Towards optimizing hospital patient transports by automatically identifying interpretable causes of delays

The continuous financial pressure on hospitals forces them to rethink various workflows. We focus on optimizing hospital transports, within the hospital, as they count up to 30% of the overall hospital cost. In this paper, we discuss a self-learning platform that learns the causes of transport delays, in order to avoid these kinds of delays in the future. We pay special attention to the explainability of the self-learning system, such that management understands the learned causes and remains in control over the automated process. This is achieved by providing the learned causes as sentences that can be understood by non-technical personnel and allowing these causes to first be supervised before the system takes them into account. Once approved, the system will calculate how much more time should be assigned to these transports in order to avoid future delays. As a result, the scheduling of patient transportation can be automatically optimized, while management remains in full control of the process

Technology Target Studies: Technology Solutions to Make Patient Care Safer and More Efficient

Presents findings on technologies that could enhance care delivery, including patient records and medication processes; features and functionality nurses require, including tracking, interoperability, and hand-held capability; and best practices

HKSC Field Guide for Developing a Healthcare Knowledge Services Center

Knowledge is the foundation of our work as librarians; however, because it is intangible, we work directly with assets that result from knowledge. Content, people, and technology are the core knowledge assets. Knowledge assets are referenced throughout the HKSC Field Guide where we define a path to delivering knowledge services. Delivering the best content is achieved through the innovation and competencies of library professionals who leverage technologies to benefit their constituents. The result is excellent knowledge services. This field guide is organized in chapters that are aligned with modules of the HKSC Model Template. The HKSC Field Guide is laid out in a linear progression of activities, with simple commentary to encourage the reader’s thinking toward eventual outcomes and changes that are required to make a transition from a library setting to a Healthcare Knowledge Services Center (HKSC) operation. It is expected that the successful manager will make several passes through the entire guide, gaining a better understanding of all the pieces that must be in place for a strategic and successful plan. Each module/chapter provides descriptions to explain the module theme and to share ideas on how to proceed with the process. Following descriptions and guidance is a worksheet for taking notes and a checklist of tasks. The intent of each worksheet is to focus on a specific data collection, a strategic planning activity, and/or to note details describing required resources. Chapters conclude with a checklist for you to sign off on for tasks considered and/or completed. Some forms may not be completed until multiple passes have been made through the guide; managers are encouraged to refine and hone activities in fine-tuning their work. A separate document (in MS Word format) supplies both worksheets and checklists for you to edit electronically –or- to create separate editable documents in modular fashion

Readiness for improving safe care delivery through web-based hospital nurse scheduling & staffing technology: A multi-hospital approach

Hospital scheduling and staffing practices are linked to patient safety, nurse satisfaction, and cost outcomes (Steege & Rainbow, 2017). Staffing, while complex, is ultimately central to the overall success of the hospital. Demands to eliminate events that cause death or serious harm, produce high patient satisfaction scores while maximizing workforce productivity, test any administrator’s skillset. Providing qualified staff in the right place at the right time can be challenged by restrictive union contracts, variable patient acuities, staff attendance, and mandated staffing ratios. These demands may lead to overtime utilization. There is a growing understanding of the negative effects of healthcare worker fatigue on patient outcomes (IOM, 2004; Stimpfel & Aiken, 2013). The impending nursing shortage has the potential to exacerbate the problem of high quality care delivery and could lead to devastating impacts to the profession as well as patients. Though Kaiser Permanente (KP) is generally known for being a healthcare trailblazer, staffing technology was lagging. The purpose of this project is to prepare KP nursing for transformative change with web-based hospital scheduling and staffing. This work addresses the readiness for deployment across the KP system. Complexity and change theories frame this project. Hospital staffing epitomizes complexity. This planned change provides a road map for other nurse leaders to navigate the lessons learned. Satisfaction surveys from 222 nursing staff receiving training in the new technology reveal a favorable intent for technology adoption. Future work will focus on the impact realization of nurse-sensitive outcome indicators and registered nurse overtime

Material Distribution and Transportation in a Norwegian Hospital:A Case Study

Automated Guided Vehicles have shown significant importance in material transportation and distribution in today’s hospitals. The increasing trends of shorter hospital stays and increase of treatments and surgeries in clinics, present new challenges for the supply of goods. The rise in patients in hospitals, and consequently the increase of treatments and surgeries, cause a growth of material usage and goods movement. This study used the Control Model methodology to analyze the material and information flow within the case hospital. Information sharing and integration is still a major issue in the case hospital. The study aims to stimulate further research in material handling and distribution in hospitals

