title: Automated medical resident rotation and shift scheduling to ensure quality resident education and patient care.
abstract: At academic teaching hospitals around the country, the majority of clinical care is provided by resident physicians. During their training, medical residents often rotate through various hospitals and/or medical services to maximize their education. Depending on the size of the training program, manually constructing such a rotation schedule can be cumbersome and time consuming. Further, rules governing allowable duty hours for residents have grown more restrictive in recent years (ACGME 2011), making day-to-day shift scheduling of residents more difficult (Connors et al., J Thorac Cardiovasc Surg 137:710-713, 2009; McCoy et al., May Clin Proc 86(3):192, 2011; Willis et al., J Surg Edu 66(4):216-221, 2009). These rules limit lengths of duty periods, allowable duty hours in a week, and rest periods, to name a few. In this paper, we present two integer programming models (IPs) with the goals of (1) creating feasible assignments of residents to rotations over a one-year period, and (2) constructing night and weekend call-shift schedules for the individual rotations. These models capture various duty-hour rules and constraints, provide the ability to test multiple what-if scenarios, and largely automate the process of schedule generation, solving these scheduling problems more effectively and efficiently compared to manual methods. Applying our models on data from a surgical residency program, we highlight the infeasibilities created by increased duty-hour restrictions placed on residents in conjunction with current scheduling paradigms.
authors.affiliation: , Knoxville, TN, USA. HKSmalley@gmail.com.
authors.forename: Hannah K
authors.initials: HK
authors.lastname: Smalley
authors.affiliation: H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, 755 Ferst Drive, Atlanta, GA, 30332, USA.
authors.forename: Pinar
authors.initials: P
authors.lastname: Keskinocak
mesh_terms: D000465:Algorithms; D006784:Hospitals, Teaching / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration* / Q000592:standards; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration* / Q000592:standards; D011787:Quality of Health Care / Q000458:organization & administration* / Q000592:standards; D012985:Software Design; D016526:Workload
keywords: Decision support; Integer programming; Physician scheduling; Rotation assignment