Medicine and Health Sciences Commons^™

A Three-Stage Matheuristic For The Blood Stochastic Inventory Routing Problem, Vincent F. Yu, Nabila Salsabila, Aldy Gunawan, Aldy Gunawan, Nurhadi Siswanto

Research Collection School Of Computing and Information Systems

This research introduces a blood distribution system under vendor-managed inventory that considers uncertain supply and demand. We present it as the Blood Stochastic Inventory Routing Problem, formulating it as a two-stage stochastic programming model. To solve this problem, this study proposes a three-stage matheuristic that combines a perturbation heuristic, Adaptive Large Neighborhood Search, and an exact approach. From historical data of Surabaya Blood Center in Indonesia, six sets of new instances are generated under different settings. Computational results show that our proposed three-stage matheuristic outperforms CPLEX and a two-stage matheuristic by gaining optimal or better solutions within a significantly shorter …

Predictors Of Healthcare Providers' Readiness For Health System Transformation In Saudi Arabia, Ahmed Ali Alasiri

Health Services Research Dissertations

The healthcare system in Saudi Arabia is undergoing significant health reform to warrant sustainable welfare provision. Privatization or public-private partnerships (PPPs) were introduced in 2021 and outlined the vision for the health system for 2023. The planned initiatives aim to be comprehensive and effectively reach individuals and society, including citizens, noncitizens, and visitors. This dissertation seeks to study and explore privatization, the role of healthcare providers, and their capacity to adapt to the transformation of the healthcare system. To achieve this ambitious goal, several interrelated projects have been undertaken. The first project was a systematic review aimed at studying the …

Health Economics Perspective On Indonesian Telemedicine Platform Practices: A Qualitative Study, Yossico Ria Wibowo, Rina Djunita Pasaribu

Kesmas

Telemedicine in Indonesia has experienced significant growth since its introduction in 2014. The financing system is regulated independently by each platform, leading to disparities in teleconsultation fees and medical incentives. This qualitative study, which involved a literature review and interviews with 33 participants, offered a health economics perspective on the implementation of telemedicine. The recommended teleconsultation fee ranges from USD 0.05 to USD 2.54, with medical incentives set at USD 1,59-3.18 for general practitioners and USD 4.77-6.36 for specialists, using telephone or video calls as the preferred means of teleconsultation. Although most patients and Indonesian Medical Association administrators generally agreed …

Dosimetric Effects Of Pinnacle³ Version 18.0 Advanced Auto-Planning Settings In Oropharyngeal Vmat Optimization, Emily Sanden

Masters Projects

This study evaluated the impact of Pinnacle³ version 18.0 auto-planning advanced settings modulation amount, monitor unit (MU) level, and dose fall-off priority on volumetric modulated arc therapy (VMAT) plan quality for bilateral oropharyngeal cancer. A total of 64 plans were generated using all possible combinations of low, medium, high, and very high settings for each parameter. A standardized base of tongue case was optimized once per plan using a single-time point approach, with planned target volume 1 (PTV1) (6996 cGy) and planned target volume 2 (PTV2) (5412 cGy) coverage evaluated. Each parotid gland, the spinal cord, brainstem, and the oral …

Achieving Equity For International Medical Graduates: A Systematic Review, Sangeeta G. Saxena, Elizabeth Tisdell, Elana Farace, Thomas Godfrey, Betsy Aumiller, Esther Dell, Omrana P. Razzak, Bernadette N. Kumar, Kristin K. Sznajder

Public Health

Introduction: Foreign-born and foreign trained International Medical Graduates (FIMGs) face greater challenges in acculturation to their host countries than IMGs who train abroad and return to practice in their home country. As FIMGs are likely to fulfill a shortage of physicians in High Income Countries in the foreseeable future, we conducted a systematic review of literature to identify acculturation interventions that help FIMGs assimilate better in their host country health systems. This improves their productivity and satisfaction, allows health systems to be more accepting of FIMGs, and most importantly, enhances patient outcomes.

