Download or read book Integrated Nurse Staffing and Assignment Under Uncertainty written by Prattana Punnakitikashem and published by ProQuest. This book was released on 2007 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: One of the major problems in the United States health care system is a shortage of nurses. Baby boomers and an increasing elderly population are the main reasons for a rapidly growing demand for nurses. Besides the decline in enrollments in registered nurse degree programs, many nurses have suffered from work burnout. High workloads and undesirable schedules are two major issues that cause nurses' job dissatisfaction. As a result, nurses plan to leave their jobs causing low retention and low entering rates. One consequence of the shortage is that excessive workload on nurses decreases the quality of patient care. Many states have seriously considered taking actions to cope with the shortage to ensure patient safety, e.g., California has regulated mandatory nurse-to-patient ratios. To satisfy patient care demands, hospital administrations are obligated to employ other expensive staffing resources, such as part-time nurses, agency nurses, overtime nurses, etc. Since nurse staffing costs account for over 50% of hospital expenditures, health care costs are continuously increasing driven by an ongoing severe shortage of nurses. Consequently, the nursing shortage will become more severe and nurse staffing has become one of the most attractive research areas. We describe four phases of nurse planning, which are nurse budgeting, nurse scheduling, nurse staffing, and nurse assignment. The first part of this dissertation considers only the last phase of nurse planning, which makes daily decisions on assigning nurses to patients. With nurses from the nurse staffing phase, a charge nurse assigns nurses to patients at the beginning of a shift. To capture uncertainty in patient care, we develop a stochastic integer programming model for nurse assignment with an objective to minimize excess workload on nurses. The problem is solved using a Benders' decomposition approach, whose master problem assigns nurses to patients, and whose recourse subproblems penalize the assignment and determine excess workload on nurses. The recourse subproblems can be considered as network flow problems, in which we develop a new greedy algorithm to solve them. When hospital units have new hires, there is no sufficient data to consider them unique. A symmetry problem may arise when there are identical nurses, which leads us to construct sets of valid inequalities to strengthen the restricted master problem. We develop sets of valid inequalities to prevent symmetric assignments, which eventually reduce the computational effort. In addition, we develop a set of valid inequalities representing the nurse-to-patient ratio to ensure patient safety. These valid inequalities not only enhance the algorithmic performance, but also prevent illegal and impractical assignments. The second part of this dissertation focuses on an integration between the third and the last phases, which makes short-term decisions (90 minutes before a shift) on staffing and assigning nurses to patients. We present a stochastic integer programming model for integrated nurse staffing and assignment with uncertain patient care with an objective of minimizing excess workload on nurses. We present three decomposition approaches based on the L-shaped method for solving our model, which are (1) Benders' decomposition, (2) Lagrangian relaxation with Benders' decomposition, and (3) nested Benders' decomposition. The Lagrangian relaxation with Benders' decomposition approach can be viewed as a novel search method for bicriteria stochastic integer programs. Computational results are provided based upon data from two medical-surgical units at Northeast Texas hospital. The focus of this dissertation is to find good solutions within 30 minutes. Results suggest that the hospital can save up to 1588 hours of excess workload each year in each unit by using our stochastic programming for nurse assignment model. The greedy algorithm for the network primal subproblem is 30 times faster than the current commercial network simplex solver (CPLEX 9.1). Moreover, integrated nurse staffing and assignment results indicated the Lagrangian relaxation with Benders' decomposition approach provided the most promising results among the three methods. Considering our model as two-stage stochastic programming results in better nurse schedules and assignments than those from three-stage, meaning that it is more beneficial to perform nurse staffing and assignment simultaneously. The nurse staffs and assignments found by these methods can be used in a nurse staffing decision supporting system, which facilitates a nurse supervisor to select a nurse staff and assignment based on a tradeoff between staffing cost and excess workload on nurses. Moreover, a nurse supervisor can also use our model to evaluate a float assignment. Our model allows decision makers to play important roles in utilizing their judgments to comply the right staffing policy. Furthermore, topics of future research are discussed. Finally, a nurse assignment decision supporting tool based on our underlying model is provided in the appendix.
Download or read book Integrated Uncertainty in Knowledge Modelling and Decision Making written by Katsuhiro Honda and published by Springer Nature. This book was released on 2022-03-03 with total page 389 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book constitutes the refereed proceedings of the 98th International Symposium on Integrated Uncertainty in Knowledge Modelling and Decision Making, IUKM 2021, held in Ishikawa, Japan, in March 2022. The 30 full papers presented were carefully reviewed and selected from 46 submissions. The papers deal with all aspects of uncertainty modelling and management and are organized in topical sections on uncertainty management and decision making, optimization and statistical methods, pattern classification and data analysis, machine learning, and economic applications.
