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Unsupervised neural networks for clustering emergent patient flows
Publication date: September 2018Source: Operations Research for Health Care, Volume 18Author(s): Marina Resta, Michele Sonnessa, Elena Tànfani, Angela TestiAbstractIn recent years, hospitals increasingly faced with a growing proportion of their inpatient admissions coming from the fluctuating demand of emergency admissions. The opportunity to move emergency patients, with a decision to admit, out of an Emergency Department (ED) is linked to the ability of the hospital to actually receive them. Indeed, the growing concern on public budget constraints implies reducing the number of inpatient ward beds making crucial to impr...
Source: Operations Research for Health Care - July 10, 2018 Category: Hospital Management Source Type: research

Block scheduling at magnetic resonance imaging labs
Publication date: September 2018Source: Operations Research for Health Care, Volume 18Author(s): Anders N. Gullhav, Marielle Christiansen, Bjørn Nygreen, Mats M. Aarlott, Jon Erik Medhus, Johan Fredrik Skomsvoll, Per Olav ØstbyhaugAbstractThis paper considers a tactical block scheduling problem at a major Norwegian hospital. Here, specific patient groups are reserved time blocks for scanning at a heterogeneous set of Magnetic Resonance Imaging (MRI) labs. The time blocks consist of several time slots, and one or more patients from the same group are scanned in a block. A total weekly number of time slots for each specifi...
Source: Operations Research for Health Care - July 10, 2018 Category: Hospital Management Source Type: research

Demand-point constrained EMS vehicle allocation problems for regions with both urban and rural areas
Publication date: September 2018Source: Operations Research for Health Care, Volume 18Author(s): Martin van Buuren, Rob van der Mei, Sandjai BhulaiAbstractGovernments deal with increasing health care demand and costs, while budgets are tightened. At the same time, ambulance providers are expected to deliver high-quality service at affordable cost. Maximum reliability and minimal availability models guarantee a minimal performance level at each demand point, in contrast to the majority of facility location and allocation methods that guarantee a minimal performance that is aggregated over the entire ambulance region. As a c...
Source: Operations Research for Health Care - July 10, 2018 Category: Hospital Management Source Type: research

Is the hospital lean? A mathematical model for assessing the implementation of lean thinking in healthcare institutions
Publication date: September 2018Source: Operations Research for Health Care, Volume 18Author(s): Gopalakrishnan Narayanamurthy, Anand GurumurthyAbstractMany academic and practice articles have been published in healthcare operations management literature documenting the experience of implementing lean thinking (LT) in healthcare institutions. But, none of them have developed a procedure for assessing the implementation of LT in healthcare institutions. Lack of assessment procedures make it difficult to evaluate the progress made during the implementation of LT. The current study attempts to address this gap by developing a...
Source: Operations Research for Health Care - July 10, 2018 Category: Hospital Management Source Type: research

Improving same-day access in primary care: Optimal reconfiguration of appointment system setups
Publication date: September 2018Source: Operations Research for Health Care, Volume 18Author(s): Matthias SchachtAbstractA concept for the optimal configuration and capacity allocation for appointment systems in primary care is presented. It is designed to provide decision-support for primary care clinics to cope with seasonal variations in patient load in order to assure a high accessibility to health care services. The central aspect of the concept is a stochastic MILP for the determination of an appointment scheduling setup configuration, which is defined by the allocation of walk-in and pre-scheduled appointment blocks...
Source: Operations Research for Health Care - July 10, 2018 Category: Hospital Management Source Type: research

A new sequential approach for chemotherapy treatment and facility operations planning
The objective of the developed models is to minimize the number of cancerous cells at the end of a planning horizon, idle/over staff working time and patients’ treatment delay. The results give the optimum starting days for new patients which achieve the best treatment plan. (Source: Operations Research for Health Care)
Source: Operations Research for Health Care - July 10, 2018 Category: Hospital Management Source Type: research

A structured literature review of simulation modelling applied to Emergency Departments: Current patterns and emerging trends
We present a selection of case studies to illustrate both our classification and findings, and suggest directions for further research. (Source: Operations Research for Health Care)
Source: Operations Research for Health Care - July 5, 2018 Category: Hospital Management Source Type: research

Modeling and analysis of short-term work planning in inpatient care settings
Publication date: Available online 3 February 2018Source: Operations Research for Health CareAuthor(s): Lucy G. Aragon, Laila Cure, Ewing Tiong, Rita BushAbstractThis paper uses operations research (OR) to investigate inpatient care work planning decisions from the perspective of a single healthcare provider in a hospital unit. While there has been considerable research on the modeling and analysis of healthcare delivery systems to support medium- to long-term decisions (e.g., daily operating room scheduling, weekly nurse scheduling), there is little research focusing on decisions made at the operational level by front-lin...
Source: Operations Research for Health Care - July 5, 2018 Category: Hospital Management Source Type: research

