Modeling and analysis to improve the quality of healthcare services

For many healthcare services or medical procedures, patients have extensive risk of complication or face death when treatment is delayed. When a queue is formed in such a situation, it is very important to assess the suffering and risk faced by patients in queue and plan sufficient medical capabilities in advance to address the concerns. As the diversity of care settings increases, congestion in facilities causes many patients to unnecessarily spend extra days in intensive care facilities. Performance evaluation of current healthcare service systems using queueing theory gains more and more importance because of patient flows and systems complexity. Queueing models have been used in handsome number of healthcare studies, but the incorporation of blocking is still limited. In this research work, we study an efficient two-stage multi-class queueing network system with blocking and phase-type service time distribution to analyze such congestion processes. We also consider parallel servers at each station and first-come-first-serve non-preemptive service discipline are used to improve the performance of healthcare service systems

Manufacturing flow line systems: a review of models and analytical results

The most important models and results of the manufacturing flow line literature are described. These include the major classes of models (asynchronous, synchronous, and continuous); the major features (blocking, processing times, failures and repairs); the major properties (conservation of flow, flow rate-idle time, reversibility, and others); and the relationships among different models. Exact and approximate methods for obtaining quantitative measures of performance are also reviewed. The exact methods are appropriate for small systems. The approximate methods, which are the only means available for large systems, are generally based on decomposition, and make use of the exact methods for small systems. Extensions are briefly discussed. Directions for future research are suggested.National Science Foundation (U.S.) (Grant DDM-8914277

Numerical methods for queues with shared service

A queueing system is a mathematical abstraction of a situation where elements, called customers, arrive in a system and wait until they receive some kind of service. Queueing systems are omnipresent in real life. Prime examples include people waiting at a counter to be served, airplanes waiting to take off, traffic jams during rush hour etc. Queueing theory is the mathematical study of queueing phenomena. As often neither the arrival instants of the customers nor their service times are known in advance, queueing theory most often assumes that these processes are random variables. The queueing process itself is then a stochastic process and most often also a Markov process, provided a proper description of the state of the queueing process is introduced. This dissertation investigates numerical methods for a particular type of Markovian queueing systems, namely queueing systems with shared service. These queueing systems differ from traditional queueing systems in that there is simultaneous service of the head-of-line customers of all queues and in that there is no service if there are no customers in one of the queues. The absence of service whenever one of the queues is empty yields particular dynamics which are not found in traditional queueing systems. These queueing systems with shared service are not only beautiful mathematical objects in their own right, but are also motivated by an extensive range of applications. The original motivation for studying queueing systems with shared service came from a particular process in inventory management called kitting. A kitting process collects the necessary parts for an end product in a box prior to sending it to the assembly area. The parts and their inventories being the customers and queues, we get ``shared service'' as kitting cannot proceed if some parts are absent. Still in the area of inventory management, the decoupling inventory of a hybrid make-to-stock/make-to-order system exhibits shared service. The production process prior to the decoupling inventory is make-to-stock and driven by demand forecasts. In contrast, the production process after the decoupling inventory is make-to-order and driven by actual demand as items from the decoupling inventory are customised according to customer specifications. At the decoupling point, the decoupling inventory is complemented with a queue of outstanding orders. As customisation only starts when the decoupling inventory is nonempty and there is at least one order, there is again shared service. Moving to applications in telecommunications, shared service applies to energy harvesting sensor nodes. Such a sensor node scavenges energy from its environment to meet its energy expenditure or to prolong its lifetime. A rechargeable battery operates very much like a queue, customers being discretised as chunks of energy. As a sensor node requires both sensed data and energy for transmission, shared service can again be identified. In the Markovian framework, "solving" a queueing system corresponds to finding the steady-state solution of the Markov process that describes the queueing system at hand. Indeed, most performance measures of interest of the queueing system can be expressed in terms of the steady-state solution of the underlying Markov process. For a finite ergodic Markov process, the steady-state solution is the unique solution of $N-1$ balance equations complemented with the normalisation condition, $N$ being the size of the state space. For the queueing systems with shared service, the size of the state space of the Markov processes grows exponentially with the number of queues involved. Hence, even if only a moderate number of queues are considered, the size of the state space is huge. This is the state-space explosion problem. As direct solution methods for such Markov processes are computationally infeasible, this dissertation aims at exploiting structural properties of the Markov processes, as to speed up computation of the steady-state solution. The first property that can be exploited is sparsity of the generator matrix of the Markov process. Indeed, the number of events that can occur in any state --- or equivalently, the number of transitions to other states --- is far smaller than the size of the state space. This means that the generator matrix of the Markov process is mainly filled with zeroes. Iterative methods for sparse linear systems --- in particular the Krylov subspace solver GMRES --- were found to be computationally efficient for studying kitting processes only if the number of queues is limited. For more queues (or a larger state space), the methods cannot calculate the steady-state performance measures sufficiently fast. The applications related to the decoupling inventory and the energy harvesting sensor node involve only two queues. In this case, the generator matrix exhibits a homogene block-tridiagonal structure. Such Markov processes can be solved efficiently by means of matrix-geometric methods, both in the case that the process has finite size and --- even more efficiently --- in the case that it has an infinite size and a finite block size. Neither of the former exact solution methods allows for investigating systems with many queues. Therefore we developed an approximate numerical solution method, based on Maclaurin series expansions. Rather than focussing on structural properties of the Markov process for any parameter setting, the series expansion technique exploits structural properties of the Markov process when some parameter is sent to zero. For the queues with shared exponential service and the service rate sent to zero, the resulting process has a single absorbing state and the states can be ordered such that the generator matrix is upper-diagonal. In this case, the solution at zero is trivial and the calculation of the higher order terms in the series expansion around zero has a computational complexity proportional to the size of the state space. This is a case of regular perturbation of the parameter and contrasts to singular perturbation which is applied when the service times of the kitting process are phase-type distributed. For singular perturbation, the Markov process has no unique steady-state solution when the parameter is sent to zero. However, similar techniques still apply, albeit at a higher computational cost. Finally we note that the numerical series expansion technique is not limited to evaluating queues with shared service. Resembling shared queueing systems in that a Markov process with multidimensional state space is considered, it is shown that the regular series expansion technique can be applied on an epidemic model for opinion propagation in a social network. Interestingly, we find that the series expansion technique complements the usual fluid approach of the epidemic literature

