable for a trip. We conducted a user study with 76 participants to evaluate our design. We compared it to two alternative presentations that are prominent in Germany. The study showed that our design performs comparably well for tasks concerning train schedules. The additional uncertainty display as well as the visualization of alternative connections was appreciated and well understood. The participants were able to estimate when they would likely arrive at their destination despite possible train delays while they were unable to estimate this with existing presentations. The users would prefer to use the new design for their trip planning.     

车间调度DSS设计的优化方法

一个复杂的制造系统不仅可能涉及到成千上万道车间调度工序,而且工序的变更又可能导致相当大的调度规模,因此车间调度是一种决策模型,应用该模型设计的车间调度决策支持系统可以在短时间内有效地提供一种优化决策。遗传算法是一种高效并行的全局搜索方法,文章通过对遗传算法关键因素的讨论,研究了SFSDSS设计的优化方法。     

An IoT-Aware System for Managing Patients’ Waiting Time Using Bluetooth Low-Energy Technology

It is a common observation that whenever patients arrives at the front desk of a hospital, outpatient clinic, or other health-associated centers, they have to first queue up in a line and wait to fill in their registration form to get admitted. The long waiting time without any status updates is the most common complaint, concerning health officials. In this paper, UrNext, a location-aware mobile-based solution using Bluetooth low-energy (BLE) technology is presented to solve the problem. Recently, a technology-oriented method, the Internet of Things (IoT), has been gaining popularity in helping to solve some of the healthcare sector’s problems. The implementation of this solution could be illustrated through a simple example of when a patient arrives at a clinic for a consultation. Instead of having to wait in long lines, that patient will be greeted automatically, receive a push notification of an admittance along with an estimated waiting time for a consultation session. This will not only provide the patients with a sense of freedom but would also reduce the uncertainty levels that are generally observed, thus saving both time and money. This work aims to improve the clinics’ quality of services, organize queues and minimize waiting times, leading to patients’ comfort while reducing the burden on nurses and receptionists. The results demonstrate that the presented system is successful in its performance and helps achieves a pleasant and conducive clinic visitation process with higher productivity.     

Intelligent timetable evaluation using fuzzy AHP

There is a substantial body of empirical literature that establishes the benefits of customer satisfaction for enterprises. Among different available options to present our service, selecting the best choice in the customers’ eyes is a vital decision.Developing appropriate passenger train schedules is counted as one of the major managerial concerns in transportation environment. Although different algorithms have been developed to create predictive schedules for a fleet of passenger trains using different performance indicators, selecting the best one embraces some ambiguities and uncertainties. That is because a one-dimensional objective function may not be sufficient for responding customer concerns.The main objective of this paper is to propose an approach within the fuzzy AHP framework for tackling the complexity of multidimensional service evaluations, where “sum of weighted waiting times”, “average of unit waiting time” and “maximum ratio of waiting time to journey time” of a schedule are evaluated and the ultimate judgment on goodness of the schedule is made via the aggregation of the performance measures used. The study is based on the knowledge of certain managers and experts in IRC (Iran Railways Corporation) who are aware of available complexities in train scheduling and have been dealing with customers for several years.     

GSPN models of Markovian multiserver multiqueue systems

The paper presents exact results for the average customer waiting and sojourn times in Markovian systems comprising a number of finite-capacity queues cyclically attended by several servers. The system behaviour is described using generalized stochastic Petri nets (GSPN), and the performance indices are obtained numerically by means of GreatSPN, the software tool for the analysis of GSPN. The average waiting and sojourn times of customers in Markovian multiserver multiqueue systems are computed exactly in this paper for the first time: they were previously estimated for similar systems by other authors only through approximate models.     

关于车间作业调度的组合优化算法

车间调度问题由于具有重要的理论和实用价值吸引了很多研究者的兴趣,但一个复杂的车间调度不仅可能涉及到成千上万道车间调度工序,而且工序的变更又可能导致相当大的调度规模.本文针对调度提出了一种改进的遗传算法,该算法引入了生物界DNA的思想将染色体分为双链,并在一个制造企业软件系统中应用了此算法.     