Download or read book Integrated Uncertainty in Knowledge Modelling and Decision Making written by Hirosato Seki and published by Springer. This book was released on 2019-03-18 with total page 455 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book constitutes the refereed proceedings of the 7th International Symposium on Integrated Uncertainty in Knowledge Modelling and Decision Making, IUKM 2019, held in Nara, Japan, in March 2019. The 37 revised full papers presented were carefully reviewed and selected from 93 submissions. The papers deal with all aspects of uncertainty modelling and management and are organized in topical sections on uncertainty management and decision support; econometrics; machine learning; machine learning applications; and statistical methods.
Download or read book An Integrated System of Patient Assessment Classification and Nurse Staffing for Long Term Care written by John P. Young and published by . This book was released on 1976 with total page 87 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Dissertation Abstracts International written by and published by . This book was released on 2008 with total page 980 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book An Integrated Nurse Staffing System written by Thomas F. Kelley and published by . This book was released on 1979 with total page 44 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book INFORMS Annual Meeting written by Institute for Operations Research and the Management Sciences. National Meeting and published by . This book was released on 2007 with total page 416 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Nursing Staff in Hospitals and Nursing Homes written by Institute of Medicine and published by National Academies Press. This book was released on 1996-03-27 with total page 558 pages. Available in PDF, EPUB and Kindle. Book excerpt: Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.
Download or read book A Long View of Research and Practice in Operations Research and Management Science written by ManMohan S. Sodhi and published by Springer Science & Business Media. This book was released on 2010-09-09 with total page 308 pages. Available in PDF, EPUB and Kindle. Book excerpt: From the Foreword by Marshall Fisher, The Wharton School, University of Pennsylvania: As generation of academics and practitioners follows generation, it is worthwhile to compile long views of the research and practice in the past to shed light on research and practice going forward. This collection of peer-reviewed articles is intended to provide such a long view. This book contains a collection of chapters written by leading scholars/practitioners who have continued their efforts in developing and/or implementing innovative OR/MS tools for solving real world problems. In this book, the contributors share their perspectives about the past, present and future of OR/MS theoretical development, solution tools, modeling approaches, and applications. Specifically, this book collects chapters that offer insights about the following topics: • Survey articles taking a long view over the past two or more decades to arrive at the present state of the art while outlining ideas for future research. Surveys focus on use of a particular OR/MS approach, e.g., mathematical programming (LP, MILP, etc.) and solution methods for particular family of application, e.g., distribution system design, distribution planning system, health care. • Autobiographical or biographical accounts of how particular inventions (e.g., Structured Modeling) were made. These could include personal experiences in early development of OR/MS and an overview of what has happened since. • Development of OR/MS mathematical tools (e.g., stochastic programming, optimization theory). • Development of OR/MS in a particular industry sector such as global supply chain management. • Modeling systems for OR/MS and their development over time as well as speculation on future development (e.g., LINDO, LINGO, and What’sBest!) • New applications of OR/MS models (e.g., happiness) The target audience of this book is young researchers, graduate/advanced undergraduate students from OR/MS and related fields like computer science, engineering, and management as well as practitioners who want to understand how OR/MS modeling came about over the past few decades and what research topics or modeling approaches they could pursue in research or application.
Download or read book Selecting and Applying Methods for Estimating the Size and Mix of Nursing Teams written by Keith Hurst and published by . This book was released on 2003 with total page 19 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Operations Management written by John O. McClain and published by . This book was released on 1992 with total page 760 pages. Available in PDF, EPUB and Kindle. Book excerpt: Geared towards problem solving and problem recognition, this text details various aspects of operations management. It includes a discussion of multi-level distribution systems and production scheduling in large organizations, as well as productivity measurement and improvement.
Download or read book Patient Safety and Quality written by Ronda Hughes and published by Department of Health and Human Services. This book was released on 2008 with total page 592 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
Download or read book Middle Range Theory for Nursing written by Mary Jane Smith, PhD, RN, FAAN and published by Springer Publishing Company. This book was released on 2018-03-10 with total page 506 pages. Available in PDF, EPUB and Kindle. Book excerpt: Three-time recipient of the AJN Book of the Year Award! Praise for the third edition: “This is an outstanding edition of this book. It has great relevance for learning about, developing, and using middle range theories. It is very user friendly, yet scholarly." Score: 90, 4 Stars -Doody's Medical Reviews The fourth edition of this invaluable publication on middle range theory in nursing reflects the most current theoretical advances in the field. With two additional chapters, new content incorporates exemplars that bridge middle range theory to advanced nursing practice and research. Additional content for DNP and PhD programs includes two new theories: Bureaucratic Caring and Self-Care of Chronic Illness. This user-friendly text stresses how theory informs practice and research in the everyday world of nursing. Divided into four sections, content sets the stage for understanding middle range theory by elaborating on disciplinary perspectives, an organizing framework, and evaluation of the theory. Middle Range Theory for Nursing, Fourth Edition presents a broad spectrum of 13 middle range theories. Each theory is broken down into its purpose, development, and conceptual underpinnings, and includes a model demonstrating the relationships among the concepts, and the use of the theory in research and practice. In addition, concept building for research through the lens of middle range theory is presented as a rigorous 10-phase process that moves from a practice story to a conceptual foundation. Exemplars are presented clarifying both the concept building process and the use of conceptual structures in research design. This new edition remains an essential text for advanced practice, theory, and research courses. New to the Fourth Edition: Reflects new theoretical advances Two completely new chapters New content for DNP and PhD programs Two new theories: Bureaucratic Caring and Self-Care of Chronic Illness Two articles from Advances in Nursing Science documenting a historical meta-perspective on middle range theory development Key Features: Provides a strong contextual foundation for understanding middle range theory Introduces the Ladder of Abstraction to clarify the range of nursing’s theoretical foundation Presents 13 middle range theories with philosophical, conceptual, and empirical dimensions of each theory Includes Appendix summarizing middle range theories from 1988 to 2016
Download or read book Taking Action Against Clinician Burnout written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2020-01-02 with total page 335 pages. Available in PDF, EPUB and Kindle. Book excerpt: Patient-centered, high-quality health care relies on the well-being, health, and safety of health care clinicians. However, alarmingly high rates of clinician burnout in the United States are detrimental to the quality of care being provided, harmful to individuals in the workforce, and costly. It is important to take a systemic approach to address burnout that focuses on the structure, organization, and culture of health care. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being builds upon two groundbreaking reports from the past twenty years, To Err Is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century, which both called attention to the issues around patient safety and quality of care. This report explores the extent, consequences, and contributing factors of clinician burnout and provides a framework for a systems approach to clinician burnout and professional well-being, a research agenda to advance clinician well-being, and recommendations for the field.
