Download or read book Integrated Simulation Model for Patient Flow Between Operating Rooms and Progressive Care Units Using Custom Objects written by Ryan L. Miller and published by . This book was released on 2020 with total page 109 pages. Available in PDF, EPUB and Kindle. Book excerpt: Process improvements in hospitals usually focus on a single department (eg. emergency department, operating theater, specialty clinic, etc). However, actions taken in one department inevitably affect the performance of other departments. Therefore, higher efficiency improvements can be obtained by considering the patient care process as one synergetic activity involving several departments and various sets of resources. In this research we propose an integrated approach for modeling the patient lifecycle for multiple departments. First we describe a patient flow from his/her entry into the hospital through a progressive care unit until the patient has fully recovered. We use process mapping methods to address value added activities and other necessary activities in the patient lifecycle. Then, a simulation model is developed in Simio using customized objects created in previous works. Those customized objects carry their own logic and behavior. For example, the Bed object includes logic for a patient recovering while using several hospital resources (nurses, therapist) in his/her hospital stay. Those objects were used to build several configurations of an integrated model with multiple departments. Data about patient arrival patterns, their health acuity, and procedure needs were obtained from a real hospital in order to test our approach. The procedures duration data (which were different for different levels of patient acuity and for different surgical and other procedures) were used to obtain service distribution using statistical analysis methods. Modular simulation objects and data distributions from real hospitals allowed us to build an integrated simulation model with several configurations of the process flow. Simulation experiments were performed on these models and performance recorded. The recommendation for implementations in the hospitals is also reported.
Download or read book Discrete Event Simulation of Operating Rooms Using Data driven Modeling written by Mandvi Malik and published by . This book was released on 2018 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Simulation has been extensively used in various studies to optimize the healthcare facility today. However, the simulation models built for the healthcare industry in the past are mostly made using a model-driven approach. The simulation models made using model-driven approach are not easy to use and modify by someone who is not familiar with simulation tools. To address this shortcoming, the focus of the present research is to create a data-driven simulation model of operating rooms. The focus is to create a simulation model that can be applied to create a simulation model of any operating room unit. For this purpose, the simulation model is built with the combination of customized objects and data-driven add-ins.
Download or read book Applying Mathematical Models to Surgical Patient Planning written by Jeroen Martijn van Oostrum and published by . This book was released on 2009 with total page 178 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book A Computer Simulation Model of Patient Flow Through the Ambulatory Patient Center at Rhode Island Hospital written by Walter L. Demers and published by . This book was released on 1972 with total page 368 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Modeling Neuroscience Patient Flow and Inpatient Bed Management written by Jonas Hiltrop and published by . This book was released on 2014 with total page 122 pages. Available in PDF, EPUB and Kindle. Book excerpt: Massachusetts General Hospital (MGH) experiences consistently high demand for its more than 900 inpatient beds. On an average weekday, the hospital admits about 220 patients, with the emergency department (ED) and the operating rooms (OR) being the main sources of admissions. Given MGH's high occupancy rates, a comparable number of discharges have to occur daily, and the intraday time distributions of admissions and discharges have to be aligned in order to avoid long wait times for beds. The situation is complicated by the specialization of beds and the medical needs of patients, which place constraints on the possible bed-patient assignments. The hospital currently manages these processes using fairly manual and static approaches, and without clear prioritization rules. The timing of discharges is not aligned with the timing of new admissions, with discharges generally occurring later in the day. For this reason MGH experiences consistent bed capacity constraints, which may cause long wait times for patients, throughput limitations, disruptions in the ED and in the perioperative environment, and adverse clinical outcomes. This project develops a detailed patient flow simulation based on historical data from MGH. The model is focused on the neuroscience clinical specialties as a microcosm of the larger hospital since the neuroscience units (22 ICU beds and 64 floor beds) are directly affected by the hospital's important capacity issues (e.g., patient overflows into other units, ICU-to-floor transfer delays). We use the model to test the effectiveness of the following three interventions: 1. Assigning available inpatient beds to newly admitted patients adaptively on a just-in-time basis; 2. Discharging patients earlier in the day; 3. Reserving beds at inpatient rehabilitation facilities, thereby reducing the MGH length of stay by one or more days for patients who need these services after discharge from the hospital. Intervention effectiveness is measured using several performance metrics, including patient wait times for beds, bed utilization, and delays unrelated to bed availability, which capture the efficiency of bed usage. We find that the simulation model captures the current state of the neuroscience services in terms of intraday wait times, and that all modeled interventions lead to significant wait time reductions for patients in the ED and in the perioperative environment. Just-in-time bed assignments reduce average wait times for patients transferring to the neuroscience floor and ICU beds by up to 35% and 48%, respectively, at current throughput levels. Discharges earlier in the day and multi-day length of stay reductions (i.e., interventions 2 and 3) lead to smaller wait time reductions. However, multi-day length of stay reductions decrease bed utilization by up to 4% under our assumptions, and create capacity for throughput increases. Considering the expected cost of implementing these interventions and the reductions in patient wait times, we recommend adopting just-in-time bed assignments to address some of the existing capacity issues. Our simulation shows that this intervention can be combined effectively with earlier discharges and multi-day length of stay reductions at a later point in order to reduce wait times even further.
