E-Health Telecommunication Systems and Networks, 2012, 1, 43-48
http://dx.doi.org/10.4236/etsn.2012.14007 Published Online December 2012 (http://www.SciRP.org/journal/etsn)
Enhanced Greedy Optimization Algorithm with Data
Warehousing for Automated Nurse Scheduling System
R. M. Kapila Taranga Ratnayaka1, Zhong-Jun Wang1, Satish Anamalamudi2, Siyue Cheng3
1Department of Statistics, Science College, Wuhan University of Technology, Wuhan, China
2School of Information Engineering, Wuhan University of Technology, Wuhan, China
3College of Engineering, Colorado State University, Fort Collins, USA
Email: kapila.tr@gmail.com, kapilar@sab.ac.lk
Received September 11, 2012; revised October 12, 2012; accepted October 21, 2012
ABSTRACT
Current Nurse scheduling process has many challenges like work plan creation and working hour allocation for em-
ployees at specific planning horizon. Hospitals in most of the developing countries use manual methods to create nurse
scheduling systems. With current existing manual nurse scheduling systems, most of the hospitals especially in devel-
oping countries don’t have efficient work plan allocation. Moreover, patients need nursing care throughout the day.
Hence, current manual nurse scheduling approach with simple statistical functions is not efficient especially for highly
populated countries. Our proposed automated nurse scheduling approach has carried out in two stages. Firstly, we pro-
pose an efficient data warehouse system based on online analytical method for hospital information system. Subse-
quently, Enhanced Greedy Optimization algorithm is implemented to optimize the nurse roster and compared with other
optimization algorithms (Simulated Annealing and Genetic Algorithm). Experimental results (MYSQL, JAVA, OLAP)
with proposed optimization algorithm outperforms compared with existing optimization solutions.
Keywords: Java; MYSQL; Date Warehouse; OLAP
1. Introduction
Nurse scheduling process is very crucial task for manag-
ing nurse duty schedules in hospital system. It is a proc-
ess of creating a balanced work schedule for nurses.
Currently, even in most of the reputed hospitals, nurses
spend additional time for creating nurse schedule manu-
ally which is very complex and not effective. Since peo-
ple need healthcare throughout 24 hours, it is important
to design efficient automated nurse scheduling software
to manage nurse duty activities.
The feasible scheduling system has main impact on the
quality of the health care and their budgets. Hence, hos-
pital management system has to concern many con-
straints at the time of implementing automated nurse
schedule [1,2]. Various necessities of patients, different
type of qualifications, experiences and specializations of
nurses, employers and employee requirements, unpre-
dictable incidence and absenteeism and other factors
make the problem more complicated.
In our proposed work, main focus is on the informa-
tion based database model for nurse management system
especially for highly populated countries [3,4]. Usually,
nurse in charge of each ward has responsibility to main-
tain records in their respective ward. Based on the pre-
pared schedule, nurses will be assigned for working
shifts with consideration of time, requirement, along with
experience and nurse skills. In this scenario, manual sys-
tem for maintaining records is not effective especially at
the time of holidays and busy working hours where most
of the nurses might be on leave [4]. With advance in IT
technology and efficient optimization algorithms it is not
so difficult to design efficient automated nurse schedul-
ing software with best optimization algorithm. Moreover,
it is flexible, reliable and more efficient compared with
manual nurse scheduling.
In our approach, data warehouse based on medical in-
formation system is used to store, retrieve and manage
the nurse information. Considering general and individ-
ual factors, efficient flexible nurse management ware-
house based online analytical process (OLAP) has been
proposed. The rest of the paper is organized as follows.
Section 2 explains about brief overview of existing solu-
tions with pros and cons. Section 3 explains about pro-
posed work with enhanced greedy optimization algo-
rithm. Section 4 explains about experimental results and
Section 5 ends up with conclusion and future work.
2. Related Works
Existing research works has been proposed diverse mod-
els and methodologies to develop automated nurse sched-
C
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R. M. K. T. RATNAYAKA ET AL.
44
uling problems. Most of the current proposed solutions
either make use of random based optimization algorithms
which won’t be efficient or applicable only for fully
automated nurse scheduling problem. Li Ping [5], Wu
Tao, Chen Mu, Zhou Bin and Xu Wei-guo has done
much research work related to Medical informatics in
2011 and had deep discussions about the role of data
warehouse management system to handle hospital and
nurse management information [6]. Multidimensional
analysis techniques under different angles were used to
extract the required data and information. Michael Silver
[7] and his group used data mining techniques for data
warehouse and published their findings under the title
“Case study: How to apply data mining techniques in a
Healthcare Data warehouse”. This approach has been
implemented successfully in many of the American hos-
pitals [8]. Two numerous data mining techniques called;
patient rule introduction method (PRMI) and weighted
item sets (WLS) were used to analyse large quantities of
data. In 1998, Peter Villiers and his team worked to-
gether to apply data mining techniques for solving clini-
cal data warehouse functionality and proposed Flexible
clinical data mining system (CDMS) using SAS statisti-
cal software [9,10]. In addition, research is carried out in
two stages. In first stage, controlled environment were
provided for CDMS access based systems and trans-
formed it into analytical clinical data. In the later stage,
operations were tested with the row data operations with
same data. Peter Villiers proposes genomic based data
for further performance enhancements.
