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

Optimisation of stochastic networks with blocking: a functional-form approach

This paper introduces a class of stochastic networks with blocking, motivated by applications arising in cellular network planning, mobile cloud computing, and spare parts supply chains. Blocking results in lost revenue due to customers or jobs being permanently removed from the system. We are interested in striking a balance between mitigating blocking by increasing service capacity, and maintaining low costs for service capacity. This problem is further complicated by the stochastic nature of the system. Owing to the complexity of the system there are no analytical results available that formulate and solve the relevant optimization problem in closed form. Traditional simulation-based methods may work well for small instances, but the associated computational costs are prohibitive for networks of realistic size. We propose a hybrid functional-form based approach for finding the optimal resource allocation, combining the speed of an analytical approach with the accuracy of simulation-based optimisation. The key insight is to replace the computationally expensive gradient estimation in simulation optimisation with a closed-form analytical approximation that is calibrated using a single simulation run. We develop two implementations of this approach and conduct extensive computational experiments on complex examples to show that it is capable of substantially improving system performance. We also provide evidence that our approach has substantially lower computational costs compared to stochastic approximation

Approximate Queueing Network Analysis of Patient Treatment Times

We develop an approximate generating function analysis (AGFA) technique which approximates the Laplace transform of the probability density function of customer response time in networks of queues with class-based priorities. From the approximated Laplace transform, we derive the first two moments of customer response time. This technique is applied to a model of a large hospitals Accident and Emergency department for which we obtain the mean and standard deviation of total patient service time. We experiment with different patient-handling priority schemes and compare the AGFA moments with the results from a discrete event simulation. Copyright 2007 ICST

STOCHASTIC MODELING AND TIME-TO-EVENT ANALYSIS OF VOIP TRAFFIC

Voice over IP (VoIP) systems are gaining increased popularity due to the cost effectiveness, ease of management, and enhanced features and capabilities. Both enterprises and carriers are deploying VoIP systems to replace their TDM-based legacy voice networks. However, the lack of engineering models for VoIP systems has been realized by many researchers, especially for large-scale networks. The purpose of traffic engineering is to minimize call blocking probability and maximize resource utilization. The current traffic engineering models are inherited from the legacy PSTN world, and these models fall short from capturing the characteristics of new traffic patterns. The objective of this research is to develop a traffic engineering model for modern VoIP networks. We studied the traffic on a large-scale VoIP network and collected several billions of call information. Our analysis shows that the traditional traffic engineering approach based on the Poisson call arrival process and exponential holding time fails to capture the modern telecommunication systems accurately. We developed a new framework for modeling call arrivals as a non-homogeneous Poisson process, and we further enhanced the model by providing a Gaussian approximation for the cases of heavy traffic condition on large-scale networks. In the second phase of the research, we followed a new time-to-event survival analysis approach to model call holding time as a generalized gamma distribution and we introduced a Call Cease Rate function to model the call durations. The modeling and statistical work of the Call Arrival model and the Call Holding Time model is constructed, verified and validated using hundreds of millions of real call information collected from an operational VoIP carrier network. The traffic data is a mixture of residential, business, and wireless traffic. Therefore, our proposed models can be applied to any modern telecommunication system. We also conducted sensitivity analysis of model parameters and performed statistical tests on the robustness of the models’ assumptions. We implemented the models in a new simulation-based traffic engineering system called VoIP Traffic Engineering Simulator (VSIM). Advanced statistical and stochastic techniques were used in building VSIM system. The core of VSIM is a simulation system that consists of two different simulation engines: the NHPP parametric simulation engine and the non-parametric simulation engine. In addition, VSIM provides several subsystems for traffic data collection, processing, statistical modeling, model parameter estimation, graph generation, and traffic prediction. VSIM is capable of extracting traffic data from a live VoIP network, processing and storing the extracted information, and then feeding it into one of the simulation engines which in turn provides resource optimization and quality of service reports

EUROPEAN CONFERENCE ON QUEUEING THEORY 2016

International audienceThis booklet contains the proceedings of the second European Conference in Queueing Theory (ECQT) that was held from the 18th to the 20th of July 2016 at the engineering school ENSEEIHT, Toulouse, France. ECQT is a biannual event where scientists and technicians in queueing theory and related areas get together to promote research, encourage interaction and exchange ideas. The spirit of the conference is to be a queueing event organized from within Europe, but open to participants from all over the world. The technical program of the 2016 edition consisted of 112 presentations organized in 29 sessions covering all trends in queueing theory, including the development of the theory, methodology advances, computational aspects and applications. Another exciting feature of ECQT2016 was the institution of the Takács Award for outstanding PhD thesis on "Queueing Theory and its Applications"

Modeling the Emergency Care Delivery System Using a Queueing Approach

This thesis considers a regional emergency care delivery system that has a common emergency medical service (EMS) provider and two hospitals, each with a single emergency department (ED) and an inpatient department (ID). Patients arrive at one of the hospital EDs either by ambulance or self-transportation, and we assume that an ambulance patient has preemptive priority over a walk-in patient. Both types of patients can potentially be admitted into the ID or discharged directly from the ED. An admitted patient who cannot access the ID due to the lack of available inpatient beds becomes a boarding patient and blocks an ED server. An ED goes on diversion, e.g., requests the EMS provider to divert incoming ambulances to the neighboring facility, if the total number of its ambulance patients and boarding patients exceeds its capacity (the total number of its servers). The EMS provider will accept the diversion request if the neighboring ED is not on diversion. Both EDs choose its capacity as its diversion threshold and never change the threshold value strategically, and hence they never game. Although the network could be an idealized model of an actual operation, it can be thought of as the simplest network model that is rich enough to reproduce the variety of interactions among different system components. In particular, we aim to highlight the bottleneck effect of inpatient units on ED overcrowding and the network effects resulting from ED diversions. A continuous time Markov chain is introduced for the network model. We show that the chain is irreversible and hence its stationary distribution is difficult to characterize analytically. We identify an alternative solution that builds on queueing decomposition and matrix-analytic methods. We demonstrate through discrete-event simulations the effectiveness of this solution on deriving various performance measures of the original network model. Moreover, by conducting extensive numerical experiments, we provide potential explanations for the overcrowding and delays in a network of hospitals. We suggest remedies from a queueing perspective for the operational challenges facing emergency care delivery systems