Gendered relations to working time: enterprise bargaining outcomes in acute care and community nursing settings in Australia

In this paper we examine the outcomes of the 2001, 2004, 2007 Enterprise Bargaining Agreements between the Australian Nursing Federation (SA) and the South Australian Government with particular focus on union-based strategies for de-intensifying nurses’ labour in the acute and community sectors. Consistent with the theoretical and empirical research on time, the strategies employed in the acute sector reflect rational, linear, bureaucratic, logical and masculinist relations to time through the use of computerised time and task measures. Community sector solutions are characterised by cyclical, messy and highly relational feminised approaches to reducing work intensification. We argue that the outcomes of these two approaches are contradictory. The community-based solution of case management is less successful in reducing workload, but maintains worker control over the labour process, while in the acute sector, the highly Taylorist approach is successful in de-intensifying workload but at the cost of reduced control over the labour processes

Enhanced evolutionary algorithm with cuckoo search for nurse scheduling and rescheduling problem

Nurse shortage, uncertain absenteeism and stress are the constituents of an unhealthy working environment in a hospital. These matters have impact on nurses' social lives and medication errors that threaten patients' safety, which lead to nurse turnover and low quality service. To address some of the issues, utilizing the existing nurses through an effective work schedule is the best alternative. However, there exists a problem of creating undesirable and non-stable nurse schedules for nurses' shift work. Thus, this research attempts to overcome these challenges by integrating components of a nurse scheduling and rescheduling problem which have normally been addressed separately in previous studies. However, when impromptu schedule changes are required and certain numbers of constraints need to be satisfied, there is a lack of flexibility element in most of scheduling and rescheduling approaches. By embedding the element, this gives a potential platform for enhancing the Evolutionary Algorithm (EA) which has been identified as the solution approach. Therefore, to minimize the constraint violations and make little but attentive changes to a postulated schedule during a disruption, an integrated model of EA with Cuckoo Search (CS) is proposed. A concept of restriction enzyme is adapted in the CS. A total of 11 EA model variants were constructed with three new parent selections, two new crossovers, and a crossover-based retrieval operator, that specifically are theoretical contributions. The proposed EA with Discovery Rate Tournament and Cuckoo Search Restriction Enzyme Point Crossover (DᵣT_CSREP) model emerges as the most effective in producing 100% feasible schedules with the minimum penalty value. Moreover, all tested disruptions were solved successfully through preretrieval and Cuckoo Search Restriction Enzyme Point Retrieval (CSREPᵣ) operators. Consequently, the EA model is able to fulfill nurses' preferences, offer fair on-call delegation, better quality of shift changes for retrieval, and comprehension on the two-way dependency between scheduling and rescheduling by examining the seriousness of disruptions

Exact and Heuristic Methodologies for Scheduling in Hospitals: Problems, Formulations and Algorithms..

Dit proefschrift handelt over een aantal exacte en heuristische pro cedures voor planningsproblemen die opduiken binnen ziekenhuizen. H et materiaal kan opgedeeld worden in drie delen. Het eerste deel richt z ich op personeelsplanning. We introduceren een nieuwe formulering en ont ledingsbenadering voor een probleem dat het opstellen van een assistente nplanning op lange termijn behelst. De benadering ontleedt het probleem op basis van de activiteiten en maakt gebruik van kolomgeneratie om een optimale oplossing te bekomen. Het resulterende vertak-en-prijs algoritm e werd geïmplementeerd in een applicatie, aangevuld met heuristische zoe kprocedures en getest op een aantal praktijkproblemen. Onze experimentel e resultaten tonen een belangrijke toename in efficiëntie aan, vergeleke n met de traditionele benaderingen die het probleem ontleden op basis va n de stafleden. Het tweede deel van deze thesis handelt over het plannen van het operati ekwartier. Eerst stellen we een model en computerprogramma voor om het g ebruik van diverse hulpmiddelen in functie van de cyclische hoofdplannin g van het operatiekwartier te visualiseren. Vervolgens stellen we een aa ntal modellen en algoritmes voor om planningen te genereren met een afge vlakte, resulterende bedbezetting. Onze ideeën werden getest op praktijk data in twee gevalstudies. In het derde deel combineren we de kennis verkregen uit de eerste twee d elen in een geïntegreerd model voor de planning van het personeel en het operatiekwartier. Het model wordt opgelost door een vertak-en-prijs alg oritme dat herhaaldelijk twee verschillende subproblemen oplost. Het eer ste behelst het genereren van een individuele planning van een personeel slid d.m.v. dynamische programmering. In het tweede subprobleem zoeken w e naar een planning van het operatiekwartier met een bijhorende ben odigde personeelsbezetting die goed past bij de gegenereerde set va n individuele planningen. Dit gebeurt via het oplossen van een geheeltal lig programmeringsprobleem. We hebben mooie rekenresultaten bekomen voor dit moeilijke probleem. Tenslotte wordt er aangetoond hoe onze benaderi ng gebruikt kan worden om verschillende ziekenhuizen te vergelijken. Con creet illustreren we hoe de resultaten geïnterpreteerd kunnen worden om de bronnen van verspilling in het personeelsbeleid van een ziekenhuis te detecteren.

