{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T13:11:20Z","timestamp":1782738680415,"version":"3.54.5"},"reference-count":36,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Algorithms"],"abstract":"<jats:p>The assignment of hospital rooms to patients is a critical operational decision that has a direct impact on patient safety, infection control, and staff workload. This study introduces HRPM\u2013IRC, an epidemiology-aware hyper-heuristic framework developed to optimize room\u2013patient matching by minimizing the risk of nosocomial infections, reducing travel and specialty mismatch costs, and promoting equitable nurse workload distribution. A mixed-integer linear programming model is formulated to capture infection transmission probabilities, isolation and cohorting requirements, and multi-ward capacity constraints. On top of this model, a bio-inspired hyper-heuristic adaptively selects and refines low-level heuristics, including cohort-first greedy allocation, risk-gradient swaps, and pathogen-aware local MILP refinement, on the basis of contextual epidemiological indicators and reinforcement learning. The framework was validated using a real-world dataset obtained from a tertiary hospital in Lebanon, comprising 142 anonymized patient admissions, 35 rooms, and six nursing teams. Results demonstrate that HRPM\u2013IRC consistently reduces modeled infection risk and workload imbalance by up to forty percent compared to conventional assignment heuristics while maintaining near-real-time decision-making capabilities suitable for dynamic hospital operations. These findings underscore the effectiveness of epidemiology-aware hyper-heuristics in enhancing hospital resilience, improving infection prevention, and supporting fair resource utilization in data-limited healthcare environments typical of Lebanon and other middle-income countries.<\/jats:p>","DOI":"10.3390\/a19030205","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T10:16:12Z","timestamp":1773051372000},"page":"205","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Infection Aware Hyper-Heuristic Framework for Hospital Room\u2013Patient Matching"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6469-672X","authenticated-orcid":false,"given":"Kassem","family":"Danach","sequence":"first","affiliation":[{"name":"Basic and Applied Sciences Research Center, Al Maaref University, Beirut P.O. Box 5078\/25, Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3802-9445","authenticated-orcid":false,"given":"Wael Hosny Fouad","family":"Aly","sequence":"additional","affiliation":[{"name":"College of Engineering and Technology, American University of the Middle East, Egaila 54200, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1442-3915","authenticated-orcid":false,"given":"Chadi Fouad","family":"Riman","sequence":"additional","affiliation":[{"name":"College of Engineering and Technology, American University of the Middle East, Egaila 54200, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"ref_1","first-page":"e50931","article-title":"Importance of Hospital Infection Control","volume":"15","author":"Kubde","year":"2023","journal-title":"Cureus"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/j.1469-0691.2005.01085.x","article-title":"Models for the organisation of hospital infection control and prevention programmes","volume":"11","author":"Gordts","year":"2005","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Daud-Gallotti, R.M., Costa, S.F., Guimar\u00e3es, T., Padilha, K.G., Inoue, E.N., Vasconcelos, T.N., Rodrigues, F., Barbose, E., Figueiredo, W., and Levin, A. (2012). Nursing workload as a risk factor for healthcare associated infections in ICU: A prospective study. PLoS ONE, 7.","DOI":"10.1371\/journal.pone.0052342"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"El Arab, R.A., Almoosa, Z., Alkhunaizi, M., Abuadas, F.H., and Somerville, J. (2025). Artificial intelligence in hospital infection prevention: An integrative review. Front. Public Health, 13.","DOI":"10.3389\/fpubh.2025.1547450"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1007\/s10729-023-09638-3","article-title":"Evaluation and implementation of a just-in-time bed-assignment strategy to reduce wait times for surgical inpatients","volume":"26","author":"Braaksma","year":"2023","journal-title":"Health Care Manag. Sci."