IISE Transactions on Healthcare Systems Engineering最新文献_第9页

Developing a subjective instrument for laparoscopic surgical workload in a high fidelity simulator using the NASA-TLX and SURG-TLX 使用NASA-TLX和SURG-TLX在高保真模拟器中开发腹腔镜手术工作量的主观仪器

IISE Transactions on Healthcare Systems Engineering Pub Date : 2020-11-23 DOI: 10.1080/24725579.2020.1854395

Jiahui Ma, B. Lowndes, K. Chrouser, S. Hallbeck, B. McCrory

{"title":"Developing a subjective instrument for laparoscopic surgical workload in a high fidelity simulator using the NASA-TLX and SURG-TLX","authors":"Jiahui Ma, B. Lowndes, K. Chrouser, S. Hallbeck, B. McCrory","doi":"10.1080/24725579.2020.1854395","DOIUrl":"https://doi.org/10.1080/24725579.2020.1854395","url":null,"abstract":"Abstract The Surgery Task Load Index (SURG-TLX) and National Aeronautics and Space Administration Task Load Index (NASA-TLX) are subjective workload assessment instruments. These instruments have three coinciding workload dimensions, but each has three unique dimensions. Each dimension is explained by a unique descriptor. It was hypothesized that the SURG-TLX and NASA-TLX workload ratings would differ when assessing the same surgical methods and tasks. Accordingly, the aim of this study was to assess the SURG- and NASA-TLX dimensions toward the creation of a novel workload instrument to better predict simulated laparoscopic surgical workload. Twenty-five (25) participants were selected at a large, midwestern teaching hospital to conduct two simulated surgical tasks using four different laparoscopic methods. Each participant completed a total of eight trials and after each trial workload was assessed using both the NASA-TLX and SURG-TLX. The overall NASA-TLX dimensions were rated significantly higher (greater workload) compared to the overall SURG-TLX dimensions (F = 12.04, p = 0.001). Principle component analysis of workload dimensions suggests that a new surgical subjective workload measurement instrument should include the dimensions of Mental Demand, Physical Demand, Temporal Demand, Performance, Frustration and Situational Stress. However, validation of this novel tool is needed.","PeriodicalId":37744,"journal":{"name":"IISE Transactions on Healthcare Systems Engineering","volume":"11 1","pages":"161 - 169"},"PeriodicalIF":0.0,"publicationDate":"2020-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24725579.2020.1854395","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41930486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Simulating cardiac arrest events to evaluate novel emergency response systems 模拟心脏骤停事件以评估新型应急响应系统

IISE Transactions on Healthcare Systems Engineering Pub Date : 2020-10-27 DOI: 10.1080/24725579.2020.1836090

G. Lancaster, J. Herrmann

{"title":"Simulating cardiac arrest events to evaluate novel emergency response systems","authors":"G. Lancaster, J. Herrmann","doi":"10.1080/24725579.2020.1836090","DOIUrl":"https://doi.org/10.1080/24725579.2020.1836090","url":null,"abstract":"Abstract This paper presents a simulation model approach to predict improvements in survival by new out-of-hospital cardiac arrest response systems. Poor cardiac arrest survival rates have motivated the exploration of new response system concepts to augment EMS systems, including citizen responders dispatched by a cell phone app, and the use of drones to deliver an AED to a cardiac arrest location. With few existing studies, the system effectiveness remains largely unknown. A predictive model was developed to understand the improvement these systems may have on cardiac arrest survival. The model uses a geospatial Monte Carlo sampling approach to simulate the random locations of cardiac arrests and the responding agents. The model predicts the response time of EMS, mobile dispatched responders, and drone AED delivery, based on the distance traveled and the mode of transit, while accounting for additional non-transit system factors. A logistic regression model is utilized to translate response times for CPR and defibrillation to a likelihood of survival. The model was developed to simulate and compare multiple response system concepts. The paper presents a case study to demonstrate the model’s utility.","PeriodicalId":37744,"journal":{"name":"IISE Transactions on Healthcare Systems Engineering","volume":"11 1","pages":"38 - 50"},"PeriodicalIF":0.0,"publicationDate":"2020-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24725579.2020.1836090","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44910213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

A multi-level stakeholder-centered approach to investigate unnecessary readmissions in emergency departments 一个多层次的以利益相关者为中心的方法来调查急诊部门不必要的再入院

IISE Transactions on Healthcare Systems Engineering Pub Date : 2020-10-08 DOI: 10.1080/24725579.2020.1834033

