Home care routing and scheduling problem with teams’ synchronization

The demand for home care (HC) services has steadily been growing for two main types of services: healthcare and social care. If, for the former, caregivers' skills are of utter importance, in the latter caregivers are not distinguishable in terms of skills. This work focuses social care and models caregivers' synchronization as a means of improving human resources management. Moreover, in social care services, several visits need to be performed in the same day since patients are frequently alone and need assistance throughout the day. Depending on the patient's autonomy, some tasks have to be performed by two caregivers (e.g. assist bedridden patients). Therefore, adequate decision support tools are crucial for assisting managers (often social workers) when designing operational plans and to efficiently assign caregivers to tasks. This paper advances the literature by 1) considering teams of one caregiver that can synchronize to perform tasks requiring two caregivers (instead of having teams of two caregivers), 2) simultaneously modelling daily continuity of care and teams' synchronization, and 3) associating dynamic time windows to teams' synchronizations introducing scheduling flexibility while minimize service and travel times. These concepts are embedded into a daily routing and scheduling MIP model, deciding on the number of caregivers and on the number and type of teams to serve all patient tasks. The main HC features of the problem, synchronization and continuity of care, are evaluated by comparing the proposed planning with the current situation of a home social care service provider in Portugal. The results show that synchronization is the feature that most increases efficiency with respect to the current situation. It evidences a surplus in working time capacity by proposing plans where all requests can be served with a smaller number of caregivers. Consequently, new patients from long waiting lists can now be served by the “available” caregivers.