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This paper advances healthcare workforce scheduling by applying Google's CP-SAT constraint programming solver to enforce strict regulatory compliance while optimizing soft objectives like cost and equity. The approach demonstrates that exact methods can scale to large hospital instances with near-linear complexity, offering a robust alternative to heuristic algorithms that often fail on complex constraints.
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From Metaheuristics to Exact Methods: A CP-SAT Approach for Multi-Objective Healthcare Workforce Scheduling

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arXiv:2608.30419v1 Announce Type: new Abstract: Healthcare workforce scheduling is an NP-hard optimization problem requiring simultaneous satisfaction of labor regulations, coverage requirements, employee preferences and cost objectives. Existing approaches (genetic algorithms, integer programming, constraint programming) model 6-12 constraints at shift-level granularity and cannot guarantee regulatory compliance. They also lack support for multi-role, multi-skill heterogeneity, mandatory break scheduling with midpoint control, acuity-weighted workload equity, sub-shift granularity, inter-week stability, and cross-midnight shifts. This paper presents CP-SAT: a Constraint Programming formulation for multi-role, multi-skill healthcare scheduling. CP-SAT enforces 14 hard constraints guaranteeing zero regulatory violations, while optimizing 15 soft objectives via a unified weighted penalty function. Contributions include a shift-window decomposition enabling break scheduling with centrality control, acuity-weighted workload equity, multi-granularity resolution from 15 minutes to 1 day, inter-week stability, and grid-offset preprocessing mapping cross-midnight shifts into a single scheduling day without solver changes. CP-SAT is evaluated on 18 instances: five synthetic hospital units (10-33 nurses), 10 INRC-II benchmarks (5-80 nurses, up to 8-week horizons) and 3 NRP-23 compatible instances (10-25 nurses) with cross-midnight Night shifts. Results: zero hard-constraint violations across all 18 instances by construction; proven optimality on INRC-II n005w4 (objective 118, gap 0.0%, 104s); feasible schedules scaling to 179,800 variables and 351,425 constraints (80 nurses); service quality improved 50-67% over MOGA; and model size scaling near-linearly at approximately 4,400 variables per employee. The formulation enforces 29 total constraints (14 hard, 15 soft), nearly three times the industry average.

Abstract:Healthcare workforce scheduling is an NP-hard optimization problem requiring simultaneous satisfaction of labor regulations, coverage requirements, employee preferences and cost objectives. Existing approaches (genetic algorithms, integer programming, constraint programming) model 6-12 constraints at shift-level granularity and cannot guarantee regulatory compliance. They also lack support for multi-role, multi-skill heterogeneity, mandatory break scheduling with midpoint control, acuity-weighted workload equity, sub-shift granularity, inter-week stability, and cross-midnight shifts. This paper presents CP-SAT: a Constraint Programming formulation for multi-role, multi-skill healthcare scheduling. CP-SAT enforces 14 hard constraints guaranteeing zero regulatory violations, while optimizing 15 soft objectives via a unified weighted penalty function. Contributions include a shift-window decomposition enabling break scheduling with centrality control, acuity-weighted workload equity, multi-granularity resolution from 15 minutes to 1 day, inter-week stability, and grid-offset preprocessing mapping cross-midnight shifts into a single scheduling day without solver changes. CP-SAT is evaluated on 18 instances: five synthetic hospital units (10-33 nurses), 10 INRC-II benchmarks (5-80 nurses, up to 8-week horizons) and 3 NRP-23 compatible instances (10-25 nurses) with cross-midnight Night shifts. Results: zero hard-constraint violations across all 18 instances by construction; proven optimality on INRC-II n005w4 (objective 118, gap 0.0%, 104s); feasible schedules scaling to 179,800 variables and 351,425 constraints (80 nurses); service quality improved 50-67% over MOGA; and model size scaling near-linearly at approximately 4,400 variables per employee. The formulation enforces 29 total constraints (14 hard, 15 soft), nearly three times the industry average.

13 pages, 10 tables. Accepted at MODeM Workshop, IJCAI-ECAI 2026. Extends arXiv:2607.05177

Artificial Intelligence (cs.AI); Optimization and Control (math.OC)

arXiv:2608.30419 [cs.AI]

(or arXiv:2608.30419v1 [cs.AI] for this version)

https://doi.org/10.48550/arXiv.2608.30419 Focus to learn more arXiv-issued DOI via DataCite

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