Nurse Rostering with Genetic Algorithms

In recent years genetic algorithms have emerged as a useful tool for the heuristic solution of complex discrete optimisation problems. In particular there has been considerable interest in their use in tackling problems arising in the areas of scheduling and timetabling. However, the classical genetic algorithm paradigm is not well equipped to handle constraints and successful implementations usually require some sort of modification to enable the search to exploit problem specific knowledge in order to overcome this shortcoming. This paper is concerned with the development of a family of genetic algorithms for the solution of a nurse rostering problem at a major UK hospital. The hospital is made up of wards of up to 30 nurses. Each ward has its own group of nurses whose shifts have to be scheduled on a weekly basis. In addition to fulfilling the minimum demand for staff over three daily shifts, nurses’ wishes and qualifications have to be taken into account. The schedules must also be seen to be fair, in that unpopular shifts have to be spread evenly amongst all nurses, and other restrictions, such as team nursing and special conditions for senior staff, have to be satisfied. The basis of the family of genetic algorithms is a classical genetic algorithm consisting of n-point crossover, single-bit mutation and a rank-based selection. The solution space consists of all schedules in which each nurse works the required number of shifts, but the remaining constraints, both hard and soft, are relaxed and penalised in the fitness function. The talk will start with a detailed description of the problem and the initial implementation and will go on to highlight the shortcomings of such an approach, in terms of the key element of balancing feasibility, i.e. covering the demand and work regulations, and quality, as measured by the nurses’ preferences. A series of experiments involving parameter adaptation, niching, intelligent weights, delta coding, local hill climbing, migration and special selection rules will then be outlined and it will be shown how a series of these enhancements were able to eradicate these difficulties. Results based on several months’ real data will be used to measure the impact of each modification, and to show that the final algorithm is able to compete with a tabu search approach currently employed at the hospital. The talk will conclude with some observations as to the overall quality of this approach to this and similar problems.

Social support in cyberspace: A content analysis of communication within a Huntington’s Disease online support group

Objective: Huntington’s Disease (HD) is an inherited disorder, characterised by a progressive degeneration of the brain. Due to the nature of the symptoms, the genetic element of the disease and the fact that there is no cure, HD patients and those in their support network often experience considerable stress and anxiety. With an expansion in Internet access, individuals affected by HD have new opportunities for information retrieval and social support. The aim of this study is to examine the provision of social support in messages posted to a HD online support group bulletin board. Methods: In total, 1313 messages were content analysed using a modified version of the Social Support Behaviour Code developed by Cutrona & Suhr (1992). Results: The analysis indicates that group members most frequently offered informational (56.2%) and emotional support (51.9%) followed by network support (48.4%) with esteem support (21.7%) and tangible assistance (9.8%) least frequently offered. Conclusion: This study suggests that exchanging informational and emotional support represents a key function of this online group. Practice implications: Online support groups provide a unique opportunity for health professionals to learn about the experiences and views of individuals affected by HD and explore where and why gaps may exist between evidence-based medicine and consumer behaviour and expectations.