Thesis (M.S.)--University of Michigan, 1982.

published_or_final_version / Community Medicine / Master / Master of Public Health

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Thesis (M.S.)--University of Wisconsin. School of Nursing, 1973. / eContent provider-neutral record in process. Description based on print version record.

This study attempts to improve the delivery of health services by applying operations research techniques to hospital admission systems. Although this study applies to hospital admissions systems in general, the admission system of one ward of one hospital was chosen to be the central object in the study. A computer simulation model was formulated to examine the -results of various policies. In the model, the admission of patients is determined primarily by the scheduling of the operating theatre and secondarily by the availability of beds. The three standard priorities for hospital admissions (elective, urgent and emergent) are given separate considerations as would be the case in real life; because scheduling can be much more flexible for elective patients, while time must be set aside for emergent patients although the hospital has no advance information about them. The general results of this study led to two suggestions that would improve most existing admission systems. The first requires that the hospital set up a special class of patients, the "quickcall patients," who would be willing to be admitted for surgery on short notice. It was shown that this procedure significantly reduced the waiting time for elective surgery. The second requires that the hospital limit each physician to a fixed number of requests for elective surgery at any given time, so that the hospital need not keep extensive files. The model could be extended to examine (1) the sensitivity of the schedule to referral patients, (2) the higher utilization of the operating theatre and (3) waiting priority based on patient need and/or utility. In conclusion the simulation study indicated that these policies if implemented would significantly reduce the waiting time (29% in the model), and increase the hospital's effectiveness in assessing the order of admission for patients. / Business, Sauder School of / Graduate

Thesis: M.S., Massachusetts Institute of Technology, Sloan School of Management, 1978 / Includes bibliographical references. / M.S. / M.S. Massachusetts Institute of Technology, Sloan School of Management

This thesis considers three physician scheduling problems in health care systems. Specifically, we focus on improvements to current physician scheduling practices through the use of mathematical modeling. In the first part of the thesis, we present a physician shift scheduling problem focusing on maximizing continuity of care (i.e., ensuring that patients are familiar with their treating physicians, and vice versa). We develop an objective scoring method for measuring the continuity of a physician schedule and combine it with a mixed integer programming model. We apply our methods to the problem faced in the pediatric intensive care unit at Children's Healthcare of Atlanta at Egleston, and show that our schedule generation approach outperforms manual methods for schedule construction, both with regards to solution time and continuity. The next topic presented in this thesis focuses on two scheduling problems: (i) the assignment of residents to rotations over a one-year period, and given that assignment, (ii) the scheduling of residents' night and weekend shifts. We present an integer programming model for the assignment of residents to rotations such that residents of the same type receive similar educational experiences. We allow for flexible input of parameters and varying groups of residents and rotations without needing to alter the model constraints. We present a simple model for scheduling 1st-year residents to night and weekend shifts. We apply these approaches to problems faced in the Department of Surgery Residency Program at Emory University School of Medicine. Rotation assignment is made more efficient through automated schedule generation, and the shift scheduling model allows us to highlight infeasibilities that occur when shift lengths exceed a certain value, and we discuss the impact of duty hour restrictions under limitations of current scheduling practices. The final topic of this thesis focuses on the assignment of physicians to various tasks while promoting equity of assignments and maximizing space utilization. We present an integer programming model to solve this problem, and we apply this model to the physician scheduling problem faced in the Department of Gynecology and Obstetrics at Emory University Hospital and generate high quality solutions very quickly.

Missed appointments by patients are a major problem for health care professionals. To combat this issue, some optometrists use a pre-appointing system in which patients are scheduled for an annual exam a year after their initial visit. Prior to that subsequent appointment, clinic staff often try to contact the patient to confirm the appointment. This study examined baseline levels of appointment keeping, analyzed existing processes for pre-appointing patients, and introduced a revised process package to improve appointment keeping at an eye care clinic. This package included training, mailed postcard reminders and two phone call reminders. Results indicate appointment keeping by pre-appointed patients increased over baseline. The intervention was also shown to be cost-beneficial.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

Thesis (M.B.M. 1976) from the Department of Commerce, University of Adelaide.