scholarly journals Electronic Consultations to Hepatologists Reduce Wait Time for Visits, Improve Communication, and Result in Cost Savings

2019 ◽  
Vol 3 (9) ◽  
pp. 1177-1182 ◽  
Author(s):  
Indira Bhavsar ◽  
Jennifer Wang ◽  
Sean M. Burke ◽  
Kimberly Dowdell ◽  
R. Ann Hays ◽  
...  
Keyword(s):  
Cost Savings ◽  
Wait Time ◽  
Reduce Wait Time

Medical readiness: evaluating the robustness of medical clinic staffing solutions

2016 ◽  
Vol 14 (4) ◽  
pp. 407-419
Author(s):  
Michael Q Corpuz ◽  
Christina F Rusnock ◽  
Vhance V Valencia ◽  
Kyle Oyama
Keyword(s):  
Negative Impact ◽  
Cost Benefit Analysis ◽  
Relative Effectiveness ◽  
Discrete Event ◽  
Cost Savings ◽  
Cost Benefit ◽  
Wait Time ◽  
Cost Effective ◽  
Wait Times ◽  
Staffing Mix

Medical readiness requires Department of Defense medical clinics to be robust to changes in patient demand. Minor fluctuations in patient demand occur on a regular basis, but major increases can also occur. Major demand increases can result from a number of occurrences, including mass military deployments, medical incidents, outbreaks, and overflow from Veterans’ Affairs clinics. This research evaluates a system of clinics at Wright-Patterson Air Force Base in order to determine its ability to handle a 200% surge in patient demand. In addition, this study evaluates the relative effectiveness of six different staffing mix options to minimize patient wait times, also under the surge demand conditions. This evaluation is conducted using discrete-event simulation to estimate patient wait times and includes a sensitivity analysis of the increased patient demand, as well as a cost–benefit analysis to determine the most cost-effective alternative scenario. The study finds that adjustments to staffing mix enable cost savings while meeting current demands. In addition, the study finds that adjusting the staffing mix will not have a negative impact on patient wait time in the surge conditions, relative to the current staffing mix.

scholarly journals Improving the wait time to triage at the emergency department

2020 ◽  
Vol 9 (1) ◽  
pp. e000708 ◽  
Author(s):  
Yuzeng Shen ◽  
Lin Hui Lee
Keyword(s):  
Emergency Department ◽  
Wait Time ◽  
Baseline Period ◽  
Quality Improvement Effort ◽  
Nurse Clinician ◽  
Reduce Wait Time ◽  
Key Steps ◽  
Improvement Effort ◽  
Period Duration ◽  
Nursing Manpower

Triaging of patients at the emergency department (ED) is one of the key steps prior to initiation of doctor consult. To improve the overall wait time to consultation, we have identified the need to reduce the wait time to triage for ED patients. We seek to determine if the implementation of a series of plan, do, study, act (PDSA) cycles would improve the wait time to triage within 1 year. The interventions related to the PDSA cycles include the refining of triage criteria, ‘eyeball’ triage by senior nurses to facilitate direct bedding of patients, formation of a triage nurse clinician role, and a needs analysis of required nursing manpower. The baseline period for this study was from January 2017 to April 2017, with the results following implementation of the respective PDSA cycles sequentially tracked from May 2017 to March 2019. There was an improvement in the wait time to triage from a baseline duration of 18 min to the postimplementation period duration of 13 min, with a 25% decrease in variance from 16 to 12 min. The improvements were sustained. Strategies to further reduce wait time to triage at the ED are discussed. We also highlight the importance of adequate triage manpower, data-driven decision making and continued engagement of stakeholders in enabling positive outcomes from this quality improvement effort.