Download or read book Multi objective Operating Room Planning and Scheduling written by Qing Li and published by . This book was released on 2010 with total page 99 pages. Available in PDF, EPUB and Kindle. Book excerpt: Surgery is one of the most important functions in a hospital with respect to operational cost, patient flow, and resource utilization. Planning and scheduling the Operating Room (OR) is important for hospitals to improve efficiency and achieve high quality of service. At the same time, it is a complex task due to the conflicting objectives and the uncertain nature of surgeries. In this dissertation, three different methodologies are developed to address OR planning and scheduling problem. First, a simulation-based framework is constructed to analyze the factors that affect the utilization of a catheterization lab and provide decision support for improving the efficiency of operations in a hospital with different priorities of patients. Both operational costs and patient satisfaction metrics are considered. Detailed parametric analysis is performed to provide generic recommendations. Overall it is found the 75th percentile of process duration is always on the efficient frontier and is a good compromise of both objectives. Next, the general OR planning and scheduling problem is formulated with a mixed integer program. The objectives include reducing staff overtime, OR idle time and patient waiting time, as well as satisfying surgeon preferences and regulating patient flow from OR to the Post Anesthesia Care Unit (PACU). Exact solutions are obtained using real data. Heuristics and a random keys genetic algorithm (RKGA) are used in the scheduling phase and compared with the optimal solutions. Interacting effects between planning and scheduling are also investigated. Lastly, a multi-objective simulation optimization approach is developed, which relaxes the deterministic assumption in the second study by integrating an optimization module of a RKGA implementation of the Non-dominated Sorting Genetic Algorithm II (NSGA-II) to search for Pareto optimal solutions, and a simulation module to evaluate the performance of a given schedule. It is experimentally shown to be an effective technique for finding Pareto optimal solutions.
Download or read book A Simulation Model of Patient Flow Through the Main Clinic Floors of the Ambulatory Patient Center at Rhode Island Hospital written by Alan Dann Knight and published by . This book was released on 1972 with total page 218 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Patient Flow written by Randolph Hall and published by Springer Science & Business Media. This book was released on 2013-12-11 with total page 547 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is dedicated to improving healthcare through reducing delays experienced by patients. With an interdisciplinary approach, this new edition, divided into five sections, begins by examining healthcare as an integrated system. Chapter 1 provides a hierarchical model of healthcare, rising from departments, to centers, regions and the “macro system.” A new chapter demonstrates how to use simulation to assess the interaction of system components to achieve performance goals, and Chapter 3 provides hands-on methods for developing process models to identify and remove bottlenecks, and for developing facility plans. Section 2 addresses crowding and the consequences of delay. Two new chapters (4 and 5) focus on delays in emergency departments, and Chapter 6 then examines medical outcomes that result from waits for surgeries. Section 3 concentrates on management of demand. Chapter 7 presents breakthrough strategies that use real-time monitoring systems for continuous improvement. Chapter 8 looks at the patient appointment system, particularly through the approach of advanced access. Chapter 9 concentrates on managing waiting lists for surgeries, and Chapter 10 examines triage outside of emergency departments, with a focus on allied health programs Section 4 offers analytical tools and models to support analysis of patient flows. Chapter 11 offers techniques for scheduling staff to match patterns in patient demand. Chapter 12 surveys the literature on simulation modeling, which is widely used for both healthcare design and process improvement. Chapter 13 is new and demonstrates the use of process mapping to represent a complex regional trauma system. Chapter 14 provides methods for forecasting demand for healthcare on a region-wide basis. Chapter 15 presents queueing theory as a method for modeling waits in healthcare, and Chapter 16 focuses on rapid delivery of medication in the event of a catastrophic event. Section 5 focuses on achieving change. Chapter 17 provides a diagnostic for assessing the state of a hospital and using the state assessment to select improvement strategies. Chapter 18 demonstrates the importance of optimizing care as patients transition from one care setting to the next. Chapter 19 is new and shows how to implement programs that improve patient satisfaction while also improving flow. Chapter 20 illustrates how to evaluate the overall portfolio of patient diagnostic groups to guide system changes, and Chapter 21 provides project management tools to guide the execution of patient flow projects.
Download or read book Keeping Patients Safe written by Institute of Medicine and published by National Academies Press. This book was released on 2004-03-27 with total page 485 pages. Available in PDF, EPUB and Kindle. Book excerpt: Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands. Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform â€" monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis â€" provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system. During the past two decades, substantial changes have been made in the organization and delivery of health care â€" and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk. This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.
