Crisis-level overcrowding conditions in emergency departments (EDs) have led hospitals to seek out new patient-flow designs improve both responsiveness and safety. One approach that has attracted attention experimentation the medicine community is a system which ED beds care teams are segregated patients “streamed” based on predictions of whether they will be discharged or admitted hospital. In this paper, we use combination analytic simulation models determine such streaming policy can...

In recent years, Operations Research/Management (OR/OM) has had a significant impact on improving the performance of hospital Emergency Departments (EDs). This includes wide range processes involving patient flow from initial call to ED through disposition, discharge home, or admission hospital. We review approximately 350 related papers (i) demonstrate influence OR/OM in EDs, and (ii) assist both researchers practitioners with techniques already available optimize flow. addition, we...

Hospital emergency departments (EDs) typically use triage systems that classify and prioritize patients almost exclusively in terms of their need for timely care. Using a combination analytic simulation models, we demonstrate adding an up-front estimate patient complexity to conventional urgency-based classification can substantially improve both safety (by reducing the risk adverse events) operational efficiency shortening average length stay). Moreover, find EDs with high resource...

In this paper we propose a modified Fuzzy Technique for Order Performance by Similarity to Ideal Solution (modified TOPSIS) the Multi-criteria Decision Making (MCDM) problem when there is group of decision makers. Regarding value truth that fuzzy number greater than or equal another number, new distance measure proposed in paper. This calculates each from both Positive (FPIS) and negative (FNIS). Then, alternative which simultaneously closer FPIS farther FNIS will be selected as best choice....

This article develops a model and analysis to provide insight into two effective remedies increase supply chain resilience: (i) contracting with secondary flexible backup supplier; (ii) monitoring primary suppliers obtain disruption risk information. To investigate the true value of these strategies, an is performed under imperfect information concerning risks considering two-stage setting recourse. In this setting, firm first monitors its then utilizes recourse option subject limited...

Remanufacturing has created considerable benefits to both industry and community. This paper generates insights into the acquisition management production planning of a hybrid manufacturing/remanufacturing system. The quantity used products is stochastic sensitive price, uncertain quality acquired leads random yield in remanufacturing process. With such market-driven channel yield, it shown how pricing, remanufacturing, manufacturing decisions can be coordinated order maximize total expected...

Operations managers do not typically have full information about the demand distribution. Recognizing this, data-driven approaches been proposed in which manager has no beyond evolving history of observations. In practice, often some partial distribution addition to We consider a repeated newsvendor setting, and propose maximum-entropy based technique, termed Second Order Belief Maximum Entropy (SOBME), allows effectively combine observations with distributional form bounds on moments or...

Telemedical physician triage (TPT) is an example of a hierarchical knowledge-based service system (HKBSS) in which second level decision agent (telemedical physician) renders on cases referred to him or her by the primary agents (triage nurses). Managing speed-versus-quality trade-off such systems presents unique challenge because interplay between knowledge and flow work two levels. We develop novel model knowledge, based beta distribution, deploy it partially observable Markov process...

To increase resilience in supply chains, we investigate the optimal design of flexibility a backup system. We model dynamics disruptions as Markov and consider multiproduct, multisupplier chain under dynamic disruption risks. Using our model, first show that little system can go long way mitigating This raises an important fundamental question designing system: to achieve benefits full flexibility, which unreliable suppliers should be backed up? answer this question, connect various queueing...

Problem definition: Autonomous sensors connected through the internet of things (IoT) are deployed by different firms in same environment. The measure an important operating-condition state variable, but their measurements noisy, so estimates imperfect. Sensors can improve own soliciting from other sensors. choice which to communicate with (target) is challenging because (1) constrained number they target and (2) only have partial knowledge how operate—that is, do not know others’ underlying...

A main research goal in various studies is to use an observational data set and provide a new of counterfactual guidelines that can yield causal improvements. Dynamic Treatment Regimes (DTRs) are widely studied formalize this process enable researchers find both personalized dynamic. However, available methods finding optimal DTRs often rely on assumptions violated real-world applications (e.g., medical decision making or public policy), especially when (a) the existence unobserved...

Accounting for race and ethnicity in estimating disease risk may improve the accuracy of predictions but also encourage a racialized view medicine.

Background Most prior studies characterizing post-transplantation diabetes mellitus (PTDM) have been limited to single-cohort, single-organ studies. This retrospective study determined PTDM across organs by comparing incidence and risk factors among 346 liver 407 kidney transplant recipients from a single center. Methods Univariate multivariate regression-based analyses were conducted determine association of various in the two cohorts, as well differences glucometrics insulin use time...

In the past two decades, government and private organizations have ramped up efforts to measure publicly report clinical outcomes, a practice known as “public reporting.” For example, in 2005 Center for Medicare Medicaid Services launched website Hospital Compare with share outcome data. Other sites, including CalHospitalCompare.org , ProPublica Surgeon Scorecard, Hospitals site by Leapfrog Group, hospital-rating websites of Healthgrades, Consumer Reports, Yelp, U.S. News, provided similar...

Lockdown policies, such as stay-at-home orders, are known to be effective in controlling the spread of novel coronavirus disease 2019. However, concerns over economic burdens these policies rapidly propelled U.S. states move toward reopening early stage pandemic. Decision making most has been challenging, especially because a dearth quantitative evidence on health gains versus different policies. To assist decision makers, we study and impacts various lockdown across shed light that...

Effective treatment of bipolar disorder (BD) requires prompt response to mood episodes. Preliminary studies suggest that predictions based on passive sensor data from personal digital devices can accurately detect episodes (e.g., between routine care appointments), but date do not use methods designed for broad application. This study evaluated whether a novel, personalized machine learning approach, trained entirely Fitbit data, with limited filtering could symptomatology in BD patients. We...

Black Americans have lower wealth, income, and education higher mortality rates than White Americans, especially during childhood. To document the extent persistence of excess infant childhood in between 1950 2019. Population-based surveillance study. The United States America. entire population States. investigators analyzed data collected by Centers for Disease Control Prevention U.S. Census Bureau from to 2019 calculated rates, life expectancy, years potential lost estimate absolute...