► We propose an integrated framework for supporting healthcare operations management. ► The framework is used to analyze patient flow through an emergency department. ► Increasing medical staffing or ...trolley numbers is costly and has limited impact. ► Enforcing boarding limit has greater impact on the performance at every stage. ► Healthcare managers can identify low-cost yet effective strategies by simulation.
The global economic crisis has a significant impact on healthcare resource provision worldwide. The management of limited healthcare resources is further challenged by the high level of uncertainty in demand, which can lead to unbalanced utilization of the available resources and a potential deterioration of patient satisfaction in terms of longer waiting times and perceived reduced quality of services. Therefore, healthcare managers require timely and accurate tools to optimize resource utility in a complex and ever-changing patient care process. An interactive simulation-based decision support framework is presented in this paper for healthcare process improvement. Complexity and different levels of variability within the process are incorporated into the process modeling phase, followed by developing a simulation model to examine the impact of potential alternatives. As a performance management tool, balanced scorecard (BSC) is incorporated within the framework to support continual and sustainable improvement by using strategic-linked performance measures and actions. These actions are evaluated by the simulation model developed, whilst the trade-off between objectives, though somewhat conflicting, is analysed by a preference model. The preference model is designed in an interactive and iterative process considering decision makers preferences regarding the selected key performance indicators (KPIs). A detailed implementation of the framework is demonstrated on an emergency department (ED) of an adult teaching hospital in north Dublin, Ireland. The results show that the unblocking of ED outflows by in-patient bed management is more effective than increasing only the ED physical capacity or the ED workforce.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
With the public heightened emphasis on mitigating the occurrence risks of health-related ailment and optimizing personal physical performance, portable chemical sensing devices emerged as an ...indispensable component of pervasive health monitoring. Chemical sensing enabled the immediate and on-site identification of biomarkers in biological fluids by integrating colorimetry, fluorescence, electrochemical, and other methods into portable sensor devices. These sensor devices incorporated microneedles, hydrogels, microfluidic modules, and papers, facilitating conformal human-device contact and providing several visual sensing options for disease prevention and healthcare management. This review systematically overviewed recent advancements in chemical sensors for marker detection, categorizing them based on monitoring device types. Furthermore, we also offered recommendations and opportunities for developing portable chemical sensing devices by summarizing sensor integration methods and tracking sites on the human body.
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•This review overviewed recent advancements in chemical sensors based on monitoring device types.•The opportunities for developing portable chemical sensing devices were offered by summarizing sensor integration methods.•This review presented expertise in chemistry, materials science, computer science to develop portable chemical devices.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Lean thinking has recently re-emerged as a fashionable management philosophy, especially in public services. A prescriptive or mainstream literature suggests that lean is rapidly diffusing into ...public sector environments, providing a much-needed rethink of traditional ways of working and stimulating performance improvements. Our study of the introduction of lean in a large UK public sector hospital challenges this argument. Based on a three-year ethnographic study of how employees make sense of lean ‘adoption’, we describe a process in which lean ideas were initially championed, later diluted and ultimately eroded. While initially functioning as a ‘mechanism of hope’ (Brunsson, 2006) around which legitimacy could be generated for tackling longstanding work problems, over time both ‘sellers’ and ‘buyers’ of the concept mobilized lean in ambiguous ways, to the extent that the notion was rendered somewhat meaningless. Ultimately, our analysis rejects current prescriptive or managerialist discourses on lean while offering support for prior positions that would explain such management fashions in terms of the ‘life cycle of a fad’.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK, VSZLJ
Non-communicable diseases (NCDs) are of increasing concern for society and national governments, as well as globally due to their high mortality rate. The main risk factors of NCDs can be classified ...into the categories of self-management, genetic factors, environmental factors, factors of medical conditions, and socio-demographic factors. The main focus is on the elements of self-management and to reach a consensus about the influence of food on risk management and actions toward the prevention of NCDs at all stages of life. Nutrition interventions are essential in managing the risk of NCDs. As they are of the utmost importance, this review highlights NCDs and their risk factors and outlines several common prevention strategies. We foresee that the best prevention management strategy will include individual (lifestyle management), societal (awareness management), national (health policy decisions), and global (health strategy) elements, with target actions, such as multi-sectoral partnership, knowledge and information management, and innovations. The most effective preventative strategy is the one that leads to changes in lifestyle with respect to diet, physical activities, cessation of smoking, and the control of metabolic disorders.
The revolution in information technologies, and the spread of the Internet of Things (IoT) and smart city industrial systems, have fostered widespread use of smart systems. As a complex, 24/7 ...service, healthcare requires efficient and reliable follow-up on daily operations, service and resources. Cloud and edge computing are essential for smart and efficient healthcare systems in smart cities. Emergency departments (ED) are real-time systems with complex dynamic behavior, and they require tailored techniques to model, simulate and optimize system resources and service flow. ED issues are mainly due to resource shortage and resource assignment efficiency. In this paper, we propose a resource preservation net (RPN) framework using Petri net, integrated with custom cloud and edge computing suitable for ED systems. The proposed framework is designed to model non-consumable resources and is theoretically described and validated. RPN is applicable to a real-life scenario where key performance indicators such as patient length of stay (LoS), resource utilization rate and average patient waiting time are modeled and optimized. As the system must be reliable, efficient and secure, the use of cloud and edge computing is critical. The proposed framework is simulated, which highlights significant improvements in LoS, resource utilization and patient waiting time.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
•This paper surveys optimization studies on outpatient appointment systems.•A framework for strategic, tactical and operational decisions is presented.•The literature is also evaluated based on ...modeling approaches and solution methods.•Future research challenges and opportunities are provided.
