Hospital physicians can’t get no long-term satisfaction: an indicator for fairness in preference fulfillment on duty schedules

  • Physicians are a scarce resource in hospitals. In order to minimize physician attrition, schedulers incorporate individual physician preferences when creating the physicians’ duty roster. The manual creation of a roster is very time-consuming and often produces suboptimal results. Many schedulers therefore use model-based software to assist in planning. The planning horizon for duty schedules is usually a single month. Many models optimize the plan for the current planning horizon, without taking into account data on preference fulfillment and work load distribution from previous months. It is therefore possible that, when looking at a longer time horizon, some physicians are disadvantaged in terms of preference fulfillment more often than their peers, simply because this generates better results for the individual months. This may be perceived as unfair by the disadvantaged physicians. In order to eliminate this imbalance, we introduce a satisfaction indicator for preferencePhysicians are a scarce resource in hospitals. In order to minimize physician attrition, schedulers incorporate individual physician preferences when creating the physicians’ duty roster. The manual creation of a roster is very time-consuming and often produces suboptimal results. Many schedulers therefore use model-based software to assist in planning. The planning horizon for duty schedules is usually a single month. Many models optimize the plan for the current planning horizon, without taking into account data on preference fulfillment and work load distribution from previous months. It is therefore possible that, when looking at a longer time horizon, some physicians are disadvantaged in terms of preference fulfillment more often than their peers, simply because this generates better results for the individual months. This may be perceived as unfair by the disadvantaged physicians. In order to eliminate this imbalance, we introduce a satisfaction indicator for preference fulfillment in physician scheduling. This indicator is computed for each physician on each monthly plan and is then used to inform decisions regarding preference fulfillment on the current and future plans. As a result, a more equal distribution of preference fulfillment among physicians is achieved. We run a computational study with three different update strategies for our satisfaction indicator. Our study uses 24 months of data from a German university hospital and derives additional generated data from it. Results indicate that our satisfaction indicator, combined with the right update strategy, can achieve an equal distribution of satisfaction over all physicians within a peer group, as well as stable satisfaction levels for each individual physician over a longer time horizon. As our main contribution, we identify that our satisfaction indicator is more effective in creating equal distribution of long-term satisfaction the higher the rate of conflicting preferences is.show moreshow less

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Metadaten
Author:Christopher Nikolaus GrossORCiD, Jens O. BrunnerORCiDGND, Manfred Blobner
Frontdoor URLhttps://opus.bibliothek.uni-augsburg.de/opus4/39036
ISSN:1572-9389OPAC
Parent Title (English):Health Care Management Science
Publisher:Springer
Place of publication:Dordrecht [u.a.]
Type:Article
Language:English
Year of first Publication:2018
Release Date:2018/07/26
Tag:OR in health services; Mixed-integer program; Long-term fairness; Physician satisfaction
Volume:22
Issue:4
First Page:691
Last Page:708
DOI:https://doi.org/10.1007/s10729-018-9452-8
Institutes:Wirtschaftswissenschaftliche Fakultät
Wirtschaftswissenschaftliche Fakultät / Institut für Betriebswirtschaftslehre
Medizinische Fakultät
Wirtschaftswissenschaftliche Fakultät / Institut für Betriebswirtschaftslehre / Lehrstuhl für Health Care Operations / Health Information Management
Medizinische Fakultät / Universitätsklinikum