Operations Research, Systems Engineering and Industrial Engineering Commons^™

Adequate Ventilation: How Is It Defined And Does It Adequately Warn Consumers?, Christopher Blankenship

Theses, Dissertations and Capstones

The purpose of this research was to clarify and define the term “adequate ventilation.” Upon looking at regulations, court cases, and other elements, it is clear that the term is inadequate to inform consumers and does not instruct consumers on how to achieve proper ventilation. To find out if consumers understand this, random persons were asked to define it. The answers were given a numerical value to show the knowledge trend. The outcome showed that most people do not understand how to achieve proper ventilation. Conclusion: Diagrams showing how to set up a room with ventilation and new instructions are …

Scheduling In Mohs Micrographic Surgery Clinics, Stephen Vincent Steidle

Open Access Theses

Mohs Micrographic Surgery (MMS) is a surgical method used for the excision of aggressive skin cancers in areas of high cosmetic importance, such as the face and hands. The practice has been gaining popularity worldwide for its low recurrence rates and cosmetic results. Current clinics though are plagued by extreme wait times and an overall poor patient experience. In this paper we look to explore this problem by applying systems engineering principles including optimization and scheduling with the goal of improving the patient experience. Currently, little literature exists exploring the difficulties associated with scheduling for MMS clinic which primarily revolve …

A Methodology For Scheduling Operating Rooms Under Uncertainty, Marbelly Paola Davila

USF Tampa Graduate Theses and Dissertations

An operating room (OR) is considered to be one of the most costly functional areas within hospitals as well as its major profit center. It is known that managing an OR department is a challenging task, which requires the integration of many actors (e.g., patients, surgeons, nurses, technicians) who may have conflicting interests and priorities.

Considering these aspects, this dissertation focuses on developing a simulation based methodology for scheduling operating rooms under uncertainty, which reflects the complexity, uncertainty and variability associated with surgery.

We split the process of scheduling ORs under uncertainty into two main components. First, we designed a …

A Mathematical Modeling Framework For Phlebotomist Scheduling And Blood Draw Assignments In Laboratory Medicine, Laquanda T. Leaven

Dissertations

Laboratory services in healthcare delivery systems play a vital role in inpatient care. Studies have shown that laboratory data affects approximately 65% of the most critical decisions on admission, discharge, and medication. Laboratory testing accounts for approximately 10% of hospital billing. Reducing laboratory costs would contribute to reducing total healthcare cost, which is one of the major goals for the U.S. healthcare delivery system. This research focuses on improving the performance of the hospital laboratory in a large hospital system. The intention of this study is to identify and then optimize the most critical stage to improve the entire laboratory …

Assessment Of Neck And Shoulder Muscle Coactivations And The Effect On The Musculoskeletal System, Regina Derria Pope-Ford

Dissertations

Musculoskeletal disorders (MSDs) constitute one of the most important occupational health issues in healthcare workers who are susceptible to upper extremity disorders. Yet MSDs in the healthcare professions have not been studied extensively beyond the lower back. The focus population for this research is the field of dentistry where neck and shoulder disorders have been documented to have a high prevalence. Though quantitative data has been collected, many prior studies have focused on self-reported information. The goal of this research is to provide insight into the inter-relationship of muscles in the upper extremities. One way to accomplish this is to …

Shared Leadership In Six Sigma Teams From The North Shore-Lij Health System, Brian J. Galli

Engineering Management & Systems Engineering Theses & Dissertations

The main goal of the research was to identify the relationships that the internal research team environment and external coaching variables had with the degree of shared leadership in the context of Six Sigma teams from the North Shore LIJ Health System. Furthermore, the research ascertained the relationships that these variables had with two performance metrics: a team's ability to complete project deliverables and satisfy customer's requirements. This research also sought to understand additional factors that affected the five variables.

The research found that while shared leadership did not positively change as a team progressed through the phases of the …

Supply Chain Optimization Of Blood Products, Serkan Gunpinar

USF Tampa Graduate Theses and Dissertations

Major challenges in the management of blood supply chain are related to the shortage and wastage of the blood products. Given the perishability characteristics of blood which can be stored up to a limited number of days, if hospitals and blood centers keep an excessive number of blood units on inventory, wastages may occur. On the other hand, if sufficient number of blood units are not stored on inventory, shortages of this resource may cause the cancellations of important activities and increase the fatality rates at hospitals. Three mathematical models have been developed with the goal to improve the efficiency …

Classification Models In Clinical Decision Making, Eleazar Gil-Herrera

USF Tampa Graduate Theses and Dissertations

In this dissertation, we present a collection of manuscripts describing the development of prognostic models designed to assist clinical decision making. This work is motivated by limitations of commonly used techniques to produce accessible prognostic models with easily interpretable and clinically credible results. Such limitations hinder prognostic model widespread utilization in medical practice.

