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A Triage System For The Distribution Of Outpatient Appointments In A Neurology Department: Systems Description, Validation Of Triage System Results And The Report Of A Delphi Method Study For Evaluating Criteria Determining Appointment Urgency, Bruce L. Austin, Durjoy Kumar Chaudhuri, J. Conomy Jun 1976

A Triage System For The Distribution Of Outpatient Appointments In A Neurology Department: Systems Description, Validation Of Triage System Results And The Report Of A Delphi Method Study For Evaluating Criteria Determining Appointment Urgency, Bruce L. Austin, Durjoy Kumar Chaudhuri, J. Conomy

Research Reports from the Department of Operations

This report addresses the challenge of effectively utilizing health care resources to meet legitimate and increasing health demands in contemporary American medicine. The delivery of health care, historically rooted in "cottage industry" models, has evolved into a limited commodity due to factors such as population growth, technological advances, and rising costs. Ensuring equitable and efficient utilization of health resources is essential for controlling costs, improving access, and fulfilling the health care system's purpose of alleviating suffering, managing health crises, and preventing disease. However, the health care delivery system faces significant issues, including regional maldistribution of resources and an imbalance between …


Forest City/University Hospitals Telemedicine System Project Evaluation: Progress Report Iii, Arnold Reisman, F.J. Staub, Betty L. Grundy, W. Pittard, Edward A. Ernst, J. S. Gravenstein, Hamilton Emmons, Teunis J. Ott, Burton V. Dean, Thomas George, Marylou Kiley, Bruce L. Austin, M. A. Chowdhury, Pauline Crawford, Ronella Fields, Willie Callaham Lambright, Charles S. Berry May 1976

Forest City/University Hospitals Telemedicine System Project Evaluation: Progress Report Iii, Arnold Reisman, F.J. Staub, Betty L. Grundy, W. Pittard, Edward A. Ernst, J. S. Gravenstein, Hamilton Emmons, Teunis J. Ott, Burton V. Dean, Thomas George, Marylou Kiley, Bruce L. Austin, M. A. Chowdhury, Pauline Crawford, Ronella Fields, Willie Callaham Lambright, Charles S. Berry

Research Reports from the Department of Operations

The maldistribution of qualified medical personnel, which has plagued this country in recent years, has become a matter of serious concern for administrators and planners in the health care sector. Inner-city and small suburban hospitals have suffered the most from this unfortunate circumstance. At various levels, public administrators have attempted to remedy the situation. Telemedicine is one system that, in several widely different environments, has shown its potential in addressing the problem. One such system has been in experimental operation for some time in Cleveland, Ohio. Under a contract with the Health Care Technical Division of the National Center for …


On The Degree Of Approximation By Monotone Polynomials, Vasant A. Ubhaya May 1976

On The Degree Of Approximation By Monotone Polynomials, Vasant A. Ubhaya

Research Reports from the Department of Operations

This article considers the problem of approximating a continuous function defined on an interval by polynomials which are monotone nondecreasing there. Upper and lower bounds on the degree of approximation are obtained in terms of moduli of monotonicity, a concept which the author introduced in an earlier article [12]. Certain asymptotic results are also established. One of the results of this article shows that when f is continuous but not nondecreasing, En(f), the degree of approximation of f by monotone polynomials of degree at most n, converges to a positive number as n→∞, at a rate which is at least …


A Study Of The Adaptability Of The Dental Management Game To Podiatry, Frank D. Ilzig, John Karaffa, Michael Rothschild, Marina Van Zyl May 1976

A Study Of The Adaptability Of The Dental Management Game To Podiatry, Frank D. Ilzig, John Karaffa, Michael Rothschild, Marina Van Zyl