Minimizing wait time between chemotherapy and radiotherapy treatments.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 82-82
Author(s):  
James J. Sauerbaum ◽  
Gina DeMaio ◽  
Bradley Geiger ◽  
Regina Cunningham ◽  
Marianna Holmes ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Task Force ◽  
Wait Time ◽  
Support Staff ◽  
Cancer Center ◽  
Wait Times ◽  
Average Wait Time ◽  
Scheduling Method ◽  
Reduce Wait Time ◽  
E Mail

82 Background: Members of the scheduling teams at the Abramson Cancer Center observed prolonged delays between chemotherapy and radiation therapy treatments scheduled by staff from 2 independent departments leading to inconvenience for patients receiving concurrent chemo- and radiation therapy (CRpts). Methods: An analysis of baseline data over 6 weeks revealed that for 157 unique consecutive patients undergoing daily chemotherapy and radiation (a total of 353 encounters), the mean time between scheduled treatments was 122 minutes. For 39% of encounters the wait time was greater than 120 minutes. To improve the adjacency of chemotherapy and radiation appointments and to consistently reduce wait time between treatments to less than 120 minutes, we formed a Chemotherapy/Radiation Scheduling Task Force consisting of patient service representatives, practice managers, and physician and nurse advisors. We determined that CRpts should be scheduled using a “huddle” strategy whereby prospectively identified CRpts are simultaneously scheduled for both treatments in a coordinated manner. Identifying CRpts for coordinated scheduling was facilitated by the creation of a chemo-radiation scheduling inbox to which clinicians and support staff e-mail names of new CRpts in order to alert the scheduling team. Our two lead schedulers meet 2-3 times per week to coordinate patient schedules. A weekly scorecard of the wait times for CRpts patients is distributed via e-mail to the clinicians and support staff. Results: Over the past 6 months, we have used the huddle method for 80% of 986 consecutive CRpt encounters. Our average wait time for huddle-scheduled encounters has been reduced to 62.5 minutes with only 9% of encounters having wait times over 120 minutes. For non-huddle-scheduled encounters, the average wait time is 129 minutes with 57% having wait times over 120 minutes. Conclusions: Utilization of a huddle scheduling method has successfully reduced wait time for CRpts. Use of the huddle method continues to grow with staff training and awareness of the new process.

scholarly journals Innovative Strategies for Decreasing Blood Collection Wait Times for Patients in Early-Phase Cancer Clinical Trials

2016 ◽  
Vol 12 (7) ◽  
pp. e784-e791 ◽  
Author(s):  
Bayabel Mengistu ◽  
Dina Ray ◽  
Passion Lockett ◽  
Vivian Dorsey ◽  
Ron A. Phipps ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Early Phase ◽  
Patient Flow ◽  
Care Facility ◽  
Cost Savings ◽  
Primary Source ◽  
Wait Time ◽  
Turnover Time ◽  
Wait Times ◽  
Blood Collection

Purpose: Long wait times are a primary source of dissatisfaction among patients enrolled in early-phase clinical trials. We hypothesized that an automated patient check-in system with readily available display for increasing awareness of waiting intervals would improve patient flow and use of our rooms, with decreased turnover time and increased throughput. Methods: We recorded in-room wait times for patients seen in our clinic and observed the logistics involved in the blood collection process to delineate causes for delays. We then implemented a three-step strategy to alleviate the causes of these delays: (1) changing the collection of materials and the review of faxed orders, (2) improving our LabTracker automated database system that included wait time calculators and real-time information regarding patient status, and (3) streamlining lower complexity appointments. Results: After our intervention, we observed a 19% decrease in mean wait times and a 30% decrease in wait times among patients waiting the longest (95th percentile). We also observed an increase in staff productivity during this process. Modifications in LabTracker provided the biggest reduction in mean wait times (17%). Conclusion: We observed a significant decrease in mean wait times after implementing our intervention. This decrease led to increased staff productivity and cost savings. Once wait times became a measurable metric, we were able to identify causes for delays and improve our operations, which can be performed in any patient care facility.

scholarly journals Reducing overcrowding in an emergency department: a pilot study

2019 ◽  
Vol 65 (12) ◽  
pp. 1476-1481
Author(s):  
Fábio Ferreira Amorim ◽  
Karlo Jozefo Quadros de Almeida ◽  
Sanderson Cesar Macedo Barbalho ◽  
Vanessa de Amorim Teixeira Balieiro ◽  
Arnaldo Machado Neto ◽  
...  
Keyword(s):  
Waiting Time ◽  
Waiting Times ◽  
Wait Time ◽  
Federal District ◽  
Arrival Times ◽  
Process Maps ◽  
Manchester Triage System ◽  
Simulation Scenario ◽  
Reduce Wait Time ◽  
Capacity Data

