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Probabilistic forecasting of hourly emergency department arrivals. 急诊室每小时到达人数的概率预测
IF 1.8
Health Systems Pub Date : 2023-05-01 eCollection Date: 2024-01-01 DOI: 10.1080/20476965.2023.2200526
Bahman Rostami-Tabar, Jethro Browell, Ivan Svetunkov
{"title":"Probabilistic forecasting of hourly emergency department arrivals.","authors":"Bahman Rostami-Tabar, Jethro Browell, Ivan Svetunkov","doi":"10.1080/20476965.2023.2200526","DOIUrl":"10.1080/20476965.2023.2200526","url":null,"abstract":"<p><p>An accurate forecast of Emergency Department (ED) arrivals by an hour of the day is critical to meet patients' demand. It enables planners to match ED staff to the number of arrivals, redeploy staff, and reconfigure units. In this study, we develop a model based on Generalised Additive Models and an advanced dynamic model based on exponential smoothing to generate an hourly probabilistic forecast of ED arrivals for a prediction window of 48 hours. We compare the forecast accuracy of these models against appropriate benchmarks, including TBATS, Poisson Regression, Prophet, and simple empirical distribution. We use Root Mean Squared Error to examine the point forecast accuracy and assess the forecast distribution accuracy using Quantile Bias, PinBall Score and Pinball Skill Score. Our results indicate that the proposed models outperform their benchmarks. Our developed models can also be generalised to other services, such as hospitals, ambulances or clinical desk services.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11123503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48961969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The better work, better care framework: 7 strategies for sustainable healthcare system process improvement. 更好的工作，更好的护理框架：可持续医疗系统流程改进的7项策略
IF 1.8
Health Systems Pub Date : 2023-04-27 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2023.2198580
W P Neumann, N Purdy
{"title":"The better work, better care framework: 7 strategies for sustainable healthcare system process improvement.","authors":"W P Neumann, N Purdy","doi":"10.1080/20476965.2023.2198580","DOIUrl":"10.1080/20476965.2023.2198580","url":null,"abstract":"<p><p>Healthcare systems are under pressure to control costs and improve performance. Efforts to apply improvement trends such as \"Lean\" and other industrial engineering approaches have led to degradation of the working environment for healthcare professionals. Research is increasingly demonstrating how poor working environments contribute to declines in care quality and has led to calls for a \"quadruple aim\" with a focus on the working environment alongside quality, cost, and patient experience factors. This paper contributes to the debate by using a \"systems\" perspective to propose seven strategies by which healthcare systems might be improved without compromising the working environment. This article presents a rationale for these strategies based on current organisational psychology and human factors research and how these strategies might be deployed in practice. The authors argue that better working conditions leads to better care for patients and presents a viable approach for both practitioners and researchers to pursue the \"Better Work, Better Care\" agenda.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10791105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45894390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Long term simulation analysis of deceased donor initiated chains in kidney exchange programs. 肾脏交换计划中已故供者启动链的长期模拟分析
IF 1.8
Health Systems Pub Date : 2023-04-04 eCollection Date: 2024-01-01 DOI: 10.1080/20476965.2023.2197023
Utkarsh Verma, Nayaran Rangaraj, Viswanath Billa, Deepa Usulumarty
{"title":"Long term simulation analysis of deceased donor initiated chains in kidney exchange programs.","authors":"Utkarsh Verma, Nayaran Rangaraj, Viswanath Billa, Deepa Usulumarty","doi":"10.1080/20476965.2023.2197023","DOIUrl":"10.1080/20476965.2023.2197023","url":null,"abstract":"<p><p>Kidney exchange programs (KEPs) aim to find compatible kidneys for recipients with incompatible donors. Patients without a living donor depend upon deceased donor (DD) donations to get a kidney transplant. In India, a ©DD donates kidneys directly to a©DD wait-list. The idea of initiating an exchange chain starting from a ©DD kidney is proposed in a few articles (and executed in Italy in 2018), but no mathematical formulation has been given for this merger. We have introduced an integer programming formulation that creates ©DD-initiated chains, considering both paired exchange registry and ©DD allocations simultaneously and addressing the overlap issue between the exchange registry and ©DD wait-list as recipients can register for both registries independently. A long-term simulation study is done to ©analyse the gain of these DD-initiated chains over time. It suggests that even with small numbers of ©DDs, these chains can significantly increase potential transplants.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11123553/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42859045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A new vision and direction for Health Systems. 卫生系统的新愿景和新方向。
IF 1.8
Health Systems Pub Date : 2023-03-08 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2023.2180173
Samir Chatterjee, Kathy Kotiadis, Daniel Gartner
