Welcome to OR&S! Where students, academics and professionals come together

In this manuscript, an overview is given of the activities done at the Operations Research and Scheduling (OR&S) research group of the faculty of Economics and Business Administration of Ghent University. Unlike the book published by [1] that gives a summary of all academic and professional activities done in the field of Project Management in collaboration with the OR&S group, the focus of the current manuscript lies on academic publications and the integration of these published results in teaching activities. An overview is given of the publications from the very beginning till today, and some of the topics that have led to publications are discussed in somewhat more detail. Moreover, it is shown how the research results have been used in the classroom to actively involve students in our research activities

BMC Public Health

BackgroundDespite WHO advocating for an integrated approach to antenatal care (ANC), testing coverage for conditions other than HIV remains low and women are referred to distant laboratories for testing. Using point-of-care tests (POCTs) at peripheral dispensaries could improve access to testing and timely treatment. However, the effect of providing additional services on nurse workload and client wait times are unknown. We use discrete-event simulation (DES) modelling to understand the effect of providing four point-of-care tests for ANC on nurse utilization and wait times for women seeking maternal and child health (MCH) services.MethodsWe collected detailed time-motion data over 20\u2009days from one high volume dispensary in western Kenya during the 8-month implementation period (2014\u20132015) of the intervention. We constructed a simulation model using empirical arrival distributions, activity durations and client pathways of women seeking MCH services. We removed the intervention from the model to obtain wait times, length-of-stay and nurse utilization rates for the baseline scenario where only HIV testing was offered for ANC. Additionally, we modelled a scenario where nurse consultations were set to have minimum durations for sufficient delivery of all WHO-recommended services.ResultsA total of 183 women visited the dispensary for MCH services and 14 of these women received point-of-care testing (POCT). The mean difference in total waiting time was 2\u2009min (95%CI: <\u20091\u20134\u2009min, p\u2009=\u20090.026) for MCH women when integrated POCT was given, and 9\u2009min (95%CI: 4\u201314\u2009min, p\u2009<\u20090.001) when integrated POCT with adequate ANC consult times was given compared to the baseline scenario. Mean\ua0length-of-stay increased by 2\u2009min (95%CI: <\u20091\u20134\u2009min, p\u2009=\u20090.015) with integrated POCT and by 16\u2009min (95%CI: 10\u201321\u2009min, p\u2009<\u20090.001) with integrated POCT and adequate consult times compared to the baseline scenario. The two nurses\u2019 overall daily utilization in the scenario with sufficient minimum consult durations were 72 and 75%.ConclusionThe intervention had a modest overall impact on wait times and length-of-stay\ua0for women seeking MCH services while ensuring pregnant women received essential diagnostic testing. Nurse utilization rates fluctuated among days: nurses experienced spikes in workload on some days but were under-utilized on the majority of days. Overall, our model suggests there was sufficient time to deliver all WHO\u2019s required ANC activities and offer integrated testing for ANC first and re-visits with the current number of healthcare staff. Further investigations on improving healthcare worker, availability, performance and quality of care are needed. Delivering four point-of-care tests together for ANC at dispensary level would be a low burden strategy to improve ANC.2019-12-03T00:00:00Z31795999PMC6892244779

A decision support system for demand and capacity modelling of an accident and emergency department

© 2019 Operational Research Society.Accident and emergency (A&E) departments in England have been struggling against severe capacity constraints. In addition, A&E demands have been increasing year on year. In this study, our aim was to develop a decision support system combining discrete event simulation and comparative forecasting techniques for the better management of the Princess Alexandra Hospital in England. We used the national hospital episodes statistics data-set including period April, 2009 – January, 2013. Two demand conditions are considered: the expected demand condition is based on A&E demands estimated by comparing forecasting methods, and the unexpected demand is based on the closure of a nearby A&E department due to budgeting constraints. We developed a discrete event simulation model to measure a number of key performance metrics. This paper presents a crucial study which will enable service managers and directors of hospitals to foresee their activities in future and form a strategic plan well in advance.Peer reviewe

Designing intelligent computer‐based simulations: A pragmatic approach

This paper examines the design of intelligent multimedia simulations. A case study is presented which uses an approach based in part on intelligent tutoring system design to integrate formative assessment into the learning of clinical decision‐making skills for nursing students. The approach advocated uses a modular design with an integrated intelligent agent within a multimedia simulation. The application was created using an object‐orientated programming language for the multimedia interface (Delphi) and a logic‐based interpreted language (Prolog) to create an expert assessment system. Domain knowledge is also encoded in a Windows help file reducing some of the complexity of the expert system. This approach offers a method for simplifying the production of an intelligent simulation system. The problems developing intelligent tutoring systems are examined and an argument is made for a practical approach to developing intelligent multimedia simulation systems

Why are Spiritual Aspects of Care so hard to Address in Nursing Education?’ A Literature Review (1993-2015)

Difficulties persist in conceptualising spiritual needs and understanding their relationship to religious needs and relevance to wellbeing. This review was undertaken to clarify some of these issues. It set out to establish what is already known about how issues of spiritual assessment and care are addressed in undergraduate nursing education. Using a systematic approach, a literature review covering the period 1993-2015 was undertaken. Reviewed materials were collected from mainly online sources including with searches conducted using CINHAL, SUMMON and PubMed databases, after defining keywords and inclusion and exclusion criteria. The study found that Spirituality appears to be a broad but useful category which is concerned with how people experience meaning and purpose in their lives. However, it also established that here are relatively few studies focused on how spiritual care competencies could be developed in nursing students. There is also little work exploring nursing educators’ perspectives and experiences about how to develop spiritual competencies in their students. The study concludes that further research is necessary in order to bridge the gap between aspirations and practice