Outpatient appointment scheduling problems have recently gained increasing attention. This paper provides a comprehensive review of recent analytical and numerical optimization studies that present decision-support tools for designing and planning outpatient appointment systems (OASs). A structure for organizing the recent literature according to various criteria is provided, including a framework that classifies decisions at the strategic, tactical, and operational levels. The OAS literature is evaluated from four perspectives: problem settings, environmental factors, modeling approaches, and solution methods. In addition, research gaps and areas of opportunity for future research are discussed.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Leadership, job satisfaction, organizational commitment and trust have become important processes for healthcare management in recent years. One of the contemporary human resource management ...functions in the organizations involves engaging in leadership development, improving organizational trust and organizational commitment and increasing job satisfaction. Considering the rapidly changing healthcare technology and higher levels of occupational complexity, healthcare organizations are increasingly in need of engaging in leadership development in any given area of expertise to address ever-changing nature of the industry and the delivery of quality of care while remaining cost-effective and competitive. This paper investigates the perceptions of both public servants and private sector employees (outsourcing) on transformational leadership, organizational commitment, organizational trust and job satisfaction in Turkish healthcare industry. Additionally, the paper analyzes the predictability of organizational commitment based on employee - both public servants (physicians, nurses, administrative personnel and other healthcare professionals) and private sector employees (outsourcing) (auxiliary services such as administrative assistants, security personnel, kitchen, laundry and housekeeping employees) - perceptions of transformational leadership, job satisfaction and organizational trust. Using a survey instrument with items adopted from the transformational leadership inventory (TLI) Podsakoff, P. M., MacKenzie, S. B., Moorman, R. H., & Fetter, R. (1990). Transformational leader behaviors and their effects on followers' trust in leader, satisfaction, and organizational citizenship behaviors. Leadership Quarterly, 1, 107-142, the organizational commitment questionnaire Meyer, J. P., & Allen, N. J. (1997). Commitment in the workplace: Theory, research, and application. Thousand Oaks, CA: Sage, the organizational trust inventory (OTI) Cummings, L. L., & Bromiley, P. (1996). The occupational trust inventory (OTI): Development and validation. In R. Kramer & T. Tyler (Eds.), Trust in organizations: Frontiers of Theory and Research (pp. 302-330). Thousand Oaks, CA: Sage and job satisfaction survey (JSS) Spector, P. E. (1985). Measurement of human service staff satisfaction: Development of the job satisfaction survey. American Journal of Community Psychology, 13, 693-731, this quantitative study was conducted among 2108 healthcare employees (public servants and private employees) in two large government hospitals in Turkey. The study findings indicate a significant difference between the public servants and private sector employees in terms of their perceptions on two dimensions of transformational leadership (being an appropriate model, providing individualized support), overall transformational leadership and one dimension of job satisfaction (communication). The two dimensions of job satisfaction - operating procedures and communication - as well as organizational trust were the significant predictors of organizational commitment of public servants, whereas the two dimensions of leadership - individualized support and fostering the acceptance - as well as the two dimensions of job satisfaction - promotion and contingent rewards - and organizational trust were the significant regressors of organizational commitment of private sector employees. In addition, there is a significant difference between the predictors of the dimensions of organizational commitment (transformational leadership, job satisfaction and organizational trust) in terms of public servants versus private sector employees. Finally, organizational trust has a significant effect on overall organizational commitment as well as its three dimensions for public servants and private employees.
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BFBNIB, IZUM, KILJ, NUK, PILJ, SAZU, UL, UM, UPUK
In order to extend the best-worst method (BWM) to uncertain circumstances, in this paper, we propose an intuitionistic fuzzy multiplicative best-worst method (IFMBWM) with intuitionistic fuzzy ...multiplicative preference relations (IFMPRs) for multi-criteria group decision making. First of all, we aggregate individual IFMPRs provided by the decision makers to a collective one by using the intuitionistic fuzzy multiplicative weighted geometric aggregation (IFMWGA) operator. Afterwards, we design an algorithm to rank the criteria according to the membership degrees of the intuitionistic fuzzy assessments, which can be used to identify the best and worst criteria by calculating the out-degrees and in-degrees of the directed network about the collective IFMPR. Furthermore, based on the new definition of the multiplicative consistent IFMPR, we develop several max-min programming models to derive the weights of criteria, and then propose a consistency ratio to check the reliability of the derived results. The procedure of the IFMBWM is provided for the convenience of practical applications. Finally, a numerical example concerning the evaluation of the severity of pulmonary emphysema is given to illustrate the proposed method.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Nowadays, the increasing attention paid to the dark side of social media (SM) in the field of healthcare management has moved both researchers and practitioners to investigate the impact of Web 2.0 ...technologies with reference to SM, because of continuous distortion created by these SM platforms for patients and the real dark side they constitute, which affects both the patient sphere and its relative empowerment.
Based on previous theoretical and managerial contributions, the paper aims to investigate both the bright and dark side of the effects of SM in the healthcare field, which affect improvements in patient empowerment. Notwithstanding, the exploratory study was developed through a common theoretical and conceptual framework to improve the understanding of emerging social and economic dynamics towards the paradigm provided by many studies on the dark side of Web 2.0.
So far, established on previous contributions to the healthcare management domain, the exploratory study identifies a set of variables related to the conceptualisations of patient empowerment and the dark side of SM, with reference to cases of digital users both with and without chronic illnesses.
Moving deeper, matching qualitative and quantitative approaches, the impact of the dark side of SM on patient empowerment was investigated using structural equation modelling through SPSS and R softwares, sampling about 650 individuals on the Italian population using computer-assisted web interviewing.
Finally, results highlight considerable correlations between many dimensions explaining patient empowerment and the dark side of SM, showing a positive effect on the improvement in patient engagement, but potential critical risks and concerns due to a misinterpretation of online information highlighting the dark side of SM.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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