Chemotherapy scheduling template development using an optimization approach.

PURPOSE: The purpose of this paper is to develop a chemotherapy scheduling template that accounts for nurse resource availability and patient treatment needs to alleviate the mid-day patient load and provide quality services for patients.

DESIGN/METHODOLOGY/APPROACH: Owing to treatment complexity in chemotherapy administration, nurses are required at the beginning, end and during treatment. When nurses are not available to continue treatment, the service is compromised, and the resource constraint is violated, which leads to inevitable delay that risks service quality. Consequently, an optimization method is used to create a scheduling template that minimizes the violation between resource assignment and treatment requirements, while leveling patient load throughout a day. A case study from a typical clinic day is presented to understand current scheduling issues, describe nursing resource constraints, and develop a constraint-based optimization model and leveling algorithm for the final template.

FINDINGS: The approach is expected to reduce the variation in the system by 24 percent and result in five fewer chemo chairs used during peak hours. Adjusting staffing levels could further reduce resource constraint violations and more savings on chair occupancy. The actual implementation results indicate a 33 percent reduction on resource constraint violations and positive feedback from nursing staff for workload.

RESEARCH LIMITATIONS/IMPLICATIONS: Other delays, including laboratory test, physician visit and treatment assignment, are potential research areas.

ORIGINALITY/VALUE: The study demonstrates significant improvement in mid-day patient load and meeting treatment needs using optimization with a unique objective.