Digital Commons Network^™

Creating Capacity To Accommodate Additional Cardiac Catheterization Procedures, Kristin Anthony

Operations Transformation

Patient access to diagnostic outpatient (OP) cardiac catheterization is limited by a perceived lack of capacity. Outpatient cardiac cath pts flow through the ACU for pre/post procedure care. Current schedule limits pts that may be scheduled through the ACU to two OP procedures/day. Cardiologists request the ability to schedule beyond the two procedures/day allowed. Significant variation in pre/postoperative care orders exist amongst cardiologists resulting in variability in length of stay. Cardiac procedures are booked either as 60/90/120 minutes – Epic case averaging technology is not active in the cath lab. As a result, the case minutes in the cath lab …

Improvement In Patient Compliance For Gynecological Care, Tracee Williams

Doctor of Nursing Practice Projects

This quality improvement project implemented the patient-initiated follow-up (PIFU) pathway in a gynecology clinic setting. PIFU has potential to lead to decreased no-show appointments and increased patient autonomy in outpatient healthcare practices. Barriers that influence compliance with plans of care include lower socioeconomic status, racial and ethnic minorities, and unmet social needs such as food insecurity, healthcare travel and cost, and child/adult care needs. In addition to higher rates of no-show appointments, individuals facing these barriers have increased comorbidities. Prior to implementing the PIFU model, patients between the ages of 18 and 42 completed a patient satisfaction survey to better …

Conflict With Administrators: Scheduling Conflicts With Administration, Constance Cleveland, Deepa Raghavan, Dipra Debnath, Jay Maixner, Ranya Krayem, Vikash Mehan, Zane Mustafa, Ayman Salem

Patient Education Projects

No abstract provided.

Conflict With Administrators: Medical School Scheduling Conflicts, Ciara White, Cornelius Lau, Hani Nasr, Kimera Harris, Lisa Doan, Kenan Abou Chaer, Astha Saini

Patient Education Projects

No abstract provided.

Conflict With Patient: Late Physician And Patient Wait Time, Anisha Patel, Annelise Gordon, Jonathan Toma, Maximilian Wehner, Rohit Goru, Amanah Fatima

Patient Education Projects

No abstract provided.

Organizational Methods Of Reducing Burnout: The Impact Of Self-Rostering On Work-Life-Integration, Cory Authement

MSN Capstone Projects

With burnout being at an all-time high, organizations must find new ways to prioritize staff wellbeing and promote work-life balance. According to the Emergency Nurses Association (ENA) turnover in emergency departments ranges from 15-30% within the first year of nursing, and 43% within the first three years (Roncallo et al., 2020). These turnover rates cost a 300-bed facility approximately four million dollars in annual expenditure (Hesse, 2016). This level of loss and expenditure is unsustainable for the future of nursing and diverts resources away from our patients.

In recent studies, it was shown that burnout leads to difficulties for nurses …

Strategic Use Of Wellness Ambassadors To Increase Attendance Of Initial Mental Health Appointments, Kaitlyn Blair, Mirna Law, Bettina Bernstein

Research Day

Background

Many adults and children with mental health conditions in the US do not receive treatment, and in Philadelphia alone, there were 174 suicide deaths in 2017. The shortage of mental health professionals and long wait times are significant barriers to accessing mental health care. Executive function difficulties can make it challenging for individuals to maintain a schedule for mental health appointments. A study found that reminder phone calls result in an increased rate of mental health appointment keeping. The goal of this project is to increase attendance of first mental health appointments by patients referred to mental health services …

Optimizing Course Offerings In A Science Department, Yu Kay Law

Academic Chairpersons Conference Proceedings

We will discuss how enrollment data and faculty/advisor input can be used to maximize schedule efficiency in course offerings and providing for student success. We will also discuss how best to monitor and rearrange course schedules in light of actual enrollment.

Conflict With Patients: Scheduling Conflict, Alem Cizmic, Elise Turke, Hope Baldwin, Justin Lee, Katherine (Katya) Parker, Rabe Al-Silwadi

Patient Education Projects

No abstract provided.

Conflict With Peers: Scheduling Conflict, Rabe Al-Silwadi, Elise Turke, Hope Baldwin, Alem Cizmic, Justin Lee, Katherine (Katya) Parker

Patient Education Projects

No abstract provided.

