Scheduling of Physicians with Time‐Varying Productivity Levels in Emergency Departments
Bibliographic record
Abstract
Emergency department (ED) overcrowding and long patient wait times have become a worldwide problem. We propose a novel approach to assign physicians to shifts such that ED wait times are reduced without adding new physicians. In particular, we extend the physician rostering problem by including the heterogeneity between emergency physicians with regard to their productivity levels (measured as patient-per-hour rate) and by including the stochastic nature of patient arrivals and physician productivity. We formulate the physician rostering problem as a two-stage stochastic program and solve it with a sample average approximation and the L-shaped method. To formulate the problem, we perform a data analysis to investigate the major drivers of physician productivity levels using patient visit data from our partner ED, and find that {individual physicians, shift hour, and shift type (e.g., day or night) are the dominating factors of ED productivity.} A simulation study calibrated using real data shows that the new scheduling from our formulation can reduce patient wait times by as much as 16%, compared to the current scheduling at our study ED. We also demonstrate how to incorporate physician preference in scheduling through physician clustering based on their productivity levels. Our simulation results show that EDs can receive almost full benefit even when the number of clusters is fairly small.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".