title: Out of hours workload management: Bayesian inference for decision support in secondary care.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Horizon Digital Economy Research Institute, The University of Nottingham, Nottingham Geospatial Building, Jubilee Campus, Wollaton Road, Nottingham NG8 1BB, UK. Electronic address: iker.perez@nottingham.ac.uk.
authors.forename: Iker
authors.initials: I
authors.lastname: Perez
authors.affiliation: Horizon Digital Economy Research Institute, The University of Nottingham, Nottingham Geospatial Building, Jubilee Campus, Wollaton Road, Nottingham NG8 1BB, UK. Electronic address: michael.brown@nottingham.ac.uk.
authors.forename: Michael
authors.initials: M
authors.lastname: Brown
authors.affiliation: Horizon Digital Economy Research Institute, The University of Nottingham, Nottingham Geospatial Building, Jubilee Campus, Wollaton Road, Nottingham NG8 1BB, UK. Electronic address: james.pinchin@nottingham.ac.uk.
authors.forename: James
authors.initials: J
authors.lastname: Pinchin
authors.affiliation: Horizon Digital Economy Research Institute, The University of Nottingham, Nottingham Geospatial Building, Jubilee Campus, Wollaton Road, Nottingham NG8 1BB, UK. Electronic address: sarah.martindale@nottingham.ac.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Martindale
authors.affiliation: Faculty of Engineering, The University of Nottingham, Room B25, Coates Building, University Park, Nottingham NG7 2RD, UK. Electronic address: sarah.sharples@nottingham.ac.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Sharples
authors.affiliation: Faculty of Medicine & Health Sciences, The University of Nottingham, Room B21, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK. Electronic address: dominic.shaw@nottingham.ac.uk.
authors.forename: Dominick
authors.initials: D
authors.lastname: Shaw
authors.affiliation: Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK. Electronic address: john.blakey@lstmed.ac.uk.
authors.forename: John
authors.initials: J
authors.lastname: Blakey
mesh_terms: D001499:Bayes Theorem; D003661:Decision Support Techniques; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D006801:Humans; D010561:Personnel Staffing and Scheduling; D063127:Secondary Health Care; D016526:Workload
keywords: Count data; Graphical model; Healthcare management; Multivariate time series; Out of hours