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An emergency department simulation and a neural network metamodel. 急诊科模拟和神经网络元模型。
Journal of the Society for Health Systems Pub Date : 1997-01-01
R A Kilmer, A E Smith, L J Shuman
{"title":"An emergency department simulation and a neural network metamodel.","authors":"R A Kilmer,&nbsp;A E Smith,&nbsp;L J Shuman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper describes a discrete event stochastic simulation of a hospital emergency department, and the development of a metamodel of that simulation. The metamodeling technique used is artificial neural networks, which are trained utilizing the output of the simulation. The performance of the neural network metamodel is compared to the simulation performance for estimating the mean and variance of patient time in the emergency department.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 3","pages":"63-79"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19992384","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
Uncertainty considerations in group decisions: staffing and ratesetting in a health promotion center. 群体决策中的不确定性因素:健康促进中心的人员配置和费率制定。
Journal of the Society for Health Systems Pub Date : 1997-01-01
M E Hatcher
{"title":"Uncertainty considerations in group decisions: staffing and ratesetting in a health promotion center.","authors":"M E Hatcher","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There are a variety of methods for including risk or uncertainty in Group Decision Support Systems (GDSS). Monte Carlo simulation is one method. An application of Monte Carlo simulation in Group Decisions and GDSS for diversification of services is presented in this paper. Specifically, the uncertainty associated with the finances of a Health Promotion Center are evaluated for staffing and rate setting. The distributions of outcome variables are used in decision rules.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 3","pages":"31-42"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19992382","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
An introduction to using computer simulation in healthcare: patient wait case study. 介绍在医疗保健中使用计算机模拟:病人等待案例研究。
Journal of the Society for Health Systems Pub Date : 1997-01-01
J C Benneyan
{"title":"An introduction to using computer simulation in healthcare: patient wait case study.","authors":"J C Benneyan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>As healthcare continues to become more competitive, the ability to assess tradeoffs between resource utilization, service, and operating costs grows in importance, such as with respect to appointment access, waiting room delays, and telephone service. This paper discusses the use of simulation analysis for studying and improving these and other health systems. A case study concerning pediatric waiting times illustrates typical steps involved in a simulation study, possible types of analyses, and resources required. Other healthcare uses of stimulation, pitfalls to avoid, and software selection also are discussed briefly.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 3","pages":"1-15"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19994597","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
Using simulation to improve the operational efficiency of a multi-disciplinary clinic. 运用模拟技术提高多学科诊所的运作效率。
Journal of the Society for Health Systems Pub Date : 1997-01-01
A G Kalton, M R Singh, D A August, C M Parin, E J Othman
{"title":"Using simulation to improve the operational efficiency of a multi-disciplinary clinic.","authors":"A G Kalton,&nbsp;M R Singh,&nbsp;D A August,&nbsp;C M Parin,&nbsp;E J Othman","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A recent trend in health care is to provide patients with the benefits of multi-disciplinary care during a single clinic visit. The University of Michigan Breast Care Center is a leading example of a multi-disciplinary clinic which has served the Midwest United States since 1985. A hallmark of the Breast Care Center operation is a patient care conference immediately following the clinical evaluation sessions, where each case is discussed by a group of experts for immediate evaluation and generation of recommendations. The Center has experienced significant increases in the number of patient visits over the nine years since its inception. The patient mix, initially all new patients, has matured, and returning patients are now a significant portion of the clinic load. Unfortunately, the success of the Breast Care Center strained its smooth operation. Physicians were unable to attend the patient care conference because the clinical evaluation sessions were too busy, and this undermined the quality of the care recommendations generated. Patients were complaining about long waits in the Breast Care Center and delays in getting their next appointment. To examine these operational problems and to suggest corrective actions, a simulation study was conducted. This paper reports the results of this study. Our findings provide interesting insights into the operation and management of multi-disciplinary clinics.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 3","pages":"43-62"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19992383","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
Determining the requirements for a computer-based patient record with an electronic meeting system. 确定以电子会议系统为基础的计算机病历的要求。
Journal of the Society for Health Systems Pub Date : 1996-01-01
C C Emery, L A Kian, M W Stewart
{"title":"Determining the requirements for a computer-based patient record with an electronic meeting system.","authors":"C C Emery,&nbsp;L A Kian,&nbsp;M W Stewart","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 2","pages":"29-39"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19943856","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
Monitoring and assessing patient focused care performance. 监测和评估以患者为中心的护理绩效。
Journal of the Society for Health Systems Pub Date : 1996-01-01
D A Briones