Dynamic vehicle routing problems: Three decades and counting

Since the late 70s, much research activity has taken place on the class of dynamic vehicle routing problems (DVRP), with the time period after year 2000 witnessing a real explosion in related papers. Our paper sheds more light into work in this area over more than 3 decades by developing a taxonomy of DVRP papers according to 11 criteria. These are (1) type of problem, (2) logistical context, (3) transportation mode, (4) objective function, (5) fleet size, (6) time constraints, (7) vehicle capacity constraints, (8) the ability to reject customers, (9) the nature of the dynamic element, (10) the nature of the stochasticity (if any), and (11) the solution method. We comment on technological vis-à-vis methodological advances for this class of problems and suggest directions for further research. The latter include alternative objective functions, vehicle speed as decision variable, more explicit linkages of methodology to technological advances and analysis of worst case or average case performance of heuristics.© 2015 Wiley Periodicals, Inc

Developing a Lean Based Model for a Hospital Pharmacy Environment

Lean strategies have become necessary in healthcare due primarily to two factors: a demand for efficiency and a need to reduce medical error. The case for the necessity of a lean program is based on trends of increasing costs and decreasing revenues resulting from government intervention. Profit margin per patient has been reduced, and therefore more patients per time period must be seen in order to meet profitability goals. Preventable medical error is shown to be a leading cause of death. Current research in the area of hospital and healthcare efficiency proves that a parallel exists between healthcare efficiency today and the state of efficiency in manufacturing during the late 70’s and early 80’s. In the 70’s and 80’s, MRP technology came into vogue as a means for attacking complicated problems with expensive, complicated, technology-based solutions. Today, many hospitals hope to solve their efficiency and human error problems by implementing computer based delivery, order-filling, and data systems. Better manufacturers made a move away from complicated solutions, toward lean practices focused on instead of simplifying the problems; healthcare should then do the same. A generic lean methodology geared toward the differing nuances of healthcare is developed. Lean is offered as a solution to both efficiency and medical error (on the basis that visual systems reduce error and that lean reduces stress, a major contributor to human error). A connection between stress and lean has been found by prior research and is taken a step further and connected with human error. This is based on research showing that stress cases the potential for human error in skilled workers to increase by 2-5 times

Corporate Services

2003 corporate services brochure, printed to provide a brief description of each area of the Corporate Service Group. Includes February 17, 2003 Blue Cross and Blue Shield of Florida at a Glance

Qualitative study exploring the phenomenon of multiple electronic prescribing systems within single hospital organisations

BACKGROUND: A previous census of electronic prescribing (EP) systems in England showed that more than half of hospitals with EP reported more than one EP system within the same hospital. Our objectives were to describe the rationale for having multiple EP systems within a single hospital, and to explore perceptions of stakeholders about the advantages and disadvantages of multiple systems including any impact on patient safety. METHODS: Hospitals were selected from previous census respondents. A decision matrix was developed to achieve a maximum variation sample, and snowball sampling used to recruit stakeholders of different professional backgrounds. We then used an a priori framework to guide and analyse semi-structured interviews. RESULTS: Ten participants, comprising pharmacists and doctors and a nurse, were interviewed from four hospitals. The findings suggest that use of multiple EP systems was not strategically planned. Three co-existing models of EP systems adoption in hospitals were identified: organisation-led, clinician-led and clinical network-led, which may have contributed to multiple systems use. Although there were some perceived benefits of multiple EP systems, particularly in niche specialities, many disadvantages were described. These included issues related to access, staff training, workflow, work duplication, and system interfacing. Fragmentation of documentation of the patient's journey was a major safety concern. DISCUSSION: The complexity of EP systems' adoption and deficiencies in IT strategic planning may have contributed to multiple EP systems use in the NHS. In the near to mid-term, multiple EP systems may remain in place in many English hospitals, which may create challenges to quality and patient safety.Peer reviewe

United Health Services: Transportation Optimization

This project is based off the desire to improve the efficiency and customer service of the United Health Services transportation departments to minimize fuel costs, turnaround time, mileage, and duplicate deliveries by May 2019. United Health Services, a medical care provider in southern New York State, has two delivery and transportation departments that service 60 facilities. Materials Handling has two drivers and a weekly schedule and oversees the delivery of various medical supplies such as bandages, syringes, and crutches. External Transportation is staffed by 12 drivers and delivers time sensitive, patient-oriented supplies such as clean and used linen, specimens, and mail, utilizing a daily schedule. The goal of the project is to merge the two departments, focusing on route schedules and the loading and unloading processes, to improve the information flow and product flow of both operations