Understanding the dynamic behavior of a workflow is crucial for being able to modify, maintain, and improve it. A particularly difficult aspect of some behavior is concurrency. Automated techniques ...which seek to mine workflow data logs to discover information about the workflows must be able to handle the concurrency that manifests itself in the workflow executions. This paper presents techniques to discover patterns of concurrent behavior from traces of workflow events. The techniques are based on a probabilistic analysis of the event traces. Using metrics for the number, frequency, and regularity of event occurrences, a determination is made of the likely concurrent behavior being manifested by the system. Discovering this behavior can help a workflow designer better understand and improve the work processes they are managing.
Complexity and Change in Nurse Workflows Vardaman, James M.; Cornell, Paul T.; Clancy, Thomas R.
The Journal of nursing administration,
02/2012, Letnik:
42, Številka:
2
Journal Article
Recenzirano
As systems evolve over time, their natural tendency is to become increasingly more complex. Studies in the field of complex systems have generated new perspectives on management in social ...organizations such as hospitals. Much of this research appears as a natural extension of the cross-disciplinary field of systems theory. This is the 20th in a series of articles applying complex systems science to the traditional management concepts of planning, organizing, directing, coordinating, and controlling. In this article, the authors discuss how nurse workflow is characteristic of complex adaptive systems and the need for caution when selecting a performance improvement method.
Morning blood sampling, conducted around 4am to 5am, is routinely ordered due to nothing-by-mouth (NPO) requirements and clinical practice norms. However, this routine may interrupt the normal sleep ...of patients and decrease the satisfaction of patients with the care received. However, our night-shift staff is not able to take all blood samples during this time, resulting in a high rate of overdue reporting.
To reduce the overdue rate of laboratory result from 62.3% to less than 19.3%.
In 2013, we performed interventions including the process reengineering of blood sampling to meet the needs of laboratory result flows and the upgrading of equipment in our neurology ward. The reengineering strategies used included the redistribution of blood sampling times in order to decrease testing for unnecessary items. The equipment upgrades improved the ability of the carrier in the pneumatic tube systems to carry the chilled blood samples. An independent two-sample t-test was used to compare the overdue rate before and a
In a recent article (Vieregge & Moseley, 2012), we reported the findings of an informal pilot survey we conducted at a meeting of the Michigan International Society for Performance Improvement (ISPI) ...chapter. The survey was intended to secure responses to a brief set of future‐focused questions from both the emerging and the seasoned talent who attended the meeting. Recently, we made the survey available for others in the human performance improvement (HPI) field to participate and offer their responses. In this article, we report the results in hopes that they will encourage continuing discussion about our future as HPI practitioners.
To describe business practice knowledge from the perspectives of nurse practitioners (NPs) who are practicing clinicians, academic instructors, and clinic managers.
Using the eight domains of ...business practice attitudes identified by the Medical Group Management Associations Body of Knowledge (MGMA), which are supported by the American Association of Colleges of Nursing (AACN), a study-specific survey was developed. Data, which describe the knowledge and attitudes with respect to business practices, were obtained from 370 participants.
Regardless of their job classification, these participants described (1) quality management, (2) risk management, and (3) patient care systems as critical business practice knowledge. Consensus was also achieved when ranking the content for business practice knowledge: (1) patient care systems, (2) business operation, and (3) financial management.
These data identify gaps in business practice knowledge and content that should be included in educational programs. Business practice knowledge is essential for a successful clinical practice and should be a professional practice skill for the NP.
Effective delivery of preventive services is an essential component of high-quality pediatric health care. However, both variation in and deviation from accepted guidelines have been reported. ...Learning collaboratives (LCs) have been shown to result in improvement in several aspects of pediatric care. The objective of this study was to determine whether pediatric practices that participated in a preventive services LC would improve their delivery of preventive services.
After conducting an initial audit of the medical records of twenty 2-year-olds and twenty 4-year-olds for documentation of preventive services on the basis of national standards, practice teams attended a quality improvement workshop. They were presented with evidence to support the value of preventive services and the results of their audits and taught quality improvement methods, eg, rapid cycles of change. Each team developed plans to improve 1 or more services. Brief audits with feedback and monthly conference calls were used to support practices to conduct rapid cycles of change, to discuss barriers and solutions, and to monitor progress. The results of final chart audits of twenty 2-year-olds and 4-year-olds were compared with the initial chart audits. A Preventive Service Score (PSS) was assigned to each practice on the basis of the number of services provided, and initial to final comparisons were made.
Fourteen practices participated. PSSs improved for all practices after the LC. Mean PSS for 2-year-olds increased from 4.0 +/- 1.1 to 4.9 +/- 1.2 and for 4-year-olds increased from 3.8 +/- 1.8 to 5.6 +/- 1.9. The proportions of children who received 9 of the 10 individual preventive services also improved significantly.
LCs are a potentially effective method of improving the quality of care that is delivered by pediatric practices.
Workers' motivation to actively take part in improvements to the work environment is assumed to be important for the efficiency of investments for that purpose. That gives rise to the need for a tool ...to measure this motivation.
A questionnaire to measure motivation for improvements to the work environment has been designed. Internal consistency and test-retest reliability of the domains of the questionnaire have been measured, and the factorial structure has been explored, from the answers of 113 employees.
The internal consistency is high (0.94), as well as the correlation for the total score (0.84). Three factors are identified accounting for 61.6% of the total variance.
The questionnaire can be a useful tool in improving intervention methods.
The expectation is that the tool can be useful, particularly with the aim of improving efficiency of companies' investments for work environment improvements.
Due to the enormous complexity of computer systems, researchers use simulators to model system behavior and generate quantitative estimates of expected performance. Researchers also use simulators to ...model and assess the efficacy of future enhancements and novel systems. Arguably the most important tools available to computer architecture researchers, simulators offer a balance of cost, timeliness, and flexibility. Improving the infrastructure, benchmarking, and methodology of simulation - the dominant computer performance evaluation method - results in higher efficiency and let architects gain more insight into processor behavior. For these reasons, architecture researchers have increasingly relied on simulators
