Integrating simulation with simulated annealing for scheduling physicians in an understaffed emergency department

Abstract

In this paper, a physician scheduling problem in an emergency department (ED) is studied. A simulation-optimisation approach, which integrates simulation into simulated annealing is proposed to solve the problem. The algorithm explores solutions iteratively, where simulations are carried out to evaluate the solution quality at each step. With the proposed simulation-optimisation algorithm, a case study of an understaffed ED in Hong Kong is conducted. The historical data provided by the ED are used to draw some managerial insights into emergency-physician scheduling. It is found that (i) the best staffing level has a similar profile to the patient arrival rate, but shifts some period behind; (ii) the use of staggered shifts is helpful in reducing patient waiting time; (iii) physician scheduling decisions have a greater impact particularly when the ED is small; and (iv) ED pooling seems more beneficial than having a good physician schedule.

Keywords:

• simulation optimisation
• staff scheduling
• emergency rooms
• overcrowding
• health-care management
• simulation
• simulated annealing

Funding

This work was supported by the Macao Science and Technology Development Fund under Grant 088/2013/A3.

ORCID

Yong Hong Kuo http://orcid.org/0000-0002-6170-324X

Notes

1. For the sake of convenience, in the rest of this paper, is assumed.

Additional information

Mr Yong Hong Kuo is a Research Assistant Professor at the CUHK Big Data Decision Analytics Research Centre at the Chinese University of Hong Kong. He received his Ph.D. and M.Phil. degrees in Systems Engineering and Engineering Management, and B.Sc. degree in Mathematics with a minor in Risk Management Science all from the Chinese University of Hong Kong. Prior to returning to the Chinese University of Hong Kong, he was an Assistant Professor at the School of Business at Macau University of Science and Technology. During his studies, he worked at the University of California at Berkeley as a Visiting Researcher and Oak Ridge National Laboratory as a Research Student. His research interests include operations research, combinatorial optimisation, logistics management, system simulation and healthcare management.