IIE transactions on healthcare systems engineering最新文献_第8页

A decision support tool for healthcare providers to evaluate readiness and impacts of adopting supply chain data standards 为医疗保健提供商提供决策支持工具，用于评估采用供应链数据标准的准备情况和影响

IIE transactions on healthcare systems engineering Pub Date : 2013-04-01 DOI: 10.1080/19488300.2013.790860

Raja Jayaraman, R. Rardin, N. Buyurgan, Vijith Varghese, Angélica Burbano Collazos

{"title":"A decision support tool for healthcare providers to evaluate readiness and impacts of adopting supply chain data standards","authors":"Raja Jayaraman, R. Rardin, N. Buyurgan, Vijith Varghese, Angélica Burbano Collazos","doi":"10.1080/19488300.2013.790860","DOIUrl":"https://doi.org/10.1080/19488300.2013.790860","url":null,"abstract":"Healthcare providers are under increasing pressure to reduce waste, eliminate unnecessary costs and redundant efforts, thereby improving the quality and consistency of healthcare delivery. Lack of automation and the lack of use of global identifiers for products and locations, also known as supply chain data standards, are two critical factors that can help streamline providers operations and improve process efficiency. Despite widespread consensus among various stakeholders, healthcare providers lack a well-defined approach towards adopting and implementing data standards. Supply chain data standards can be defined as a set of product and location identifiers which are used in supply chain related processes and transactions. Healthcare providers willing to successfully adopt data standards in some or all of their operations need to invest in several process changes and technology installations or upgrades; however, they often struggle to justify returns on those investments and hence, find uncertain Return on Investment (ROI) as a critical barrier. In this article, we present a hierarchical comprehensive spreadsheet based decision support tool that helps potential healthcare providers to evaluate their readiness requirements and quantify the potential impacts of their decisions in terms of non-monetary performance measures, such as increased productivity, enhanced patient safety and reduction in errors resulting in decreased volume of transactions. This tool has undergone extensive testing with healthcare providers of different size, scope, and needs. We present numerical results showcased through practical examples in this article. The software is publicly available free of cost for download at http://cihl.uark.edu.","PeriodicalId":89563,"journal":{"name":"IIE transactions on healthcare systems engineering","volume":"3 1","pages":"110 - 126"},"PeriodicalIF":0.0,"publicationDate":"2013-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/19488300.2013.790860","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60563516","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: 12

Anomaly detection in medical treatment to discover unusual patient management 在医疗异常检测中发现异常患者管理

IIE transactions on healthcare systems engineering Pub Date : 2013-03-26 DOI: 10.1080/19488300.2013.787564

D. Antonelli, G. Bruno, S. Chiusano

{"title":"Anomaly detection in medical treatment to discover unusual patient management","authors":"D. Antonelli, G. Bruno, S. Chiusano","doi":"10.1080/19488300.2013.787564","DOIUrl":"https://doi.org/10.1080/19488300.2013.787564","url":null,"abstract":"The increasing availability of electronic medical records makes it possible to reconstruct patient treatment patterns adopted in a given clinical setting. Developing methods to detect deviations from these patterns may help to determine whether the management of a patient is unusual in some way. Using pattern mining techniques, our method extracts frequent patterns from a given dataset of treatment undergone by patients. Comparison is then made between frequent patterns of treatment and the domain medical knowledge, thus allowing the detection of two types of anomalies. The first type includes frequent patterns which deviate from accepted guidelines. These patterns can be evaluated and eventually fed back into improving the guidelines. The second type of anomalies comprises the anomalous cases that deviate from the frequent patterns. They may simply indicate variations in the examinations prescribed due to specific patient conditions, otherwise they may reveal limitation in accessing public health services or identify errors in the data entry process. In all these cases, the detection of the anomalies is useful for a successive analysis by domain experts. We applied our method to three case studies to show how it can be successfully exploited in real medical domain.","PeriodicalId":89563,"journal":{"name":"IIE transactions on healthcare systems engineering","volume":"3 1","pages":"69 - 77"},"PeriodicalIF":0.0,"publicationDate":"2013-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/19488300.2013.787564","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60563056","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: 10

Emergency medical service allocation in response to large-scale events 应对大型事件的紧急医疗服务分配

IIE transactions on healthcare systems engineering Pub Date : 2013-01-01 DOI: 10.1080/19488300.2012.762816

