2,605 research outputs found
Use and misuse of Queueing Theory for hospital capacity decisions
No full textThis chapter is based on experiences with applying Queueing Theory at an NHS acute hospital trust in Greater Manchester in the UK, for resizing its paediatric inpatient department. With an average bed occupancy of 54%, the hospital management thought it would be possible to reduce the number of beds, as according to a rule of thumb a target bed occupancy of 85% should be possible. Originating from a Monte Carlo computer simulation study, the 85-bed occupancy target had found its way into acute hospitals within the NHS, despite of the fact that the setting of the simulation study could be very different from the setting looked at. Certainly, in this case as in paediatrics, most admissions are emergency, and children cannot be transferred to another ward.By applying the basics of Queueing Theory to the setting of the paediatric department, is was possible to show that using a bed occupancy target of 85% would result in a risk of 33% that all beds would be full – which was clearly unacceptable – and that using a very low risk of all beds full of 0.1% (as data for English hospitals suggest for paediatrics) would result in an average bed occupancy of 55%. So, no bed reduction was recommended.In this chapter, examples are also provided of the use of Queueing Theory for pooling wards, and for reducing the variation in arrivals and in service times
Data and modelling
No full textChapter 3 delves into the processes involved in the transitions between the three levels that can be distinguished for modelling work: reality – system – model. To work up – from the reality plane (the problem investigated) to the system plane (demarcation of the system studied) and to the model plane (the model developed for experimenting with solutions) – and down again, is an art that can probably best be taught by experience. However, we try to give a flavour of the activities involved in modelling and particular issues to watch out for.It also opens the lid of the box marked ‘model’. There are many approaches in the model toolkit. The chapter introduces the basic ideas of some common and archetypical operational research techniques.These quantitative models depend on the data parameters fed to them and, in the case of simulation models, themselves generate a lot of data. We therefore also introduced examples of some typical data analysis tasks and useful statistical tools.Later chapters contain some larger examples of applications of models to healthcare problems
Operations Management for Healthcare
No full textThis fully updated edition of the bestselling textbook on Health Service Operations Management provides an invaluable reference for students and researchers in the fields of healthcare management, operations management and patient flow logistics. Featuring theoretical frameworks and a comprehensive set of practical case studies, this book also covers subjects such as hospital planning and supply chain management in healthcare, quality assurance and performance management.Healthcare managers work together with healthcare professionals in a multitude of challenging scenarios. Trade-offs have to be made between waiting times for customers and efficient use of scarce resources, between quality of care and quality of services, between the perspective of a single pathway and the total system, and between the perspective of a single provider and that of a network of providers working together in the chain of primary care, hospitals, nursing homes and home care. This book guides healthcare students and professionals through a set of practical tools and resources, ranging from simple queueing models to more complicated analytical models, to help address these issues.The book can be used at an undergraduate level by introducing concepts, definitions and approaches, and at a postgraduate level through the application of approaches to operations management problems in healthcare practice. It will serve as a primary textbook for a health service operations management course module in a Master's program on healthcare management
Dr. Nathan Nobis, Morehouse College, August 2011
No full textThis video is a conversation with Dr. Nathan Nobis. Dr. Nobis talks about his paper, "The Harmful, Nontherapeutic use of Animals in Research is Morally Wrong." Brad Ost, AUC Woodruff Library, is the interviewer
Towards fully-facilitated discrete event simulation modelling : Addressing the model coding stage
Full text linkThe literature suggests that increasing stakeholder engagement has a positive impact on projects using discrete-event simulation in healthcare. This suggests projects should strive to involve the stakeholders in as much of the project as possible, through facilitated workshops. A notable gap in stakeholder involvement is the model coding stage, in which a conceptual model is turned into a discrete-event simulation model running on a computer. This paper investigates how and under what circumstances model coding might also be conducted in facilitated workshops, in particular through the use of the Business Process Model and Notation (BPMN) modelling standard. This work arose from a series of modelling projects with two hospitals, one in Italy and the other in the UK. The paper describes how BPMN can contribute, with a case in which model coding was achieved in a facilitated workshop and a second in which it was not but which highlights further barriers to this in some contexts. These barriers arise from the detail necessary for requisite modelling regarding i) the level of complexity of the model and ii) challenges in data access and analysis to populate the model. The relationship between the technical capabilities of tools available and the impact of these barriers is also discussed. We believe this is the first time that discrete-event simulation model coding in a facilitated workshop in healthcare has been described, and we provide a clear view of the further barriers. To indicate when facilitated model coding is currently achievable, we suggest a contextual matrix
