Healthcare Systems. Группа авторов. Читать онлайн. Newlib. NEWLIB.NET

Автор: Группа авторов
Издательство: John Wiley & Sons Limited
Серия:
Жанр произведения: Медицина
Год издания: 0
isbn: 9781119902607
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route, the caregiver starts from origin 0, which is generally the HHC structure, and visits the nodes {i, i + 1, i + 2, ..., j-1, j}. In our case, we have to calculate a score cij (equation [2.1]), thus calculating the sum of the distances traveled by the caregiver from their starting point, until they return to the HHC at the end of their schedules. Likewise, the fitness function must take into consideration time constraints, that is, the penalties incurred in the case of violating a patient’s availability time window.

      dij denotes the distances between two patients i and j; v represents the cost per distance traveled; ke and kl represent, respectively, the penalties when a caregiver arrives at the patient’s home too early or too late; ei and li denote the availability time window of patient i and ai indicates the caregiver arrival time at the home of patient i. We have also integrated the variable Qu into the fitness function to designate whether a care worker is qualified to perform a treatment or a visit or not. We considered a correlation between the caregiver qualification and the patient dependency level. The variable Qu can be equal to 1 or 0 indicating, respectively, a qualified or unqualified caregiver.

      Selection. Once the score has been calculated for the whole population, we can select the most adapted individuals to become parents. There are different approaches for the selection. In our case, we have chosen to apply a probabilistic method called “roulette wheel selection”.

      Crossing. This is a mechanism by which the selected chromosomes produce a new generation. This genetic operator will help us to explore the full range of possible solutions.

      Stop condition. The process is repeated until a maximum number of generations is reached. When looking for an optimal solution, many conditions are taken into account. A workload is limited to up to four patients for each caregiver, and patients are visited according to their availability windows.

      2.3.2. Rescheduling in online mode

      SA corresponds to the scheduling agent who is the request sender, MSAk represents the care worker k with a modification on their schedule, Vm (t) corresponds to the vector containing all the tasks t to be performed by MSAk, TreatmentTime (Vm) corresponds to the duration of the treatment Vm (t), PC refers to the geolocation coordinates of the patient and PS corresponds to the full patient features. When an MSAk receives a new schedule, they must approve it by notifying the SA scheduling agent.

      To conclude, we have chosen a modeling approach based on two phases. The first phase is establishing caregiver schedules in an offline mode. The second phase, dedicated to the management of disruptions, generates a new schedule in real time, that is, online. It consists of rescheduling the GGA algorithm several times, taking into consideration the available caregivers and the associated information known at the time of the rescheduling (the state of their current schedule and their geolocation).

      In order to ensure better patient care, we develop a platform that optimizes routes by taking into account the constraints related to patients and caregivers. The medical and coordination staff can thus communicate with each other and receive information on the patients treated and those still waiting for treatment. The platform is developed used for both offline planning and online rescheduling. It also allows the HHC schedule coordinator to record and consult the information needed. The main component of this platform is the genetic clustering algorithm. This algorithm communicates with Google Maps API to display the routes of caregivers as well as the geographical location of patients.

      The algorithm assigns caregivers to patients based on availability, qualification and preference constraints. Patients are automatically identified on the map via their address, which is used for the calculation of the distances traveled. The routes are then determined according to the constraints. If a caregiver is absent or late, their status is updated and the routes are recalculated in order to take this information into account.

Number of caregivers Number of patients Computation time (s)
2 2 4 8 1.58 3.27 5.09
4 4 8 16 7.43 10.60 12.44
8 8 16 32 13.80 14.38 16.73

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