Robust surgery loading

We consider the robust surgery loading problem for a hospital’s operating theatre department, which concerns assigning surgeries and sufficient planned slack to operating room days. The objective is to maximize capacity utilization and minimize the risk of overtime, and thus cancelled patients. This research was performed in collaboration with the Erasmus MC, a large academic hospital in the Netherlands, which has also provided historical data for the experiments. We propose various constructive heuristics and local search methods that use statistical information on surgery durations to exploit the portfolio effect, and thereby to minimize the required slack. We demonstrate that our approach frees a lot of operating room capacity, which may be used to perform additional surgeries. Furthermore, we show that by combining advanced optimization techniques with extensive historical statistical records on surgery durations can significantly improve the operating room department utilization.     

A Web-based ERP system for business services and supply chain management: Application to real-world process scheduling

A Web-based ERP system developed for attacking business problems and managing real-world business processes ranging from simple office automation procedures to complicated supply chain planning is presented. The system’s Web-aspect provides significant advantages, as the system is distributed through interoperable, cross-platform and highly pluggable Web-service components. The system involves a powerful workflow engine that manages the entire process event flow within the enterprise increasing efficiency and control at the same time. Business processes, when needed, are controlled by the enterprise quality management system and consequently the ISO directives are accurately followed. A real-world process scheduling system developed for the specific needs of Greek Construction Manufacturing Enterprises is illustrated as a detailed paradigm of the system’s capabilities. The problem was formulated to assign project tasks in form of lots to enterprise resources in order that resources idle time and delays in project preparation time were minimized. The problem was solved by a simple and effective heuristic algorithm.     

Efficiency and welfare implications of managed public sector hospital waiting lists

A queuing model for public health service waiting lists is developed, and the implications for patient welfare of different systems for managing the waiting list are analysed. If patients are admitted to hospital on a first-come-first-served basis, a welfare gain is achieved by moving from a system of implicit to one of explicit rationing of access to the waiting list. If individual waiting times and hospital admissions are dependent on clinical priority, a further welfare gain is achievable without the use of explicit rationing, by reallocating the total waiting time from the more towards the less seriously ill. On efficiency and welfare criteria, a maximum waiting time guarantee does not appear to be a desirable development.     

A column generation approach for solving the patient admission scheduling problem

This paper addresses the Patient Admission Scheduling (PAS) problem. The PAS problem entails assigning elective patients to beds, while satisfying a number of hard constraints and as many soft constraints as is possible, and arises at all planning levels for hospital management. There exist a few, different variants of this problem. In this paper we consider one such variant and propose an optimization-based heuristic building on branch-and-bound, column generation, and dynamic constraint aggregation to solve it. We achieve tighter lower bounds than previously reported in the literature and, in addition, we are able to produce new best known solutions for five out of twelve instances from a publicly available repository.     

Using phase-type models to cost stroke patient care across health,social and community services

Stroke disease places a heavy burden on society, incurring long periods of time in hospital and community care, and associated costs. Also stroke is a highly complex disease with diverse outcomes and multiple strategies for therapy and care. Previously a modeling framework has been developed which clusters patients into classes with respect to their length of stay (LOS) in hospital. Phase-type models were then used to describe patient flows for each cluster. Also multiple outcomes, such as discharge to normal residence, nursing home, or death can be permitted. We here add costs to this model and obtain the Moment Generating Function for the total cost of a system consisting of multiple transient phase-type classes with multiple absorbing states. This system represents different classes of patients in different hospital and community services states. Based on stroke patients’ data from the Belfast City Hospital, various scenarios are explored with a focus on comparing the cost of thrombolysis treatment under different regimes. The overall modeling framework characterizes the behavior of stroke patient populations, with a focus on integrated system-wide costing and planning, encompassing hospital and community services. Within this general framework we have developed models which take account of patient heterogeneity and multiple care options. Such complex strategies depend crucially on developing a deep engagement with the health care professionals and underpinning the models with detailed patient-specific data.     

Product form in networks of queues with batch arrivals and batch services

A product form equilibrium distribution is derived for a class of queueing networks in either discrete or continuous time, in which multiple customers arrive simultaneously and batches of customers complete service simultaneously.     

Application of structural equation modeling to evaluate the intention of shippers to use Internet services in liner shipping

Operations research (OR) is the application of modeling techniques to formulate and analyze systems and problems for management decision-making. Structural equation modeling (SEM) is a modeling technique applied to social or behavioral systems to understand and explain relationships that may exist among elements of systems. Recently, the measurement of unobservable variables has gained increasing attention in operations management (OM) research, and the OR discipline has begun to recognize the value of applying SEM to analyze behavioral-related OR problems. To provide OR researchers with a better understanding of the application of this useful statistical modeling technique, this paper presents a tutorial on the application of SEM. Specifically, we investigate the key factors that affect the adoption of Internet services in the context of liner shipping services. Although [Fishbein, M.A., Ajzen, I., 1975. Belief, Attitude, Intention and Behavior: An Introduction to Theory and Research, Addison-Wesley, Reading, MA; Davis, F.D., 1989. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly 13 (3), 319–339; Ajzen, I., 1985. From intention to actions: A theory of planned behavior. In: Kuhl, J., Bechmann, J. (Eds.), Action Control: From Cognition to Behavior. Springer Verlag, New York, pp. 11–39; Ajzen, I., 1991. The theory of planned behavior. Organizational Behavior and Human Decision Processes 50, 179–211] have made important contributions to understanding users’ behavior of technology acceptance, shippers’ resistance to end-user systems is still a common problem in the liner shipping industry. To better predict, explain, and increase shippers’ acceptance of technology, we need to understand why shippers accept or reject Internet services provided by their liner shipping carriers. Another objective of this paper is to propose and empirically test a theoretical framework that relates the intention of shippers to use Internet services in liner shipping with its antecedents such as perceived usefulness, perceived ease of use, and the perceptions of security protection. Tests of the structural model confirm Davis’s (1989) notion that perceived ease of use explains the intention of shippers to use Internet services, and that perceived ease of use has a strong positive effect on perceived usefulness. The results also indicate that security protection influences perceived ease of use. The SEM analyses in this study offer OR researchers a methodological guide on how to assess the efficacy of both a measurement model that relates observed indicators to latent factors and a structural model that poses relationships between constructs.     

Cost-Effective Migration from Sub-Lambda to Wavelength-Based Metro Networks

This article will discuss the importance of hybrid coexistence of sub-lambda grooming with wavelength-based services for driving down costs and maximizing the use of metro bandwidth, as well as enabling next-generation lambda-based services. The article will also address migration to all optical metro networks.     

医院医疗服务质量管理的灰关联分析

将灰关联分析方法应用于医院管理年活动中,分析了影响医疗服务质量的相关因素,并对医院医疗服务质量进行综合评价.     

Closed queueing networks with batch services

In this paper we study queueing networks which allow multiple changes at a given time. The model has a natural application to discrete-time queueing networks but describes also queueing networks in continuous time. It is shown that product-form results which are known to hold when there are single changes at a given instant remain valid when multiple changes are allowed.