Our methodology is based on Rough Set Theory (RST) as a mathematical tool for clinical data anal- ysis. We focus on developing rule-based prognostic models for end-of life care decision making in an effort to improve the hospice referral process. The development of the prognostic models is …

The Role Of Is Infrastructure And Organizational Context On Implementation Of Electronic Health Records Systems, Pilar Pazos, Anjee Gorkhali, Rolando Delaguila

Engineering Management & Systems Engineering Faculty Publications

This research explores the role that Information System (IS) infrastructure and organizational context play on the implementation of Electronic Health Records (EHR) Systems. A number of indicators can be used as a proxy for IS infrastructure such as: Information System (IS) Department Budget allocation, percentage of full time IS staff and the number of technical trainings provided by the IS department to the clinical staff. Data was obtained from the Healthcare Information and Management Systems Society (HIMSS) database, a non-for profit organization that evaluates the use of information technology in the health care industry. This paper reports on the development …

The Factors Behind A Successful Implementation Of Electronic Health Records Systems, Anjee Gorkhali

Engineering Management & Systems Engineering Theses & Dissertations

This research explores the role that budget for Information System (IS) and technical expertise of healthcare service provider staff play on the successful leap from a partial to exhaustive implementation of Electronic Health Records (EHR) Systems. Technical expertise in Information Systems might not be easily measurable directly, but there are a number of indicators that could be used as a proxy, such as: Information System (IS) Department Budget, number of IS staff and the extent of technical trainings provided by the IS department to the clinical staff. This research study hypothesizes that quality technical trainings conducted by an IS department …

Modeling The Adoption Of Identification Standards Within The Healthcare Supply Chain, Angelica Burbano

Graduate Theses and Dissertations

The adoption of identification standards and its associated technology in the healthcare supply chain has been slow over the past twenty five years, despite the evidence of the benefits that can be achieved. The widespread use of identification standards in the form of barcode labeled medical products can contribute to the reduction of point of care errors and can increase the efficiency of healthcare supply chain related processes. This research is focused on the analysis of the adoption of identification standards in the healthcare supply chain with a particular focus on the healthcare provider adoption challenges. The research is divided …

Patient And Nurse Considerations In Home Health Routing With Remote Monitoring Devices, Jessica Spicer

Graduate Theses and Dissertations

We build on the current consistent vehicle routing problem literature by formulating a novel multi- objective mathematical model of the home health scheduling and routing problem that includes the option of assigning some patient visits to remote monitoring devices, with the objectives of mini- mizing total cost, achieving nurse consistency and creating balanced nurse workloads. A heuristic solution approach that approximates the efficient frontier of this multiobjective problem is pre- sented and validated, and the results of using this methodology to solve several realistic instances are included. We also analyze the assignment of patients to devices and present some managerial …

Improving Health Care Quality And Safety: The Development And Assessment Of Laparoscopic Surgery Instrumentation, Practices And Procedures, Bernadette Mccrory

Department of Mechanical and Materials Engineering: Dissertations, Theses, and Student Research

Adverse events due to medical errors are a leading cause of death in the United States exceeding the mortality rates of motor vehicle accidents, breast cancer and AIDS. Improvements can and should be made to reduce the rates of preventable surgical errors since they account for nearly half of all adverse events within hospitals. Although minimally invasive surgery has proven patient benefits such as reduced postoperative pain and hospital stay, its operative environment imposes substantial physical and cognitive strain on the surgeon increasing the risk of error. In order to mitigate errors and protect patients, a multidisciplinary approach was taken …

Safety, Ergonomics And Human Factors Engineering On Biomedical Devices Design, Alejandra Sandoval Vazquez^, Noe Vargas Hernandez*

COURI Symposium Abstracts, Spring 2012

No abstract provided.

A System Dynamics Model For Simulating Ambulatory Health Care Demands, Rafael Diaz, Joshua G. Behr, Mandar Tulpule

VMASC Publications

Introduction: This article demonstrates the utility of the system dynamics approach to model and simulate US demand for ambulatory health care service both for the general population and for specific cohort subpopulations over the 5-year period, from 2003 to 2008. A system dynamics approach that is shown to meaningfully project demand for services has implications for health resource planning and for generating knowledge that is critical to assessing interventions.

