Reallocating resources to focused factories: a case study in chemotherapy

This study investigates the expected service performance associated with a proposal to reallocate resources from a centralized chemotherapy department to a breast cancer focused factory. Using a slotted queueing model we show that a decrease in performance is expected and calculate the amount of additional resources required to offset these losses. The model relies solely on typical outpatient scheduling system data, making the methodology easy to replicate in other outpatient clinic settings. Finally, the paper highlights important factors to consider when assigning capacity to focused factories. These considerations are generally relevant to other resource allocation decisions

A Systematic Review of Web-Based Interventions for Patient Empowerment and Physical Activity in Chronic Diseases: Relevance for Cancer Survivors

Background: Patient empowerment reflects the ability of patients to positively influence their health and health behavior such as physical activity. While interactive Web-based interventions are increasingly used in various chronic disease settings to enhance empowerment and physical activity, such interventions are still uncommon for cancer survivors. Objective: The objective of this study was to systematically review the literature regarding interactive Web-based interventions. We focused on interventions aimed at increasing patient empowerment and physical activity for various chronic conditions, and explored their possible relevance for cancer survivors. Methods: Searches were performed in PubMed, Embase, and Scopus to identify peer-reviewed papers reporting on randomized controlled trials that studied the effects of Web-based interventions. These interventions were developed for adults with diabetes, cardiovascular disease, chronic obstructive pulmonary disease, heart failure, or cancer. Intervention characteristics, effects on patient empowerment and physical activity, information on barriers to and facilitators of intervention use, users’ experiences, and methodological quality were assessed. Results were summarized in a qualitative way. We used the recommendations of the Institute of Medicine (IOM) regarding cancer survivorship care to explore the relevance of the interventions for cancer survivors. Results: We included 19 papers reporting on trials with 18 unique studies. Significant, positive effects on patient empowerment were reported by 4 studies and 2 studies reported positive effects on physical activity. The remaining studies yielded mixed results or no significant group differences in these outcomes (ie, no change or improvement for all groups). Although the content, duration, and frequency of interventions varied considerably across studies, commonly used elements included education, self-monitoring, feedback/tailored information, self-management training, personal exercise program, and communication (eg, chat, email) with either health care providers or patients. Limited information was found on barriers, facilitators, and users’ experiences. Methodological quality varied, with 13 studies being of moderate quality. The reported Web-based intervention elements appeared to be highly relevant to address the specific needs of cancer survivors as indicated by the IOM. Conclusions: We identified 7 common elements of interactive, Web-based interventions in chronic disease settings that could possibly be translated into eHealth recommendations for cancer survivors. While further work is needed to determine optimal intervention characteristics, the work performed in other chronic disease settings provides a basis for the design of an interactive eHealth approach to improve patient empowerment and physical activity in cancer survivors. This may subsequently improve their health status and quality of life and reduce their need for supportive car

Reallocating resources to focused factories: a case study in chemotherapy

This study investigates the expected service performance associated with a proposal to reallocate resources from a centralized chemotherapy department to a breast cancer focused factory. Using a slotted queueing model we show that a decrease in performance is expected and calculate the amount of additional resources required to offset these losses. The model relies solely on typical outpatient scheduling system data, making the methodology easy to replicate in other outpatient clinic settings. Finally, the paper highlights important factors to consider when assigning capacity to focused factories. These considerations are generally relevant to other resource allocation decisions

A scenario based approach for flexible resource loading under uncertainty

Order acceptance decisions in manufacture-to-order environments are often made based on incomplete or uncertain information. To promise reliable due dates and to manage resource capacity adequately, resource capacity loading is an indispensable supporting tool. We propose a scenario based approach for resource loading under uncertainty that minimises the expected costs. The approach uses an MILP to find a plan that has minimum expected costs over all relevant scenarios. We propose an exact and a heuristic solution approach to solve this MILP. A disadvantage of this approach is that the MILP may become too large to solve in reasonable time. We therefore propose another approach that uses an MILP with a sample of all scenarios. We use the same exact and heuristic methods to solve this MILP. Computational experiments show that, especially for instances with much slack, solutions obtained with deterministic techniques for a expected scenario can be improved with respect to their expected costs. We also show that for large instances the heuristic outperforms the exact approach given a computation time as a stopping criterion

Een jaarverslag om bang van te worden!

Samen met waarschijnlijk vele andere studenten zwoeg ik door deze (gelukkig niet zo hete) zomer. De een werkt aan een verbetering van zijn financiële omstandigheden en de ander aan de afronding van een tentamen en ik ... aan mijn scriptie

Orde en chaos rond de studiefinanciering

Zoals bekend heeft de Informatiseringsbank getracht orde aan te brengen in de informatie-uitwisseling tussen cliënten en "Groningen" door de invoering van formulieren. Tevens zijn complementaire communicatiemogelijkheden ten behoeve van de cliënten gecreëerd in de vorm van decentrale steunpunten en brochures. Dat chaos niet altijd voorkomen kan worden blijkt uit het onderstaande

Overheid en media in crisissituaties

Wanneer een trein ontspoort, een tank op een fabrieksterrein ontploft of een groep mensen tegen het regeringsbeleid protesteert, spelen de media veelal een grote rol. Crises zijn media gebeurtenissen bij uitstek. In veel gevallen worden besluitvormers tijdens crisissituaties door media verrast. In dit artikel 7.31 blijken, dat een zorgvuldige omgang met de pers noodzakelijk is