Centralized Ambulance Diversion Policy Using Rolling-Horizon Optimization Framework to Minimize Patient Tardiness

Ambulance diversion (AD) is a common method for reducing crowdedness of emergency departments by diverting ambulance-transported patients to a neighboring hospital. In a multi-hospital system, the AD of one hospital increases the neighboring hospital’s congestion. This should be carefully considered for minimizing patients’ tardiness in the entire multi-hospital system. Therefore, this paper proposes a centralized AD policy based on a rolling-horizon optimization framework. It is an iterative methodology for coping with uncertainty, which first solves the centralized optimization model formulated as a mixed-integer linear programming model at each discretized time, and then moves forward for the time interval reflecting the realized uncertainty. Furthermore, the decentralized optimization, decentralized priority, and No-AD models are presented for practical application, which can also show the impact of using the following three factors: centralization, mathematical model, and AD strategy. The numerical experiments conducted based on the historical data of Seoul, South Korea, for 2017, show that the centralized AD policy outperforms the other three policies by 30%, 37%, and 44%, respectively, and that all three factors contribute to reducing patients’ tardiness. The proposed policy yields an efficient centralized AD management strategy, which can improve the local healthcare system with active coordination between hospitals.

Integration of Production Planning and Scheduling Based on RTN Representation under Uncertainties

Production planning and scheduling are important bases for production decisions. Concerning the traditional modeling of production planning and scheduling based on Resource-Task Network (RTN) representation, uncertain factors such as utilities are rarely considered as constraints. For the production planning and scheduling problem based on RTN representation in an uncertain environment, this paper formulates the multi-period bi-level integrated model of planning and scheduling, and introduces the uncertainties of demand and utility in planning and scheduling layers respectively. Rolling horizon optimization strategy is utilized to solve the bi-level integrated model iteratively. The simulation results show that the proposed model and algorithm are feasible and effective, can calculate the consumption of utility in every period, decrease the effects of uncertain factors on optimization results, more accurately describe the uncertain factors, and reflect the actual production process.