Queuing-Inventory Models with MAP Demands and Random Replenishment Opportunities

Combining the study of queuing with inventory is very common and such systems are referred to as queuing-inventory systems in the literature. These systems occur naturally in practice and have been studied extensively in the literature. The inventory systems considered in the literature generally include (s, S)-type. However, in this paper we look at opportunistic-type inventory replenishment in which there is an independent point process that is used to model events that are called opportunistic for replenishing inventory. When an opportunity (to replenish) occurs, a probabilistic rule that depends on the inventory level is used to determine whether to avail it or not. Assuming that the customers arrive according to a Markovian arrival process, the demands for inventory occur in batches of varying size, the demands require random service times that are modeled using a continuous-time phase-type distribution, and the point process for the opportunistic replenishment is a Poisson process, we apply matrix-analytic methods to study two of such models. In one of the models, the customers are lost when at arrivals there is no inventory and in the other model, the customers can enter into the system even if the inventory is zero but the server has to be busy at that moment. However, the customers are lost at arrivals when the server is idle with zero inventory or at service completion epochs that leave the inventory to be zero. Illustrative numerical examples are presented, and some possible future work is highlighted

Queues in a random environment

Exponential single server queues with state dependent arrival and service rates are considered which evolve under influences of external environments. The transitions of the queues are influenced by the environment's state and the movements of the environment depend on the status of the queues (bi-directional interaction). The structure of the environment is constructed in a way to encompass various models from the recent Operation Research literature, where a queue is coupled e.g. with an inventory or with reliability issues. With a Markovian joint queueing-environment process we prove separability for a large class of such interactive systems, i.e. the steady state distribution is of product form and explicitly given: The queue and the environment processes decouple asymptotically and in steady state. For non-separable systems we develop ergodicity criteria via Lyapunov functions. By examples we show principles for bounding throughputs of non-separable systems by throughputs of two separable systems as upper and lower bound

Serial production line performance under random variation:Dealing with the ‘Law of Variability’

Many Queueing Theory and Production Management studies have investigated specific effects of variability on the performance of serial lines since variability has a significant impact on performance. To date, there has been no single summary source of the most relevant research results concerned with variability, particularly as they relate to the need to better understand the ‘Law of Variability’. This paper fills this gap and provides readers the foundational knowledge needed to develop intuition and insights on the complexities of stochastic simple serial lines, and serves as a guide to better understand and manage the effects of variability and design factors related to improving serial production line performance, i.e. throughput, inter-departure time and flow time, under random variation