Research Reports from the Department of Operations

This paper explores the similarities between the practices of podiatry and dentistry, focusing on their shared clinical and managerial aspects. Both professions involve managing specialized areas of the body, directing assistants, and utilizing similar physical layouts, equipment, and treatment processes. However, students in both fields receive limited training in practice management during their predoctoral years. To address this gap, a computer-aided dental management game, developed at Case Western Reserve University, teaches dental students decision-making skills related to practice setup, patient scheduling, and staff management. The game evaluates performance based on costs, income, patient care, and resource utilization. Due to the …


Systems And Procedures Of Patients And Information Flow In The Outpatient Clinic Of A Large Health Center: A Systems Description, Critical Evaluation, And Recommendations For Improvement, Arnold Reisman, Joao Mello Da Silva, Joe Mantell May 1976

Systems And Procedures Of Patients And Information Flow In The Outpatient Clinic Of A Large Health Center: A Systems Description, Critical Evaluation, And Recommendations For Improvement, Arnold Reisman, Joao Mello Da Silva, Joe Mantell

Research Reports from the Department of Operations

Systems analysis methods were used to describe the existing procedures for patient and information flow in the outpatient clinic of a large metropolitan health center. The procedures were complex, and they fell short of being effective from the physicians’, the patients’, and the administrators’ points of view. They were the result of the dynamics of natural degradation during a period of institutional expansion and extension. The paper delineates, in operationally meaningful terms, the ultimate goals and the objectives for the Patient and Information Flow System as well as the processes to be used to achieve same.


Nonlinear Programming, Approximation, And Optimization On Infinitely Differentiable Functions, Vasant A. Ubhaya Apr 1976

Nonlinear Programming, Approximation, And Optimization On Infinitely Differentiable Functions, Vasant A. Ubhaya

Research Reports from the Department of Operations

A nonnegative, infinitely differentiable function φ defined on the real line is called a Friedrichs mollifier function if it has support in [0,1] and ∫₀¹ φ(t)dt = 1. In this article the following problem is considered: Determine Ak = inf ∫₀¹ φ(k)(t)dt, k=1,2,..., where φ(k) denotes the kth derivative of φ and the infimum is taken over the set of all mollifier functions, which is a convex set. This problem has applications to monotone polynomial approximation as shown by this author in Ref. 2. The problem is reducible to three equivalent problems--a nonlinear programming problem, a problem on the functions …


Economic Analysis Applied To The Practice Of Dentistry, Arnold Reisman, Hamilton Emmons, Edward J. Green, Ronald Occhionero, Keki R. Dadachanji, Shailesh J. Mehta, Susumu Morito Mar 1976

Economic Analysis Applied To The Practice Of Dentistry, Arnold Reisman, Hamilton Emmons, Edward J. Green, Ronald Occhionero, Keki R. Dadachanji, Shailesh J. Mehta, Susumu Morito

Research Reports from the Department of Operations

This paper describes one aspect of a general methodology for the management of a dental practice; in general and in particular, of one involving Expanded Duty Dental Auxiliaries. The aspect of concern in this paper centers on the economic analysis of practice management. Thus, the paper presents both an algebraic statement of the economic analysis and a set of forms (similar in format to the International Revenue Service 1040 forms) which can be used to respond to the following questions: (1) Given a patient load and mix, a practice configuration (i.e., the number of operatories and of workers of each …


On The Next-To-Dominating Eigenvalues Of A Markov Matrix, Teunis J. Ott Mar 1976

On The Next-To-Dominating Eigenvalues Of A Markov Matrix, Teunis J. Ott

Research Reports from the Department of Operations

It is proven that two matrices, each of which has the property that all its rowsums are equal, and which have the property that one can be obtained from the other by adding, for every column, the same number to all elements of that column, have essentially the same set of eigenvalues. This result is used to give an upper bound for the absolute value of the "next-to-dominating" eigenvalue of a markov matrix. The two foregoing results together are used to suggest an iterative procedure for the value-determination step in markov-decision processes.