{"title":"Monitoring and assessing patient focused care performance.","authors":"D A Briones","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This case study shares the experiences of converting a conventional financial and productivity performance system into one which measures, with greater detail, hospital operations undergoing changes in delivering patient care. An aggressive yet practical approach was used to meet management's main informational need for measuring the productivity and financial impacts of transitioning from a primary nursing care model (i.e., patient care being delivered exclusively by registered nurses) to a patient-focused care model while minimizing the impact of changing performance systems in the organization. Through this conversion, management can quickly detect and assess areas not complying with the patient-focused care model.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 2","pages":"9-14"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19944567","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
Physician productivity measurement, methodology and implementation. 医师生产力测量、方法与实施。
Journal of the Society for Health Systems Pub Date : 1996-01-01
P Lagasse
{"title":"Physician productivity measurement, methodology and implementation.","authors":"P Lagasse","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>These components are integrated into a single monthly report and distributed to all departments in the health system. Figures 2 and 3 illustrate the four main reports the system can generate. Shown are the overall facility report and the six month trend; the departmental report showing each department as compared to the facility; an individual department report that clearly illustrates each physician's contribution; and finally an individual provider report with trend analysis. These reports are modified slightly as required by each department, but the core information of RVUs/hour remains the basic comparative element. Each report contains comparisons of individual providers within their specialty, department or group, and at the facility and system level. Each department with specific needs has the report prepared to meet these needs, yet the entire facility follows a single standard to make inter-department comparisons meaningful. The information available on each individual report includes: Month. Number of patient visits. Number of unique patients. Average Number of visits per patient. Charges. Part A and Part B worked hours. Paid hours. RVUs generated per worked hour. Productivity measured against. The providers department average. The total group average. Year to date averages. Graphical depiction of RVUs. Hour with trend line. The department summary contains similar information while the department detail report provides a means to easily compare providers within the department against each other and the group as a whole. The overall BMERF report uses summary information from each department and provides a graphical indication of how each department is performing.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 2","pages":"41-9"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19943857","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
Quality infrastructure: the key to implementing a total quality program in a clinical care setting. 质量基础设施:在临床护理环境中实施全面质量计划的关键。
Journal of the Society for Health Systems Pub Date : 1996-01-01
D Lowery
{"title":"Quality infrastructure: the key to implementing a total quality program in a clinical care setting.","authors":"D Lowery","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The implementation of total quality principles and practices in health care requires a clear recognition of the physician's unique role in the industry. The author addresses the implementation of a total quality program in an 80-physician clinical care setting. The program's success is linked to the development of a supportive quality infrastructure that effectively accommodates this unique role.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 2","pages":"51-64"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19943858","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
Responsible choices for achieving reform of the American health system. 为实现美国医疗体系改革做出负责任的选择。
Journal of the Society for Health Systems Pub Date : 1996-01-01
P Ellwood, A Enthoven
{"title":"Responsible choices for achieving reform of the American health system.","authors":"P Ellwood,&nbsp;A Enthoven","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>\"Responsible Choices\" identifies the actions the private sector and government should take to improve the American health system and accelerate and expand the health care revolution that is already underway. Policy proposals are made for: Medicare; Medicaid; reforming the tax treatment of health insurance; insurance reforms and expanding group purchasing opportunities; and improving the availability of comparative information on health benefit offerings, quality accountability, and cost and coverage information. The recommendations refocus the Jackson Hole Group's original managed competition proposals contained in \"The 21st Century American Health System\" (1991).</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 2","pages":"15-28"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19943855","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
Switchboard simulation to improve productivity and customer service. 模拟总机，提高生产效率和客户服务。
Journal of the Society for Health Systems Pub Date : 1996-01-01
E D LaCourse
{"title":"Switchboard simulation to improve productivity and customer service.","authors":"E D LaCourse","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An application of classical industrial engineering/operations research techniques (i.e., multichannel queueing analysis) and detailed workload distribution data. An analytic simulation model developed on a personal computer (PC) is used with interactive analysis to develop switchboard coverage requirements and optimal staffing schedules by time of day and day of week. This represents a tangible example of how classical techniques can be used with newer approaches and a close working relationship between the analyst and line management, to solve a practical problem of optimizing both productivity and customer service quality.</p>","PeriodicalId":77231,"journal":{"name":"Journal of the Society for Health Systems","volume":"5 2","pages":"65-72"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19943859","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
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