Gabriel Zayas-Cabán, M. Lewis, M. Olson, Samuel Schmitz

{"title":"Emergency medical service allocation in response to large-scale events","authors":"Gabriel Zayas-Cabán, M. Lewis, M. Olson, Samuel Schmitz","doi":"10.1080/19488300.2012.762816","DOIUrl":"https://doi.org/10.1080/19488300.2012.762816","url":null,"abstract":"In the event of a catastrophic or large-scale event, demand for Emergency Medical Service (EMS) vehicles will almost certainly overwhelm the available supply. In such cases, it is necessary for cities to request aid (in the form of added capacity) from neighboring municipalities in order to bring the affected region back to its day-to-day levels of operation. In particular, we consider a region consisting of several cities, where each city is in charge of managing its own EMS vehicles. We propose that a centralized or statewide decision-maker coordinate the temporary transfer of resources (EMS vehicles) from cities in the unaffected region into the cities in the affected region. The control of each city’s EMS vehicles is modeled as a multi-server queueing system and classical results are used to estimate the number of vehicles available at each city. We then develop a deterministic resource allocation model to guide the allocation of available vehicles from the donor area into the affected one and a clearing system model to dynamically control the added resources.As the dimension of the problem is large, a heuristic we call the buddy system is proposed where cities are paired to form city groups. Within the city groups the clearing system model is solved by Markov decision processes. The performance of our heuristic is compared to several other reasonable heuristics via a detailed numerical study. Results show that the buddy system exhibits significant cost and time savings, and is generally robust to varying parameters.","PeriodicalId":89563,"journal":{"name":"IIE transactions on healthcare systems engineering","volume":"21 1","pages":"57 - 68"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/19488300.2012.762816","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60562716","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

Motion-compensating intensity maps in intensity-modulated radiation therapy 调强放射治疗中的运动补偿强度图

IIE transactions on healthcare systems engineering Pub Date : 2013-01-01 DOI: 10.1080/19488300.2012.749436

T. Chan

{"title":"Motion-compensating intensity maps in intensity-modulated radiation therapy","authors":"T. Chan","doi":"10.1080/19488300.2012.749436","DOIUrl":"https://doi.org/10.1080/19488300.2012.749436","url":null,"abstract":"Managing the effects of tumor motion during radiation therapy is critical to ensuring that a robust treatment is delivered to a cancer patient. Tumor motion due to patient breathing may result in the tumor moving in and out of the beam of radiation, causing the edge of the tumor to be underdosed. One approach to managing the effects of motion is to increase the intensity of the radiation delivered at the edge of the tumor—an edge-enhanced intensity map—which decreases the likelihood of underdosing that area. A second approach is to use a margin, which increases the volume of irradiation surrounding the tumor, also with the aim of reducing the risk of underdosage. In this paper, we characterize the structure of optimal solutions within these two classes of intensity maps. We prove that the ratio of the tumor size to the standard deviation of motion characterizes the structure of an optimal edge-enhanced intensity map. Similar results are derived for a three-dimensional margin case. Furthermore, we extend our analysis by considering a robust version of the problem where the parameters of the underlying motion distribution are not known with certainty, but lie in pre-specified intervals. We show that the robust counterpart of the uncertain 3D margin problem has a very similar structure to the nominal (no uncertainty) problem.","PeriodicalId":89563,"journal":{"name":"IIE transactions on healthcare systems engineering","volume":"176 1","pages":"1 - 22"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/19488300.2012.749436","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60562834","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

Optimal nurse scheduling based on quantitative models of work-related fatigue 基于工作疲劳定量模型的护士优化调度

IIE transactions on healthcare systems engineering Pub Date : 2013-01-01 DOI: 10.1080/19488300.2012.762072

Rung-Chuan Lin, M. Sir, Esra Sisikoglu, K. Pasupathy, L. Steege

{"title":"Optimal nurse scheduling based on quantitative models of work-related fatigue","authors":"Rung-Chuan Lin, M. Sir, Esra Sisikoglu, K. Pasupathy, L. Steege","doi":"10.1080/19488300.2012.762072","DOIUrl":"https://doi.org/10.1080/19488300.2012.762072","url":null,"abstract":"Previous nurse scheduling models have mainly focused on managerial constraints to minimize costs. Although some models incorporate nurse preferences and safety guidelines, human factors considerations related to performance of nurses (fatigue) have not been studied extensively. Fatigue has been linked to nursing injuries and medical errors, and shown to be impacted by schedule-related parameters (shift length). Thus, the objective of this article was to develop a nurse scheduling model incorporating quantitative models of fatigue. This model can help a nurse manager to make schedule-related decisions by highlighting trade-offs among many (conflicting) objectives including nurse shift preferences and nurse fatigue levels obtained from two different fatigue models, namely survey-based and circadian function-based fatigue models. The data used in the numerical experiments were obtained from real patient census data and various surveys of nurses working in different hospitals across the United States. Numerical results show that it is possible to obtain Pareto-optimal schedules where the nurse fatigue levels are significantly reduced for a slight decrement in nurse preferences.","PeriodicalId":89563,"journal":{"name":"IIE transactions on healthcare systems engineering","volume":"3 1","pages":"23 - 38"},"PeriodicalIF":0.0,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/19488300.2012.762072","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60562999","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: 22

Districting and dispatching policies for emergency medical service systems to improve patient survival 急诊医疗服务系统的分区调度政策，提高患者存活率

IIE transactions on healthcare systems engineering Pub Date : 2013-01-01 DOI: 10.1080/19488300.2012.762437

M. Mayorga, D. Bandara, L. McLay

引用次数: 39

Exploring the effects of network structure and healthcare worker behavior on the transmission of hospital-acquired infections 探讨网络结构和医护人员行为对医院获得性感染传播的影响

IIE transactions on healthcare systems engineering Pub Date : 2012-10-01 DOI: 10.1080/19488300.2012.736120