},{"key":"ref_6","unstructured":"Saghafian, S., Kilinc, D., and Traub, S. (2022). Dynamic assignment of patients to primary and secondary inpatient units: Is patience a virtue?. The Cambridge Handbook of Healthcare Productivity, Efficiency, Effectiveness, Cambridge University Press."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.ejor.2019.07.073","article-title":"Recent Advances in Selection Hyper-Heuristics","volume":"285","author":"Drake","year":"2020","journal-title":"Eur. J. Oper. Res."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Shams Eddin, M., and El Hajj, H. (2025). An Optimization-Based Framework to Dynamically Schedule Hospital Beds in a Pandemic. Healthcare, 13.","DOI":"10.20944\/preprints202508.1668.v1"},{"key":"ref_9","unstructured":"Moody, M. (2025). Multi-Factor Mathematical Optimization for Healthcare Referral and Facility Placement, The University of Alabama in Huntsville."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"22639","DOI":"10.1038\/s41598-025-06329-7","article-title":"A novel intelligent approach for infection protection using a multidisciplinary collaboration in regional general hospitals","volume":"15","author":"Yuan","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Paul, T., Paul, T., and Kolay, A. (2026, January 16\u201319). Multi-agent Decision Support Framework for Bed Allocation and Patient Flow Optimization in Hospitals. Proceedings of the International Conference on Distributed Computing and Intelligent Technology, Bhubaneswar, Odisha, India.","DOI":"10.1007\/978-3-032-16632-6_31"},{"key":"ref_12","unstructured":"Cignarale, C. (2013). Analysis and Optimization of Patient Bed Assignments Within a Hospital. [Ph.D. Thesis, Rochester Institute of Technology]."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/01.NUMA.0000388667.17910.16","article-title":"Simulation and patient assignment: Unearthing patterns","volume":"41","author":"Sundaramoorthi","year":"2010","journal-title":"Nurs. Manag."},{"key":"ref_14","unstructured":"Matos, J., and Rodrigues, P.P. (2011, January 26\u201329). Modeling decisions for hospital bed management\u2014A review. Proceedings of the International Conference on Health Informatics, Rome, Italy."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.cie.2018.10.033","article-title":"A systematic review of research design and modeling techniques in inpatient bed management","volume":"127","author":"He","year":"2019","journal-title":"Comput. Ind. Eng."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"469580251335799","DOI":"10.1177\/00469580251335799","article-title":"Optimizing Emergency Department Patient Flow Through Bed Allocation Strategies: A Discrete-Event Simulation Study","volume":"62","author":"Wang","year":"2025","journal-title":"Inquiry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.1098\/rsif.2008.0013","article-title":"Dynamic social networks and the implications for the spread of infectious disease","volume":"5","author":"Read","year":"2008","journal-title":"J. R. Soc. Interface"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"105850","DOI":"10.1016\/j.compbiomed.2022.105850","article-title":"A room-oriented artificial bee colony algorithm for optimizing the patient admission scheduling problem","volume":"148","author":"Bolaji","year":"2022","journal-title":"Comput. Biol. Med."},{"key":"ref_19","first-page":"45","article-title":"Optimization of the Roles and Responsibilities Infection Prevention Control Nurses in a Government Hospital in Jakarta","volume":"6","author":"Siahaan","year":"2019","journal-title":"Int. J. Nurs. Health Sci."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1097\/CNQ.0000000000000388","article-title":"A new patient acuity tool to support equitable patient assignments in a progressive care unit","volume":"45","author":"Eastman","year":"2022","journal-title":"Crit. Care Nurs. Q."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"113926","DOI":"10.1016\/j.dss.2023.113926","article-title":"Promoting continuity of care in nurse-patient assignment: A multiple objective heuristic algorithm","volume":"167","author":"Jiang","year":"2023","journal-title":"Decis. Support Syst."