An Analytical Approach for Improving Patient-centric Delivery of Dialysis Services

Abstract

In this paper, we report on the development of an analytical model and a decision support tool for meeting the complex challenge of scheduling dialysis patients. The tool has two optimization objectives: First, waiting times for the start of the dialysis after the patients' arrivals must be minimized. Second, the minimization of lateness after the scheduled finish time, which is relevant for transport services, are pursued. We model the problem as a mathematical program considering clinical pathways, a limited number of nurses managing the patients, and dialysis stations. Furthermore, information about patients' drop-off and pick-up time windows at/from the dialysis unit are considered. We develop a platform in Microsoft Excel and implement the analytical model using an Open Source optimization solver. A case study from a dialysis unit in the UK shows that a user can compute a schedule efficiently and the results provide useful information for patients, caregivers, clinicians and transport services.