Methods: The study uses a cohort-component method in combination with structural modeling to simulate ambulatory health care utilization. Data are drawn from the National Ambulatory Medical Care Survey and the National …

Adaptive Intensity Modulated Radiation Therapy Planning Optimization With Changing Tumor Geometry And Biology Enforcing Both Cumulative And Fraction Size Dose Constraints, Behlul Saka

Graduate Theses and Dissertations

Intensity Modulated Radiation Therapy (IMRT) is a modern technique of delivering radiation treatments to cancer patients. In IMRT technology, intensities must be chosen for the many small unit grids into which the beams are divided to produce a desired distribution of dose at points throughout the body with the goal of maximizing dose delivered to the tumor while sparing healthy tissues from excessive radiation and keeping dose homogeneous across the tumor. Although IMRT plans are optimized as a single overall treatment plan, they are delivered over 30-50 treatment sessions (fractions) and both cumulative and per-fraction dose constraints apply. The extended …

Applying Inventory Control Practices Within The Sisters Of Mercy Health Care Supply Chain, Server Apras

Graduate Theses and Dissertations

This research lays a foundation for the better understanding of the application and acceptance of more advanced inventory control practices within the health care supply chain. The demand characteristics and optimal control policies for pharmaceutical items within a multi-echelon provider network are examined within the framework of a case study. Demand forecasting algorithms were applied to forecast demand for inventory control procedures. A spreadsheet-based inventory planning tool was used to minimize the inventory holding and ordering costs subject to fill rate constraints. The costs of inventory control models are compared to the current ordering and inventory control strategies to document …

Evaluating The Capacity Of A Proton Therapy Facility, Ridvan Gedik

Graduate Theses and Dissertations

A relatively new consideration in proton therapy planning is the requirement that the mix of patients treated satisfy desired percentages. Since it is very dicult to satisfy an integer number of patients in light of these requirements, deviations from patient mix preferences and their impacts on operational capabilities are of particular interest to healthcare planners. Therefore, we propose a bicriteria mathematical programming model that determines an outpatient schedule maximizing the number of fractions and minimizing the deviations from the patient mix ratios over the planning horizon. The tradeos between the two objectives are identied through analysis of ecient frontiers. Our …

An Empirical Investigation Of Supply Chain Excellence In Healthcare, Brian Keith Smith

Graduate Theses and Dissertations

This research is motivated by opportunities to improve the cost and quality of healthcare delivery through improved supply chain processes. This research assesses the quality of the healthcare supply chain and identifies factors that are driving supply chain excellence among organizations in the healthcare industry. The first objective of this research is to assess the state of quality measurement in the healthcare supply chain. The achievement of this first objective is presented in Chapter 3 of this dissertation in the form of a manuscript accepted for publication in The Quality Management Journal. The second research objective is to develop …

A Primary Care Workload Production Model For Estimating Relative Value Unit Output, Rachel G. Murphy

Theses and Dissertations

Health care costs have grown to unsustainable levels nationally and within the Department of Defense. Military health care costs have historically been difficult to isolate, causing budget cuts to be the vehicle for cost control. Maximum efficiency, therefore, is the goal in order to show improvement. With the Air Force’s new preventive health plan, they aim to drive a long-term posture for cost reduction through prevention. This research effort aimed to develop a tool to assist in future efforts to understand and improve efficiency in workload output, and whether a relationship exists between patient workload demand and the per-encounter variables …

Modeling And Surveillance Of Pandemic Influenza Outbreaks, Diana Prieto

USF Tampa Graduate Theses and Dissertations

Pandemic outbreaks are unpredictable as to their virus strain, transmissibility, and impact on our quality of life. Hence, the decision support models for mitigation of pandemic outbreaks must be user-friendly and operational, and also incorporate valid estimates of disease transmissibility and severity. This dissertation research is aimed at 1) reviewing the existing pandemic simulation models to identify their implementation gaps with regard to usability and operability, and suggesting research remedies, 2) increasing operability of simulation models by calibrating them via an epidemiological model that estimates infection probabilities using viral shedding profiles of concurrent pandemic and seasonal influenza, and 3) developing …

Decision Aid Models For Resource Sharing Strategies During Global Influenza Pandemics, Alfredo Santana Reynoso

USF Tampa Graduate Theses and Dissertations

Pandemic influenza outbreaks have historically entailed significant societal and economic disruptions. Today, our quality of life is threatened by our inadequate preparedness for the imminent pandemic. The key challenges we are facing stem from a significant uncertainty in virus epidemiology, limited response resources, inadequate international collaboration, and the lack of appropriate science-based decision support tools. The existing literature falls short of comprehensive models for global pandemic spread and mitigation which incorporate the heterogeneity of the world regions and realistic travel networks. In addition, there exist virtually no studies which quantify the impact of resource sharing strategies among multiple countries. This …

A Study To Determine The Influence Of Workload On Nursing Personnel, Supreeta G. Amin

