A mathematical model for scheduling and staffing multiclinic health regions

This paper describes the design and analysis of a multiobjective integer linear program for scheduling and staffing multiple clinics with itinerant health personnel in multiclinic regions. Specifically, the optimal assignment of physicians, nurse practitioners, nurses and/or assistants to differing types of medical clinics with differing personnel needs is considered in conjunction with determination of individual clinic operating schedules. The scheduling model incorporates parameters such as distance between clinics, personnel availability, personnel time, demand for services, and the mix of personnel required to meet quality goals, minimize travel costs, and maximize staff preferences for certain assignments. The model is illustrated using data provided by family planning decision makers in a rural health care environment. Analysis of the results shows that the formulation is easily generalizable to multiple settings and that the essence of the scheduling decision can be represented by the mathematical programming framework. Because of the size of the problem, techniuqes for improving computational aspects are discussed. The model is designed to be used as a benchmark to enable the development of heuristic scheduling methods which can be used on a PC for near optimal scheduling.