SUMMARY OBJECTIVE Exploring the use of forecasting models and simulation tools to estimate demand and reduce the waiting time of patients in Emergency Departments (EDs). METHODS The analysis was based on data collected in May 2013 in the ED of Recanto das Emas, Federal District, Brasil, which uses a Manchester Triage System. A total of 100 consecutive patients were included: 70 yellow (70%) and 30 green (30%). Flow patterns, observed waiting time, and inter-arrival times of patients were collected. Process maps, demand, and capacity data were used to build a simulation, which was calibrated against the observed flow times. What-if analysis was conducted to reduce waiting times. RESULTS Green and yellow patient arrival-time patterns were similar, but inter-arrival times were 5 and 38 minutes, respectively. Wait-time was 14 minutes for yellow patients, and 4 hours for green patients. The physician staff comprised four doctors per shift. A simulation predicted that allocating one more doctor per shift would reduce wait-time to 2.5 hours for green patients, with a small impact in yellow patients’ wait-time. Maintaining four doctors and allocating one doctor exclusively for green patients would reduce the waiting time to 1.5 hours for green patients and increase it in 15 minutes for yellow patients. The best simulation scenario employed five doctors per shift, with two doctors exclusively for green patients. CONCLUSION Waiting times can be reduced by balancing the allocation of doctors to green and yellow patients and matching the availability of doctors to forecasted demand patterns. Simulations of EDs’ can be used to generate and test solutions to decrease overcrowding.

scholarly journals Learning End-to-End Goal-Oriented Dialog with Maximal User Task Success and Minimal Human Agent Use

2019 ◽  
Vol 7 ◽  
pp. 375-386
Author(s):  
Janarthanan Rajendran ◽  
Jatin Ganhotra ◽  
Lazaros C. Polymenakos
Keyword(s):  
Customer Service ◽  
User Behavior ◽  
Wait Time ◽  
Test Time ◽  
Dialog Systems ◽  
User Behaviors ◽  
Human Agent ◽  
Task Success ◽  
End To End ◽  
Reduce Wait Time

Neural end-to-end goal-oriented dialog systems showed promise to reduce the workload of human agents for customer service, as well as reduce wait time for users. However, their inability to handle new user behavior at deployment has limited their usage in real world. In this work, we propose an end-to-end trainable method for neural goal-oriented dialog systems that handles new user behaviors at deployment by transferring the dialog to a human agent intelligently. The proposed method has three goals: 1) maximize user’s task success by transferring to human agents, 2) minimize the load on the human agents by transferring to them only when it is essential, and 3) learn online from the human agent’s responses to reduce human agents’ load further. We evaluate our proposed method on a modified-bAbI dialog task, 1 which simulates the scenario of new user behaviors occurring at test time. Experimental results show that our proposed method is effective in achieving the desired goals.

scholarly journals Implementation of a triage system to reduce wait time and prioritise care for high-risk obstetric patients in a regional hospital in Accra, Ghana

2016 ◽  
Vol 4 ◽  
pp. S16
Author(s):  
Medge D Owen ◽  
Liz Floyd ◽  
Fiona Bryce ◽  
Rohit Ramaswamy ◽  
Nancy Pearson ◽  
...  
Keyword(s):  
High Risk ◽  
Wait Time ◽  
Regional Hospital ◽  
Triage System ◽  
Reduce Wait Time

scholarly journals Transforming Access to Specialist Care for Inflammatory Bowel Disease: The PACE Telemedicine Program

2018 ◽  
Vol 2 (4) ◽  
pp. 186-194 ◽  
Author(s):  
Peter Habashi ◽  
Shelley Bouchard ◽  
Geoffrey C Nguyen
Keyword(s):  
Median Time ◽  
Cost Savings ◽  
Wait Time ◽  
Wait Times ◽  
Specialist Care ◽  
Potential Cost ◽  
Health Administrative Data ◽  
Geographic Disparities ◽  
Inflammatory Bowel ◽  
Travel Grant

