Out of hours workload management: Bayesian inference for decision support in secondary care

Artif Intell Med. 2016 Oct:73:34-44. doi: 10.1016/j.artmed.2016.09.005. Epub 2016 Oct 1.

Abstract

Objective: In this paper, we aim to evaluate the use of electronic technologies in out of hours (OoH) task-management for assisting the design of effective support systems in health care; targeting local facilities, wards or specific working groups. In addition, we seek to draw and validate conclusions with relevance to a frequently revised service, subject to increasing pressures.

Methods and material: We have analysed 4 years of digitised demand-data extracted from a recently deployed electronic task-management system, within the Hospital at Night setting in two jointly coordinated hospitals in the United Kingdom. The methodology employed relies on Bayesian inference methods and parameter-driven state-space models for multivariate series of count data.

Results: Main results support claims relating to (i) the importance of data-driven staffing alternatives and (ii) demand forecasts serving as a basis to intelligent scheduling within working groups. We have displayed a split in workload patterns across groups of medical and surgical specialities, and sustained assertions regarding staff behaviour and work-need changes according to shifts or days of the week. Also, we have provided evidence regarding the relevance of day-to-day planning and prioritisation.

Conclusions: The work exhibits potential contributions of electronic tasking alternatives for the purpose of data-driven support systems design; for scheduling, prioritisation and management of care delivery. Electronic tasking technologies provide means to design intelligent systems specific to a ward, speciality or task-type; hence, the paper emphasizes the importance of replacing traditional pager-based approaches to management for modern alternatives.

Keywords: Count data; Graphical model; Healthcare management; Multivariate time series; Out of hours.

MeSH terms

  • Bayes Theorem
  • Decision Support Techniques*
  • Delivery of Health Care / statistics & numerical data*
  • Humans
  • Personnel Staffing and Scheduling*
  • Secondary Care
  • Workload*