Thesis (MTech (Business Administration))--Cape Technikon, Cape Town, 2000 / The current rationalisation of health care in the Western Cape may result in a decrease in the number of patients attending the Trauma Unit at Groote Schuur Hospital (GSH), one of the two large tertiary care hospitals in the Western Cape. This in turn may result in cuts in staff allocations to this unit. The nursing staff need to be proactive in preventing potential cuts which may compromise the services that they offer. Current statistics collected by nursing managers in the trauma unit at GSH provide an indication of the volume of work handled, but do not necessarily capture the intensity of that work. The purpose of this research project will determine the extent to which nursing care required by patients attending the trauma unit at GSH has increased and to establish appropriate staff workload scheduling. The existing classification systems available for assessing patient acuity levels are no longer suitable as they use patient numbers to describe workload. By using a classification system specifically developed for the use by nurse managers in high care units (trauma units), the appropriate staffing norms based on the acuity level of patients can be determined. Finally, this research project will determine a suitable model for measuring the intensity of workload specific to a trauma unit environment for the effective and efficient allocation of staff.

The emergency department of Lions Gate Hospital was studied both in regard to the patients' current visit to this facility and in regard to the patients' other sources of ambulatory medical care. The objectives of the study were: (1) to understand why patients seek care at Lions Gate's emergency department; (2) to discover how this facility fits into the patients' overall patterns of medical care; and (3) on the basis of the above data, to propose any appropriate changes in the organization of the emergency department. The study was conducted during 14 days in September, 1974; the sampling frame covered all hours of the day and all days of the week. Data were gathered by questionnaires administered in the emergency department, with 85.60 percent of the sample responding. The increase in demand for emergency department services has been attributed to a variety of factors. The present study determined that private physicians and their non-availability are the predominant factors contributing to emergency department usage at Lions Gate Hospital, indicating that this facility is substituting for the wider primary care system. Data pertaining to the patients' overall patterns of medical care provided further evidence that the emergency department has gained wide acceptance by the patients as a source of primary medical care. Moreover, the emergency department was identified as an important and continuing source of care in the medical care patterns of many of its patients. As a result of the above findings, it was recommended that future plans for either the modification or expansion of Lions Gate's emergency department should include the establishment within the department of a walk-in ambulatory clinic. The proposed ambulatory care department, consisting of an emergency centre and primary care clinic, would assist Lions Gate Hospital to fit its services to the medical care needs which its patients exhibit. / Business, Sauder School of / Graduate

The rapid and accelerating growth of hospital Emergency Department utilization over the past twenty years has transformed a once well-defined and well bounded care setting into a highly complex and integral component of a total health care system. This increasing role complexity has created a demand by hospital decision-makers for an information system to describe, measure and evaluate Emergency Department activity within the context of broader health care issues and activities. This study is an attempt to identify and integrate the information needs of the hospital decision-makers into a meaningful whole. The evolution of emergency care in British Columbia is described in order that needs for information will not be developed in isolation from the activities of major planning, funding and professional groups in the health services. Two major issues are identified in the literature - the utilization of Emergency Departments and thrusts towards classification or categorization of Emergency Department capabilities. From this, three major policy/planning foci are selected - day to day emergency care, disaster planning, and the "mopping-up" role of Emergency Departments. Ideas about these are developed in light of six classifications of information users' needs - patient care, management, quality of care, strategic planning, research and development and policy-formulation. "Needs" were validated by two panels of major decision-makers from a representative sample of Greater Vancouver Regional Hospital District Hospitals. The results of the investigation are analyzed in light of the issues of professional power and control and political influences and recommendations made as to the appropriate components of a hospital emergency department information system. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

No description available.

Yes / The resilience of systems derives from many inputs, relating both to design and to operational planning. In the latter context the role and effective functioning of the ‘blue light’ emergency services is often critical. The judgements and decisions that have to be made are complex and time-constrained, often undertaken before all the critical information that might be wanted is available. Recent developments in decision research, notably the on-going dual process debate, suggest that the process of decision making adopted is often more complex than had previously been appreciated and strongly linked to both context and individual factors, notably expertise. In the light of such developments, this paper presents an empirical study of emergency responders working in realistic, non-laboratory conditions. It argues that recent moves to recognise the need to support, through the way in which information is provided, more intuitive as well as analytic modes of thinking in decision support are timely and that an important research agenda exists linking decision support design with a fuller understanding of exactly how individuals make their decisions in emergency conditions. / This research was funded by ESRC and 1Spatial, a Cambridge-based software company specialising in high volume, business critical data.

