Extraadrenal paragangliomas of the head and neck are tumors with variable clinical behavior. Because tumor growth as well surgery can cause disabling loss function, knowledge natural history is important for development treatment strategies.The volume, rate, doubling time 48 at different anatomic locations in region were estimated retrospectively using sequential radiologic imaging.During a mean follow-up period 4.2 years, volume increase > 20% was observed 60% paragangliomas. In these cases...

Purpose The purpose of this study is to reflect upon the ramifications two decades Lean Six Sigma implementations in Dutch healthcare institutions light current COVID-19 pandemic. Design/methodology/approach authors provide an evaluation impact that have had on ability respond adequately needs during crisis. Findings Process improvement has a tendency cut capacity and flexibility which are needed deal with excessive demand shocks, such as main reason for failure seems be overly strong focus...

The amount of available data is rapidly increasing, which an opportunity to the Lean Six Sigma (LSS) methodology. Starting off with a well-established definition LSS as theoretical foundations we employ theory-generating case-study research. Three successful improvement projects from large financial services firm in Netherlands are analyzed. Clear differences observed. research leads three recommendations for integrating science LSS. Concerning structure organization, skills employees and,...

In last-mile routing, the task of finding a route is often framed as Traveling Salesman Problem to minimize travel time and associated cost. However, solutions stemming from this approach do not match realized paths drivers deviate due navigational considerations preferences. To prescribe routes that incorporate tacit knowledge, data-driven model proposed aligns well with hierarchical structure delivery data wherein each stop belongs zone—a geographical area. First, on global level, zone...

ABSTRACT Appointment scheduling is generally applied in outpatient clinics and other healthcare services. The challenge to find a strategy for dealing with variability unpredictability service duration patient arrivals. consequences of an ineffective include long waiting times patients idle time the provider. In turn, these have implications perceived quality, cost‐efficiency, capacity generation optimal schedules notoriously intractable problem, earlier attempts at designing effective...

Appointment schedules, in essence, balance supply and demand are often employed settings where resources scarce thus a high utilization is realized (e.g., healthcare). Whereas most of the existing literature focuses on single-server case, framework developed to study appointment scheduling multiserver settings. Relying phase-type approximations, general service-time distributions modeled, which fed into recursive approach allowing evaluation optimization an objective function that balances...

When detailed product information is not available to consumers inferences are made using cues reduce uncertainty and form perceptions of products. Advertisers can make use sport sponsorship celebrity endorsement as extrinsic influence consumers\' pre-purchase attitudes. These expensive forms advertising. Managers need establish whether they provide a satisfactory return on investment. This study explored attitudes the effect event key brand/manufacturer related variables such brand quality,...

Over the last decade, various financial service providers have embraced a range of methods for improving their customer processes. A method that has proven to be great value structurally streams is Lean Six Sigma (LSS).

In statistical process monitoring, the CUSUM and EWMA control charts have received considerable attention because of their remarkable ability to detect small sustained shifts. practice, variation shifts are anticipated beforehand in many processes, so focus should be on detecting a moderate large shift. The aforementioned identify minor changes population parameters as out-of-control scenarios; thus, "small" potentially practically insignificant producing signals. To counteract this, both...

Click to increase image sizeClick decrease size Additional informationNotes on contributorsAlex KuiperAlex Kuiper obtained his master's degree in mathematics and econometrics from the University of Amsterdam 2013. Currently, he works for Institute Business Industrial Statistics as a Lean Six Sigma Consultant is Ph.D. student at Amsterdam. His current research interests include applied statistics stochastic optimization.Michiel van RaalteMichiel Raalte Black Belt owner Durapharm BV. He...

Abstract The operating rooms within the surgical unit take center stage in a hospital. fact that, practice, actual durations of surgery do not coincide with their allotted times yields extra costs; for example, earliness results unutilized room time, and lateness incurs waiting patients. Various machine learning methods are employed to predict data used stems from Shahid Chamran Trauma educational-medical hospital (Shiraz, Iran) 2018 until 2021. performances across four methods, linear...

The problem of finding the optimal appointment schedule has received significant consideration in literature on healthcare optimization. Due to randomness determining when clients should be scheduled order strike a balance terms idle times, waiting and overtime is non-trivial task. Furthermore, it often solely studied dimension scheduling, whereas sequencing decision which heterogeneous (e.g., new return clients) are arrive at least equal importance. approach presented integrates an...

Appointment schedules aim at achieving a proper balance between the conflicting interests of service provider and her clients: primary objective is to fully utilize available time, whereas clients want avoid excessive waiting times. Setting up that strike good severely complicated by fact clients' times are random. Because lack explicit expressions, one has often set relying on simulation techniques. In this paper, we take radically different approach: use newly developed analytical...

Problem definition:Traditionally, appointment schedules have been determined by minimizing a specific cost function consisting of clients' waiting times and server idling. Under stochastic service times, this intra-day problem is predominantly studied in static sense, assuming that schedule---after determined---is fixed. Technological advancements now enable real-time communication with clients during the day. Using such channels allows for updating on fly, example, postponing appointments...

BACKGROUND Extraadrenal paragangliomas of the head and neck are tumors with variable clinical behavior. Because tumor growth as well surgery can cause disabling loss function, knowledge natural history is important for development treatment strategies. METHODS The volume, rate, doubling time 48 at different anatomic locations in region were estimated retrospectively using sequential radiologic imaging. RESULTS During a mean follow-up period 4.2 years, volume increase > 20% was observed 60%...

In last-mile routing, the task of finding a route is often framed as Traveling Salesman Problem to minimize travel time and associated cost. However, solutions stemming from this approach do not match realized paths drivers deviate due navigational considerations preferences. To prescribe routes that incorporate tacit knowledge, data-driven model proposed aligns well with hierarchical structure delivery data wherein each stop belongs zone---a geographical area. First, on global level, zone...