To Schedule or to Execute: Decision Support and Performance Implications

This paper addresses a fundamental trade-off in dynamic scheduling between the cost of scheduling and the quality of the resulting schedules. The time allocated to scheduling must be controlled explicitly, in order to obtain good-quality schedules in reasonable times. As task constraints are relaxed, the algorithms proposed in this paper increase scheduling complexity to optimize longer and obtain high-quality schedules. When task constraints are tightened, the algorithms adjust scheduling complexity to reduce the adverse effect of long scheduling times on the schedule quality. We show that taking into account the scheduling time is crucial for honoring the deadlines of scheduled tasks. We investigate the performance of our algorithms in two scheduling models: one that allows idle-time intervals to exist in the schedule and another that does not. The model with idle-time intervals has important implications for dynamic scheduling which are discussed in the paper. Experimental evaluation of the proposed algorithms shows that our algorithms outperform other candidate algorithms in several parameter configurations.     

Job scheduling in a partitionable mesh using a two-dimensionalbuddy system partitioning scheme

The job scheduling problem in a partitionable mesh-connected system in which jobs require square meshes and the system is a square mesh whose size is a power of two is discussed. A heuristic algorithm of time complexity O(n(log n+log p)), in which n is the number of jobs to be scheduled and p is the size of the system is presented. The algorithm adopts the largest-job-first scheduling policy and uses a two-dimensional buddy system as the system partitioning scheme. It is shown that, in the worst case, the algorithm produces a schedule four times longer than an optimal schedule, and, on the average, schedules generated by the algorithm are twice as long as optimal schedules     

A finite source multi-server inventory system with service facility

In this article, we study a continuous review retrial inventory system with a finite source of customers and identical multiple servers in parallel. The customers arrive according a quasi-random process. The customers demand unit item and the demanded items are delivered after performing some service the duration of which is distributed as exponential. The ordering policy is according to (s, S) policy. The lead times for the orders are assumed to have independent and identical exponential distributions. The arriving customer who finds all servers are busy or all items are in service, joins an orbit. These orbiting customer competes for service by sending out signals at random times until she finds a free server and at least one item is not in the service. The inter-retrial times are exponentially distributed with parameter depending on the number of customers in the orbit. The joint probability distribution of the number of customer in the orbit, the number of busy servers and the inventory level is obtained in the steady state case. The Laplace–Stieltjes transform of the waiting time distribution and the moments of the waiting time distribution are calculated. Various measures of stationary system performance are computed and the total expected cost per unit time is calculated. The results are illustrated numerically.     

A finite source multi-server inventory system with service facility

In this article, we study a continuous review retrial inventory system with a finite source of customers and identical multiple servers in parallel. The customers arrive according a quasi-random process. The customers demand unit item and the demanded items are delivered after performing some service the duration of which is distributed as exponential. The ordering policy is according to (s, S) policy. The lead times for the orders are assumed to have independent and identical exponential distributions. The arriving customer who finds all servers are busy or all items are in service, joins an orbit. These orbiting customer competes for service by sending out signals at random times until she finds a free server and at least one item is not in the service. The inter-retrial times are exponentially distributed with parameter depending on the number of customers in the orbit. The joint probability distribution of the number of customer in the orbit, the number of busy servers and the inventory level is obtained in the steady state case. The Laplace–Stieltjes transform of the waiting time distribution and the moments of the waiting time distribution are calculated. Various measures of stationary system performance are computed and the total expected cost per unit time is calculated. The results are illustrated numerically.     