Information needs in the day-to-day operations management of hospital units

Day-to-day operations management of hospital units is complex due to several actors, changing situations and various information systems in use. Responsible professionals face challenges to obtain important information for managerial decision-making. The aim of this study was to model important information needed in the day-to-day operations management of hospital units. The study had an observational design. The professionals responsible are here referred to as ‘shift leaders’ and they included nurses and physicians in charge. Data were collected in 2012–2016. First, a literature review was done to describe information systems developed for the day-to-day operations management of hospital units. Second, an instrument for exploring information needed in the day-to-day operations management of hospital units was developed and tested. Third, a national survey was done to model important information needed in the day-to-day operations management of hospital units. Thereafter, one information model was clinically tested. The findings showed that numerous information systems have been developed for professionals responsible for the day-to-day operations management of hospital units, but these do not adequately support managerial decision-making. The instrument for exploring information needed in the day-to-day operations management of hospital units was valid and reliable, and data collected with it showed that the needs differed between professionals, time of day and types of units. The largest difference was between professionals. Nurses’ important information needs covered patients, personnel and materials, while physicians’ needs focused on patient care. Categories of important information for the model were determined by factor analysis for these different user groups. The final model of important information had ten information categories, all of which were needed by different user groups that had a different set of individual items. This model may be used to develop and improve information processing in the day-to-day operations management of hospital units to support the safe, efficient and cost-effective provision of care.Tiedon tarpeet sairaalayksikön päivittäisen toiminnan johtamisessa Sairaalayksikön päivittäisen toiminnan johtamien on haastavaa usean toimijan, muuttuvien tilanteiden ja lukuisten käytössä olevien tietojärjestelmien vuoksi. Toiminnasta vastaavilla ammattilaisilla on vaikeuksia saada tärkeää tietoa päätöksenteon tueksi. Tutkimuksen tarkoitus oli mallintaa sairaalayksikön päivittäisen toiminnan johtamisessa tarvittavia tärkeitä tietoja. Tutkimusasetelma oli havainnoiva. Toiminnasta vastaavat ammattilaiset olivat sairaanhoitajia ja lääkäreitä. Aineistot kerättiin vuosina 2012–2016. Aluksi kuvattiin sairaalayksikön päivittäisen toiminnan johtamiseen kehitettyjä tietojärjestelmiä kirjallisuuskatsauksella. Toiseksi, kehitettiin ja testattiin mittari, jolla voitiin tarkastella tiedon tarpeita sairaalayksikön päivittäisen toiminnan johtamisessa. Kolmanneksi, tehtiin kansallinen kysely, jonka perusteella sairaalayksiköiden päivittäisen toiminnan johtamisessa tarvittavia tärkeitä tietoja voitiin mallintaa. Lopuksi, yksi malli testattiin kliinisessä ympäristössä. Päivittäisen toiminnan johtamiseen on tulosten perusteella kehitetty lukuisia tietojärjestelmiä, mutta ne tukevat johtamisen päätöksentekoa vain osin. Sairaalayksikön päivittäisen toiminnan johtamisen tiedontarpeiden selvittämiseen kehitetty mittari osoittautui validiksi ja reliaabeliksi. Mittarilla kerätty tieto osoitti, että tiedontarpeet eroavat ammattiryhmän, ajankohdan ja sairaalayksikön mukaan. Suurin ero oli ammattiryhmien välillä. Sairaanhoitajat tarvitsivat tietoa potilaista, henkilöstöstä ja materiaaleista kun taas lääkäreiden tarpeet keskittyivät potilashoitoon. Käyttäjäryhmien tärkeitä tietosisältöjä jäsenneltiin faktorianalyysin avulla. Tärkeiden tietojen malli koostui yhteensä kymmenestä tietokategoriasta, jotka vaihtelivat käyttäjäryhmittäin. Myös kategorioiden sisällä olevat yksittäiset tiedon tarpeet vaihtelivat käyttäjäryhmillä. Tämä korostaa joustavien ja käyttäjälähtöisesti räätälöityjen tietojärjestelmien tarvetta. Mallia voidaan käyttää tietojen käsittelyn kehittämiseen sairaalayksiköiden päivittäisen toiminnan johtamisessa, jotta paremmin tuetaan turvallisia, vaikuttavia ja kustannustehokkaita palveluita

