TITLE:
Dynamic Optimization of Caregiver Schedules Based on Vital Sign Streams
AUTHORS:
Mohamed Saad, Bilal Khan
KEYWORDS:
Critical Care; Nurse Scheduling; Optimization
JOURNAL NAME:
E-Health Telecommunication Systems and Networks,
Vol.2 No.2,
June
28,
2013
ABSTRACT: Hospital facilities use a collection of heterogeneous
devices, produced by many different vendors, to monitor the state of patient
vital signs. The limited interoperability of current devices makes it difficult
to synthesize multivariate monitoring data into a unified array of real-time
information regarding the patients state. Without an infrastructure for the
integrated evaluation, display, and storage of vital sign data, one cannot
adequately ensure that the assignment of caregivers to patients
reflects the relative urgency of patient needs. This is an especially serious
issue in critical care units (CCUs). We present a formal mathematical model of
an operational critical care unit, together with metrics for evaluating the
systematic impact of caregiver scheduling decisions on patient care. The model
is rich enough to capture the essential features of device and patient
diversity, and so enables us to test the hypothesis that integration of vital
sign data could realistically yield a significant positive impact on the
efficacy of critical care delivery outcome. To test the hypothesis, we employ
the model within a computer simulation. The simulation enables us to compare
the current scheduling processes in widespread use within CCUs, against a new
scheduling algorithm that makes use of an integrated array of
patient information collected by an (anticipated) vital sign data integration infrastructure.
The simulation study provides clear evidence that such an infrastructure
reduces risk to patients and lowers operational costs, and in so doing reveals
the inherent costs of medical device non-interoperability.