A Methodology For Forecasting Patient Load For A Dental Practice, Arnold Reisman, Hamilton Emmons, Edward J. Green, Ronald Occhionero, Keki R. Dadachanji, Susumu Morito Mar 1976

A Methodology For Forecasting Patient Load For A Dental Practice, Arnold Reisman, Hamilton Emmons, Edward J. Green, Ronald Occhionero, Keki R. Dadachanji, Susumu Morito

Research Reports from the Department of Operations

This paper describes a methodology to forecast the patient load in a dental practice. Three different situations are treated individually: Forecasting in a new practice, forecasting in an established practice, and forecasting during merger. The paper presents both the mathematical models used in forecasting and a set of forms (similar in format to the Internal Revenue Service 1040 forms) which can be used to systematically compute the forecast value. Scheduling of patients and operatories [4,12] and economic analysis of a dental practice [6] require a dependable forecast of the patient load. This paper is intended to help the dentist make …


Nonlinear Programming And An Optimization Problem On Infinitely Differentiable Functions, Vasant A. Ubhaya Mar 1976

Nonlinear Programming And An Optimization Problem On Infinitely Differentiable Functions, Vasant A. Ubhaya

Research Reports from the Department of Operations

This paper was originally titled "Extremum Problems on the Space of Infinitely Differentiable Functions, I”. A nonnegative, infinitely differentiable function φ defined on the real line is called a Friedrichs mollifier function if it has support in [0,1] and ∫₀¹ φ(t)dt = 1. In this article and a sequel [18], the following problem is considered: Determine Ak = inf ∫₀¹ φ(k)(t)dt, k=1,2,..., where φ(k) denotes the kth derivative of φ and the infimum is taken over the set of all mollifier functions, which is a convex set. This problem has applications to monotone polynomial approximation as shown by this author …


The Solution Of Nonlinear Programs Using The Generalized Reduced Gradient Method, Arvind Jain Mar 1976

The Solution Of Nonlinear Programs Using The Generalized Reduced Gradient Method, Arvind Jain

Research Reports from the Department of Operations

The Generalized Reduced Gradient Method for nonlinear programming is discussed with emphasis on a fast, reliable computer implementation of the algorithm. The problems studied relate to basis selection, degeneracy, the acceleration of the solution of nonlinear equations, and the design of a mathematical programming system for sparse large-scale nonlinear programs.


Simulation Models Applied To Dental Practice Management: A Survey, Susumu Morito, Arnold Reisman, Hamilton Emmons, Edward J. Green, Ronald Occhionero Mar 1976

Simulation Models Applied To Dental Practice Management: A Survey, Susumu Morito, Arnold Reisman, Hamilton Emmons, Edward J. Green, Ronald Occhionero

Research Reports from the Department of Operations

The purpose of this paper is to review recently completed and ongoing work in the field of simulation applied to dental practice management in general and problems of scheduling patients, workers and operatories in particular. In dentistry, as in many other areas of health care delivery, rapid changes are coming about. Practices are moving toward an increasing prevalence of group practices and to the introduction of new categories of allied professionals. These factors, plus the increased demand for dental care that may be anticipated in the coming years, are making it ever harder, and ever more important, to find solutions …


Computer Simulation Of Pre-Scheduling In A Dental Practice Involving Expanded Function Dental Auxiliaries, Arnold Reisman, Hamilton Emmons, Edward J. Green, Ronald Occhionero, Shailesh J. Mehta, Susumu Morito, Keki R. Dadachanji Mar 1976

Computer Simulation Of Pre-Scheduling In A Dental Practice Involving Expanded Function Dental Auxiliaries, Arnold Reisman, Hamilton Emmons, Edward J. Green, Ronald Occhionero, Shailesh J. Mehta, Susumu Morito, Keki R. Dadachanji

Research Reports from the Department of Operations

This paper discusses computer-aided comparisons of performance of alternative policies for patient and worker scheduling in a practice involving expanded function dental auxiliaries. The comparisons are made in terms of net earnings, total number of patients served, worker utilization, etc., using computer based simulation. Predetermined scheduling is proved to be an efficient method under a wide range of conditions.


