Computationally Efficient Simulation of Queues: The R Package queuecomputer

Large networks of queueing systems model important real-world systems such as MapReduce clusters, web-servers, hospitals, call centers and airport passenger terminals. To model such systems accurately, we must infer queueing parameters from data. Unfortunately, for many queueing networks there is no clear way to proceed with parameter inference from data. Approximate Bayesian computation could offer a straightforward way to infer parameters for such networks if we could simulate data quickly enough. We present a computationally efficient method for simulating from a very general set of queueing networks with the R package queuecomputer. Remarkable speedups of more than 2 orders of magnitude are observed relative to the popular DES packages simmer and simpy. We replicate output from these packages to validate the package. The package is modular and integrates well with the popular R package dplyr. Complex queueing networks with tandem, parallel and fork/join topologies can easily be built with these two packages together. We show how to use this package with two examples: a call center and an airport terminal.Comment: Updated for queuecomputer_0.8.

A Priority-based Fair Queuing (PFQ) Model for Wireless Healthcare System

Healthcare is a very active research area, primarily due to the increase in the elderly population that leads to increasing number of emergency situations that require urgent actions. In recent years some of wireless networked medical devices were equipped with different sensors to measure and report on vital signs of patient remotely. The most important sensors are Heart Beat Rate (ECG), Pressure and Glucose sensors. However, the strict requirements and real-time nature of medical applications dictate the extreme importance and need for appropriate Quality of Service (QoS), fast and accurate delivery of a patient’s measurements in reliable e-Health ecosystem. As the elderly age and older adult population is increasing (65 years and above) due to the advancement in medicine and medical care in the last two decades; high QoS and reliable e-health ecosystem has become a major challenge in Healthcare especially for patients who require continuous monitoring and attention. Nevertheless, predictions have indicated that elderly population will be approximately 2 billion in developing countries by 2050 where availability of medical staff shall be unable to cope with this growth and emergency cases that need immediate intervention. On the other side, limitations in communication networks capacity, congestions and the humongous increase of devices, applications and IOT using the available communication networks add extra layer of challenges on E-health ecosystem such as time constraints, quality of measurements and signals reaching healthcare centres. Hence this research has tackled the delay and jitter parameters in E-health M2M wireless communication and succeeded in reducing them in comparison to current available models. The novelty of this research has succeeded in developing a new Priority Queuing model ‘’Priority Based-Fair Queuing’’ (PFQ) where a new priority level and concept of ‘’Patient’s Health Record’’ (PHR) has been developed and integrated with the Priority Parameters (PP) values of each sensor to add a second level of priority. The results and data analysis performed on the PFQ model under different scenarios simulating real M2M E-health environment have revealed that the PFQ has outperformed the results obtained from simulating the widely used current models such as First in First Out (FIFO) and Weight Fair Queuing (WFQ). PFQ model has improved transmission of ECG sensor data by decreasing delay and jitter in emergency cases by 83.32% and 75.88% respectively in comparison to FIFO and 46.65% and 60.13% with respect to WFQ model. Similarly, in pressure sensor the improvements were 82.41% and 71.5% and 68.43% and 73.36% in comparison to FIFO and WFQ respectively. Data transmission were also improved in the Glucose sensor by 80.85% and 64.7% and 92.1% and 83.17% in comparison to FIFO and WFQ respectively. However, non-emergency cases data transmission using PFQ model was negatively impacted and scored higher rates than FIFO and WFQ since PFQ tends to give higher priority to emergency cases. Thus, a derivative from the PFQ model has been developed to create a new version namely “Priority Based-Fair Queuing-Tolerated Delay” (PFQ-TD) to balance the data transmission between emergency and non-emergency cases where tolerated delay in emergency cases has been considered. PFQ-TD has succeeded in balancing fairly this issue and reducing the total average delay and jitter of emergency and non-emergency cases in all sensors and keep them within the acceptable allowable standards. PFQ-TD has improved the overall average delay and jitter in emergency and non-emergency cases among all sensors by 41% and 84% respectively in comparison to PFQ model

An analytical comparison of the patient-to-doctor policy and the doctor-to-patient policy in the outpatient clinic