Dynamic vehicle allocation control for automated material handling system in semiconductor manufacturing

The current study examines the dynamic vehicle allocation problems of the automated material handling system (AMHS) in semiconductor manufacturing. With the uncertainty involved in wafer lot movement, dynamically allocating vehicles to each intrabay is very difficult. The cycle time and overall tool productivity of the wafer lots are affected when a vehicle takes too long to arrive. In the current study, a Markov decision model is developed to study the vehicle allocation control problem in the AMHS. The objective is to minimize the sum of the expected long-run average transport job waiting cost. An interesting exhaustive structure in the optimal vehicle allocation control is found in accordance with the Markov decision model. Based on this exhaustive structure, an efficient algorithm is then developed to solve the vehicle allocation control problem numerically. The performance of the proposed method is verified by a simulation study. Compared with other methods, the proposed method can significantly reduce the waiting cost of wafer lots for AMHS vehicle transportation.     

时空众包环境下时效均衡的在线任务分配算法

针对时空众包任务分配研究中单一考虑任务分配总效用或任务等待时间，导致总体分配效果不佳的问题，提出一种基于分配时间因子的动态阈值算法。首先，基于预估等待分配时间和已等待分配时间计算任务的分配时间因子；其次，综合考虑任务的回报值和分配时间因子进行任务分配排序；然后，在初始值的基础上增加动态调整项为每一项任务设置阈值；最后，根据阈值条件为每一项任务设置候选匹配集，并从候选匹配集中选择匹配系数最大的候选匹配对加入结果集，完成任务分配。通过实验证明，该算法在任务分配率达到95.8%的情况下，与贪心算法相比，在分配总效用方面提升20.4%；与随机阈值算法相比，在分配总效用方面提升17.8%，在任务平均等待时间方面缩短13.2%；与基于两阶段框架模型的在线微任务分配改进（TGOA-Greedy）算法相比，在分配总效用方面提升13.9%。实验结果表明，该算法能够在提升任务分配总效用的同时缩短任务的平均等待时间，实现分配总效用与任务等待时间两者间的均衡。     

Appointment scheduling algorithm considering routine and urgent patients

This paper derives a solution approach to solve the outpatient appointment schedule problem for given numbers of routine and urgent patients considering a no-show probability to minimize the weighted sum of average patient wait time, physician idle time and overtime. An exact deterministic service time method is proposed to find the optimal schedule. An exponentially distributed service time property is presented to show that the objective function for routine and urgent patients is not multimodular, and consequently a local search algorithm based on multimodulary does not guarantee global optimality. Thus, a heuristic algorithm based on two kinds of shifting policies (HE-TKS) is developed to solve the appointment schedule, which gives a local optimal solution as an upper bound for the optimal schedule. Numerical experiments are conducted to illustrate how the critical factors affect service efficiency of the clinic in practice. It reveals that lower no-show probability, smaller interval lengths, shorter service times, and more urgent patients will benefit both patients and clinics.     

Analysing stability and investments in railway networks using advanced evolutionary algorithms

We consider a network of periodically running railway lines. Investments are possible to increase the speed and to improve the synchronisation of trains. The model also includes random delays of trains and the propagation of delays across the network. We derive a cost‐benefit analysis of investments, where the benefit is measured in reduced waiting time for passengers changing lines. We also estimate the actual mean waiting time simulating the train delays. This allows us to analyse the impact that an increasing synchronisation of the timetable has on its stability. Simulation is based on an analytical model obtained from queueing theory. We use sophisticated adaptive evolutionary algorithms, which send off avant‐garde solutions from time to time to speed up the optimisation process. As there is a high correlation between scheduled and estimated waiting times for badly synchronised timetables, we are even able to include the time consuming simulation into our optimisation runs.     

General Perfectly Periodic Scheduling

In a perfectly periodic schedule, each job must be scheduled precisely every some fixed number of time units after its previous occurrence. Traditionally, motivated by centralized systems, the perfect periodicity requirement is relaxed, the main goal being to attain the requested average rate. Recently, motivated by mobile clients with limited power supply, perfect periodicity seems to be an attractive alternative that allows clients to save energy by reducing their "busy waiting" time. In this case, clients may be willing to compromise their requested service rate in order to get perfect periodicity. In this paper we study a general model of perfectly periodic schedules, where each job has a requested period and a length; we assume that m jobs can be served in parallel for some given m. Job lengths may not be truncated, but granted periods may be different than the requested periods. We present an algorithm which computes schedules such that the worst-case proportion between the requested period and the granted period is guaranteed to be close to the lower bound. This algorithm improves on previous algorithms for perfect schedules in providing a worst-case guarantee rather than an average-case guarantee, in generalizing unit length jobs to arbitrary length jobs, and in generalizing the single-server model to multiple servers.     

