'The application of Bayesian Optimization and Classifier Systems in Nurse Scheduling'

Abstract. Two ideas taken from Bayesian optimization and classifier systems are presented for personnel scheduling based on choosing a suitable scheduling rule from a set for each person's assignment. Unlike our previous work of using genetic algorithms whose learning is implicit, the learning in both approaches is explicit, i.e. we are able to identify building blocks directly. To achieve this target, the Bayesian optimization algorithm builds a Bayesian network of the joint probability distribution of the rules used to construct solutions, while the adapted classifier system assigns each rule a strength value that is constantly updated according to its usefulness in the current situation. Computational results from 52 real data instances of nurse scheduling demonstrate the success of both approaches. It is also suggested that the learning mechanism in the proposed approaches might be suitable for other scheduling problems.

'The application of Bayesian Optimization and Classifier Systems in Nurse Scheduling'

Abstract. Two ideas taken from Bayesian optimization and classifier systems are presented for personnel scheduling based on choosing a suitable scheduling rule from a set for each person's assignment. Unlike our previous work of using genetic algorithms whose learning is implicit, the learning in both approaches is explicit, i.e. we are able to identify building blocks directly. To achieve this target, the Bayesian optimization algorithm builds a Bayesian network of the joint probability distribution of the rules used to construct solutions, while the adapted classifier system assigns each rule a strength value that is constantly updated according to its usefulness in the current situation. Computational results from 52 real data instances of nurse scheduling demonstrate the success of both approaches. It is also suggested that the learning mechanism in the proposed approaches might be suitable for other scheduling problems.

The organization, form and function of intermediate care services and systems in England: results from a national survey

This paper reports the results of a postal survey of intermediate care co-ordinators (ICCs) on the organization and delivery of intermediate care services for older people in England, conducted between November 2003 and May 2004. Questionnaires, which covered a range of issues with a variety of quantitative, ‘tick-box’ and open-ended questions, were returned by 106 respondents, representing just over 35% of primary care trusts (PCTs). We discuss the role of ICCs, the integration of local systems of intermediate care provision, and the form, function and model of delivery of services described by respondents. Using descriptive and statistical analysis of the responses, we highlight in particular the relationship between provision of admission avoidance and supported discharge, the availability of 24-hour care, and the locations in which care is provided, and relate our findings to the emerging evidence base for intermediate care, guidance on implementation from central government, and debate in the literature. Whilst the expansion and integration of intermediate care appear to be continuing apace, much provision seems concentrated in supported discharge services rather than acute admission avoidance, and particularly in residential forms of post-acute intermediate care. Supported discharge services tend to be found in residential settings, while admission avoidance provision tends to be non-residential in nature. Twenty-four hour care in non-residential settings is not available in several responding PCTs. These findings raise questions about the relationship between the implementation of intermediate care and the evidence for and aims of the policy as part of NHS modernization, and the extent to which intermediate care represents a genuinely novel approach to the care and rehabilitation of older people.

Safety and complexity: the inter-departmental threats to patient safety in the operating department

Purpose: Current thinking about ‘patient safety’ emphasises the causal relationship between the work environment and the delivery of clinical care. This research draws on the theory of Normal Accidents to extend this analysis and better understand the ‘organisational factors’ that threaten safety. Methods: Ethnographic research methods were used, with observations of the operating department setting for 18 month and interviews with 80 members of hospital staff. The setting for the study was the Operating Department of a large teaching hospital in the North-West of England. Results: The work of the operating department is determined by inter-dependant, ‘tightly coupled’ organisational relationships between hospital departments based upon the timely exchange of information, services and resources required for the delivery of care. Failures within these processes, manifest as ‘breakdowns’ within inter-departmental relationships lead to situations of constraint, rapid change and uncertainty in the work of the operating department that require staff to break with established routines and work with increased time and emotional pressures. This means that staff focus on working quickly, as opposed to working safely. Conclusion: Analysis of safety needs to move beyond a focus on the immediate work environment and individual practice, to consider the more complex and deeply structured organisational systems of hospital activity. For departmental managers the scope for service planning to control for safety may be limited as the structured ‘real world’ situation of service delivery is shaped by inter-department and organisational factors that are perhaps beyond the scope of departmental management.

Organizational, systems and human issues in production planning, scheduling and control

With global markets and global competition, pressures are placed on manufacturing organizations to compress order fulfillment times, meet delivery commitments consistently and also maintain efficiency in operations to address cost issues. This chapter argues for a process perspective on planning, scheduling and control that integrates organizational planning structures, information systems as well as human decision makers. The chapter begins with a reconsideration of the gap between theory and practice, in particular for classical scheduling theory and hierarchical production planning and control. A number of the key studies of industrial practice are then described and their implications noted. A recent model of scheduling practice derived from a detailed study of real businesses is described. Socio-technical concepts are then introduced and their implications for the design and management of planning, scheduling and control systems are discussed. The implications of adopting a process perspective are noted along with insights from knowledge management. An overview is presented of a methodology for the (re-)design of planning, scheduling and control systems that integrates organizational, system and human perspectives. The most important messages from the chapter are then summarized.