Conflict With Administrators: Scheduling Conflicts, Alem Cizmic, Elise Turke, Hope Baldwin, Justin Lee, Katherine (Katya) Parker, Rabe Al-Silwadi

Patient Education Projects

No abstract provided.

The Veteran Administration’S Appointment Scheduling Processes’ Effect On The Homeless Women Veteran’S Phenomenon, Vicki Ann Thompson

Walden Dissertations and Doctoral Studies

Concealed numbers of homeless women veterans could be exposed in the Veterans Administration (VA) appointment scheduling data. The challenges of scheduling healthcare or mental health appointments with the VA could prevent homeless women veterans from gaining access. Studies have shown the problems that male veterans have with scheduling appointments. However, not much research exists on the issues homeless female veterans face in scheduling appointments with the VA. This quantitative study examined the correlation between the number of women and men veterans on the VA’s electronic wait list and the percentages of unsheltered women and men veterans at the Continuum of …

Labor Planning Outcomes: Systemic Management Models, Human Interactions, And Knowledge Sharing, Richard J. Tarpey

USF Tampa Graduate Theses and Dissertations

This project takes a systemic approach to hospital labor planning and allocation rather than sub-optimizing the individual components of workload demand forecasting, scheduling, and staffing separately. The research considers all three components within their interdependent, dynamic, cyclical systemic nature to develop a better labor planning and allocation cycle (LPAC) management model across the various subsystems of the hospital. We used an Action Design Research (ADR) method to the guided emergence of innovative artifacts – Systemic LPAC Management Model and LPAC Performance Metrics – that we evaluate and improve through interventions in situ with practitioners. The Systemic LPAC Management Model leveraged …

Effects Of Incorporating Patient Acuity Into The Rn Assignment Process, Melissa L. Forton

Evidence-Based Practice Project Reports

As the largest sector of healthcare, nurses are the primary providers of patient care. By 2025, it is estimated that there will be a shortage of over 250,000 registered nurses (RNs) (American Association of Colleges of Nursing, 2011). Factors contributing to the nursing shortage include increased complexity of patients and decreased staffing that leads to decreased job satisfaction (Fox & Abrahamson, 2009). Over half of neonatal intensive care nurses reported missing at least one nursing task per shift when staffing was inadequate or patient acuity was high (TubbsCooley, Pickler, Younger, & Mark, 2015). The purpose of this evidence-based practice (EBP) …

A Multi-Method Scheduling Framework For Medical Staff, Wael Rashwan, John Fowler, Amr Arisha

Conference Papers

Hospital planning teams are always concerned with optimizing staffing and scheduling decisions in order to improve hospital performance, patient experience, and staff satisfaction. A multi-method approach including data analytics, modeling and simulation, machine learning, and optimization is proposed to provide a framework for smart and applicable solutions for staffing and shift scheduling. Factors regarding patients, staff, and hospitals are considered in the decision. This framework is piloted using the Emergency Department(ED) of a leading university hospital in Dublin. The optimized base staffing patterns and shift schedules actively contributed to solving ED overcrowding problem and reduced the average waiting time for …

Identifying Ways That Institutional Staffing And Scheduling Committees Engage Nursing Staff In Resource Allocation At The Unit And Institutional Levels, Kevin M. Shimp

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

The American Nurses Association (ANA) recommends that at least fifty percent direct care providers are involved in staffing and scheduling decisions at the institutional level (ANA Staffing, 2015). This recommendation coincides with Magnet recommendations for the staff most impacted by staffing levels. Magnet organizations are recognized for superior nursing processes and quality patient care, which lead to the highest levels of safety, quality, and patient satisfaction (ANCC, 2015). Existing research, largely at the unit level, shows that registered nurses in acute care environments have higher general work satisfaction and morale when they are engaged in decision making around staffing (Ellerbe …

Readiness For Improving Safe Care Delivery Through Web-Based Hospital Nurse Scheduling & Staffing Technology: A Multi-Hospital Approach, Lisa Massarweh