{"title":"A new vision and direction for <i>Health Systems</i>.","authors":"Samir Chatterjee, Kathy Kotiadis, Daniel Gartner","doi":"10.1080/20476965.2023.2180173","DOIUrl":"10.1080/20476965.2023.2180173","url":null,"abstract":"","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10013346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9492040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Balancing the satisfaction of stakeholders in home health care coordination: a novel OptaPlanner CSP model. 平衡家庭医疗保健协调中利益相关者的满意度：一种新的OptaPlanner CSP模型
IF 1.8
Health Systems Pub Date : 2023-02-27 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2023.2179947
Liwen Zhang, Hervé Pingaud, Franck Fontanili, Elyes Lamine, Cléa Martinez, Christophe Bortolaso, Mustapha Derras
{"title":"Balancing the satisfaction of stakeholders in home health care coordination: a novel OptaPlanner CSP model.","authors":"Liwen Zhang, Hervé Pingaud, Franck Fontanili, Elyes Lamine, Cléa Martinez, Christophe Bortolaso, Mustapha Derras","doi":"10.1080/20476965.2023.2179947","DOIUrl":"10.1080/20476965.2023.2179947","url":null,"abstract":"<p><p>Home Health Care Routing and Scheduling Problem (HHCRSP) has been widely investigated in operations research. In this paper, a model based on the Constraint Satisfaction Problem (CSP) is proposed, which is able to deal with daily HHCRSPs. Human factors are considered in our formulation of the problem and we seek a balance between the different stakeholders' satisfaction criteria. The considered temporal constraints are soft and controlled by the stakeholders' personalised tolerance and satisfaction rates. We will explain how this new Satisfaction-Oriented HHCRSP (SOH2CRSP) model is built and solved by using an open-source solver: the OptaPlanner. In order to examine the impact of human factors, a study will estimate the added value provided when satisfaction is considered in the problem formulation. The comparison is based on a use case derived from the dataset of an existing HHC organisation. The numerical results will show the benefits of our approach.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10791095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47269170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring adaptive mirroring in healthcare IT architectures. 探索医疗保健IT体系结构中的自适应镜像
IF 1.8
Health Systems Pub Date : 2023-02-24 eCollection Date: 2024-01-01 DOI: 10.1080/20476965.2023.2182238
Egil Øvrelid
{"title":"Exploring adaptive mirroring in healthcare IT architectures.","authors":"Egil Øvrelid","doi":"10.1080/20476965.2023.2182238","DOIUrl":"10.1080/20476965.2023.2182238","url":null,"abstract":"<p><p>Digital transformation is demanding for incumbent organizations such as healthcare, where legacy-based IT architectures challenge the establishment of effective digital services. We refer to this as the IT silo problem, where multiple non-consolidated IT systems are implemented to support expert practices. In this paper, we analyze this challenge using a mirroring lens. Our research question is, how can we create efficient digital services, utilizing the existing legacy systems in healthcare IT architectures? Our empirical evidence comes from a Norwegian case and contributes to the literature on IT architecture within Healthcare. First, we demonstrate how strict mirroring leading to sub-optimization and silofication is a major cause for the presence of IT silos. Second, we describe a process towards adaptive mirroring, and the resulting adaptive mirroring architecture. Adaptive mirroring is an architectural combinatory device that facilitates the design and use of efficient services, while also improving the flexibility of IT architectures.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11123499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47815744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A genetic algorithm-based strategic planning framework for optimising accessibility and costs of general practices in Northland, New Zealand. 基于遗传算法的战略规划框架，用于优化新西兰Northland的一般做法的可及性和成本
IF 1.8
Health Systems Pub Date : 2023-02-16 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2023.2174454
Fulvio D Lopane, Melanie Reuter-Oppermann, Andrea Raith, Daniel J Exeter, Ilze Ziedins, Richard Dawson
{"title":"A genetic algorithm-based strategic planning framework for optimising accessibility and costs of general practices in Northland, New Zealand.","authors":"Fulvio D Lopane, Melanie Reuter-Oppermann, Andrea Raith, Daniel J Exeter, Ilze Ziedins, Richard Dawson","doi":"10.1080/20476965.2023.2174454","DOIUrl":"10.1080/20476965.2023.2174454","url":null,"abstract":"<p><p>Shortage of general practitioners (GP) is a challenge worldwide, not only in Europe, but also in countries like New Zealand. Providing primary care in rural areas is especially challenging. In order to support decision makers, it is necessary to first assess the current GP coverage and then to determine different scenarios and plans for the future. In this paper, we first present a thorough overview of related literature on locating GP practices. Second, we propose an approach for assessing the GP coverage and determining future GP locations based on a genetic algorithm framework. As a use case, we have chosen the rural New Zealand region of Northland. We also perform a sensitivity analysis for the main input parameters.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10583631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41535798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Using stochastic simulation modelling to study occupancy levels of decentralised admission avoidance units in Norway 使用随机模拟模型研究挪威分散式免入单元的入住率