A Hybrid Modelling Framework for Real-time Decision-support for Urgent and Emergency Healthcare

In healthcare, opportunities to use real-time data to support quick and effective decision-making are expanding rapidly, as data increases in volume, velocity and variety. In parallel, the need for short-term decision-support to improve system resilience is increasingly relevant, with the recent COVID-19 crisis underlining the pressure that our healthcare services are under to deliver safe, effective, quality care in the face of rapidly-shifting parameters. A real-time hybrid model (HM) which combines real-time data, predictions, and simulation, has the potential to support short-term decision-making in healthcare. Considering decision-making as a consequence of situation awareness focuses the HM on what information is needed where, when, how, and by whom with a view toward sustained implementation. However the articulation between real-time decision-support tools and a sociotechnical approach to their development and implementation is currently lacking in the literature. Having identified the need for a conceptual framework to support the development of real-time HMs for short-term decision-support, this research proposed and tested the Integrated Hybrid Analytics Framework (IHAF) through an examination of the stages of a Design Science methodology and insights from the literature examining decision-making in dynamic, sociotechnical systems, data analytics, and simulation. Informed by IHAF, a HM was developed using real-time Emergency Department data, time-series forecasting, and discrete-event simulation. The application started with patient questionnaires to support problem definition and to act as a formative evaluation, and was subsequently evaluated using staff interviews. Evaluation of the application found multiple examples where the objectives of people or sub-systems are not aligned, resulting in inefficiencies and other quality problems, which are characteristic of complex adaptive sociotechnical systems. Synthesis of the literature, the formative evaluation, and the final evaluation found significant themes which can act as antecedents or evaluation criteria for future real-time HM studies in sociotechnical systems, in particular in healthcare. The generic utility of IHAF is emphasised for supporting future applications in similar domains

La Salle University Evening Division Bulletin 1989-1990

Issued for La Salle University Evening Division 1989-1990https://digitalcommons.lasalle.edu/course_catalogs/1144/thumbnail.jp

La Salle University School of Continuing Studies Bulletin 1991-1993

Issued for La Salle University School of Continuing Studies 1991-1993https://digitalcommons.lasalle.edu/course_catalogs/1150/thumbnail.jp

La Salle University Evening Division Bulletin 1990-1991

Issued for La Salle University Evening Division 1990-1991https://digitalcommons.lasalle.edu/course_catalogs/1147/thumbnail.jp

La Salle University Bulletin: School of Continuing 1993-1994 Studies

Issued for La Salle University School of Continuing Studies 1993-1994https://digitalcommons.lasalle.edu/course_catalogs/1154/thumbnail.jp