},{"key":"ref_22","first-page":"872","article-title":"Optimizing infection control and antimicrobial stewardship team communication and patient outcomes","volume":"52","author":"Bonaconsa","year":"2024","journal-title":"Am. J. Infect. Control"},{"key":"ref_23","first-page":"580","article-title":"Reinforcement Learning for Dynamic Vehicle Routing Problem: A Case Study with Real-World Scenarios","volume":"16","author":"Danach","year":"2024","journal-title":"Int. J. Commun. Netw. Inf. Secur."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1007\/s10479-025-06553-4","article-title":"Markov decision process and approximate dynamic programming for a patient assignment scheduling problem","volume":"347","author":"Krasnicki","year":"2025","journal-title":"Ann. Oper. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"6348","DOI":"10.29020\/nybg.ejpam.v18i3.6348","article-title":"Adaptive Hyperheuristic Framework for Hyperparameter Tuning: A Q-Learning-Based Heuristic Selection Approach with Simulated Annealing Acceptance Criteria","volume":"18","author":"Danach","year":"2025","journal-title":"Eur. J. Pure Appl. Math."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1080\/20476965.2024.2408543","article-title":"Balanced patient assignment to healthcare centres through dispatching rules","volume":"14","author":"Teymourifar","year":"2025","journal-title":"Health Syst."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Danach, K., Rammal, A., Moukadem, I., Harb, H., and Nasser, A. (2025). Advanced Optimization in E-Commerce Logistics: Combining Matheuristics with Random Forests for Hub Location Efficiency. IEEE Access.","DOI":"10.1109\/ACCESS.2025.3550560"},{"key":"ref_28","unstructured":"Brandt, T. (2025). Structural Insights and Efficient Algorithms for the Patient-To-Room Assignment Problem with Equal Rooms. [Ph.D. Thesis, RWTH Aachen University]."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"103833","DOI":"10.1016\/j.rineng.2024.103833","article-title":"Location planning techniques for Internet provider service unmanned aerial vehicles during crisis","volume":"25","author":"Danach","year":"2025","journal-title":"Results Eng."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1007\/s10729-024-09675-6","article-title":"Multi-resource allocation and care sequence assignment in patient management: A stochastic programming approach","volume":"27","author":"Yao","year":"2024","journal-title":"Health Care Manag. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Abbas, Q., Jeong, W., and Lee, S.W. (2025). Explainable AI in Clinical Decision Support Systems: A Meta-Analysis of Methods, Applications, and Usability Challenges. Healthcare, 13.","DOI":"10.3390\/healthcare13172154"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.ejor.2025.02.018","article-title":"Patient-to-room assignment with single-rooms entitlements: Combinatorial insights and integer programming formulations","volume":"325","author":"Brandt","year":"2025","journal-title":"Eur. J. Oper. Res."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Zanazzo, E., Ceschia, S., and Schaerf, A. (2025). Multi-neighborhood simulated annealing for the integrated patient-to-room and nurse-to-patient assignment problem. Flex. Serv. Manuf. J.","DOI":"10.1007\/s10696-025-09591-z"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Jedidi, H., Ben-Romdhane, H., Nouaouri, I., and Krichen, S. (2024, January 31). Bi-objective Hospital Bed Assignment Problem in Emergencies. Proceedings of the International Conference on Decision Aid and Artificial Intelligence (ICODAI 2024), Alecso, Tunisia.","DOI":"10.2991\/978-94-6463-654-3_11"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Dorigo, M., and St\u00fctzle, T. (2004). Ant Colony Optimization, MIT Press.","DOI":"10.7551\/mitpress\/1290.001.0001"},{"key":"ref_36","unstructured":"Castro, L.N.D., and Timmis, J. (2002). Artificial Immune Systems: A New Computational Intelligence Approach, Springer."}],"container-title":["Algorithms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4893\/19\/3\/205\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T10:26:30Z","timestamp":1773051990000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4893\/19\/3\/205"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":36,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["a19030205"],"URL":"https:\/\/doi.org\/10.3390\/a19030205","relation":{},"ISSN":["1999-4893"],"issn-type":[{"value":"1999-4893","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,9]]}}}