Asynchronous Task Plan Refinement for Multi-Robot Task and Motion Planning

This paper explores general multi-robot task and motion planning, where multiple robots in close proximity manipulate objects while satisfying constraints and a given goal. In particular, we formulate the plan refinement problem--which, given a task plan, finds valid assignments of variables corresponding to solution trajectories--as a hybrid constraint satisfaction problem. The proposed algorithm follows several design principles that yield the following features: (1) efficient solution finding due to sequential heuristics and implicit time and roadmap representations, and (2) maximized feasible solution space obtained by introducing minimally necessary coordination-induced constraints and not relying on prevalent simplifications that exist in the literature. The evaluation results demonstrate the planning efficiency of the proposed algorithm, outperforming the synchronous approach in terms of makespan

The Veterans Health Administration: Taking Home Telehealth Services to Scale Nationally

Since the 1990s, the Veterans Health Administration (VHA) has used information and communications technologies to provide high-quality, coordinated, and comprehensive primary and specialist care services to its veteran population. Within the VHA, the Office of Telehealth Services offers veterans a program called Care Coordination/Home Telehealth (CCHT) to provide routine noninstitutional care and targeted care management and case management services to veterans with diabetes, congestive heart failure, hypertension, post-traumatic stress disorder, and other conditions. The program uses remote monitoring devices in veterans' homes to communicate health status and to capture and transmit biometric data that are monitored remotely by care coordinators. CCHT has shown promising results: fewer bed days of care, reduced hospital admissions, and high rates of patient satisfaction. This issue brief highlights factors critical to the VHA's success -- like the organization's leadership, culture, and existing information technology infrastructure -- as well as opportunities and challenges

An Evaluation of a Care Conference Model and Improvement in the Transition Process for Medically Complex Pediatric Patients between Inpatient and Outpatient Care

Medically complex and/or fragile pediatric patients are high utilizers of health care dollars. This population represents less than one percent of the general pediatric population, yet they account for more than 30% of pediatric healthcare costs. These patients tend to have longer lengths of stay in the hospital, high readmission rates, and lower healthcare satisfaction scores. They also have multiple transitions between inpatient and outpatient care which increases the opportunity for medical errors. Research has shown that care conferences attended by key stakeholders tend to reduce readmissions and healthcare utilization while improving satisfaction rates and patient outcomes. Research also shows that efficient transitions of care processes improve patient outcomes through reduced errors while also improving satisfaction rates of patients, families, and providers. This project focused on both the evaluation of a process to streamline care coordination conferences as well as transitions of care for medically complex patients between inpatient and outpatient care. In order to streamline care conferences, standard work was written to standardize processes with the goal of increasing their perceived value and improving attendance. Results of a pre-implementation survey showed primary care providers desired more involvement throughout the course of hospitalization for their medically complex pediatric patients. A new process was begun where resident physicians notified primary care providers when these patients were admitted. A post-implementation survey showed improved satisfaction with communication

Complex Care Management Program Overview

This report includes brief updates on various forms of complex care management including: Aetna - Medicare Advantage Embedded Case Management ProgramBrigham and Women's Hospital - Care Management ProgramIndependent Health - Care PartnersIntermountain Healthcare and Oregon Health and Science University - Care Management PlusJohns Hopkins University - Hospital at HomeMount Sinai Medical Center -- New York - Mount Sinai Visiting Doctors Program/ Chelsea-Village House Calls ProgramsPartners in Care Foundation - HomeMeds ProgramPrinceton HealthCare System - Partnerships for PIECEQuality Improvement for Complex Chronic Conditions - CarePartner ProgramSenior Services - Project Enhance/EnhanceWellnessSenior Whole Health - Complex Care Management ProgramSumma Health/Ohio Department of Aging - PASSPORT Medicaid Waiver ProgramSutter Health - Sutter Care Coordination ProgramUniversity of Washington School of Medicine - TEAMcar

Strategic HRM and Organizational Behavior: Integrating Multiple Levels of Analysis