Samuel Bonet Olivencia, Sudeep Hegde, F. Sasangohar

{"title":"A multi-level stakeholder-centered approach to investigate unnecessary readmissions in emergency departments","authors":"Samuel Bonet Olivencia, Sudeep Hegde, F. Sasangohar","doi":"10.1080/24725579.2020.1834033","DOIUrl":"https://doi.org/10.1080/24725579.2020.1834033","url":null,"abstract":"Abstract Unnecessary readmissions have become a recurring problem in the Emergency Departments (ED) across the United States. While the current knowledge on the contributors to this problem is dominated by patient-level factors, an understanding of more diverse perspectives across the healthcare organization is needed. This research study provides a multi-level stakeholder-centered view of the problem of readmissions in EDs. Interviews were conducted with 12 relevant stakeholders at different levels of the hierarchy of a representative U.S. healthcare system, including senior leadership, clinical management, and front-line patient care. Thematic analysis was conducted to identify factors that contribute to unnecessary readmissions, and potential strategies to reduce readmissions. The findings revealed eleven potential factors that may contribute to unnecessary ED readmission, including culture, resources constraints, and locality-based factors, among others. Ten potential strategies to reduce readmissions were derived from the interview analysis including, centralized and accessible information, patient education, and coordination with local clinics, among others. Further, a thematic mapping was created to connect the identified factors to the potential strategies. Findings reveal a complex relationship between readmission factors and reduction strategies. Further investigation is needed to validate these findings and to integrate and implement these strategies as bundled interventions in practice.","PeriodicalId":37744,"journal":{"name":"IISE Transactions on Healthcare Systems Engineering","volume":"11 1","pages":"24 - 37"},"PeriodicalIF":0.0,"publicationDate":"2020-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24725579.2020.1834033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44185852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Spatiotemporal regularization for inverse ECG modeling 逆心电建模的时空正则化

IISE Transactions on Healthcare Systems Engineering Pub Date : 2020-10-07 DOI: 10.1080/24725579.2020.1823531

B. Yao, Hui Yang

{"title":"Spatiotemporal regularization for inverse ECG modeling","authors":"B. Yao, Hui Yang","doi":"10.1080/24725579.2020.1823531","DOIUrl":"https://doi.org/10.1080/24725579.2020.1823531","url":null,"abstract":"Abstract Advanced sensing such as the wearable sensor network provides an unprecedented opportunity to capture a wealth of information pertinent to space-time electrical activity of the heart, and facilitate the inverse electrocardiographic (ECG) modeling with the readily available data of body surface potential mapping. However, it is often challenging to derive heart-surface potentials from body-surface measurements, which is called the “inverse ECG problem.” Traditional regression is not concerned about spatiotemporal dynamic variables in complex geometries, and tends to be limited in the ability to handle high-dimensional spatiotemporal data for solving the inverse ECG problem. This paper presents a comparison study of regularization methods in the performance to achieve robust solutions of the inverse ECG problem. We first introduce the forward and inverse ECG problems. Second, we propose two spatiotemporal regularization (STRE) models to increase the robustness of inverse ECG modeling. Finally, case studies are conducted on the two-sphere geometry, as well as a real-world torso-heart geometry to evaluate the performance of different regularization methods. Experimental results show that STRE models effectively tackle the ill-conditioned inverse ECG problem and yield 56.3% and 67.3% performance improvement compared to the traditional Tikhonov regularization in the two-sphere and the torso-heart geometries, respectively. The spatiotemporal regularization methodology is shown to have strong potential to achieve robust solutions for high-dimensional predictive modeling in the inverse ECG problem.","PeriodicalId":37744,"journal":{"name":"IISE Transactions on Healthcare Systems Engineering","volume":"11 1","pages":"11 - 23"},"PeriodicalIF":0.0,"publicationDate":"2020-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24725579.2020.1823531","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49545095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9

Stress and burnout among attending and resident physicians in the ED: a comparative study 急诊科主治医师与住院医师的压力与倦怠:一项比较研究

IISE Transactions on Healthcare Systems Engineering Pub Date : 2020-09-03 DOI: 10.1080/24725579.2020.1814456