Methods: Following the PRISMA statement, we searched PubMed, …

New Patient Onboarding, Jennifer Fournier, Sarah Flagg, Alletta Roberts Dzik, Lyndsay Stevens, Shannon Smith, Karen Waterhouse

Operations Transformation

Currently there are barriers to establish a new patient with a primary care. The workflow for patients who self-refer currently requires 10 steps and is performed by 7 care team members.

• 4 PSR at the front desk complete paper intake forms that are then manually entered into a spreadsheet by 3 other care team members.

The step in the workflow, to obtain the release of information for patient records to be requested and submit the form, is inconsistently followed internally and externally and results in very long process time of 40+ days. This step is frequently overlooked due to the …

Visualisasi Data Dalam Pencegahan Dan Pengendalian Infeksi: Otomasi Data Komite Ppi Rumah Sakit Universitas Indonesia Tahun 2024, Clarissa T. Firjatullah, Kemal N. Siregar, Dara A. Wardhani

Jurnal Biostatistik, Kependudukan, dan Informatika Kesehatan

Health Care Associated Infections (HAIs), salah satu masalah kesehatan yang dapat meningkatkan morbiditas dan mortalitas pasien yang dirawat. Di Asia Tenggara, prevalensi HAIs mencapai 21,6% dengan Indonesia sebagai negara dengan prevalensi tertinggi, yaitu 30,4%. Pencegahan dilakukan melalui surveilans HAIs oleh Komite Pencegahan dan Pengendalian Infeksi (PPI). Tujuan dari studi ini adalah menghasilkan analisis sederhana secara grafis dengan visualisasi data melalui dashboard data infeksi HAIs, NSI, dan audit penerapan PPI di RS UI tahun 2024. Data yang digunakan dari database Komite PPI RS UI adalah kasus Phlebitis, CLABSI, CAUTI, VAP, HAP, SSI, NSI, audit hand hygiene dan penggunaan APD, audit bundles …

Enhancing Medication Communication In The Acute Care Setting To Strengthen Patient Comprehension And Retention, Ashleigh C. Christensen

Student Scholarly Projects

Practice Problem: Research has shown that breakdowns in communication, especially in the context of medication education, play a critical role in the delivery of safe and effective patient care. These findings underscore the need to prioritize effective communication in medication education. In the acute care setting, effective communication is essential for ensuring patient safety, adherence, and improved patient-centered outcomes.

PICOT: In clinical staff providing direct patient care in the acute care setting (P), does the implementation of the evidence-based teach-back method (I), as compared to current practice (C), improve patient knowledge, understanding, and self-management upon discharge (O), over ten weeks …

Implementation Of Artificial Intelligence For Scribing In An Outpatient Mental Health Clinic, Elissa A. Moore

Student Scholarly Projects

Practice Problem: Traditional documentation practices place a significant burden on psychiatric mental health nurse practitioners (PMHNP) in outpatient mental health clinics (MHC), contributing to provider burnout and negatively impacting the patient-provider relationship. Preserving practicing PMHNPs is essential across the United States, but imperative in medically underserved areas where mental health services are limited.

PICOT: In PMHNPs (Population), does the use of AI scribing software (Intervention) compared to traditional documentation methods (Comparison) reduce documentation time and increase provider satisfaction (Outcome) over a ten-week period (Time)?

Evidence: This Doctor of Nursing Practice (DNP) scholarly project was informed by evidence obtained from 15 …

A Cancer Education Needs Assessment: Informing Middle-Aged Female Patients About The Relationships Between Obesity And Women’S Health Concerns In The Reproductive System, Breast, And Endometrial Health, Batul Mirza

MUSC Theses and Dissertations

Obesity significantly impacts women’s health, particularly among middle-aged women, by increasing the risk of hormone-sensitive cancers such as breast, endometrial, and reproductive system cancers. This study examines the educational needs of this demographic group regarding obesity-related cancer risks and explores effective intervention strategies. Obesity-induced mechanisms – hormonal imbalances, chronic inflammation, and insulin resistance – drive cancer susceptibility, emphasizing the need for targeted health education. The study employs a qualitative design, which includes interviews with subject matter experts (SMEs) and surveys of middle-aged women. The goal is to assess awareness, perceived barriers, and preferred learning methods. Findings suggest that with many …