[Excerpt] A few trends have emerged in the field of Strategic Human Resource Management (SHRM) over the past few years. First, and most obviously, has been the extensive effort to demonstrate a link between HRM practices and firm performance (Becker & Gerhart, 1996). Researchers such as Huselid (1995), MacDuffie (1995), Delery and Doty (1996), and Guthrie (2000) have published empirical studies showing a statistically significant linkage between HRM practices and some measures of organizational performance. A second trend has been to try to understand the mechanisms through which this relationship takes place. Authors such as Becker & Gerhart, (1996), Dyer and Reeves (1995), Guest, (1997) and Wright and Gardner (2003), have all called for research that uncovers some of the mediating relationships that must exist between the HRM practices and organizational performance. A final trend has been the recent interest in taking a multi-level approach to understanding SHRM. Wright and Boswell (2001) reviewed the SHRM literature and categorized this research as being differentiated along one dimension representing whether the focus was on single or multiple practices, and along a second dimension dealing with the unit of analysis, specifically the individual versus the group or organization. Ostroff and Bowen (2000) and more recently Bowen and Ostroff (2004) have developed the most extensive multi-level model of SHRM to date. Their theoretical approach argues that HR practices serve as communications mechanism signaling employees to engage in certain behaviors; relying on communications theory they contend that different aspects of HRM systems impede or facilitate this communication process. The purpose of this paper is related to these last two trends: we conceptually examine some of the mediating processes that might occur in the HRM – performance relationship, and try to make explicit their multilevel nature. In order to accomplish this, we will first explore the concept of variance, which is crucial to the analysis of any phenomena across multiple levels. We will show how virtually all existing SHRM research focuses on variance at one level of analysis while assuming constancy at other levels. We will next discuss the process through which HRM practices must act, and identify some of the relevant variables that have heretofore been virtually ignored in the empirical SHRM literature, specifically focusing on variance at different (unit vs. individual) levels of analysis. Finally, we will present some implications for theorizing and research in this area

Quality of integrated chronic care measured by patient survey: identification, selection and application of most appropriate instruments\ud

Objective  To identify the most appropriate generic instrument to measure experience and/or satisfaction of people receiving integrated chronic care.\ud \ud Background  Health care is becoming more user-centred and, as a result, the experience of users of care and evaluation of their experience and/or satisfaction is taken more seriously. It is unclear to what extent existing instruments are appropriate in measuring the experience and/or satisfaction of people using integrated chronic care.\ud \ud Methods  Instruments were identified by means of a systematic literature review. Appropriateness of instruments was analysed on seven criteria. The two most promising instruments were translated into Dutch, if necessary, and administered to a convenience sample of 109 people with a chronic illness. Data derived from respondents were analysed statistically. Focus-group interviews were conducted to assess the semantic and technical equivalence as well as opinions of people about the applicability and relevance of the translated instruments.\ud \ud Results  From 37 instruments identified, the Patients’ Assessment of Care for chronIc Conditions (PACIC) and the short form of the Patient Satisfaction Questionnaire III (PSQ-18) were selected as most promising instruments. Both instruments produced similar median scores across people with different chronic conditions. The overall PACIC and its subscales and the overall PSQ-18 were highly internally consistent, but not the PSQ-18 subscales. Overall, the PACIC demonstrated better psychometric characteristics. PACIC and PSQ-18 scores were found to be moderately correlated. Whereas more respondents preferred the PSQ-18, focus-group participants regarded the PACIC to be more applicable and relevant. The technical and semantic equivalence of both instruments were sufficient.\ud \ud Conclusions  Because of its psychometric characteristics, perceived applicability and relevance, the PACIC is the most appropriate instrument to measure the experience of people receiving integrated chronic care\u

Scaling Up: Bringing the Transitional Care Model Into the Mainstream

Describes features of an innovative care management intervention to facilitate elderly, chronically ill patients' transitions among providers and settings; the adopting organization; and the external environment that affect its translation into practice

Incorporating Ethics into Economics: Problems and Possibilities

In traditional economics the decision-making process for individuals has effectively no role for ethics as individuals are self-interested. The key concepts in economics which determine the role of ethics in the decision-making process are utility, rationality and methodological individualism and hence how these can be and are formulated and combined determines different roles for ethics in economics. Amitai Etzioni, Amartya Sen and John Broome use different definitions of these concepts and hence find different problems and possibilities for a greater role for ethics in economics. This paper integrates the different approaches of these authors and suggests a general mono-utility framework for incorporating ethics into economics whereby the concept of utility requires adaptation