Vishnunarayan Girishan Prabhu, K. Taaffe, R. Pirrallo, Dotan I Shvorin

{"title":"Stress and burnout among attending and resident physicians in the ED: a comparative study","authors":"Vishnunarayan Girishan Prabhu, K. Taaffe, R. Pirrallo, Dotan I Shvorin","doi":"10.1080/24725579.2020.1814456","DOIUrl":"https://doi.org/10.1080/24725579.2020.1814456","url":null,"abstract":"Abstract Emergency department physicians work in complex care settings with frequent exposure to stressful conditions. Burnout in physicians is increasing each year, and one of the most prone groups are emergency medicine providers. This research sought to understand if a difference in stress levels and burnout rate exists between attending and resident physicians working in an academic Level 1 trauma center emergency department on the same shift. Twelve attending and resident physicians from Greenville Memorial Hospital in Greenville, SC, participated in the study. Stress levels were estimated using physiological measures, including heart rate variability and electrodermal activity. Burnout scores and workload index were collected using the Maslach Burnout Inventory-Human Services Survey, and the NASA-TLX survey. Over 100 h of physiological data were collected, and 42 events were compared across the two physician groups. Attending physicians showed a higher heart rate variability for the entire shift, RMSSD (44.2 vs. 35.4, p = .033) and during the trauma events, RMSSD (47.0 vs. 35.2, p = .001), LF/HF ratio (1.7 vs. 2.5, p = .001), implying lower stress levels. Furthermore, attending physicians recorded a lower workload index (35.1 vs. 49.2, p=.004). However, no significant differences were observed in the burnout scores.","PeriodicalId":37744,"journal":{"name":"IISE Transactions on Healthcare Systems Engineering","volume":"11 1","pages":"1 - 10"},"PeriodicalIF":0.0,"publicationDate":"2020-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24725579.2020.1814456","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43260516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Planning models for skills-sensitive surgical nurse staffing: a case study at a large academic medical center 对技能敏感的外科护士人员配置的规划模型:一个大型学术医疗中心的案例研究

IISE Transactions on Healthcare Systems Engineering Pub Date : 2020-08-27 DOI: 10.1080/24725579.2020.1805050

Maya Bam, Zheng Zhang, B. Denton, M. Duck, M. P. Van Oyen

引用次数: 1

Outpatient appointment scheduling with walk-ins in fixed arrival periods 门诊预约安排在固定的到达时间内进行预约

IISE Transactions on Healthcare Systems Engineering Pub Date : 2020-08-24 DOI: 10.1080/24725579.2020.1801909

E. S. Taiwo, Frank Y. Chen, K. Chin

{"title":"Outpatient appointment scheduling with walk-ins in fixed arrival periods","authors":"E. S. Taiwo, Frank Y. Chen, K. Chin","doi":"10.1080/24725579.2020.1801909","DOIUrl":"https://doi.org/10.1080/24725579.2020.1801909","url":null,"abstract":"Abstract We study the problem of determining the optimal appointment scheduling decision in the presence of patient’s no-show behavior and random walk-ins arriving in a specified time window. We propose a two-stage optimization model to determine the optimal time window for the arrival of walk-ins and corresponding optimal appointment schedule for regular patients, to minimize the total cost of patients’ waiting time, and physician’s idleness and overtime. We demonstrate that the objective function for the first stage optimization problem is multimodular and propose a variable neighborhood descent (VND) algorithm to solve the proposed model. The VND algorithm performs well compared with some common local search algorithms. Our analysis suggests that the policy that stipulates an optimal time window for the arrival of walk-ins performs better than the general random walk-in arrival (open walk-in) policy when the arrival rate of walk-ins is moderate relative to the clinic’s capacity. In particular, utilizing the optimal time window policy can lead to a fair reduction in system cost and preservation of an increased level of patients’ access to care.","PeriodicalId":37744,"journal":{"name":"IISE Transactions on Healthcare Systems Engineering","volume":"10 1","pages":"261 - 276"},"PeriodicalIF":0.0,"publicationDate":"2020-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24725579.2020.1801909","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45252038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Tactical scheduling of surgeries to level bed utilization in the intensive care unit 战术调度手术，以提高病床利用率在重症监护病房

IISE Transactions on Healthcare Systems Engineering Pub Date : 2020-07-09 DOI: 10.1080/24725579.2020.1793845

Steffen Heider, J. Schoenfelder, Sebastian McRae, T. Koperna, J. Brunner

{"title":"Tactical scheduling of surgeries to level bed utilization in the intensive care unit","authors":"Steffen Heider, J. Schoenfelder, Sebastian McRae, T. Koperna, J. Brunner","doi":"10.1080/24725579.2020.1793845","DOIUrl":"https://doi.org/10.1080/24725579.2020.1793845","url":null,"abstract":"Abstract The intensive care unit is a highly specialized and expensive hospital resource serving both emergency and scheduled patients. The vast majority of scheduled patients arrive from the operating theater. Therefore, the operating theater schedule has a strong impact on intensive care unit occupancy levels. Prior research focuses on the creation of a new master surgery schedule to optimize the patient flow in downstream units. In practice, however, the master surgery schedule affects a multitude of related processes, and changing it causes significant disruptions within the hospital. Hence, our approach emphasizes a centralized reallocation of scheduled surgeries while maintaining the existing master surgery schedule. We propose a mixed-integer quadratic model that optimizes the tactical surgery schedule to balance the expected day-to-day occupancy of scheduled patients in the surgical intensive care unit. Supported by two years of data from a German university hospital, we analyze three planning strategies and their impact on bed utilization in the intensive care unit. Our approach yields an improvement of 17.5% in intensive care bed utilization variability compared to a decentral approach, which is similar to current hospital practice. Additionally, we show that our approach can realize the majority of the improvement potential without the disruptions that derive from an entirely new master surgery schedule.","PeriodicalId":37744,"journal":{"name":"IISE Transactions on Healthcare Systems Engineering","volume":"10 1","pages":"229 - 242"},"PeriodicalIF":0.0,"publicationDate":"2020-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24725579.2020.1793845","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60128449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13