Case Report: Solitary Adrenal Metastasis From Esophageal Adenocarcinoma, Riddhi Machchhar, Ahmed Dawood Al Mahrizi, Fatima Mossolem, Mariam Abdeen, Ujjwala Jain, Jyotibala Jain, Prashant Desai

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Solitary adrenal metastasis from a primary esophageal malignancy is relatively rare. While there are case reports of aggressive treatment with esophagectomy and adrenalectomy providing long-term survival, the treatment paradigm is not well defined. Complications from esophageal adenocarcinoma and its treatment can significantly impact the patient's quality of life and prognosis.

CASE PRESENTATION: Our patient was treated with systemic therapy and, although he initially had a complete response, he later experienced local disease progression along with the development of additional metastatic sites. The patient began FOLFOX, a standard chemotherapy regimen for esophageal/gastric cancer. He experienced side effects such as fever, …

Public Sector Employment In Mountain West Cities, 2019, Olivia K. Cheche, William E. Brown Jr.

Economic Development & Workforce

This fact sheet presents data on public sector employment in 16 cities within the Mountain West states of Arizona, Colorado, Nevada, and New Mexico. The Urban Institute’s “Public Sector Employment and Its Role in Local Economic Development” report provides data on publicly driven jobs in the 100 largest U.S. cities as of 2019. This fact sheet focuses on city-level data from the largest cities in the Mountain West.

Care Coordination In Pediatric Primary Care, Alyssa K. Durzo

Dissertations

No central documentation of care plans exists for children with special healthcare needs (CSHCN) in the electronic health record (EHR). Providers of a large pediatric primary care office in St. Louis Missouri were asked to identify CSHCN in the practice. Clinic nurses completed a comprehensive chart review of the patients identified and constructed care coordination documents using a pre-established smart-text phrase. Subsequently, these were documented centrally in the EHR under the Problem List.

Likert score data was obtained from providers on the acceptability, appropriateness, and feasibility of the intervention through the verified tools: Acceptability of Intervention Measure (AIM), Intervention Appropriateness …

Patient Information Needs During Ambulatory Medication Changes: A Qualitative Study, Elaine Giletta, Vanessa B. Hurley, Yushi Yang, Jessica L. Schwartz, Rabia Jalalzai, Nicole L. Mollenkopf, Raquel Mayne, Samantha I. Pitts

Journal of Patient-Centered Research and Reviews

Purpose: We performed interviews with patients and caregivers to explore whole-person, whole-regimen information needs at times of routine outpatient medication changes. We categorized information needs in this relatively unstudied context and identified which needs were commonly recognized as insufficiently met.

Methods: We explored the content of the semi-structured interviews, which involved nine patients and two caregivers of pediatric patients, all of whom experienced a recent medication change in the outpatient setting of a large urban academic healthcare system. We used inductive thematic analysis to organize information needs into categories to identify key information gaps.

Results: We identified five categories of …

Educating Healthcare Providers To Prevent And Mitigate The Effects Of Zoom Fatigue, Andrea Lima

Doctor of Nursing Practice Scholarly Projects

Zoom Fatigue (ZF), or physical and neuropsychological responses to excessive videoconferencing (VC), increased during the COVID-19 pandemic. Like burnout, ZF can compromise patient safety by causing decreased job satisfaction, social isolation, disrupted focus, and difficulty empathizing with patients. This Plan-Do-Study-Act quality improvement project aimed to assess feelings about VC, raise awareness of the adverse effects of overuse, and empower primary care providers (PCPs) to improve their work experiences. A group of on-site PCPs at a tertiary care medical center in the Southwest, who continued holding exclusive virtual team meetings after the pandemic, was asked to complete the 15-question Zoom Exhaustion …