Download or read book Engineering a Learning Healthcare System written by National Academy of Engineering and published by National Academies Press. This book was released on 2011-07-14 with total page 340 pages. Available in PDF, EPUB and Kindle. Book excerpt: Improving our nation's healthcare system is a challenge which, because of its scale and complexity, requires a creative approach and input from many different fields of expertise. Lessons from engineering have the potential to improve both the efficiency and quality of healthcare delivery. The fundamental notion of a high-performing healthcare system-one that increasingly is more effective, more efficient, safer, and higher quality-is rooted in continuous improvement principles that medicine shares with engineering. As part of its Learning Health System series of workshops, the Institute of Medicine's Roundtable on Value and Science-Driven Health Care and the National Academy of Engineering, hosted a workshop on lessons from systems and operations engineering that could be applied to health care. Building on previous work done in this area the workshop convened leading engineering practitioners, health professionals, and scholars to explore how the field might learn from and apply systems engineering principles in the design of a learning healthcare system. Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary focuses on current major healthcare system challenges and what the field of engineering has to offer in the redesign of the system toward a learning healthcare system.
Download or read book Resident Duty Hours written by Institute of Medicine and published by National Academies Press. This book was released on 2009-04-27 with total page 427 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medical residents in hospitals are often required to be on duty for long hours. In 2003 the organization overseeing graduate medical education adopted common program requirements to restrict resident workweeks, including limits to an average of 80 hours over 4 weeks and the longest consecutive period of work to 30 hours in order to protect patients and residents from unsafe conditions resulting from excessive fatigue. Resident Duty Hours provides a timely examination of how those requirements were implemented and their impact on safety, education, and the training institutions. An in-depth review of the evidence on sleep and human performance indicated a need to increase opportunities for sleep during residency training to prevent acute and chronic sleep deprivation and minimize the risk of fatigue-related errors. In addition to recommending opportunities for on-duty sleep during long duty periods and breaks for sleep of appropriate lengths between work periods, the committee also recommends enhancements of supervision, appropriate workload, and changes in the work environment to improve conditions for safety and learning. All residents, medical educators, those involved with academic training institutions, specialty societies, professional groups, and consumer/patient safety organizations will find this book useful to advocate for an improved culture of safety.
Download or read book Handbook of Healthcare Operations Management written by Brian T. Denton and published by Springer Science & Business Media. This book was released on 2013-02-28 with total page 542 pages. Available in PDF, EPUB and Kindle. Book excerpt: From the Preface: Collectively, the chapters in this book address application domains including inpatient and outpatient services, public health networks, supply chain management, and resource constrained settings in developing countries. Many of the chapters provide specific examples or case studies illustrating the applications of operations research methods across the globe, including Africa, Australia, Belgium, Canada, the United Kingdom, and the United States. Chapters 1-4 review operations research methods that are most commonly applied to health care operations management including: queuing, simulation, and mathematical programming. Chapters 5-7 address challenges related to inpatient services in hospitals such as surgery, intensive care units, and hospital wards. Chapters 8-10 cover outpatient services, the fastest growing part of many health systems, and describe operations research models for primary and specialty care services, and how to plan for patient no-shows. Chapters 12 – 16 cover topics related to the broader integration of health services in the context of public health, including optimizing the location of emergency vehicles, planning for mass vaccination events, and the coordination among different parts of a health system. Chapters 17-18 address supply chain management within hospitals, with a focus on pharmaceutical supply management, and the challenges of managing inventory for nursing units. Finally, Chapters 19-20 provide examples of important and emerging research in the realm of humanitarian logistics.