Optimal sensor placement in a hospital operating room 医院手术室中传感器的最佳放置

IISE Transactions on Healthcare Systems Engineering Pub Date : 2020-07-02 DOI: 10.1080/24725579.2020.1790698

E. Mousavi, A. Khademi, K. Taaffe

{"title":"Optimal sensor placement in a hospital operating room","authors":"E. Mousavi, A. Khademi, K. Taaffe","doi":"10.1080/24725579.2020.1790698","DOIUrl":"https://doi.org/10.1080/24725579.2020.1790698","url":null,"abstract":"Abstract Building ventilation systems are responsible for providing a favorable thermal condition, as well as maintaining acceptable indoor air quality. Thus, ventilation rates are extremely high in hospitals to avoid exposure to potentially fatal threads. This, of course, means higher energy consumption rates, making hospitals among the top energy intensive buildings. One approach to circumvent such a tradeoff is to design a smart ventilation system, where air quality is continuously measured by a series of sensors, whose real time readings help adjust the ventilation rates. In this paper, we introduce optimization problems to study the optimal number and location of sensors in a hospital operating room (OR). In particular, we formulate several optimization problems to find the optimal location and sensors to minimize the expected detection time. We propose three solution procedures to solve the said optimization problems. The first method extends and applies Monte Carlo simulation models to our problem and serves as a benchmark; the second method develops a novel decomposition approach along with a marginal benefit argument to provide solutions; and the third method develops an integer programing method for a discrete probability distribution of contamination on space. We apply our methods to a real data set from an OR of a hospital and our results show that our proposed algorithms are near-optimal, the optimal placement is sensitive to the probability density of contamination location, and optimal placement for sensors is near patient bed and OR doors.","PeriodicalId":37744,"journal":{"name":"IISE Transactions on Healthcare Systems Engineering","volume":"10 1","pages":"212 - 227"},"PeriodicalIF":0.0,"publicationDate":"2020-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24725579.2020.1790698","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42050336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 5

Modeling of the collections process in the blood supply chain: A literature review 血液供应链中采集过程的建模：文献综述

IISE Transactions on Healthcare Systems Engineering Pub Date : 2020-07-02 DOI: 10.1080/24725579.2020.1776426

Emily P. Williams, P. Harper, D. Gartner

{"title":"Modeling of the collections process in the blood supply chain: A literature review","authors":"Emily P. Williams, P. Harper, D. Gartner","doi":"10.1080/24725579.2020.1776426","DOIUrl":"https://doi.org/10.1080/24725579.2020.1776426","url":null,"abstract":"Abstract Human blood is a scarce resource and its role in healthcare is fundamental, with donated blood saving the lives of many on a daily basis. The blood supply chain is responsible for the transfer of blood from donor to the recipient, but the availability of such an invaluable resource as human blood is ultimately attributable to the many voluntary donors. Thus, the efficiency of the collection of donated blood is crucial to the downstream effectiveness of the blood supply chain. We provide a detailed review on the use of quantitative methods for the process of blood collection from donors. We describe the functional areas which are appointment scheduling, collection policy, crisis situation, donor demographics, location/clinic planning, staff utilization and vehicle routing. Furthermore, we analyze the existing literature with regards to methods, modeling objectives and the planning levels such as strategic, tactical and operational. Finally, we break down the articles into whether or not case studies lead to the implementation of the methods in practice. In total, we review 46 relevant publications on the intersection between OR/MS and other disciplines. We use our presented framework to categorize the existing approaches and highlight gaps such as scheduling of both staff and appointments for blood donation clinics.","PeriodicalId":37744,"journal":{"name":"IISE Transactions on Healthcare Systems Engineering","volume":"10 1","pages":"200 - 211"},"PeriodicalIF":0.0,"publicationDate":"2020-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24725579.2020.1776426","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49586278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14