Impact Of Race On Admission, Clinical Outcomes, And Disposition In Cholangiocarcinoma: Insights From The National Inpatient Database, Tijin A. Mathew, Teresa M. Varghese, Nithya Krishnakumaran, George M. Varghese, Khwaja S. Haq, Akshita Khosla, Rojymon Jacob, Gina Vaccaro

School of Medicine Faculty Publications

BACKGROUND: Cholangiocarcinoma, malignancies arising from the intrahepatic and extrahepatic bile ducts, has increased in incidence in the United States over the past few decades. The reported incidence of cholangiocarcinomas is high, particularly in specific racial groups such as Asian and Pacific Islander patients. Race also significantly impacts disparities in healthcare utilization and clinical outcomes. Our study focused on the impact of race on admission, clinical outcomes, and disposition of cholangiocarcinoma. METHODS: We performed a retrospective analysis of cholangiocarcinoma-related hospital admissions, using the National Inpatient Sample for the year 2022. Patients were stratified according to race into the following groups: White, …

Evaluation Of The Feasibility And Effectiveness Of Trauma-Focused Cognitive Behavioural Therapy For Children And Youth In Ukraine During The War, Elisa Pfeiffer, Maike Garbade, Renee Beer, Anette Birgersson, Natalie Cabrera, Judith A Cohen, Esther Deblinger, Rafaela Gjini, Veronica Kirsch, Zlatina Kostova, Michael Larsson, Anthony Mannarino, Gavin Moffitt, Marja Onsjö, Tale Ostensjo, Anna Vikgren, Hanna Weyler, Vitalii Klymchuk, Cedric Sachser

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: The large-scale Russian invasion of Ukraine in early 2022 resulted in a humanitarian crisis with hundreds of thousands of children exposed to traumatic events. To date, trauma-focused evidence-based treatments (EBTs) for children and youth have not been systematically evaluated and implemented in Ukraine. This study aims at evaluating 1) the feasibility of a training program for Ukrainian therapists on Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and 2) the feasibility and effectiveness of the treatment for children, youth, and their families in and from Ukraine during the ongoing war.

METHODS: The project "TF-CBT Ukraine" was implemented between March 2022 and May …

Implementing A Team-Based Approach To Reduce Blood Culture Contamination Rates In The Emergency Department: A Quality Improvement Initiative, Melissa Lockhart

Doctor of Nursing Practice Projects

Background: Blood culture contaminations (BCC) present significant risks to patients, including adverse drug reactions and the exacerbation of antibiotic resistance. BCC can also result in millions of dollars in financial burdens for hospitals due to the need for follow-up testing, treatment complications, and antibiotic stewardship efforts. At this facility, the contamination rate in the emergency department (ED) consistently exceeds the national benchmark of 3%. Contributing factors include high patient turnover and increased nursing workloads, which can lead to shortcuts in essential practices such as hand hygiene and skin disinfection before collection.

Purpose: This project aimed to evaluate whether implementing a …

Unsuitable Underlying Cause-Of-Death Statements: Implementation And Evaluation Of A Structured Process For Healthcare Providers Certifying Natural Causes Of Death In An Outpatient Setting, Naida Rutherford

Doctor of Nursing Practice Projects

Background: Accuracy in death certification is crucial for effective public health initiatives. Inaccuracies in unsuitable Underlying Cause-of-Death (UCOD) statements can distort mortality statistics, influence health policy, and impact resource allocation. In South Carolina, changes in the death registration process and the introduction of an unsuitable cause-of-death list highlighted an urgent need for structured training among certifiers to enhance accuracy in death documentation.

Purpose: The purpose of this project was to implement a standardized training program for healthcare providers certifying natural causes of death and assessing the impact of reducing the unsuitable underlying cause-of-death inaccuracies in an outpatient hospice setting.