IF 1.8
Health Systems Pub Date : 2023-02-15 DOI: 10.1080/20476965.2023.2174453
Meetali Kakad, M. Utley, F. A. Dahl
{"title":"Using stochastic simulation modelling to study occupancy levels of decentralised admission avoidance units in Norway","authors":"Meetali Kakad, M. Utley, F. A. Dahl","doi":"10.1080/20476965.2023.2174453","DOIUrl":"https://doi.org/10.1080/20476965.2023.2174453","url":null,"abstract":"ABSTRACT Identifying alternatives to acute hospital admission is a priority for many countries. Over 200 decentralised municipal acute units (MAUs) were established in Norway to divert low-acuity patients away from hospitals. MAUs have faced criticism for low mean occupancy and not relieving pressures on hospitals. We developed a discrete time simulation model of admissions and discharges to MAUs to test scenarios for increasing absolute mean occupancy. We also used the model to estimate the number of patients turned away as historical data was unavailable. Our experiments suggest that mergers alone are unlikely to substantially increase MAU absolute mean occupancy as unmet demand is generally low. However, merging MAUs offers scope for up to 20% reduction in bed capacity, without affecting service provision. Our work has relevance for other admissions avoidance units and provides a method for estimating unconstrained demand for beds in the absence of historical data.","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46265431","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: 0
Participatory design research for the development of real-time simulation models in healthcare. 医疗保健实时仿真模型开发的参与式设计研究
IF 1.8
Health Systems Pub Date : 2023-02-09 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2023.2175730
Alison Harper, Navonil Mustafee
{"title":"Participatory design research for the development of real-time simulation models in healthcare.","authors":"Alison Harper, Navonil Mustafee","doi":"10.1080/20476965.2023.2175730","DOIUrl":"10.1080/20476965.2023.2175730","url":null,"abstract":"<p><p>The implementation challenges for modelling and simulation in health and social care are well-known and understood. Yet increasing availability of data and a better understanding of the value of Operational Research (OR) applications are strengthening opportunities to support healthcare delivery. Participative approaches in healthcare modelling have shown value through stakeholder engagement and commitment towards co-creation of models and knowledge but are limited in focus on model design and development. For simulation modelling, a participative design research methodology can support development for sustained use, emphasising model usefulness and usability using iterative cycles of development and evaluation. Within a structured methodology, measures of success are built into the design process, focusing on factors which contribute to success, with implicit goals of implementation and improvement. We illustrate this through a participative case study which demonstrates development of the component parts of a real-time simulation model aimed at reducing emergency department crowding.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10791085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44672029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing the impact of software quality models in healthcare software systems. 评估软件质量模型对医疗保健软件系统的影响。
IF 1.2
Health Systems Pub Date : 2023-01-08 eCollection Date: 2023-01-01 DOI: 10.1080/20476965.2022.2162445
Elisabetta Ronchieri, Marco Canaparo
{"title":"Assessing the impact of software quality models in healthcare software systems.","authors":"Elisabetta Ronchieri, Marco Canaparo","doi":"10.1080/20476965.2022.2162445","DOIUrl":"10.1080/20476965.2022.2162445","url":null,"abstract":"<p><p>Health and medical care are safety-critical environments. The development of a safe and reliable healthcare software system is one of the most important processes which may affect the accuracy of clinical decision making and have an impact on determining diagnoses of and treatment for diseases. The aim of this study is to assess if software quality models, such as McCall, can have an impact on healthcare software quality for the purpose of reducing software failures. We have identified the main criticalities of healthcare software systems based on existing literature, software quality models and programming language standards; we have related these criticalities to software characteristics; we have analysed the relationship between the main criticalities of healthcare software systems and their software characteristics. The following criticalities - the risk of changing hard-coded software and the importance of developing maintainable software - must be addressed at the start of the software development process.</p>","PeriodicalId":44699,"journal":{"name":"Health Systems","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10013535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9131150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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