Vers un outil d'aide à la planification et à l'ordonnancement des ressources dans les services de soins

Towards a support decision tool for resource planning and scheduling in healthcare services

• Auteur / Autrice : Aïda Jebali
• Direction : Pierre Ladet
• Type : Thèse de doctorat
• Discipline(s) : Génie industriel
• Date : Soutenance en 2004
• Etablissement(s) : Grenoble INPG

Résumé

Le travail présenté dans cette thèse aborde le problème de la planification et de l'ordonnancement des ressources dans les services de soins. Nous proposons ici d'explorer une approche par processus de soins dans l'objectif de minimiser le délai de séjour du patient dans l'hôpital ainsi que les coûts de sa prise en charge, et ce dans le respect de la qualité des soins. Cette approche est particulièrement illustrée dans le cas de processus de soins passant par un service de chirurgie. Afin de tenir compte des aspects aléatoires, l'une des caractéristiques importantes de l'environnement hospitalier, nous proposons de traiter le problème de la planification et de l'ordonnancement des ressources suivant une structure hiérarchique qui porte sur quatre niveaux décisionnels : la planification des admissions, la construction du programme opératoire sur l'horizon de T jours, la construction du programme opératoire journalier et le pilotage temps-réel du bloc opératoire

In this thesis we are interested with the planification and scheduling problem in healthcare systems. A literature review permit us to opt for an approach based on the concept of healthcare process. The aim is to minimize patient length of stay as well as healthcare process costs while maintaining a good quality of service. This approach was particularly illustrated in the case of a healthcare process including a surgical stage. In order to take into account perturbations, one of the important characteristics of the hospital environment, we propose to treat the planification and scheduling problem following a hierarchical structure comprising four decision-making levels. The first level is carried out by admission planning which consists in fixing patient hospitalization dates. However, the admission date given to a patient risks not being very reliable because of the occurrence of various perturbations. Henceforth, hospitalization dates are confirmed according to the operating planning contructed on the horizon of T days. The third decision-making level consists in constructing a daily operating schedule. This decision-making level has double objectives: (1) update the operating planning established on the horizon of T days while integrating various perturbations which occur in the healthcare system; (2) determine the order of intervention achievement by considering the critical resources used in the operating process. Then, we propose an approach for real-time piloting aid of operating theatre in front of the occurrence of perturbations requiring to rethink the daily operating schedule. Among the various types of perturbations, here we treat emergency admissions.