Mediating governance goals with patients and nurses satisfaction: a multi-actor multi-objective problem including fairness

Balancing conflicting goals among different stakeholders is a challenging problem in various application domains. In this paper, we analyse it in the context of home healthcare. Fairness objective functions for nurses and patients are combined with system-level governance goals of the territorial centers in charge of the assistance service. From the solution of several multi-objective problems including one objective for each actor hierarchically ordered, the best goal for each stakeholder is identified and interesting managerial conclusions are drawn. To efficiently solve large-size instances, we introduce a parallel Adaptive Large Neighborhood Search algorithm with destroy and repair operators customised to solve multi-objective multi-actor problems. The algorithm proves to be highly efficient and effective when compared to a commercial Mixed Integer Programming solver, either in its plain form or enforced by a mild start and a primal heuristic. Additionally, we devise a metaheuristic method to generate the Pareto frontier of an instance.