Operations Research, Systems Engineering and Industrial Engineering Commons^™

Estimating Likelihood Of Having A Brca Gene Mutation Based On Family History Of Cancers And Recommending Optimized Cancer Preventive Actions, Mehrnaz Abdollahian

USF Tampa Graduate Theses and Dissertations

BRCA1 and BRCA2 are gene mutations that drastically increase chances of developing breast and ovarian cancers, up to 20-fold, for women. A genetic blood test is used to detect BRCA mutations. Though these mutations occur in one of every 400 in the general population (excluding Ashkenazi Jewish ethnicity), they are present in most cases of hereditary breast and ovarian cancer patients. Hence, it is common practice for the physicians to require genetic testing for those that fit the rules as recommended by the National Cancer Comprehensive Network. However, data from the Myriad Laboratory, the only provider of the test until …

Guidelines For Scheduling In Primary Care: An Empirically Driven Mathematical Programming Approach, Hyun Jung Alvarez Oh

Doctoral Dissertations

Primary care practices play a vital role in healthcare delivery since they are the first point of contact for most patients, and provide health prevention, counseling, education, diagnosis and treatment. Practices, however, face a complex appointment scheduling problem because of the variety of patient conditions, the mix of appointment types, the uncertain service times with providers and non-provider staff (nurses/medical assistants), and no-show rates which all compound into a highly variable and unpredictable flow of patients. The end result is an imbalance between provider idle time and patient waiting time. To understand the realities of the scheduling problem we analyze …

Developing An Optimal Model For Infant Home Visitation, Isaac Atuahene

Doctoral Dissertations

The United States, Great Britain, Denmark, Canada and many other countries have accepted home visitation (HV) as a promising strategy for interventions for infants after births and for their mothers. Prior HV studies have focused on theoretical foundations, evaluations of programs, cost/benefit analysis and cost estimation by using hospital/payer/insurance data to prove its effectiveness and high cost. As governments and private organizations continue to fund HVs, it is an opportune time to develop and formulate operations research (OR) models of HV coverage, quality and cost so they might be used in program implementation as done for adult home healthcare (HHC) …

Preventive Maintenance Decision Modeling In Health And Service Systems, Mahboubeh Madadi

Graduate Theses and Dissertations

This dissertation focuses on the preventive maintenance decision modeling in healthcare and service systems. In the first part of this dissertation, some issues in preventive health decisions for breast cancer are addressed, and in the second part, the required characteristics for preventive maintenance of an unreliable queuing system are derived.

Adherence to cancer screening is the first issue that is addressed in this dissertation. Women’s adherence or compliance with mammography screening remained low in the recent years. In this dissertation, we first develop a design-based logistic regression model to quantify the probability of adherence to screening schedules based on women’s …

Understanding Technology Diffusion And Spatial Accessibility In The Home Healthcare Industry, Mehmet Serdar Kilinç

Graduate Theses and Dissertations

Home healthcare is becoming an important alternative to institutionalized care. It not only reduces costs but also increases health outcomes and patient satisfaction. However, the availability and efficiency of home healthcare services need to be improved as the aging population increases in the US. Hence, understanding home healthcare utilization and access are the essential steps to develop strategies ensuring effective and sustainable services to patients.

This research aims to study two main issues in the US home healthcare system: diffusion and long-term impacts of home telehealth and potential spatial accessibility of home healthcare services. Home telehealth is a promising technology …

Model-Based Guidance For Human-Intensive Processes, Stefan Christov

Doctoral Dissertations

Human-intensive processes (HIPs), such as medical processes involving coordination among doctors, nurses, and other medical staff, often play a critical role in society. Despite considerable work and progress in error reduction, human errors are still a major concern for many HIPs. To address this problem of human errors in HIPs, this thesis investigates two approaches for online process guidance, i.e., for guiding process performers while a process is being executed. Both approaches rely on monitoring a process execution and base the guidance they provide on a detailed formal process model that captures the recommended ways to perform the corresponding HIP. …

Modeling And Optimization Of Non-Profit Hospital Call Centers With Service Blending, Yanli Zhao

Wayne State University Dissertations

This dissertation focuses on the operations problems in non-profit hospital call centers with inbound and outbound calls service blending.

