Taxonomic classification of planning decisions in health care: a review of the state of the art in OR/MS

We provide a structured overview of the typical decisions to be made in resource capacity planning and control in health care, and a review of relevant OR/MS articles for each planning decision. The contribution of this paper is twofold. First, to position the planning decisions, a taxonomy is presented. This taxonomy provides health care managers and OR/MS researchers with a method to identify, break down and classify planning and control decisions. Second, following the taxonomy, for six health care services, we provide an exhaustive specification of planning and control decisions in resource capacity planning and control. For each planning and control decision, we structurally review the key OR/MS articles and the OR/MS methods and techniques that are applied in the literature to support decision making

Modeling emergency departments using discrete event simulation techniques

This paper discusses the application of Discrete Event Simulation (DES) for modeling the operations of an Emer-gency Department (ED). The model was developed to help the ED managers understand the behavior of the system with regards to the hidden causes of excessive waiting times. It served as a tool for assessing the impact of major departmental resources on Key Performance Indicators (KPIs), and was also used as a cost effective method for testing various what-if scenarios for possible system im-provement. The study greatly enhanced managers’ under-standing of the system and how patient flow is influenced by process changes and resource availability. The results of this work also helped managers to either reverse or modify some proposed changes to the system that were previously being considered. The results also show a possible reduc-tion of more than 20% in patients waiting times

A multilevel integrative approach to hospital case mix and capacity planning.

Hospital case mix and capacity planning involves the decision making both on patient volumes that can be taken care of at a hospital and on resource requirements and capacity management. In this research, to advance both the hospital resource efficiency and the health care service level, a multilevel integrative approach to the planning problem is proposed on the basis of mathematical programming modeling and simulation analysis. It consists of three stages, namely the case mix planning phase, the master surgery scheduling phase and the operational performance evaluation phase. At the case mix planning phase, a hospital is assumed to choose the optimal patient mix and volume that can bring the maximum overall financial contribution under the given resource capacity. Then, in order to improve the patient service level potentially, the total expected bed shortage due to the variable length of stay of patients is minimized through reallocating the bed capacity and building balanced master surgery schedules at the master surgery scheduling phase. After that, the performance evaluation is carried out at the operational stage through simulation analysis, and a few effective operational policies are suggested and analyzed to enhance the trade-offs between resource efficiency and service level. The three stages are interacting and are combined in an iterative way to make sound decisions both on the patient case mix and on the resource allocation.Health care; Case mix and capacity planning; Master surgery schedule; Multilevel; Resource efficiency; Service level;

Textual Mediation in Simulated Nursing Handoffs: Examining How Student Writing Coordinates Action

In clinical nursing simulations, a group of students provide care for a robotic patient during a structured scenario. As care is transferred from one group to another, they participate in a patient handoff, with outgoing students passing key information onto incoming students. In healthcare, the nursing handoff is a critical and perilous communication moment that is mediated by a range of participants and texts. Drawing on observations and video recordings of 52 simulation handoffs in the United States, this article examines how two student-designed texts – a collaborative patient chart and individual notes – are leveraged during the handoff. I also consider how handoff talk and writing changes as student nursing knowledge increases over the course of a year. By focusing on textual mediation of the simulated nursing handoff, this article contributes to existing research on professional writing pedagogy and to nursing scholarship on the handoff. Ultimately, it argues that a textual mediation framework can help bridge class room and professional contexts by evaluating student writing not for how successfully it meets a set of imposed criteria but for how effectively it supports classroom activities

Energy Projects in Milton Keynes: Energy Consultative Unit Progress Report 1976-1981

The Energy Consultative Unit was a joint Open University/MKDC body set up by Professor Jake Chapman, founder of the OU Energy Research Group. This report describes the work carried out on energy-related projects in Milton Keynes over the period 1976-1981, many of them involving the Open University. After a short explanation of how energy is used in the UK, the report introduces the Energy Consultative Unit projects and summarises the main conclusions drawn from the Unit's work. It then describes the projects on which the Unit has worked and summarises other energy projects under way in the new city. It does not go into the projects in detail, but there are a number of technical reports available for people who want to study them in more depth, and these are listed in the back of the report. The projects represent the work of a considerable number of people and a list of acknowledgements, indicating who should be contacted for further information, is also set out at the back of the report

Modelling and simulating unplanned and urgent healthcare: the contribution of scenarios of future healthcare systems.

The current financial challenges being faced by the UK economy have meant that the NHS will have to make £20 billion of savings between 2010 and 2014 requiring it to be innovative about how it delivers healthcare. This paper presents the methodology of a research project that is simulating the whole healthcare system with the aim of reducing waste within urgent unscheduled care streams whilst understanding the impact of such changes on the whole system. The research is aimed at care commissioners who could use such simulation in their decision-making practice, and the paper presents the findings from early stakeholder discussions about the scope and focus of the research and the relevance of stakeholder consultation and scenarios in the development of a valid decision-support tool that is fit for purpose

Guidelines for assessing pedestrian evacuation software applications

This paper serves to clearly identify and explain criteria to consider when evaluating the suitability of a pedestrian evacuation software application to assess the evacuation process of a building. Guidelines in the form of nine topic areas identify different modelling approaches adopted, as well as features / functionality provided by applications designed specifically for simulating the egress of pedestrians from inside a building. The paper concludes with a synopsis of these guidelines, identifying key questions (by topic area) to found an evaluation