Project …

Increasing Colorectal Cancer Screening Rates For Patients Without Insurance, Andrea F. Day

Doctor of Nursing Practice Projects

Background: Colorectal cancer is a leading cause of cancer-related death in the United States (U.S.), ranking as second most prevalent overall. Despite many initiatives, screening rates remain low, especially among clinic patients without insurance. The lack of an evidence-based screening protocol exacerbates these issues and increases the risk of advanced cancer and death. Initial data showed that 0% of patients were screened according to recommended guidelines.

Purpose: The project implemented a standard screening protocol to increase colorectal cancer screening rates in a rural Alabama free clinic for patients ages 45-64 lacking insurance.

Project Design: This quality improvement …

Reporting And Tracking Of Occupational Bloodborne Pathogen Exposures, Olivia Smith

Doctor of Nursing Practice Final Project Abstract

Purpose/Background: Underreporting of occupational bloodborne pathogen (BBP) exposures remains a significant patient and employee safety issue. At UT Health, outdated paper-based systems hindered accurate tracking, timely follow-up, and reporting compliance. The aim of this quality improvement (QI) project was to achieve a 30% increase in quarterly BBP exposure reports, from 30 to 39, by implementing an electronic reporting system between January 1 and March 31, 2025.

Methodology: Guided by the Health Belief Model and using the Implementation and Improvement Science (IIS) Framework, the project replaced the existing paper form with an external, user-friendly digital system. Staff received structured training, and …

July 2025, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

YOGA classes coming

SUMMER SELF-CARE IDEAS

In honor of Parks and Recreation Month

SWOSU has earned the Oklahoma Certified Healthy Campus Certificate

SWOSU Pool Hours

Extubation Decisions With Predictive Information For Mechanically Ventilated Patients In Icu, Guang Cheng, Jingui Xie, Zhichao Zheng, Haidong Luo, Oon Cheong Ooi

Research Collection Lee Kong Chian School Of Business

Weaning patients from mechanical ventilators is a crucial decision in intensive care units (ICUs), significantly affecting patient outcomes and the throughput of ICUs. This study aims to improve the current extubation protocols by incorporating predictive information on patient health conditions. We develop a discrete-time, finite-horizon Markov decision process with predictions of future state to support extubation decisions. We characterize the structure of the optimal policy and provide important insights into how predictive information can lead to different decision protocols. We demonstrate that adding predictive information is always beneficial, even if physicians place excessive trust in the predictions, as long as …

Care Alert Program In Chronic Emergency Department Using Patients: Expanded Study, Jonathan Leggett, Kaitlyn Phelps, David Nuñez, Brent Wright, Erica Gibbons, Jonathan Bryan, Brian Griggs

HCA Healthcare Journal of Medicine

Introduction

The Care Alert Program (CAP) is designed to help navigate encounters with patients who are high utilizers of Emergency Department (ED) resources. The CAP intends to address the needs of this challenging patient population by designing individualized care plans that are approved by a multidisciplinary committee. The patient populations that frequently use ED resources often have chronic medical conditions, a poor understanding of their conditions, unrealistic expectations regarding treatment, a lack of outpatient resources, and present with multiple complaints when using ED resources.

Methods

The CAP was adopted by our facility in the spring of 2020. The present study …

Age-Friendly Care And Mobility In Hospitalized Older Adults With Cognitive Impairment: A Feasibility Quality Improvement Initiative, Jasmine K. Vickers, Richard E. Kennedy, Shari Harrell, David H. James, Katrina Booth, Emily Simmons, Cynthia J. Brown, Kellie L. Flood

School of Medicine Faculty Publications

BACKGROUND: Hospitalized older adults with cognitive impairment (CI) have an increased risk for adverse outcomes. Acute Care for Elders (ACE) Units were developed to reduce functional decline in hospitalized older adults. INTERVENTION: We developed a quality improvement (QI) initiative to disseminate ACE care processes to non-ACE units, converting them into "Virtual ACE" units. The aim of this evaluation is to examine the impact of this intervention on the mobilization of patients with CI. POPULATION: Older adults with CI admitted to a study unit (ACE Unit or seven Virtual ACE units). METHODS: We conducted a pre/post-intervention evaluation of the proportion of …