Sequencing Jobs For A Single Worker To Process And Deliver, R. Chandrasekaran, Hamilton Emmons Feb 1976

Sequencing Jobs For A Single Worker To Process And Deliver, R. Chandrasekaran, Hamilton Emmons

Research Reports from the Department of Operations

The problem of sequencing n jobs on one processor is considered, under the additional assumption that jobs are not completed until delivered. A single worker does both the processing and delivery, and deliveries can take place in batches following the completion of any job. Several special cases of this general class of problems are motivated, formulated, and solved.


Survey Of The Alumni Of The Department Of Operations Research Case Western Reserve University 1951-1975, John J. Rasmussen, Thomas George Feb 1976

Survey Of The Alumni Of The Department Of Operations Research Case Western Reserve University 1951-1975, John J. Rasmussen, Thomas George

Research Reports from the Department of Operations

The Department of Operations Research at Case Western Reserve University conducted a survey of alumni to assess the educational background, curriculum effectiveness, career paths, and utility of their degrees over its 25-year history. The findings reveal a strong preference among graduates for incorporating applied and implementation-focused content into the curriculum. Most alumni pursue careers in non-academic settings, with many earning additional graduate degrees. Recent graduates frequently work in industries where the degree is not explicitly required. The results provide valuable insights for current students planning their educational and professional trajectories and inform departmental decisions on curriculum development. Additionally, the study …


Agricultural Plant Protection: A Study Of The Economics Of Information, Ehud Gelb, David Pollak, Amit Schpar, Amos Dinur, Arnold Reisman Jan 1976

Agricultural Plant Protection: A Study Of The Economics Of Information, Ehud Gelb, David Pollak, Amit Schpar, Amos Dinur, Arnold Reisman

Research Reports from the Department of Operations

The epidemiologic aspects of field crop infestation and disease spread have been the subject of scientific inquiry across the globe for a number of decades. Scientific researches into the agrotechnic aspects of plant protection have been equally extensive and productive of pragmatic results. Hard data are available for each of a number of crops regarding the economic impact of yield and quality reductions attributable to specific diseases and their level of progress at harvesting time. Clearly the costs of spraying are easily obtainable. This paper develops a decision-tree model to help farmers evaluate the expected net benefits that will accrue …


Booking Policies For Outpatient Clinics, Joao Mello Da Silva Jan 1976

Booking Policies For Outpatient Clinics, Joao Mello Da Silva

Research Reports from the Department of Operations

This dissertation is concerned with models for booking patient-visits to physicians in the various departments of an outpatient clinic. A major outpatient clinic is used as the institutional basis for this study. A general description of the operations of the particular clinic is presented. A review of the literature is made. It is noted that most of the research for medical clinics is oriented towards minimizing both the physicians' idle time and the patients' waiting time. Similarities between the booking of passengers to airplane seats and patients to doctors are presented. Certain appointment types may generate appointment requests for the …


Integer Programming By Group Theory, Susumu Morito Jan 1976

Integer Programming By Group Theory, Susumu Morito

Research Reports from the Department of Operations

This report discusses various aspects of group theoretic algorithms in integer programming. A group theoretic algorithm transforms the original integer program to an optimization problem over an abelian group by relaxing nonnegativity, but not integrality, constraints on the variables corresponding to a linear programming basis. More specifically, columns of constraint coefficients, and the right hand sides in the group problem are elements of an abelian group with D elements, where D is the absolute value of the determinant of the linear programming basis. Several groups may be used to derive the optimization problem and the particular group selected indicates the …


A Difficult Small Integer Program, Harvey M. Salkin, Susumu Morito Dec 1975

A Difficult Small Integer Program, Harvey M. Salkin, Susumu Morito

Research Reports from the Department of Operations

An apparently difficult, yet small, integer program has been tested on what we believe to be is a most efficient computer system containing a group theoretic algorithm. Although a good solution was produced, the code did not converge in at most thirty seconds of UNIVAC 1108 time, and thus the integer program can serve as a principal test problem. The model represents a real world chemical blending situation and was received from E. I. DuPont DeNemours & Co., Inc.