Doctor of Nursing Practice (DNP) Projects

Hospital scheduling and staffing practices are linked to patient safety, nurse satisfaction, and cost outcomes (Steege & Rainbow, 2017). Staffing, while complex, is ultimately central to the overall success of the hospital. Demands to eliminate events that cause death or serious harm, produce high patient satisfaction scores while maximizing workforce productivity, test any administrator’s skillset. Providing qualified staff in the right place at the right time can be challenged by restrictive union contracts, variable patient acuities, staff attendance, and mandated staffing ratios. These demands may lead to overtime utilization. There is a growing understanding of the negative effects of healthcare …

Nursing Assignments Based On Patient Acuity: The Road To Nursing Job Satisfaction, Kristina Tomic

Evidence-Based Practice Project Reports

Challenges in the healthcare industry, including nursing shortages and low nursing retention, have resulted in nurses’ job dissatisfaction. Improving work environment and workload can lead to improved and equitable nursing shift assignments, which may improve nursing job satisfaction. The purpose of this EBP project was to (a) implement a patient acuity tool in the hospital unit, (b) assess its effectiveness in appropriating nursing shift assignments, and (c) evaluate its effect on nursing job satisfaction. The Evidence Based Medicine (EBM) Model was used as a guide to facilitate the transition of the best evidence into practice. As suggested within the evidence, …

Strategic Planning For Setting Up Base Stations In Emergency Medical Systems, Supriyo Ghosh, Pradeep Varakantham

Research Collection School Of Computing and Information Systems

Emergency Medical Systems (EMSs) are an important component of public health-care services. Improving infrastructure for EMS and specifically the construction of base stations at the ”right” locations to reduce response times is the main focus of this paper. This is a computationally challenging task because of the: (a) exponentially large action space arising from having to consider combinations of potential base locations, which themselves can be significant; and (b) direct impact on the performance of the ambulance allocation problem, where we decide allocation of ambulances to bases. We present an incremental greedy approach to discover the placement of bases that …

Improving Patient Satisfaction Through Reducing Nurse Overtime And Redesigning Nurse Staffing And Scheduling, Abby Romme

Master's Projects and Capstones

Increasing cardiac device patient demands within a large Midwest healthcare institution resulted in significant increases in staff shift requirements and corresponding patient complaints. The quality improvement project aimed to decrease patient complaints by executing a standard baseline daily full time equivalent (FTE) staffing strategy for future schedules, increasing nursing FTE, and maintaining institutional staffing standards. Standard calculated daily nursing requirements targeted 17.0 FTE. Implementation occurred over a three month period including schedule reprocessing, a pending incremental nursing FTE request, and a restructuring of unit based scheduling and paid time off guidelines. The completed schedule accurately captured staffing requirements for 100% …

Closing The Loop: The Effects Of Scheduling Patients' Follow-Up Prior To Emergency Department Discharge, Jens Hansen

Doctor of Nursing Practice (DNP) Program

Background: A large percentage of serious medical errors involve miscommunication during the hand-off of patients between medical providers. In addition, care providers do not effectively or completely communicate important information among themselves, to the patient, or to those taking care of the patient at home in a timely fashion. The communication method whether verbal, recorded, or written has proven to be ineffective. As healthcare disparities increase with healthcare complexity, it is important to extrapolate the best evidence based practice and bring these practices to the front line.

Literature Search: A comprehensive literature search using the Cumulative Index to Nursing and …

Large-Scale Solution Approaches For Healthcare And Supply Chain Scheduling, Ridvan Gedik

Graduate Theses and Dissertations

This research proposes novel solution techniques for two real world problems. We first consider a patient scheduling problem in a proton therapy facility with deterministic patient arrivals. In order to assess the impacts of several operational constraints, we propose single and multi-criteria linear programming models. In addition, we ensure that the strategic patient mix restrictions predetermined by the decision makers are also enforced within the planning horizon. We study the mathematical structures of the single criteria model with strict patient mix restrictions and derive analytical equations for the optimal solutions under several operational restrictions. These efforts lead to a set …

Rural Pediatric Primary Care Practice Patterns As A Result Of An On-Site Behavioral Health Consultant: A Retrospective Analysis, Kayla D. Mccarter