Download or read book Foundations of Stochastic Inventory Theory written by Evan L. Porteus and published by Stanford University Press. This book was released on 2002 with total page 330 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book has a dual purpose?serving as an advanced textbook designed to prepare doctoral students to do research on the mathematical foundations of inventory theory, and as a reference work for those already engaged in such research. All chapters conclude with exercises that either solidify or extend the concepts introduced.
Download or read book Pain Management and the Opioid Epidemic written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2017-09-28 with total page 483 pages. Available in PDF, EPUB and Kindle. Book excerpt: Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
Download or read book Bioinformatics and Biomedical Engineering written by Ignacio Rojas and published by Springer. This book was released on 2019-04-30 with total page 605 pages. Available in PDF, EPUB and Kindle. Book excerpt: The two-volume set LNBI 11465 and LNBI 11466 constitutes the proceedings of the 7th International Work-Conference on Bioinformatics and Biomedical Engineering, IWBBIO 2019, held in Granada, Spain, in May 2019. The total of 97 papers presented in the proceedings, was carefully reviewed and selected from 301 submissions. The papers are organized in topical sections as follows: Part I: High-throughput genomics: bioinformatics tools and medical applications; omics data acquisition, processing, and analysis; bioinformatics approaches for analyzing cancer sequencing data; next generation sequencing and sequence analysis; structural bioinformatics and function; telemedicine for smart homes and remote monitoring; clustering and analysis of biological sequences with optimization algorithms; and computational approaches for drug repurposing and personalized medicine. Part II: Bioinformatics for healthcare and diseases; computational genomics/proteomics; computational systems for modelling biological processes; biomedical engineering; biomedical image analysis; and biomedicine and e-health.
Download or read book Modelling in Healthcare written by and published by American Mathematical Soc.. This book was released on 2010 with total page 238 pages. Available in PDF, EPUB and Kindle. Book excerpt: A model is a simplified representation of a real-world situation used to help answer a specific question. This book provides a look into the world of modelling with the focus on modelling in healthcare.--[from preface]
Download or read book Bulletin of the Atomic Scientists written by and published by . This book was released on 1970-06 with total page 116 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Bulletin of the Atomic Scientists is the premier public resource on scientific and technological developments that impact global security. Founded by Manhattan Project Scientists, the Bulletin's iconic "Doomsday Clock" stimulates solutions for a safer world.
Download or read book Disease Control Priorities Third Edition Volume 6 written by King K. Holmes and published by World Bank Publications. This book was released on 2017-11-06 with total page 1027 pages. Available in PDF, EPUB and Kindle. Book excerpt: Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
Download or read book Caring for our future written by Great Britain: Department of Health and published by The Stationery Office. This book was released on 2012-07-11 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt: Care and support affects a large number of people: eight out of 10 people aged 65 will need some care and support in their later years; some people have impairments from birth or develop them during their working life; some 5 million people care for a friend or relative, some for more than 50 hours a week. The current system does not offer enough support until a crisis point is reached, the quality of care is variable and inconsistent, and the growing and ageing population is only going to increase the pressure. Consequently, two core principles lie at the heart of this White Paper. The first is that individuals, communities and Government should do everything possible to prevent, postpone and minimise people's need for formal care and support. The system should be built around the promotion of people's independence and well-being. The second principle is that people should be in control of their own care and support, with personal budgets and direct payments, backed by clear, comparable information and advice that will allow individuals and their carers to make the choices that are right for them. This paper sets out the principles and approach, with sections covering: strengthening support within communities; housing; better information and advice; assessment, eligibility and portability for people who use care services; carers' support; defining high-quality care; improving quality; keeping people safe; a better local care market; workforce; personalised care and support; integration and joined-up care.
Download or read book Health 4 0 How Virtualization and Big Data are Revolutionizing Healthcare written by Christoph Thuemmler and published by Springer. This book was released on 2017-01-07 with total page 257 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book describes how the creation of new digital services—through vertical and horizontal integration of data coming from sensors on top of existing legacy systems—that has already had a major impact on industry is now extending to healthcare. The book describes the fourth industrial revolution (i.e. Health 4.0), which is based on virtualization and service aggregation. It shows how sensors, embedded systems, and cyber-physical systems are fundamentally changing the way industrial processes work, their business models, and how we consume, while also affecting the health and care domains. Chapters describe the technology behind the shift of point of care to point of need and away from hospitals and institutions; how care will be delivered virtually outside hospitals; that services will be tailored to individuals rather than being designed as statistical averages; that data analytics will be used to help patients to manage their chronic conditions with help of smart devices; and that pharmaceuticals will be interactive to help prevent adverse reactions. The topics presented will have an impact on a variety of healthcare stakeholders in a continuously global and hyper-connected world. · Presents explanations of emerging topics as they relate to e-health, such as Industry 4.0, Precision Medicine, Mobile Health, 5G, Big Data, and Cyber-physical systems; · Provides overviews of technologies in addition to possible application scenarios and market conditions; · Features comprehensive demographic and statistic coverage of Health 4.0 presented in a graphical manner.