Emergency services has a vital function in society, and except saving lifes a functioning emergency service system provides the inhabitants of any give society with a sence of feeling secure. Because of the delicate nature of the services provided there is always an interest in improvement with regards to the performance of the system. In order to have a good system there are a variety of models that can be used as decision making support. An important component in many of these models are the travel time of an emergency vehicle. In In this study the focus lies in travel time estimation for the emergency services and how it could be estimated by using a neural network, called a deep learning process in this report. The data used in the report is map matched GPS points that have been collected by the emergency services in two counties in Sweden, Östergötland and Västergötland. The map matched data has then been matched with NVDB, which is the the national road database, adding an extra layer of information, such as roadlink geometry, number of roundabouts etc. To find the most important features to use as input in the developed model a Pearson and Spearman correlation test was performed. Even if these two tests do not capture all possible relations between features they still give an indication of what features that can be included. The deep learning process developed within this study uses route length, average weighted speed limit, resource category, and road width. It is trained with 75% of the data leaving the remaining 25% for testing of the model. The DLP gives a mean absolute error of 51.39 when trained and 59.21 seconds when presented with new data. This in comparison a simpler model which calculates the travel time by dividing the route length with the weighted averag speed limt, which gives a mean absolute error of 227.48 seconds. According to the error metrics used in order to evaluate the models the DLP performs better than the current model. However there is a dimension of complexity with the DLP which makes it sort of a black box where something goes in and out comes an estimated travel time. If the aim is to have a more comprehensive model, then the current model has its benefits over a DLP. However the potential that lies in using a DLP is entruiging, and with a more in depth analysis of features and how to classify these in combination with more data there may be room for developing more complex DLPs.

A rapidez na realização do atendimento às vítimas é uma das maiores necessidades de serviços de atendimento médico de urgência, e o tempo decorrido entre o instante da ocorrência da solicitação pelo serviço e o início do atendimento, denominado tempo de resposta, é um dos principais fatores que influenciam o desempenho do sistema. Este tempo depende de uma reunião de fatores como condições de tráfego, dia e período do dia, número de veículos disponíveis e suas localizações, capacitação profissional da equipe, etc. Apresenta-se neste trabalho uma análise do desempenho do serviço oferecido na cidade de Campinas-SP, tratando o problema por meio do modelo hipercubo de filas, que considera as variações aleatórias dos processos de chegadas e atendimento dos chamados. Sua aplicação produz uma ampla variedade de indicadores de desempenho para o sistema, que são comparados com os valores reais observados, para validar a hipótese de aplicação do modelo. Os resultados de sua aplicação para configurações operacionais alternativas, tais como descentralização e aumento do número de ambulâncias, mostraram uma elevação significativa do nível de serviço oferecido ao usuário. Conclui-se que o modelo constitui uma importante ferramenta de análise para este tipo de sistema, auxiliando na tomada de decisões estratégicas e operacionais do sistema. / One of the major concerns of medical emergency systems is to provide the fastest possible medical attention for the victims. The time elapsed between the emergency call and the assistance, called the response time, is one of the main factors that influence the system\'s performance. This time lapse depends on traffic conditions, the day of the week and time of day, the number of available vehicles and their location, the rescue team\'s professional qualifications, etc. This work consists of an analysis of the performance of the emergency service available in Campinas, SP, and deals with the problem using the hypercube queuing model, which considers stochastic variations of the arrival and assistance processes. The application of this model produces a wide variety of system performance indicators, which are compared with the real observed values to validate the model\'s hypothetical application. Application of the model in alternative operational scenarios, such as decentralization and a greater number of ambulances, showed a significant increase in the quality of the service offered to the user. It was concluded that the model constitutes an important analytical tool for this type of system, serving as an aid for strategic and operational decision-making.