Enhancing Care Transitions for Older People through Interprofessional Simulation: A Mixed Method Evaluation

Introduction: The educational needs of the health and social care workforce for delivering effective integrated care are important. This paper reports on the development, pilot and evaluation of an interprofessional simulation course, which aimed to support integrated care models for care transitions for older people from hospital to home. Theory and methods: The course development was informed by a literature review and a scoping exercise with the health and social care workforce. The course ran six times and was attended by health and social care professionals from hospital and community (n=49). The evaluation aimed to elicit staff perceptions of their learning about care transfers of older people and to explore application of learning into practice and perceived outcomes. The study used a sequential mixed method design with questionnaires completed pre (n=44) and post (n=47) course and interviews (n=9) 2-5 months later. Results:Participants evaluated interprofessional simulation as a successful strategy. Post-course, participants identified learning points and at the interviews, similar themes with examples of application in practice were: Understanding individual needs and empathy; Communicating with patients and families; Interprofessional working; Working across settings to achieve effective care transitions. Conclusions and discussion:An interprofessional simulation course successfully brought together health and social care professionals across settings to develop integrated care skills and improve care transitions for older people with complex needs from hospital to home

An Examination of the Application of Problem Based Learning: A Valuable Tool to Improve Student Learning or a Challenging Teaching Adjustment?

Pedagogic transitions towards constructivist, student-centred learning models have increased applications of active teaching methods such as problem-based learning (PBL), but little research has explored student perceptions of PBL applications within undergraduate geography curricula. This paper aims to determine whether PBL applications are beneficial to student learning and development; and to determine whether PBL applications such as a migration management case study are suitable for continued use within the undergraduate geography degree programme at the University of Hertfordshire. This study examines the utility of PBL by reviewing existing education and discipline specific literature and by studying geography student reflections of a PBL migration management activity. The findings suggest that undergraduate geography students are largely receptive to PBL applications and find the inclusion of PBL activities within lectures to be useful and engaging. Although challenges can be associated with implementing PBL into higher education curricula, these challenges can be alleviated by using recommendations for best practice and it appears that the advantages of PBL applications for student learning and development strongly outweigh initial adjustment challenges. The predominantly positive student feedback demonstrates that the PBL migration case study is a beneficial addition to the geography degree programme at the University of Hertfordshire and that further applications of PBL within the curricula could be extremely valuable for undergraduate geography students

Emergency and on-demand health care: modelling a large complex system

This paper describes how system dynamics was used as a central part of a whole-system review of emergency and on-demand health care in Nottingham, England. Based on interviews with 30 key individuals across health and social care, a 'conceptual map' of the system was developed, showing potential patient pathways through the system. This was used to construct a stock-flow model, populated with current activity data, in order to simulate patient flows and to identify system bottle-necks. Without intervention, assuming current trends continue, Nottingham hospitals are unlikely to reach elective admission targets or achieve the government target of 82% bed occupancy. Admissions from general practice had the greatest influence on occupancy rates. Preventing a small number of emergency admissions in elderly patients showed a substantial effect, reducing bed occupancy by 1% per annum over 5 years. Modelling indicated a range of undesirable outcomes associated with continued growth in demand for emergency care, but also considerable potential to intervene to alleviate these problems, in particular by increasing the care options available in the community

The critical elements of effective academic-practice partnerships: a framework derived from the Department of Veterans Affairs Nursing Academy.

BackgroundThe nursing profession is exploring how academic-practice partnerships should be structured to maximize the potential benefits for each partner. As part of an evaluation of the U.S. Department of Veterans Affairs Nursing Academy (VANA) program, we sought to identify indicators of successful partnerships during the crucial first year.MethodsWe conducted a qualitative analysis of 142 individual interviews and 23 focus groups with stakeholders from 15 partnerships across the nation. Interview respondents typically included the nursing school Dean, the VA chief nurse, both VANA Program Directors (VA-based and nursing school-based), and select VANA faculty members. The focus groups included a total of 222 VANA students and the nursing unit managers and staff from units where VANA students were placed. An ethnographic approach was utilized to identify emergent themes from these data that underscored indicators of and influences on Launch Year achievement.ResultsWe emphasize five key themes: the criticality of inter-organizational collaboration; challenges arising from blending different cultures; challenges associated with recruiting nurses to take on faculty roles; the importance of structuring the partnership to promote evidence-based practice and simulation-based learning in the clinical setting; and recognizing that stable relationships must be based on long-term commitments rather than short-term changes in the demand for nursing care.ConclusionsDeveloping an academic-clinical partnership requires identifying how organizations with different leadership and management structures, different responsibilities, goals and priorities, different cultures, and different financial models and accountability systems can bridge these differences to develop joint programs integrating activities across the organizations. The experience of the VANA sites in implementing academic-clinical partnerships provides a broad set of experiences from which to learn about how such partnerships can be effectively implemented, the barriers and challenges that will be encountered, and strategies and factors to overcome challenges and build an effective, sustainable partnership. This framework provides actionable guidelines for structuring and implementing effective academic-practice partnerships that support undergraduate nursing education

Total skin self-examination at home for people treated for cutaneous melanoma : development and pilot of a digital intervention

This work was funded by the RCUK Digital Economy award to the dot.rural Digital Economy Hub, University of Aberdeen; award reference: EP/G066051/1. The Experience Laboratory event was supported in part by a separate award from the University of Aberdeen Knowledge Exchange and Transfer Fund; award reference: GP057 UZZ0101.Peer reviewedPublisher PD