Markov Decision Process and Approximate Dynamic Programming for a Patient Assignment Scheduling problem

Abstract: We study the Patient Assignment Scheduling (PAS) problem in a random environment that arises in the management of patient flow in the hospital systems, due to the stochastic nature of the arrivals as well as the Length of Stay distribution. We develop a Markov Decision Process (MDP) which aims to assign the newly arrived patients in an optimal way so as to minimise the total expected long-run cost per unit time over an infinite horizon. We assume Poisson arrival rates that depend on patient types, and Length of Stay distributions that depend on whether patients stay in their primary wards or not. Since the instances of realistic size of this problem are not easy to solve, we develop numerical methods based on Approximate Dynamic Programming. We illustrate the theory with numerical examples with parameters obtained by fitting to data from a tertiary referral hospital in Australia, and demonstrate the application potential of our methodology under practical considerations.