In 2008, S. Kundu and M. Mahato described the use of
Genetic Algorithm (GA) for solving NSP. They used two
different models, Simulated Annealing and Genetic Al-
gorithm to solve this problem. Compare nurse perform-
ance at different levels. They have considered soft and
hard constraints [1].
End of 2009 K. Jaumard reported a method to solve
the nurse roster problem using column generation. There
sub problem was formulated as a shortest path problem
with resource constraints, where each possible shift was
represented by a node and It was solved by using a
two-stage algorithm.
2.1. Problem Definition
Organizations that operate continuously can divide their
daily works into shifts. In such scenario, scheduling ap-
proach to assign work schedule to each worker, which
involves building a timetable for specified period is re-
quired. In such scenario, efficient evolutionary based
algorithms should be implemented along with data ware-
house to enhance the performance of automated nurse
scheduling approach. Most of the current research works
[11] has been proposed with either random based opti-
mization algorithms or local optimization algorithms
which cannot withstand for difficult scenarios. Moreover,
it may lead to local optimization which causes severe
performance degradation. In addition, there are cases
where nurses may change their present shift, while other
nurses are scheduled around this pre-shift. In this case,
hospital management with manual nurse scheduling can
face many difficulties to assign works for nurses in dif-
ferent wards to the shifts according to the requirements.
This is one important and challenging consideration
which has not been proposed in any of the current re-
search works. In our proposed work, a module is de-
signed which can dynamically mange the shift change of
nurse whenever someone needs to change their shift time.
This needs to maintain a list of nurse information for
those who are going to work in next given schedule and
those who are on leave. Whenever, some wants change
the shift, our proposed module will shows the list of
names which is easy to adjust with other nurses. More-
over, each and every staff member should be equally
allocated for the night shifts, off days in weekends and
public holidays. Also different type of qualifications,
skills and experiences, different demands of patients,
unpredictable absenteeism and other factors make the
problem complicated. The objectives in this problem are
multiple and complicated. So, our main target is to find
high quality feasible schedule and resource assignments
under the labour contract rules and satisfying employees
as well as employer’s requirements and constraints. Sev-
eral requirements and constraints were identified during
the requirement analysis. Easy to understand, it is di-
vided in to three categories.
Manpower demand and working hour constraints
Working experiences and rank, staff group, skills,
gender, total number of working hours per month in-
cluding OT and other special qualifications were based
on this category.
Shift distribution and sequence pattern constraints
This category include the number of working hours
and pattern of shifts to be assign on consecutive days for
each and every staff member within the month [12].
Maximum and minimum shift constraints
The number of shift per month assigned to each nurse
must be within the limits of legal regulations.
In general, head nurse has a responsibility to construct
nurse roster and should be published before next month
in current manual nurse scheduling process. These tradi-
tional database systems are not well suitable to deal with
statistical techniques and quick decisions. Moreover, it
makes so redundant and surplus works [13]. In this paper,
we focus to find a feasible solution for nurse scheduling
system considering mentioned constraints and regula-
tions based on data warehouse with online analytical
processing (OLAP) techniques. Java, PHP and MYSQL
Copyright © 2012 SciRes. ETSN
R. M. K. T. RATNAYAKA ET AL. 45
were used to handle programming language and database
management systems.
3. Proposed Work
Nurse scheduling system represents the important ad-
ministrative activity in real world modern hospitals. Ma-
jor task is to identify the main areas, main working cate-
gories and allocation of recourses in efficient way. Based
on requirement analysis, five main categories were iden-
tified. They were administrators (employer), Head nurse
and nurses (employee), patients (customers) and other
staff members.
3.1. OLAP in the Multidimensional Data Model
Define abbreviations and acronyms the first time they are
used in the text, even after they have been defined in the
abstract. Abbreviations such as IEEE, SI, MKS, CGS, sc,
dc, and rms do not have to be defined. Do not use abbre-
viations in the title or heads unless they are unavoidable.
