Aspects logistiques de la chimiothérapie à domicile: Application au Centre Hospitalier Régional de Verviers

Abstract

A new trend currently appears in Belgium in the healthcare sector: the development of the home healthcare. This evolution reflects the changes currently occurring in the society, such as the increase in chronic diseases as well as the fact that the patients are increasingly demanding. The current Public Health Minister realises that the home healthcare is a potential solution to this transformation and launched several pilot projects in order to test and encourage this new form of healthcare. The hospital of Verviers is the member of one of these pilot projects, in collaboration with 5 other hospitals in the Liège area. This pilot-project is focused on the administration of chemotherapy and intravenous antibiotic therapy. To be able to implement this new form of hospitalisation, the CHR Verviers needs to overcome the different logistic challenges that are brought by the home healthcare. The objective of this paper is then to study the operational aspects of the problem and to provide potential solutions to these challenges. Three dimensions have been studied throughout the paper. First, the aim was to determine selection criteria for patients in order to make this service as efficient as possible. The analysis was conducted at an operational level by comparing the efficiency of different routes. Secondly, the impact of the inclusion of the patients’ desires concerning the time of the visit has been studied. To do so, random time windows have been assigned to patients. The final attention point is related to the inter-hospital situation. We attempted to determine whether it was advantageous for the different institutions to collaborate and to share patients, and if that is the case, to determine a methodology that can be used to allocate patients to the different hospitals. The analysis conducted stayed focus on the operational facet of the problem, and so, was based on the routing and scheduling problem.