University of Twente Student Theses


Optimizing the planning of regular multi-disciplinary checkups in Isala using discrete event simulation

Horstman, J.B.M. (2023) Optimizing the planning of regular multi-disciplinary checkups in Isala using discrete event simulation.

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Abstract:Problem definition: This research is performed at the internal medicine department of Isala Clinics in Zwolle (Isala), with a special focus on the diabetes center in Zwolle. The diabetes center treats diabetes people of all ages with diabetes. These patients have an annual multidisciplinary checkup, called the IDEAAL checkup. Currently the department finds themselves in a situation where it is too hard to plan IDEAAL checkups for every patient on one day respectively. Therefore, we formulate the following research question: How can the number of scheduled hospital days for the IDEAAL checkup per individual patient be minimized without increasing the overtime for staff and while minimizing the waiting time between appointments? In the current situation the planners do not plan every element (appointment) of the checkup, resulting in partly scheduled IDEAAL checkups. Also, these different appointments are not planned on a single day, resulting in more pressure on the logistics of the hospital and calendars of patients. The reason for not planning complete IDEAAL checkups on a single day finds its roots in the low availability of caregivers and the need for rescheduling a complex combination of appointments after a potential cancellation. Both of these problems are influenced by the booking horizon, which thus became the focus of this research. We start by determining how well the current situation performs, in which we found that 0.4% of the IDEAAL checkups got carried out entirely in a single day. This is mostly caused by the planners not being instructed to plan complete IDEAAL checkups nor them being instructed to plan them on a single day. All based on the presumption of IDEAAL checkups being impossible to plan on a single day. Solution Design and Evaluation: We design a solution approach for the analyzed problem. We formulated a discrete event simulation (DES) to test different booking horizons and see how changing this booking horizon impacts the potential to plan complete IDEAAL checkups in a single day. To first proof planning IDEAAL checkups in a single day is possible, a mathematical model has been developed. Thereafter, by using the DES we can give a more specific advice, related to the focus of this research, the booking horizon. The DES contains several heuristics, to approach reality as much as possible. Examples of the use of these heuristics are: finding appointment dates, sequencing appointments and changing availability. The Key Performance Indicators (KPIs) used to measure results from the DES are: “Fraction of single day checkups”, “Fraction of not scheduled patients”, “Throughput time of patients” and “Delta weeks”. With the first KPI “fraction of single day checkups” being the most important measure to take into account.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:31 mathematics, 50 technical science in general
Programme:Industrial Engineering and Management MSc (60029)
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