Managing Waiting Times to Predict No-shows and Cancelations at a Children’s Hospital

Purpose: Since long waits in hospitals have been found to be related to high rates of no-shows and cancelations, managing waiting times should be considered as an important tool that hospitals can use to reduce missed appointments. The aim of this study is to analyze patients’ behavior in order to predict no-show and cancelation rates correlated to waiting times. Design/methodology/approach: This study is based on the data from a US children’s hospital, which includes all the appointments registered during one year of observation. We used the call-appointment interval to establish the wait time to get an appointment. Four different types of appointment-keeping behavior and two types of patients were distinguished: arrival, no-show, cancelation with no reschedule, and cancelation with reschedule; and new and established patients. Findings: Results confirmed a strong impact of long waiting times on patients’ appointment-keeping behavior, and the logarithmic regression was found as the best-fit function for the correlation between variables in all cases. The correlation analysis showed that new patients tend to miss appointments more often than established patients when the waiting time increases. It was also found that, depending on the patients’ appointment distribution, it might get more complicated for hospitals to reduce missed appointments as the waiting time is reduced. Originality/value: The methodology applied in our study, which combines the use of regression analysis and patients’ appointment distribution analysis, would help health care managers to understand the initial implications of long waiting times and to address improvement related to patient satisfaction and hospital performance.Peer Reviewe

High coercivity induced by mechanical milling in cobalt ferrite powders

In this work we report a study of the magnetic behavior of ferrimagnetic oxide CoFe2O4 treated by mechanical milling with different grinding balls. The cobalt ferrite nanoparticles were prepared using a simple hydrothermal method and annealed at 500oC. The non-milled sample presented coercivity of about 1.9 kOe, saturation magnetization of 69.5 emu/g, and a remanence ratio of 0.42. After milling, two samples attained coercivity of 4.2 and 4.1 kOe, and saturation magnetization of 67.0 and 71.4 emu/g respectively. The remanence ratio MR/MS for these samples increase to 0.49 and 0.51, respectively. To investigate the influence of the microstructure on the magnetic behavior of these samples, we used X-ray powder diffraction (XPD), transmission electron microscopy (TEM), and vibrating sample magnetometry (VSM). The XPD analysis by the Williamson-Hall plot was used to estimate the average crystallite size and strain induced by mechanical milling in the samples

Impact of DM direct searches and the LHC analyses on branon phenomenology

Dark Matter direct detection experiments are able to exclude interesting parameter space regions of particle models which predict an important amount of thermal relics. We use recent data to constrain the branon model and to compute the region that is favored by CDMS measurements. Within this work, we also update present colliders constraints with new studies coming from the LHC. Despite the present low luminosity, it is remarkable that for heavy branons, CMS and ATLAS measurements are already more constraining than previous analyses performed with TEVATRON and LEP data.Comment: 17 pages, 2 figure

Periodic orbit bifurcations and scattering time delay fluctuations

We study fluctuations of the Wigner time delay for open (scattering) systems which exhibit mixed dynamics in the classical limit. It is shown that in the semiclassical limit the time delay fluctuations have a distribution that differs markedly from those which describe fully chaotic (or strongly disordered) systems: their moments have a power law dependence on a semiclassical parameter, with exponents that are rational fractions. These exponents are obtained from bifurcating periodic orbits trapped in the system. They are universal in situations where sufficiently long orbits contribute. We illustrate the influence of bifurcations on the time delay numerically using an open quantum map.Comment: 9 pages, 3 figures, contribution to QMC200

High-temperature phase transitions in SrBi_2Ta_2O_9 film: a study by THz spectroscopy

Time-domain THz transmission experiment was performed on a $\rm SrBi_2Ta_2O_9$ film deposited on sapphire substrate. Temperatures between 300 and 923 K were investigated and complex permittivity spectra of the film were determined. The lowest frequency optic phonon near 28 cm$^{-1}$ reveals a slow monotonic decrease in frequency on heating with no significant anomaly near the phase transitions. We show that the dielectric anomaly near the ferroelectric phase transition can be explained by slowing down of a relaxational mode, observed in the THz spectra. A second harmonic generation signal observed in a single crystal confirms a loss of center of symmetry in the ferroelectric phase and a presence of polar clusters in the intermediate ferroelastic phase.Comment: subm. to J. Phys.: Condens. Matte

Increasing Competitiveness through the Implementation of Lean Management in Healthcare

The main aim of this paper was two-fold: first, to design a participative methodology that facilitates lean management implementation in healthcare by adopting the action research approach; second, to illustrate the usefulness of this methodology by applying it to the sleep unit of a public hospital in Spain. This methodology proposes the implementation of lean management in its broadest sense: adopting both lean principles and some of its practical tools or practices in order to achieve competitive advantage. The complete service value chain was considered when introducing changes through lean management implementation. This implementation involved training and involving staff in the project (personnel pillar), detecting and analysing "waste" in value chain processes (processes pillar) and establishing control and measurement mechanisms in line with objectives (key performance indicators pillar) and putting in place improvement actions to achieve these objectives. The application of this methodology brought about an improvement in the management of patient flow in terms of effectiveness, efficiency and quality but also an internal transformation towards lean culture

Topological defects and misfit strain in magnetic stripe domains of lateral multilayers with perpendicular magnetic anisotropy

Stripe domains are studied in perpendicular magnetic anisotropy films nanostructured with a periodic thickness modulation that induces the lateral modulation of both stripe periods and inplane magnetization. The resulting system is the 2D equivalent of a strained superlattice with properties controlled by interfacial misfit strain within the magnetic stripe structure and shape anisotropy. This allows us to observe, experimentally for the first time, the continuous structural transformation of a grain boundary in this 2D magnetic crystal in the whole angular range. The magnetization reversal process can be tailored through the effect of misfit strain due to the coupling between disclinations in the magnetic stripe pattern and domain walls in the in-plane magnetization configuration