Data storage, retrieval and management are one of the
crucial factors for managing efficient automated nurse
scheduling software. Hence, data warehouse and OLAP
tools based on a multidimensional model has been used
in transformation process. Nurse Management system
along with hospital information management system in-
cludes monthly working schedule (nurse roster), mini-
mum and maximum monthly workload, Special duties
with OT periods, working preferences, requirements,
skill levels, categories, previous working records, work-
shops, educational information and personal information.
Moreover, it should be linked with management of pa-
tient information, management of medicine information
and hospital business information systems. In multidi-
mensional model, data are organized into multiple di-
mensions, and each dimension contains multiple level of
abstraction defined by concept hierarchies. Nurse sched-
uling system cube contains three dimensions such as;
Department, Ward and seniority. Also data warehouse
often adopt three-tier architecture: bottom tier (data
warehouse server), middle tier (OLAP server) and top
tier (front-end tools).
Bottom tier layer: The bottom tier is a warehouse data
base server that is almost a relational database system.
It is the first layer which stores pure information. This
tier also connects to the metadata repository, which
stores information about data warehouse and its con-
tent.
Middle tier (OLAP server): The middle tier is an
OLAP server, which handles the request of the client
to complete some logic task. Normally OLAP servers
present business with multidimensional data from the
data warehouse or data mart. However, the physical
architecture and implementation of must consider
data storage issues.
Top tier: This is a user interface layer, which contains
query, reporting analysis and data mining tools. The ar-
chitecture and functional overview of data warehouse is
shown in Figure 1.
3.2. Design of a Data warehouse: Roster Analysis
Framework
Proposed solution is a web based automated system for
nurses scheduling. Hence, one can update and view their
records in online. The data warehouse for the hospital is
a large-scale database. As a first step, Administrator in
the Hospital management system is a main user. The
proposed system mainly divided in to two parts called;
hospital management system and clinical information
system. Figure 1 clearly explains about OLAP design
model for Nurse scheduling problem.
The design mode of the OLAP model based data
warehouse is based on Figure 1. Hospital management
system includes Management information unit of em-
ployees and Pharmacy information database. Clinical
information system includes Accident and Emergency
Unit, Patient information unit (OPD and home), Surgery
and Clinical information, Maternity unit, Dental unit and
electronic medical information database. For reliable
handing, administrator appointed department heads for
each and every department. Department heads have a
responsibility to maintain their departments’ accounts. So
department heads appointed head nurses for every ward.
Head nurse is a main user in the ward and she creates
new accounts for nurses in her ward. Hence, all the
nurses must register the system and need to create their
own accounts. Once user gets activated their access, sys-
tem provides a facility to update their details, apply
leaves, apply and conform OT, view their time tables for
nurses. So, nurses must send their leave details through
their accounts before creation the roster. In this proposed
system, Modified Greedy algorithm is used to create fea-
sible high quality roster. Based on the output of optimi-
zation algorithm, scheduling tasks will be activated and
Figure 1. Design overview of NSP in OLAP.
Copyright © 2012 SciRes. ETSN
R. M. K. T. RATNAYAKA ET AL.
46
assigned to corresponding users.
3.3. Enhanced Greedy Optimization
Algorithm
Greedy Algorithm follows heuristic problem solving
with locally optimal choice at each stage with the hope of
finding a global optimum. “Traveling salesman problem”
is one of the best examples for heuristic based approach.
In our approach, Enhanced Greed optimization is used to
generate best global optimized value for nurse schedul-
ing.
Proposed Enhanced Greedy Algorithm has five crucial
components
Candidate set should be created.
Selection function should be defined so that it selects
the best candidate to add to the solution.
Feasibility function should be defined to identify
whenever a candidate can be used to contribute to a
solution.
Modified objective function is used to assign a value
to local solution, or a partial solution,
Solution function helps to identify the complete solu-
tion of the intended problem.
Proposed Greedy algorithm is divided into two catego-
ries namely (1) Degree based Ordering and (2) Grouping.
The algorithm for degree based ordering with graph col-
ouring approach is explained in (1).
Based on proposed algorithm, first matrix is created
for the nurses and monthly dates where nurse names
were taken as rows and days of the month was taken as
columns. In matrix, nurse names will be “i” and days of
the month will be “j”. Hence it explains total number of
nurses working in a ward for 31 days of the month. Later,
matrix is divided into four equal sub matrices. Firstly,
night shifts for Diagonal of the first sub matrix were as-
signed. Secondly, night shifts were assigned for diagonal
of the fourth sub matrix. Later night shifts were assigned
for 2nd and 3rd sub matrices.
3.4. Degree Based Ordering for Nurse
Scheduling : Graph Colouring Approach
{
Vertex (G) {x1,x2……….xn}
Colour(G) {c1, c2,c3,c4…..cn}
for (i=0; i<n; i++) // where n= number of vertices
{
for each colour vertex u -> n2(vi) do // u is subset of ‘v’.