On Convergence Of A Sequence Of Probability Measures On A Locally Compact Abelian Group To A Degenerate Limit, Teunis J. Ott Dec 1975

On Convergence Of A Sequence Of Probability Measures On A Locally Compact Abelian Group To A Degenerate Limit, Teunis J. Ott

Research Reports from the Department of Operations

A condition is given on the Fourier-transforms of a sequence of probability measures on a locally compact abelian group G, which guarantees weak convergence of that sequence to a degenerate probability measure, and which is "weakest" with that property. The result is reformulated for the special case G = R^n, in which situation the Fourier-transforms are characteristic functions of n-dimensional random vectors.


Infinitely Divisible Non-Negative Matrices, Teunis J. Ott Dec 1975

Infinitely Divisible Non-Negative Matrices, Teunis J. Ott

Research Reports from the Department of Operations

It is proven that a finite non-negative matrix is infinitely divisible if and only if it can be imbedded in a continuous semigroup of non-negative matrices. A result by Doeblin and Doob, that every halfgroup of finite Markov matrices is continuous, is extended to finite non-negative matrices. Canonical forms are given for halfgroups of finite (possibly complex-valued) matrices and for commutating systems of finite non-negative matrices.


Grg System Documentation, Leon S. Lasdon, Allan D. Waren, Margery W. Ratner, Arvind Jain Nov 1975

Grg System Documentation, Leon S. Lasdon, Allan D. Waren, Margery W. Ratner, Arvind Jain

Research Reports from the Department of Operations

This report was prepared as part of the joint activities of the Computer and Information Science Department, Cleveland State University and the Department of Operations Research, Case Western Reserve University, partially supported under Contract 00014-75-C-0240 with the Office of Naval Research and under National Science Foundation Grant SOC74-23808. Reproduction in whole or in part is permitted for any purpose by the United States Government.


Versions Of The Bible: A Classification And A Selection Procedure, John J. Rasmussen Nov 1975

Versions Of The Bible: A Classification And A Selection Procedure, John J. Rasmussen

Research Reports from the Department of Operations

This paper outlines a four-step procedure to help individuals select a Bible for personal use amidst the influence of advertising, peer opinions, and expert recommendations. The process begins by identifying the intended purpose of the Bible. Next, desired characteristics are selected from a list of ten objective elements. These characteristics are then matched to a version on a taxonomy chart. Finally, a list of 37 distinct English versions is provided to refine the selection. The procedure demonstrates principles of taxonomy and rational decision-making, offering a systematic approach to choosing the most suitable version.


Grg User's Guide, Leon S. Lasdon, Allan D. Waren, Margery W. Ratner, Arvind Jain Nov 1975

Grg User's Guide, Leon S. Lasdon, Allan D. Waren, Margery W. Ratner, Arvind Jain

Research Reports from the Department of Operations

This report was prepared as part of the joint activities of the Computer and Information Science Department, Cleveland State University and the Department of Operations Research, Case Western Reserve University, partially supported under Contract 00014-75-C-0240 with the Office of Naval Research and under National Science Foundation Grant SOC74-23808. Reproduction in whole or in part is permitted for any purpose by the United States Government.


Set Covering Algorithm And Computer Program Usetco User's Manual, Harvey M. Salkin Sep 1975

Set Covering Algorithm And Computer Program Usetco User's Manual, Harvey M. Salkin

Research Reports from the Department of Operations

These pages discuss the code USETCO which contains an algorithm for the set covering problem. (That is, minimize cx, subject to Ex ≥ e, x≥0, and x integer; where E is an m by n matrix of 1's and 0's, and e is an m vector of 1's.) The special problem structure permits a rather efficient, yet simple, solution procedure which is basically a zero-one search of the single branch type coupled with linear programming and a suboptimization technique. The algorithm has been found to be highly effective for a good number of relatively large problems. Problems from 30 to …