First, the routing policy for inbound and outbound calls is considered. The objective is to improve the system utilization under constraints of service quality and operators' quantity. A collection of practical staffing assignment methods, separating and mixing staffing policy are evaluated. Erlang C queuing model is used to decide the minimum number of operators required by inbound calls. Theoretical analysis and numerical experiments illustrate that through dynamically assigning the inbound and outbound calls to operators under optimal threshold policy, mixing staffing …

Predictive Analytics For Disease Condition Of Patients In Emergency Department, Azade Tabaie

Wayne State University Theses

Emergency Departments (EDs) in hospitals are experiencing severe crowding and prolonged patient waiting times. The reported crowding in hospitals shows patients in hospital hallways, long waiting times and full occupancy of ED beds. ED crowding has several potential unfavorable effects including patients and staff frustration, lower patient satisfaction and poor health outcomes. The primary motivations behind this study are shortening the patients’ waiting time and improving patient satisfaction and level of care.

The very initial interaction between clinicians and a patient is recorded on nurse triage notes which contain details of the reason for patient’s visit including specific symptoms and …

Retaining Behavioral Healthcare Employees Of The Millennial Generation, David W. Gomel

Walden Dissertations and Doctoral Studies

As a result of the passage of the Affordable Care Act, the behavioral healthcare field is experiencing an increased demand for services. This increase is based on the availability of healthcare coverage to an estimated 13.4 million previously uninsured individuals. To meet this demand for treatment, the workforce of behavioral health therapists must grow. The largest generation entering the workforce, the Millennial Generation - those born after 1980 - is believed to lack commitment to their employers, frequently vacating their positions for the next best offer. The purpose of this case study was to determine factors that both affect retention …

Clinical Significance Of Response Shift In A Spine Interventional Clinical Trial, Robin Carlson

Walden Dissertations and Doctoral Studies

The effectiveness of treatments for degenerative spine conditions, where the primary symptom is back pain, is typically determined using patient-reported quality of life (QoL) measures. However, patients may adjust their internal standards when scoring QoL based on factors other than their health. This response shift phenomenon could confound the interpretation of study data and impact effectiveness conclusions. In the current study, response shift was examined using structural equation modeling (SEM) and previously collected clinical trial data comparing 2 minimally invasive medical devices in lumbar spinal stenosis patients through 1 year postintervention. In subject QoL results, reprioritization shift between 3 months …

Patient Populations, Clinical Associations, And System Efficiency In Healthcare Delivery System, Yazhuo Liu

USF Tampa Graduate Theses and Dissertations

The efforts to improve health care delivery usually involve studies and analysis of patient populations and healthcare systems. In this dissertation, I present the research conducted in the following areas: identifying patient groups, improving treatments for specific conditions by using statistical as well as data mining techniques, and developing new operation research models to increase system efficiency from the health institutes’ perspective. The results provide better understanding of high risk patient groups, more accuracy in detecting disease’ correlations and practical scheduling tools that consider uncertain operation durations and real-life constraints.

A Decision Support Simulation Model For Bed Management In Healthcare, Raja A. Baru

Masters Theses

"In order to provide access to care in a timely manner, it is necessary to effectively manage the allocation of limited resources such as beds. Bed management is key to the effective delivery of high-quality and low-cost healthcare. An efficient utilization of beds requires a detailed understanding of the hospital's operational behavior. It is necessary to understand the behavior of a hospital in order to make necessary adjustments to its resources, and policies, which can improve patient's access to care. The aim of this research was to develop a discrete event simulation to assist in planning and staff scheduling decisions. …