S. Barnes, B. Golden, E. Wasil

引用次数: 8

Designing patient flow in emergency departments 急诊科病人流程设计

IIE transactions on healthcare systems engineering Pub Date : 2012-10-01 DOI: 10.1080/19488300.2012.736118

Y. Marmor, B. Golany, S. Israelit, A. Mandelbaum

{"title":"Designing patient flow in emergency departments","authors":"Y. Marmor, B. Golany, S. Israelit, A. Mandelbaum","doi":"10.1080/19488300.2012.736118","DOIUrl":"https://doi.org/10.1080/19488300.2012.736118","url":null,"abstract":"Emergency Department (ED) managers can choose from several operational models, for example, Triage or Fast-Track. The following questions thus naturally arise: why does a hospital choose to work with its particular operational model rather than another? Or what is the best model to operate under? More specifically, how to fit an operational model to an ED's uncontrollable (environmental) parameters? To address such questions, we develop a methodology for ED Design (EDD): we apply it to data collected over a period of two to four years from eight hospitals, of various sizes and deploying various ED operational models. (To cover all size-model combinations, we enrich our data via accurate ED simulation.) The EDD methodology first feeds the data into a Data Envelopment Analysis (DEA) program, which determines the relative efficiency of each month of the different operational models of each hospital. Then, after taking into account the individual hospitals effect, we identify the operational model that is dominant under each set of uncontrollable parameters. We discovered that different operational models dominate others over different combinations of uncontrollable parameters. For example, a hospital catering to an aging population is best served by a fast-track operational model.","PeriodicalId":89563,"journal":{"name":"IIE transactions on healthcare systems engineering","volume":"2 1","pages":"233 - 247"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/19488300.2012.736118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60562489","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: 31

Setting sites for faster results: Optimizing locations and capacities of new tuberculosis testing laboratories 为更快取得结果而设置地点:优化新的结核病检测实验室的地点和能力

IIE transactions on healthcare systems engineering Pub Date : 2012-10-01 DOI: 10.1080/19488300.2012.736119

Fatemeh Saveh-Shemshaki, Steven M. Shechter, P. Tang, J. Isaac-Renton

{"title":"Setting sites for faster results: Optimizing locations and capacities of new tuberculosis testing laboratories","authors":"Fatemeh Saveh-Shemshaki, Steven M. Shechter, P. Tang, J. Isaac-Renton","doi":"10.1080/19488300.2012.736119","DOIUrl":"https://doi.org/10.1080/19488300.2012.736119","url":null,"abstract":"A reduced turnaround time to obtain initial test results for detecting the bacterial agent that causes tuberculosis (TB) can significantly improve the management of this communicable disease. We propose a new facility location modeling approach for designing a network of TB testing laboratories so as to reduce transportation times and thereby decrease overall test turnaround time. Our mathematical formulation chooses new laboratory facility locations, the capacities of those laboratories, as well as the assignment of TB samples to regional laboratories so as to minimize total sample transportation time, while considering constraints on the laboratory capacities, budget, and maximum transportation times between any origin and the testing laboratory. We ran the model using the TB testing demand and laboratory data for the TB reference laboratory in the Canadian province of British Columbia (BC), and demonstrate its potential to improve patient care and population health by optimizing the locations of additional testing laboratories. Furthermore, we explored data limitations and assumptions through several sensitivity analyses.","PeriodicalId":89563,"journal":{"name":"IIE transactions on healthcare systems engineering","volume":"2 1","pages":"248 - 258"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/19488300.2012.736119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60562302","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: 11

Assessing appointment systems’ operational performance with policy targets 根据政策目标评估预约系统的运作表现

IIE transactions on healthcare systems engineering Pub Date : 2012-10-01 DOI: 10.1080/19488300.2012.736121

William P. Millhiser, Emre A. Veral, Benedetto C. Valenti

{"title":"Assessing appointment systems’ operational performance with policy targets","authors":"William P. Millhiser, Emre A. Veral, Benedetto C. Valenti","doi":"10.1080/19488300.2012.736121","DOIUrl":"https://doi.org/10.1080/19488300.2012.736121","url":null,"abstract":"We propose a paradigm shift in how the performance of outpatient clinic appointment schedules is evaluated in practice and academia. Our research addresses the traditional dilemma between patients’ wait times and providers’ idle time and overtime, but with operational performance metrics that assess their respective probabilities of exceeding established thresholds, instead of optimizing a presumed cost function. Using a stochastic model, we introduce a new way of analyzing appointment schedules that is absent from the literature but appealing to practitioners. We take into account the variable nature of patient consultation times, known differences in the duration of diverse consults, and patients’ propensity to miss their appointments. Analysis shows that traditional scheduling systems have serious shortcomings in terms of providing consistent service levels, and we conclude that the managerial decision space so far investigated in the appointment scheduling literature is not adequate for exercising operational control over appointment system performance.","PeriodicalId":89563,"journal":{"name":"IIE transactions on healthcare systems engineering","volume":"2 1","pages":"274 - 289"},"PeriodicalIF":0.0,"publicationDate":"2012-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/19488300.2012.736121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"60562510","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: 19