Aide à la décision pour le dimensionnement et le pilotage de ressources humaines mutualisées en milieu hospitalier

Le regroupement des blocs operatoires au sein d'un Plateau Medico-Technique (PMT) presente des enjeux dans la phase de conception (dimensionnement des ressources et choix d'organisation) et dans la phase de pilotage (planification de l'activite et affectation des ressources humaines et materielles) face auxquels les decideurs hospitaliers manquent d'outils. En reponse a ces besoins, cette these propose une demarche globale d'aide a la decision pour la conception du PMT et le pilotage des ressources humaines mutualisees de ce secteur. Cette demarche aborde trois principaux problemes. Dans un premier temps, nous nous interessons a la modelisation des processus de PMT existants, dont le but est de faire emerger un diagnostic et d'engager une demarche d'amelioration de la performance. Ces modeles sont reutilises dans un second temps pour la modelisation des processus cibles qui nous permettent d'obtenir, par simulation de l'activite, les courbes de charge exprimant les besoins en personnel. Nous abordons la question du dimensionnement du personnel regroupe du PMT par la construction des vacations couvrant cette charge previsionnelle, a l'aide de la Programmation Lineaire en Nombres Entiers (PLNE) couplee a la simulation de flux. Dans un troisieme temps, nous etudions deux problemes de planication d'horaires de travail : celui des infirmiers anesthesistes et celui des medecins anesthesistes, pour lesquels nous developpons plusieurs approches de resolution basees sur la Programmation Lineaire Mixte (PLM) et sur la Programmation Par Contraintes (PPC), experimentees et validees dans le cadre d'applications reelles.

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