Undergraduate Honors Theses

Nationally, it has been estimated that 10 to 21% of children with psychosocial concerns are seen in primary care settings (Jellinek et al., 1999; McInerny, Szilagyi, Childs, Wasserman & Kelleher, 2000; Palermo et al., 2002). Often, however, children go undiagnosed with/treated for psychosocial concerns in pediatric primary care due to lack of physician time and poor referral rates to mental health providers. Evaluations of integrated care models, in which a behavioral health consultant is present in primary care practices, has shown to increase the availability of mental health services (Stancin, Perrin, & Ramirez, 2009). Using extant data from patient records …

No Shows: Effectiveness Of Termination Policy And Review Of Best Practices, Maalinii Vijayan

Master of Public Health Program Student Publications

The primary objective of the study was to identify whether the implementation of Patient No Show and Termination policy at Five Rivers Health Centers (FRHC) is associated with a significant reduction of its no show rate. The secondary objective was to perform the best practices review on other strategies to reduce no shows. The data for this study was obtained retrospectively from the electronic medical records of the seven clinical centers of FRHC. Individual clinic's no show rates and cumulative no show rates for pre-implementation and post-implementation period were calculated. Chi-squared test were used to detect statistical significance between pre- …

Master Physician Scheduling Problem, Aldy Gunawan, Hoong Chuin Lau

Research Collection School Of Computing and Information Systems

We study a real-world problem arising from the operations of a hospital service provider, which we term the master physician scheduling problem. It is a planning problem of assigning physicians’ full range of day-to-day duties (including surgery, clinics, scopes, calls, administration) to the defined time slots/shifts over a time horizon, incorporating a large number of constraints and complex physician preferences. The goals are to satisfy as many physicians’ preferences and duty requirements as possible while ensuring optimum usage of available resources. We propose mathematical programming models that represent different variants of this problem. The models were tested on a real …

Probabilistic Models For Patient Scheduling, Adel Alaeddini

Wayne State University Theses

In spite of the success of theoretical appointment scheduling methods, there have been significant failures in practice primarily due to the rapid increase in the number of no-shows and cancelations from the individuals in recent times. These disruptions not only cause inconvenience to the management but also has a significant impact on the revenue, cost and resource utilization. In this research, we develop a hybrid probabilistic model based on logistic regression and Bayesian inference to predict the probability of no-shows in real-time. We also develop two novel non-sequential and sequential optimization models which can effectively use no-show probabilities for scheduling …

Ariel - Volume () Number 1, Amy Colcher, H. M. Benshoff, Franny Lizerbram, Dave Cahn, Raj Sinha, Anton Phibes, Bruce Watson, Palmar Norte, C. Hathaway, Diane Wonnell, Ron Berna, Wasyl Szeremeta

Ariel

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Ariel - Volume 9 Number 6, Jim Mcweeney, John P. Welch, George Winch, Steve Levine, Phillip U. Gilman, Michael X. Repka, Dick Moberg, Mark Rubin, Mark Z. Repka

Ariel

Executive Editor

Seth B. Paul

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Warren J. Ventriglia

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University News

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Features

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Circulation

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Lee Wugofski

Graphics and Art

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Commons Editor

Brenda Peterson

Ariel - Volume 9 Number 5, John Welch, George Coar, John W. Smith, Ii, Richard Yelovich, Mark Rubin, Roslyn Taylor, Steve Levine, John Radomski, Robert L. Brent, Vincent Viscomi, Jon Adams, Joyce Freidel, Mark Repka

Ariel

Executive Editor

Seth B. Paul

Associate Editor

Warren J. Ventriglia

Business Manager

Fredric Jay Matlin

University News

John Patrick Welch

World News

George Robert Coar

Editorials Editor

Steve Levine

Features

Mark Rubin

Brad Feldstein

Sports Editor

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Circulation

Victor Onufreiczuk

Lee Wugofski

Graphics and Art

Steve Hulkower

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Brenda Peterson

Ariel - Volume 8 Number 2, Marianne Ritchie, Nicholas Tepe, George Risi, Richard Perry, Dave Gastfriend, Martin Trichtinger, Gail Greenspan, Scott A. Waldman, William J. Adams, Jr., Robert L. Brent, Jamie Lockard, Ronald D. Springel, Patrick Sokas, Richard P. Margolies, Dick Moberg, Shahab Minassian, Jane Mooney, Neeraj Kanwal

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Issue Editor

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University News

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