Letter from Nathan Bankhead, Bankhead and Henderson, to Carl Hayden
No full textLetter from Nathan Bankhead to Carl Hayden concerning his sheep and the accusations of Horace M. Albright
A BPMN extension to support discrete-event simulation for healthcare applications : an explicit representation of queues, attributes and data-driven decision points
Full text linkStakeholder engagement in simulation projects is important, especially in healthcare where there is a plurality of stakeholder opinions, objectives and power. One promising approach for increasing engagement is facilitated modelling. Currently, the complexity of producing a simulation model means that the ‘model coding’ stage is performed without the involvement of stakeholders, interrupting the possibility of a fully-facilitated project. Early work demonstrated that with currently-available software tools we can represent a simple healthcare process using Business Process Model and Notation (BPMN) and generate a simulation model automatically. However, for more complex processes, BPMN currently has a number of limitations, namely the ability to represent queues and data-driven decision points. To address these limitations, we propose a conceptual design for an extension to BPMN (BPMN4SIM) using Model Driven Architecture. Application to an elderly emergency care pathway in a UK hospital shows that BPMN4SIM is able to represent a more-complex business process
Nathan Newsom diary
No full textNarrative account entitled "A Short summary of a journey, taken by volunteers from Gallia County; for the purpose of destroying Indians and the invasion of Canada," written by Nathan Newsom. Newsom was an orderly sergeant in Captain Calvin Shepard's company from Gallia County, Ohio, during the War of 1812. This volume conveys conditions experienced by soldiers during the war, including low pay, shortages of food and clothing, low morale, and severe weather conditions. Newsom also describes the cooperation of the army with friendly Indians and the disciplinary measures taken for desertion and other offenses
Design and development of a digital diagnostic Clinical Pathway:Evidence from an action research study
No full textPurposeThe primary objective of this paper is to show a systematic and methodological approach for the digitalization of critical clinical pathways (CPs) within the healthcare domain.Design/methodology/approachThe methodology entails the integration of service design (SD) and action research (AR) methodologies, characterized by iterative phases that systematically alternate between action and reflective processes, fostering cycles of change and learning. Within this framework, stakeholders are engaged through semi-structured interviews, while the existing and envisioned processes are delineated and represented using BPMN 2.0. These methodological steps emphasize the development of an autonomous, patient-centric web application alongside the implementation of an adaptable and patient-oriented scheduling system. Also, business processes simulation is employed to measure key performance indicators of processes and test for potential improvements. This method is implemented in the context of the CP addressing transient loss of consciousness (TLOC), within a publicly funded hospital setting.FindingsThe methodology integrating SD and AR enables the detection of pivotal bottlenecks within diagnostic CPs and proposes optimal corrective measures to ensure uninterrupted patient care, all the while advancing the digitalization of diagnostic CP management. This study contributes to theoretical discussions by emphasizing the criticality of process optimization, the transformative potential of digitalization in healthcare and the paramount importance of user-centric design principles, and offers valuable insights into healthcare management implications.Originality/valueThe study’s relevance lies in its ability to enhance healthcare practices without necessitating disruptive and resource-intensive process overhauls. This pragmatic approach aligns with the imperative for healthcare organizations to improve their operations efficiently and cost-effectively, making the study’s findings relevant
Guilt, Memory, and the Beta-God: Nathan Englander on kaddish.com
Full text linkDiane Feigenson Lecture in Jewish Literature… Nathan Englander, Bestselling author, For the Relief of Unbearable Urges, What We Talk About When We Talk, About Anne Frank, and kaddish.com (2019).https://digitalcommons.fairfield.edu/bennettcenter-posters/1360/thumbnail.jp
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