Adapting GA to solve a novel model for operating room scheduling problem with endogenous uncertainty
Publication date: Available online 5 March 2018Source: Operations Research for Health CareAuthor(s): F. Hooshmand, S.A. MirHassani, A. AkhaveinAbstractThis paper addresses a new variant of the daily operating room scheduling problem in which, surgeries have stochastic durations, and in order to get a more flexible schedule, the initial scheduling and the rescheduling decisions are simultaneously considered within a single optimization model. The main point in the formulation of this problem is that the time of the uncertainty realization is decision dependent and hence, the uncertainty is of endogenous nature which is a ne...
Source: Operations Research for Health Care - July 5, 2018 Category: Hospital Management Source Type: research

Iterative conceptual modeling: A case study in cardiac patient survival simulation
Publication date: Available online 9 March 2018Source: Operations Research for Health CareAuthor(s): Roger McHaney, Iris Reychav, Lin Zhu, Megan McHaney Lindstrom, Yaron ArbelAbstractIterative conceptual modeling techniques were used to abstract a computer model of emergency department patient characteristics from a medical dataset. This research effort focused on unbalanced medical data then developed and defined a simulation of cardiac patient survival. The approach focused on desired real-world outcomes for the model. Specifically, iterative conceptual modeling ensured alignment between real-world needs and model develo...
Source: Operations Research for Health Care - July 5, 2018 Category: Hospital Management Source Type: research

Streamlining pathways for minor injuries in emergency departments through radiographer-led discharge
In this study, we model patient pathways through an emergency department (ED) at a hospital in the South West of England using process mapping, interviews with ED staff and discrete event simulation (DES). The DES model allowed us to compare the current practice at the hospital with scenarios using radiographer-led discharge of patients directly after imaging and assess the reduction in patients’ length of stay in ED. We also quantified trade-offs between the provision of radiographer-led discharge and its effects, i.e. reduction in waiting times and ED workload. Finally, we discuss how this decision support tool can be ...
Source: Operations Research for Health Care - July 5, 2018 Category: Hospital Management Source Type: research

Shelf-space optimization models in decentralized automated dispensing cabinets
Publication date: Available online 5 April 2018Source: Operations Research for Health CareAuthor(s): Nazanin Esmaili, Bryan A. Norman, Jayant RajgopalAbstractWe propose a mixed integer programming (MIP) model to help clinicians store medications and medical supplies optimally in space-constrained, decentralized Automated Dispensing Cabinets (ADCs) located on hospital patient floors. We also propose a second MIP model that addresses human errors associated with the selection of pharmaceuticals from floor storage, and not only selects the best set of medications for storage but also determines their optimal layout within the...
Source: Operations Research for Health Care - July 5, 2018 Category: Hospital Management Source Type: research

Duty rostering for physicians at a department of orthopedics and trauma surgery
Publication date: Available online 5 April 2018Source: Operations Research for Health CareAuthor(s): Clemens ThielenAbstractThis paper presents a case study of duty rostering for physicians at a department of orthopedics and trauma surgery. We provide a detailed description of the rostering problem faced and present an integer programming model that has been used in practice for creating duty rosters at the department for more than a year. Using real world data, we compare the model output to a manually generated roster as used previously by the department and analyze the quality of the rosters generated by the model over ...
Source: Operations Research for Health Care - July 5, 2018 Category: Hospital Management Source Type: research

Multi-dose vial administration with non-stationary demand and delayed service
Publication date: Available online 6 April 2018Source: Operations Research for Health CareAuthor(s): Maryam Mofrad, Lisa M. Maillart, Bryan A. Norman, Jayant RajgopalAbstractTo vaccinate patients arriving to clinics in remote locations, clinicians reconstitute vials containing multiple doses of lyophilized vaccines, but often only partially use the vials by the end of the vaccination session. The unused doses are discarded and termed “open vial waste”. Current practice is typically to vaccinate all patients as long as there is inventory on-hand, which results in significant open vial waste. Previous work on determining...
Source: Operations Research for Health Care - July 5, 2018 Category: Hospital Management Source Type: research

A case study of nonlinear programming approach for repeated testing of HIV in a population stratified by subpopulations according to different risks of new infections
Publication date: Available online 9 April 2018Source: Operations Research for Health CareAuthor(s): Ping Yan, Fan ZhangAbstractMotivated by the vision of the Joint United Nations Programme on HIV/AIDS that 90% of people living with HIV will be diagnosed by year 2020, we present an optimization framework regarding repeated testing of an infectious disease which is transmitted unevenly in the population. A subset of HIV surveillance data in Canada with detailed and compatible variables is pooled for statistical analysis. The study population is Men having Sex with Men (MSM) in Canada from the pooled data. Estimated paramete...
Source: Operations Research for Health Care - July 5, 2018 Category: Hospital Management Source Type: research