Optimal patient allocation for echocardiographic assessments

TL;DR

This paper develops a data-driven, reinforcement learning-based approach to optimize the scheduling and resource allocation for echocardiographic exams, addressing variability and constraints in hospital settings.

Contribution

It introduces a stochastic simulation framework combined with RL to derive near-optimal dynamic scheduling policies for echocardiography labs.

Findings

On-the-fly allocation outperforms reservation strategies.

RL-based policies significantly improve resource utilization.

Empirical data informs realistic simulation and policy evaluation.

Abstract

Scheduling echocardiographic exams in a hospital presents significant challenges due to non-deterministic factors (e.g., patient no-shows, patient arrival times, diverse exam durations, etc.) and asymmetric resource constraints between fetal and non-fetal patient streams. To address these challenges, we first conducted extensive pre-processing on one week of operational data from the Echo Laboratory at Stanford University's Lucile Packard Children's Hospital, to estimate patient no-show probabilities and derive empirical distributions of arrival times and exam durations. Based on these inputs, we developed a discrete-event stochastic simulation model using SimPy, and integrate it with the open source Gymnasium Python library. As a baseline for policy optimization, we developed a comparative framework to evaluate on-the-fly versus reservation-based allocation strategies, in which different proportions of resources are reserved in advance. Considering a hospital configuration with a 1:6 ratio of fetal to non-fetal rooms and a 4:2 ratio of fetal to non-fetal sonographers, we show that on-the-fly allocation generally yields better performance, more effectively adapting to patient variability and resource constraints. Building on this foundation, we apply reinforcement learning (RL) to derive an approximated optimal dynamic allocation policy. This RL-based policy is benchmarked against the best-performing rule-based strategies, allowing us to quantify their differences and provide actionable insights for improving echo lab efficiency through intelligent, data-driven resource management.