Supply Chain Management : Logistic ( TSP / VRP Scheduling )

Routing and Scheduling of Phlebotomists

Phlebotomists are clinical laboratory technicians who are responsible for drawing blood specimens from patients in the hospital. Their routine responsibilities include drawing samples for laboratory tests ordered that are to be completed on that day by the day crew. A 500- bed medical center usually employs five to seven technicians in this capacity. The morning pickups are made between 6:30 A.M. and 8:00 A.M. On a given morning there may be requests to draw blood samples from 120 to 150 patients. The time required to draw the blood necessary to complete a physician’s order varies depending on age, physical condition, and the number of different types of tests required of a patient. For example, a single phlebotomist may be able to draw samples for 20 maternity patients in 90 minutes, since most of these women are healthy and do not require “unusual” types of blood work. However, that same phlebotomist may only be able to draw blood from eight critically ill patients, who usually require more varied tests and may, because of their physical condition, require more time. The same limitation is true for infants and small children who require special collection techniques due to their size. In addition to their routine pickups, which must be completed within the 90-minute preshift interval, there are routine specimens that must be drawn at a specified time. These timed specimens include fasting specimens (such as blood glucose tests), which must be collected before the patient eats, and blood gases, which are collected 30 minutes after a patient has received a respiratory treatment. With either of these tests, there is a margin for “error” of 15 minutes. Generally, more routine tests are also collected along with the timed specimens. The medical center has five floors, each of which specializes in a particular type of patient. For example, one floor may handle surgical patients and another orthopedic patients. In addition, there are special sections, including the nursery, the pediatric floor, and the intensive care unit. Because of the location of the respiratory equipment and monitors, all patients requiring daily blood gases are located in intensive care. It is the task of the chief phlebotomist to estimate the number of phlebotomists needed on a given day and to assign patients to technicians such that all deliveries are made before the start of the day shift (continued) and timed specimens are collected within a 15-minute window of the specified time.

Discussion Questions

1. What characteristics of routing and scheduling are exhibited in this problem?

2. What type of data would you need to collect in order to most effectively schedule technicians?

3. Does a deadhead time exist in this situation? If so, where?

4. If you were to view this as a cluster first, route second situation, based on what criteria would you form clusters?

5. Suggest how you would solve the problem if the timed specimens and routine pickups were considered separately