Abstract Background There are significant geographic disparities in the delivery of IBD healthcare in Ontario which may ultimately impact health outcomes. Telemedicine-based health services may potentially bridge gaps in access to gastroenterologists in remote and underserved areas. Methods We conducted a needs assessment for IBD specialist care in Ontario using health administrative data. As part of a separate initiative to address geographic disparities in access to care, we described the development and implementation of our Promoting Access and Care through Centres of Excellence (PACE) Telemedicine Program. Over the first 18 months, we measured wait times and potential cost savings. Results We found substantial deficiencies in specialist care early in the course of IBD and continuous IBD care in regions where the number of gastroenterologists per capita were low. The PACE Telemedicine Program enabled new IBD consultations within a median time of 17 days (interquartile range [IQR], 7–32 days) and visits for active IBD symptoms with a median time of 8.5 days (IQR, 4–14 days). Forty-five percent of new consultations and 83% of patients with active IBD symptoms were seen within the target wait time of two weeks. Telemedicine services resulted in an estimated cost savings of $47,565 among individuals who qualified for Ontario’s Northern Travel Grant. Conclusions The implementation of telemedicine services for IBD is highly feasible and can reduce wait times to see gastroenterologists that meet nationally recommended targets and can lead to cost savings.

Operational efficiencies in the infusion center: Improving nursing efficiencies and patient wait times while decreasing costs.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 56-56
Author(s):  
Alyssa Garth ◽  
Susan Schreiner ◽  
Dawn Jourdan
Keyword(s):  
Patient Flow ◽  
Cost Savings ◽  
Wait Time ◽  
Labor Cost ◽  
Nursing Workload ◽  
Wait Times ◽  
Staff Nurse ◽  
Patient Centered ◽  
Patient Assignment ◽  
Role Based

56 Background: Decreased nursing efficiency and patient assignments has increased patient wait times and has significant implications on overall patient flow in the infusion center and labor dollars. Historically, staff nurses signed up for their patients, and took an average of 2 patients at one time. This created disparity in patient/staffing ratios, high number of labor dollars per worked infusion and an overall atmosphere of inequity among the nurses. Methods: Patient flow and labor cost were examined. Analysis of the nursing staffing matrix led to the creation of a patient placement nurse, taken from the daily staff allocation, assigning patients based on current patient assignment and acuity of patients. Nurses were identified to learn the patient placement nurse role based on critical thinking and organizational skills. With the assistance of a patient locator system, the patient placement nurse is able to identify when a patient’s wait begins and which nurse is the best choice to be assigned. A system was implemented in which a staff nurse was assigned a patient every 30-40 minutes with a maximum patient assignment of 4 concurrently. A standard 1:3 nurse to patient ratio was established unless a patient’s acuity prohibited this ratio. Results: Nursing ratios stabilized at 1:3. Staff became more efficient and work was reorganized for less subjectivity in patient assignments, producing more equitable workloads. This resulted in an increase in patients seen within 15 minutes improving from 69.8% to 85.3%. In addition, it allowed for the elimination of one nurse per day shift, resulting in a cost savings of approximately a 1.0 FTE/week or average annual salary of $62,129. Conclusions: Development of a standardized patient placement process can increase infusion center efficiencies and stabilize nursing workload, as well as decrease patient wait time and reduce the cost per infusion. This supports a delivery of patient-centered care while utilizing staff efficiently and appropriately and decreasing cost.

Inline FOUP Cleaner - The New Type FOUP Cleaner for the Next Generation

2016 ◽  
Vol 255 ◽  
pp. 387-389 ◽  
Author(s):  
Sa Gong Gwon ◽  
Kwang Bong Lee ◽  
Byoung Jun Lee ◽  
Geun Min Choi
Keyword(s):  
Monitoring System ◽  
Cost Savings ◽  
Wait Time ◽  
Next Generation ◽  
New Approach ◽  
Particle Counter ◽  
Interesting Approach ◽  
New Type ◽  
Areas Of Concern ◽  
Total Integration

The existing methodology for Front Opening Unified Pod (FOUP) cleaning, storage, and transfer is inherently flawed in three areas: a) equipment layout, b) intra-process wait time, and c) human handling. In each area, improved solutions are suggested and a new approach is developed and named In-line FOUP Cleaner (IFC). IFC is a new, singular approach accomplished via total integration of multiple equipment types including sorter, FOUP cleaner, stocker, particle counter, and the FDC monitoring system. Utilizing the IFC approach, significant improvements have been documented with respect to all three areas of concern. Overall cost savings, as well as a side benefit of improved fume removal, are carefully observed. It appears to be an interesting approach to solving the problems associated with FOUP cleaning, storage, and transfer for the next generation semiconductor fab.

Sign in / Sign up

Export Citation Format

Share Document