Outpatient clinics traditionally organize processes such that the doctor remains in a consultation room, while patients visit for consultation, we call this the Patient-to-Doctor policy. A different approach is the Doctor-to-Patient policy, whereby the doctor travels between multiple consultation rooms, in which patients prepare for their consultation. In the latter approach, the doctor saves time by consulting fully prepared patients. We compare the two policies via a queueing theoretic and a discrete-event simulation approach. We analytically show that the Doctor-to-Patient policy is superior to the Patient-to-Doctor policy under the condition that the doctor’s travel time between rooms is lower than the patient’s preparation time. Simulation results indicate that the same applies when the average travel time is lower than the average preparation time. In addition, to calculate the required number of consultation rooms in the Doctor-to-Patient policy, we provide an expression for the fraction of consultations that are in immediate succession; or, in other words, the fraction of time the next patient is prepared and ready, immediately after a doctor finishes a consultation.We apply our methods for a range of distributions and parameters and to a case study in a medium-sized general hospital that inspired this research

A survey of health care models that encompass multiple departments

In this survey we review quantitative health care models to illustrate the extent to which they encompass multiple hospital departments. The paper provides general overviews of the relationships that exists between major hospital departments and describes how these relationships are accounted for by researchers. We find the atomistic view of hospitals often taken by researchers is partially due to the ambiguity of patient care trajectories. To this end clinical pathways literature is reviewed to illustrate its potential for clarifying patient flows and for providing a holistic hospital perspective

Modeling a healthcare system as a queueing network:The case of a Belgian hospital.

The performance of health care systems in terms of patient flow times and utilization of critical resources can be assessed through queueing and simulation models. We model the orthopaedic department of the Middelheim hospital (Antwerpen, Belgium) focusing on the impact of outages (preemptive and nonpreemptive outages) on the effective utilization of resources and on the flowtime of patients. Several queueing network solution procedures are developed such as the decomposition and Brownian motion approaches. Simulation is used as a validation tool. We present new approaches to model outages. The model offers a valuable tool to study the trade-off between the capacity structure, sources of variability and patient flow times.Belgium; Brownian motion; Capacity management; Decomposition; Health care; Healthcare; Impact; Model; Models; Performance; Performance measurement; Queueing; Queueing theory; Simulation; Stochastic processes; Structure; Studies; Systems; Time; Tool; Validation; Variability;

Health care operations management

Health care operations management has become a major topic for health care service providers and society. Operations research already has and further will make considerable contributions for the effective and efficient delivery of health care services. This special issue collects seven carefully selected papers dealing with optimization and decision analysis problems in the field of health care operations management

Analytical models to determine room requirements in outpatient clinics

Outpatient clinics traditionally organize processes such that the doctor remains in a consultation room while patients visit for consultation, we call this the Patient-to-Doctor policy (PtD-policy). A different approach is the Doctor-to-Patient policy (DtP-policy), whereby the doctor travels between multiple consultation rooms, in which patients prepare for their consultation. In the latter approach, the doctor saves time by consulting fully prepared patients. We use a queueing theoretic and a discrete-event simulation approach to provide generic models that enable performance evaluations of the two policies for different parameter settings. These models can be used by managers of outpatient clinics to compare the two policies and choose a particular policy when redesigning the patient process.We use the models to analytically show that the DtP-policy is superior to the PtD-policy under the condition that the doctor’s travel time between rooms is lower than the patient’s preparation time. In addition, to calculate the required number of consultation rooms in the DtP-policy, we provide an expression for the fraction of consultations that are in immediate succession; or, in other words, the fraction of time the next patient is prepared and ready, immediately after a doctor finishes a consultation. We apply our methods for a range of distributions and parameters and to a case study in a medium-sized general hospital that inspired this research

Probabilistic maximal covering location-allocation models with constrained waiting time or queue length for congested systems

When dealing with the design of service networks, such as health and EMS services, banking or distributed ticket selling services, the location of service centers has a strong influence on the congestion at each of them, and consequently, on the quality of service. In this paper, several models are presented to consider service congestion. The first model addresses the issue of the location of the least number of single--server centers such that all the population is served within a standard distance, and nobody stands in line for a time longer than a given time--limit, or with more than a predetermined number of other clients. We then formulate several maximal coverage models, with one or more servers per service center. A new heuristic is developed to solve the models and tested in a 30--nodes network.Discrete facility location, queuing, emergency services location