A rapidez na realização do atendimento às vítimas é uma das maiores necessidades de serviços de atendimento médico de urgência, e o tempo decorrido entre o instante da ocorrência da solicitação pelo serviço e o início do atendimento, denominado tempo de resposta, é um dos principais fatores que influenciam o desempenho do sistema. Este tempo depende de uma reunião de fatores como condições de tráfego, dia e período do dia, número de veículos disponíveis e suas localizações, capacitação profissional da equipe, etc. Apresenta-se neste trabalho uma análise do desempenho do serviço oferecido na cidade de Campinas-SP, tratando o problema por meio do modelo hipercubo de filas, que considera as variações aleatórias dos processos de chegadas e atendimento dos chamados. Sua aplicação produz uma ampla variedade de indicadores de desempenho para o sistema, que são comparados com os valores reais observados, para validar a hipótese de aplicação do modelo. Os resultados de sua aplicação para configurações operacionais alternativas, tais como descentralização e aumento do número de ambulâncias, mostraram uma elevação significativa do nível de serviço oferecido ao usuário. Conclui-se que o modelo constitui uma importante ferramenta de análise para este tipo de sistema, auxiliando na tomada de decisões estratégicas e operacionais do sistema. / One of the major concerns of medical emergency systems is to provide the fastest possible medical attention for the victims. The time elapsed between the emergency call and the assistance, called the response time, is one of the main factors that influence the system\'s performance. This time lapse depends on traffic conditions, the day of the week and time of day, the number of available vehicles and their location, the rescue team\'s professional qualifications, etc. This work consists of an analysis of the performance of the emergency service available in Campinas, SP, and deals with the problem using the hypercube queuing model, which considers stochastic variations of the arrival and assistance processes. The application of this model produces a wide variety of system performance indicators, which are compared with the real observed values to validate the model\'s hypothetical application. Application of the model in alternative operational scenarios, such as decentralization and a greater number of ambulances, showed a significant increase in the quality of the service offered to the user. It was concluded that the model constitutes an important analytical tool for this type of system, serving as an aid for strategic and operational decision-making.

Student Number : 9301997W - MSc thesis - School of Electrical and Information Engineering - Faculty of Engineering and the Built Environment / Emergency services are vital for the minimization of damage, injury and loss of life. These services are, by definition, a combination of telecommunications and information services, and are by nature, distributed. However, most current emergency services do not take advantage of emerging technology, and hence, are restricted in the functionality they offer. This project proposes the design a full information structure for an emergency call centre service, which can be offered as a service or application on any core network. As emergency services are distributed, and combine both telecommunications and information services, an appropriate design tool which caters for these issues, is the Reference Model for Open Distributed Processing (RM-ODP), which will be used in the design of the emergency service. In addition, OSA/Parlay Application Programming Interfaces (APIs) will be used for the application to access telecommunication network functionality. The enterprise viewpoint examines the design requirements and considerations for an emergency system, which is the first step in designing a service based on the RMODP guidelines. Secondly, the information viewpoint is defined, which identifies the information flows between the objects and classes defined in the enterprise viewpoint with the aid of robustness diagrams and high level message sequence charts. Next, the computational viewpoint of the emergency service describes the components that the service consists of and the interfaces through which they communicate, enabling distribution of the system to be visualized. In addition, the engineering and technology viewpoints are briefly touched upon. The RM-ODP proves to be a useful tool the design of this application. In addition, the use of OSA/Parlay APIs have also proved beneficial, enabling the application to run on any platform, irrespective of the level of functionality it already provides. The benefits that this design offers over conventional emergency services are allowing callers and emergency response personnel full access to the functionality of the service, despite any limitations on their telecommunications network, finding the location of a caller from a fixed or mobile phone, ease and speed of obtaining relevant emergency information, and the ease and speed of sending relevant information to emergency response personnel. Finally we recommend improvements in the reliability and accuracy of finding the location of mobile phones, as well as creating ways of identifying the location of VoIP users.

The purpose of this study is to gain information about the social service needs and demographic characteristics of patients admitted to Providence Hospital's emergency room during the hours a social worker is not available. The emergency room staff requested the information in order to utilize it in planning emergency room services