Implementation Of Patient Safety Incident Reporting Using Web-Based Quality Management Information System In Hospital X Tangerang, Andrew Jeremia, Mardiati Nadjib

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Patient safety incident reporting is a critical component of hospital quality systems. This study evaluated the implementation of a Quality Management Information System (QMIS) for incident reporting at Hospital X using the Structure–Process–Outcome (SPO) framework integrated with the HOT-Fit model. A mixed-methods case study was conducted, combining analysis of 774 incident reports submitted between March 2023 and December 2024 with in-depth interviews involving clinical staff, unit heads, and the Quality and Risk (QR) Manager. Findings revealed that while structural elements such as computing infrastructure and leadership support were in place, gaps remained in staff training, procedural awareness, and system usability. …

Analisis Implementasi Program Promosi Kesehatan Di Rumah Sakit Umum Daerah Reda Bolo Kabupaten Sumba Barat Daya, Bewa Dangu Wole, Didik Hadi Santosa

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The provision of healthcare services is increasingly focused on health promotion, maintenance, and protection, rather than solely on disease recovery or treatment. However, in practice, many hospitals still emphasize curative and rehabilitative services due to the suboptimal implementation of Hospital Health Promotion (PKRS). This study aims to analyze the implementation of the PKRS program at Reda Bolo Regional Public Hospital (RSUD) in Southwest Sumba Regency, based on three standards: policy, assessment, and intervention. The study was conducted from February to March 2025 using a descriptive qualitative approach to examine and analyze the implementation of the PKRS program. Data were collected …

Transforming Primary Care: Innovative Post Graduate Pa Training For Real-World Solutions, Kenneth Botelho, James Ali

Lynchburg Journal of Medical Science

The ongoing crisis in primary care demands innovative and scalable strategies to prepare and retain advanced practice providers. This article introduces the Primary Care Practitioner (PCP) Program, a conceptual postgraduate training model designed for certified physician associates/assistants (PAs) who aim to serve in underserved and rural communities. The program integrates advanced clinical training, leadership development, telehealth competencies, VR-enhanced simulation, and evidence-based strategies to promote provider resilience. Rooted in systems-based thinking and real-world applicability, the PCP Program culminates in capstone projects that encourage innovation in care delivery and population health.

Aligned with national frameworks such as the HRSA Primary Care Training …

Peran Unit Pengelola Darah Rumah Sakit Terhadap Peningkatan Kinerja Layanan Transfusi Darah: Tinjauan Literatur Naratif, Adhika Putra Marsaban, Mardiati Nadjib

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

The performance of hospital blood transfusion services is crucial for patient safety and overall operational effectiveness. Blood management, as a vital and limited resource, plays a significant role. Traditional centralized blood management models often face challenges regarding response speed, potential waste, and quality control. As an alternative, Unit Pengelola Darah Rumah Sakit (UPDRS) offers the potential for performance enhancement. This narrative literature review is based on 16 relevant scientific articles identified through a database search (Scopus, Proquest, Wiley, Google Scholar) and a selection process visualized with a PRISMA diagram. Key findings identified significant impacts on cost efficiency, time efficiency (faster …

Retrospective Study Of Elective Intracranial Tumor Surgery Waiting Time At A National Referral Hospital In Indonesia, Sayyid Abdil Hakam Perkasa, Habibah Nurul Rahmah, Abrar Arham

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Elective surgery waiting times are a key measure of healthcare system performance and service quality. Long wait times can lower patients’ quality of life, worsen symptoms, reduce treatment effectiveness, and increase financial stress. We aimed to provide a descriptive analysis of elective surgery waiting time for Intracranial Tumors at Mahar Mardjono National Brain Center Hospital in 2023. This study is a descriptive retrospective cross-sectional study using data from Electronic Health Records (EHR). The study sample included all elective intracranial tumor surgeries performed in 2023. A total of 371 elective intracranial tumor surgeries were analyzed. The median age of patients was …