An Analysis Of A Method For Reducing Pretrial Delay In Court Systems, Burton V. Dean, John N. Barrer Sep 1975

An Analysis Of A Method For Reducing Pretrial Delay In Court Systems, Burton V. Dean, John N. Barrer

Research Reports from the Department of Operations

An analysis is performed to measure the effect on court processing times produced by a project implemented by Lewis Katz of the Case Western Reserve University's School of Law. The project formalized the procedure known as plea bargaining through the cooperation of prosecuting and defense attorneys in each of three test cities - New Haven, Connecticut; Norfolk, Virginia; and Salt Lake City, Utah. The analysis reveals that the project reduced the average processing time in New Haven by 45%, but had no significant effect on the processing times in the other two cities. Differences in procedures between New Haven and …


Duality In Approximation And Conjugate Cones In Normed Linear Spaces, Vasant A. Ubhaya Sep 1975

Duality In Approximation And Conjugate Cones In Normed Linear Spaces, Vasant A. Ubhaya

Research Reports from the Department of Operations

Duality in a normed linear space X, refers to a relationship between a pair of extremum problems: the primal problem on X and the dual problem on the dual space X*. Given a closed convex cone K defined in terms of a set of continuous linear functionals in X*, the dual extremum problems associated with the primal problem. Necessary and sufficient conditions are established so that the "duality gaps" between pairs of primal-dual problems do not exist, that is, the extremal or the optimal values of the primal and dual problems are equal. These conditions prominently involve the conjugate cone …


Set Covering Algorithm And Computer Program Usetco Programmer's Manual, Harvey M. Salkin Sep 1975

Set Covering Algorithm And Computer Program Usetco Programmer's Manual, Harvey M. Salkin

Research Reports from the Department of Operations

These pages discuss the code USETCO which contains an algorithm for the set covering problem. (That is, minimize cx, subject to Ex ≥ e, x≥0, and x integer; where E is an m by n matrix of 1's and 0's, and e is an m vector of 1's.) The special problem structure permits a rather efficient, yet simple, solution procedure which is basically a zero-one search of the single branch type coupled with linear programming and a suboptimization technique. The algorithm has been found to be highly effective for a good number of relatively large problems. Problems from 30 to …


A Dental Management Game, Hamilton Emmons, Arnold Reisman, Susumu Morito, J. Shultz, Joe Mantell, N. Segal, Edward J. Green, Ronald Occhionero Sep 1975

A Dental Management Game, Hamilton Emmons, Arnold Reisman, Susumu Morito, J. Shultz, Joe Mantell, N. Segal, Edward J. Green, Ronald Occhionero

Research Reports from the Department of Operations

This paper discusses progress on the development of a computer aided game to teach various management skills to dental students as well as to dental practitioners. The game first deals with the decisions concerning the establishment of a practice, e. g., preferences regarding location, the form (solo, associate or group) of practice, staff patterns and salaries, purchasing of facilities, etc. Next considered are decisions which must be made daily, e. g., patient and worker scheduling, control of supplies, etc. Performance is evaluated in terms of income, costs, care delivered, patient waiting time and personnel utilization.


Scheduling Independent Jobs On Parallel Machines To Minimize Two Objectives Related To Job Tardiness, Thomas S. Nunnikhoven Aug 1975

Scheduling Independent Jobs On Parallel Machines To Minimize Two Objectives Related To Job Tardiness, Thomas S. Nunnikhoven

Research Reports from the Department of Operations

This research considers the scheduling on parallel machines of jobs which are independent and simultaneously available for processing and which have due dates and known processing times. Cases in which the machines are identical and in which they operate at different speeds are both covered. The principal objective treated is finding a schedule which meets all due dates and uses the minimum number of machines required for that criterion. It is shown that methods which solve for this first objective can easily be modified for a second, that of minimizing maximum tardiness on a given number of machines. An assumption …