RASON: A new approach to the scheduling radiotherapy problem that considers the current waiting times

Scheduling Radiotherapy treatments for cancer patient is a major concern for hospital and clinics. The main problem consists in minimizing the patient waiting time in order to maximize the treatment effectiveness. Most of the modern scheduling approaches use expert systems based on scheduling heuristics and algorithms to develop detailed schedules, in order to efficiently map the patients requirements to the treatment capacity of the health center. In this paper, we propose RASON, a new heuristic based scheduling algorithm for radiotherapy treatments, which main objective is to minimize the average waiting time for each patient. In contrast to well-known existing approaches, our solution manages a priority list that can be dynamically updated according to both the patient category and his/her current waiting time. The generated schedule also impacts the minimization of the average tardiness of the first treatment sessions for each patient. We have evaluated our algorithm using both real data from the Institute of Radiotherapy in Santiago, Chilean and artificial cases generated with a self-developed generator called GeneRa. GeneRa is able to generate cases according to particular constraints inherent to several countries like UK, France and Italy. We show in our proposal evaluation that an on-the-fly scheduling has a great positive impact, allowing to reduce the average waiting time and tardiness for all patients categories. Our algorithm outperforms the JIT and ASAP well-known approaches, with a 95% statistical significance. Our scheduling algorithm allows to significantly reduce the treatment waiting time for different categories of patients. This is a major improvement for the patients as time and delays are crucial parameters to achieve the best effectiveness in cancer treatments.     

A perishable inventory system with service facilities and retrial customers

In this article, we present a continuous review perishable (s, S) inventory system with a service facility consisting of finite waiting room and a single server. The customers arrive according to a Markovian arrival process (MAP). The individual customer’s unit demand is satisfied after a random time of service which is assumed to have phase-type distribution. The life time of each item and the lead time of reorders are assumed to have independent exponential distributions. Any arriving customer, who finds the waiting room is full, enters into the orbit of infinite space. These orbiting customers compete for service by sending out signals the duration between two successive attempts are exponentially distributed. The joint probability distribution of the number of customers in the waiting room, number of customers in the orbit and the inventory level is obtained in the steady-state case. Various stationary system performance measures are computed and total expected cost rate is calculated.     

云计算中基于排队系统的任务调度模型研究

为缩短云计算中任务调度过程任务等待时间及提高虚拟机任务调度系统的执行效率,提出一种云环境下基于 排队系统的任务调度模型。对该模型中系统稳态分布和条件随机分解结果进行了分析,给出该模型的稳态队长的随机分解和稳态等待时间,结合数值例子,准确的找到服务率与期望队长、期望等待时间及其它性能指标之间的关系。通过云任务调度系统的仿真,实验结果验证了该模型能够快速地完成云任务的调度,提高了虚拟机资源的平均利用率。     

Load-sensitive dynamic workflow re-orchestration and optimisation for faster patient healthcare

Hospital waiting times are considerably long, with no signs of reducing any-time soon. A number of factors including population growth, the ageing population and a lack of new infrastructure are expected to further exacerbate waiting times in the near future. In this work, we show how healthcare services can be modelled as queueing nodes, together with healthcare service workflows, such that these workflows can be optimised during execution in order to reduce patient waiting times. Services such as X-ray, computer tomography, and magnetic resonance imaging often form queues, thus, by taking into account the waiting times of each service, the workflow can be re-orchestrated and optimised. Experimental results indicate average waiting time reductions are achievable by optimising workflows using dynamic re-orchestration.