Dissertations

The alarming number of adverse medical events and associated costs have placed immense importance toward the safety and health of both patients and medical personnel. A shrinking nurse workforce, an aging patient and nursing population coupled with a mismatch between hospital demands and the available nursing staff have created a situation detrimental to both patient and nursing personnel. Long working hours, working more than one job, low staffing ratios, high patient acuity, minimal social support, low experience level, complicated equipment, complex procedures and varying workload are some factors that may have a negative impact on the quality of care provided …

Apparent Total Evaporative Resistance Values From Human Trials Over A Range Of Metabolic And Heat Stress Levels, Matthew David Dooris

USF Tampa Graduate Theses and Dissertations

Failure to maintain thermal equilibrium can cause uncontrollable increases in body core temperature beyond critical upper limits. In selecting clothing, consideration must be given to the heat transfer properties of clothing that may restrict the cooling capacity of the human body under heat stress conditions, most importantly, apparent total evaporative resistance (R_e,T,_a). This study calculated and compared R_e,T,_a for five clothing ensembles under varying heat stress conditions, including three relative humidity (RH) levels and three stages of heat stress to determine if R_e,T,_a values varied or remained the same with …

Identification Of Patient Recovery Patterns After Cardiovascular Surgery Based On Laboratory Tests Results, Alcides Ricardo Santander Mercado

USF Tampa Graduate Theses and Dissertations

In this dissertation is proposed a methodology to identify patient's recovery patterns after cardiovascular surgery based on laboratory tests results. The main purpose is to enhance the understanding of the manifestations of postsurgical complications in patients who underwent cardiovascular surgery. The analysis of patients' recovery process is based on the relationship between plasma calcium, ionized calcium and platelet count over time.

Laboratory results from the James A. Haley Veterans' Hospital databases, related to patients admitted to the Surgical Intensive Care Unit (SICU) after cardiac surgery (coronary artery bypass, aortic value replacement and mitral valve replacement), are used. These databases contain …

The Impact Of Pharmacy Work Design On Pharmacist Productivity, Nicholas Allen Coblio

USF Tampa Graduate Theses and Dissertations

Healthcare costs in the United States continue to grow at an alarming rate. Concerning the cost of medications, there are a number of factors that drive these costs. While personnel costs are not the largest of these, they do contribute a significant portion. The cost of the cognitive component of order processing by pharmacists can range from three dollars to over six dollars per prescription depending on the production throughput of the pharmacist.

Studies at the organization which was the focus of the research, as well as reports in the literature, indicated that work disruption and other environmental factors could …

Analytical Methods To Support Risk Identification And Analysis In Healthcare Systems, Laila Nadime Cure Vellojin

USF Tampa Graduate Theses and Dissertations

Healthcare systems require continuous monitoring of risk to prevent adverse events. Risk analysis is a time consuming activity that depends on the background of analysts and available data. Patient safety data is often incomplete and biased. This research proposes systematic approaches to monitor risk in healthcare using available patient safety data. The methodologies combine traditional healthcare risk analysis methods with safety theory concepts, in an innovative manner, to allocate available evidence to potential risk sources throughout the system. We propose the use of data mining to analyze near-miss reports and guide the identification of risk sources. In addition, we propose …

The Bi-Objective Master Physician Scheduling Problem, Aldy Gunawan, Hoong Chuin Lau

Research Collection School Of Computing and Information Systems

Physician scheduling is the assignment of physicians to perform different duties in the hospital timetable. In this paper, the goals are to satisfy as many physicians’ preferences and duty requirements as possible while ensuring optimum usage of available resources. We present a mathematical programming model to represent the problem as a bi-objective optimization problem. Three different methods based on ε–Constraint Method, Weighted-Sum Method and HillClimbing algorithm are proposed. These methods were tested on a real case from the Surgery Department of a large local government hospital, as well as on randomly generated problem instances. The strengths and weaknesses of the …

Digital Human Models Of People With Disabilities, Ron Hamameh

Wayne State University Theses

The current state-of-the-art in Digital Human Modeling (DHM) allows for full simulation and analysis of any task a person is required to perform at home, at work, in the military, in space, in sports, etc. The problem is that the software is missing a very important population: people with physical disabilities. What modifications and enhancements must be made to existing, commercially available DHM software to include this population?

Hazard Identification, Risk Assessment And Risk Control (Hirarc) In A Corrugated Box Manufacturer., Fraziel Barahim

Student Works (2010-2019)

Packaging is one of the biggest industries in the world. It involves paper, glass,metal, flexible and plastic. The corrugated paper packaging worldwide has been growing at 3% to 4% per annum. In line with the expansion of the corrugated paper packaging manufacturing, the potential hazards to human physical and health, property and the environment posed by its operations and production activities have created an increase in awareness and brought up safety issues amongst industry, government and public. The hazard identification and risk assessment plays a role in a number of areas in the safety management, including regulatory policies and guidelines, …