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

Functional status and prosthesis use in amputees, measured with the Prosthetic Profile of the Amputee (PPA) and the short version of the Sickness Impact Profile (SIP68)

Amputation of (a part of) the lower extremity will cause loss or disturbance of locomotion. With prosthetic devices and rehabilitation many amputees are able to restore their locomotive function as well as their social function. Maintenance or restoration of function after discharge is even more important. In rehabilitating amputees, prosthetic devices can improve mobility. Little is known about whether these devices will still be used at home after discharge and if the improvement in functioning is stable. To verify whether the treatment strategy of amputees is sufficient or needs to be modified, it is important to check if the goals of rehabilitation are achieved. Outcome in amputees used to be related to mortality and cure, especially mobility, for example, by the Amputee Activity Score, a measure for activity, not related to age, sex or handicap (Day, 1981). Recently, ‘quality of life’ and ‘reintegration in normal life’ have been emphasized in measuring outcomes of rehabilitation programmes. Research on 42 amputees (Nissen and Newman, 1992) indicated that more attention should be paid to community, mobility, recreation and additional illnesses after amputation to improve reintegration to normal living. The purpose of this study is to evaluate (1) the status at discharge and (2) the maintenance of physical functioning (including mobility) and psycho-social functioning after a follow-up period of 2 months after discharge from a rehabilitation setting. Since mobility is related to prosthesis use, prosthesis use is also evaluated

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

On the Nonlinearity of Modern Shock-Capturing Schemes

The development is reviewed of shock capturing methods, paying special attention to the increasing nonlinearity in the design of numerical schemes. The nature is studies of this nonlinearity and its relation to upwind differencing is examined. This nonlinearity of the modern shock capturing methods is essential, in the sense that linear analysis is not justified and may lead to wrong conclusions. Examples to demonstrate this point are given

An exact approach for relating recovering surgical patient workload to the master surgical schedule

No other department influences the workload of a hospital more than the Department of Surgery and in particular, the activities in the operating room. These activities are governed by the master surgical schedule (MSS), which states which patient types receive surgery on which day. In this paper we describe an analytical approach to project the workload for downstream departments based on this MSS. Specifically the ward occupancy distributions, patient admission/discharge distributions, and the distributions for ongoing interventions/treatments is computed. Recovering after surgery requires the support of multiple departments, such as nursing, physiotherapy, rehabilitation and long term care. With our model, managers from these departments can determine their workload by aggregating tasks associated with recovering surgical patients. The model, which supported the development of a new MSS at the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, provides the foundation for a decision support tool to relate downstream hospital departments to the operating room

Two-Dimensional Central-Upwind Schemes for Curvilinear Grids and Application to Gas Dynamics with Angular Momentum

In this work we present new second order semi-discrete central schemes for systems of hyperbolic conservation laws on curvilinear grids. Our methods generalise the two-dimensional central-upwind schemes developed by Kurganov and Tadmor. In these schemes we account for area and volume changes in the numerical flux functions due to the non-cartesian geometries. In case of vectorial conservation laws we introduce a general prescription of the geometrical source terms valid for various orthogonal curvilinear coordinate systems. The methods are applied to the two-dimensional Euler equations of inviscid gas dynamics with and without angular momentum transport. In the latter case we introduce a new test problem to examine the detailed conservation of specific angular momentum.Comment: 38 pages, 1