{
TabooColors(color(u)) = vi
}
Colour (vi) = min{c : TabooColors(c) !=vi}
loop: Let Ci be the first colour in C.
For each j with i<j and xj adjacent to xj in G
Set Cj = Cj -{ Ci} //where xj will not have same colour
as xi
Change i to i+1 and if i+1 n,
Return to “loop”.
} (1)
Optimization of Nurse scheduling with grouping sce-
nario is explained in (2).
3.5. Greedy Algorithm for Grouping
{
Create variable start Nurse(SN), Start day(SD), end nurse
(EN) & end day(ED);
Nurses working in ward=r;
Working days =q;
Create 2 way integer array {NURSESSHIFTS }
// Rows
Day & column
Nurse identity
If(nurse shift== True)
{
Shift1;
}
else
shift0;
Group nurse number with group identity
One way group Array {Category}
Ward number x;
Assign (r/2)th(Q/2)th position of nurse shifts
Send (SN=r/2), (SD=q/2),(ED=r)
(ED=q) to scheduler Filling(SF)
Initiate (SN=0), (SD=q/2),(EN=r/2) and (ED=q) to SF
Send (SN=r/2), (SD=0),(EN=r) and (ED=q/2) to SF
Send (SN=0), (SD=0),(EN=r/2) and (ED=q/2) to SF
} (2)
Optimized solution of the nurse scheduling can be
generated with set of feasible solutions and optimization
function.
At each generation, decision should be best with re-
spect to time.
On the other hand, simulated annealing and Genetic
algorithm is used to compare the results with proposed
enhanced greedy optimization algorithm. Comparison
with other intelligent optimization is made in terms of
start time, stop time and cost function value which is
briefly explained in below.
4. Experimental Results
OLAP is used as a data ware house to store, retrieve and
manage the nurse information. MYSQL is used to access
Copyright © 2012 SciRes. ETSN
R. M. K. T. RATNAYAKA ET AL. 47
information from data warehouse with Java frontend.
Firstly, proposed Greedy optimization algorithm is im-
plemented in java. Detailed nurse information is created
and accessed through MYSQL. Optimization with prede-
fined cost function and set of feasible solutions are used
to determine the best optimized value.
Optimization is done in terms of 7, 14, 21 and 30 days.
Problem size is considered as 500 and compared the
proposed greedy solutions with simulated annealing and
Genetic algorithm. Table 1 explains about the compari-
son of proposed results with simulated annealing and GA
with respect to time in seconds.
Firstly, average time taken for greedy is 0.67 sec
whereas for SA it is 0.77 and GA it is 2.5 seconds. For,
14 days greedy has taken 1.34 sec whereas SA has taken
2.85 and 7.21 for GA. Similarly, for 21 day schedule,
3.21 is for greedy, 3.48 for SA and 8.26 for GA. Com-
pared with 7, 14, 21 day simulation results, 30 day simu-
lation result is almost same for Greedy, SA and GA.
From these, one can say that for few day schedules
greedy and simulated annealing performance is very near
compared with Genetic optimizations. For long period
simulations, all the three optimization algorithms holds
good to get optimized nurse schedule results. Hence, it is
good to choose greedy or simulated annealing for short
period nurse scheduling and can use genetic optimizatio-
for long period nurse schedule.
Gnu plot is used for graphical representation of simu-
lation results that were compared from optimization
algorithms.
5. Conclusion and Further Works
Nurse scheduling is one of the crucial problem that are
facing in many hospitals all around the world. Some con-
Table 1. Various optimization algorithms for nurse schedul-
ing problem.
Days Count Algorithm Solved
Avg. Time
(Sec)
MGA 460 0.67
SA 440 0.77
7 500
GA 400 2.5
MGA 470 1.34
SA 460 2.85 14 500
GA 365 7.21
MGA 470 3.21
SA 455 3.48 21 500
GA 430 8.26
MGA 485 11.18
SA 325 11.77 30 500
GA 320 11.28
straints make the problem more complex and compli-
cated. Currently high qualified health personals have
been conducting so many researches to find fair and bet-
ter solution. This research described new information
system based on OLAP data warehouse techniques.
Moreover, this study opens a new path for hospital in-
formation systems to deal with statistical methods such
as data ware house and data mining.
New proposed system helps to keep their records
foundation for making future decisions. Our proposed
work outperforms compared with existing manual system
and automated local optimization algorithms.
To fulfill the business requirements, there are few
other constraints that have to be added with current pro-
posed solution. In future, enhancements like linking da-
tabases for OLAP online system can be done to make it
as high quality and reliable solution.
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