Improving Quality and Efficiency in Home Health Care: an application of Constraint Logic Programming for the Ferrara NHS unit

Although sometimes it is necessary, no one likes to stay in a hospital, and patients who need to stay in bed but do not require constant medical surveillance prefer their own bed at home. At the same time, a patient in a hospital has a high cost for the community, that is not acceptable if the patient needs service only a few minutes a day. For these reasons, the current trend in Europe and North-America is to send nurses to visit patients in their home: this choice reduces costs for the community and gives better quality of life to patients. On the other hand, it introduces the combinatorial problem of assigning patients to the available nurses in order to maximize the quality of service, without having nurses travel for overly long distances. In this paper, we describe the problem as a practical application of Constraint Logic Programming. We first introduce the problem, as it is currently addressed by the nurses in the National Health Service (NHS) in Ferrara, a mid-sized city in the North of Italy. Currently, the nurses solve the problem by hand, and this introduces several inefficiencies in the schedules. We formalize the problem, obtained by interacting with the nurses in the NHS, into a Constraint Logic Programming model. In order to solve the problem efficiently, we implemented a new constraint that tackles with the routing part of the problem. We propose a declarative semantics for the new constraint, and an implementation based on an external solver