The research reported in this paper quantifies the impact of inclement weather (precipitation and visibility) on traffic stream behavior and key traffic stream parameters, including free-flow speed, speed at capacity, capacity, and jam density. The analysis is conducted using weather data (precipitation and visibility) and loop detector data (speed, flow, and density) obtained from the Baltimore, Maryland; Minneapolis–Saint Paul, Minnesota; and Seattle, Washington, areas in the United States. The precipitation data included intensities up to 1.6 and 0.33 cm/h for rain and water equivalent of snow intensity, respectively. The paper demonstrates that the traffic stream jam density is not affected by weather conditions. Snow results in larger reductions in traffic stream free-flow speed and capacity when compared with rain. Reductions in roadway capacity are not affected by the precipitation intensity except in the case of snow. Reductions in free-flow speed and speed at capacity increase as the rain and snow intensities increase. Finally, the paper also develops free-flow speed, speed-at-capacity, and capacity weather adjustment factors that are multiplied by the base clear-condition variables to compute inclement weather parameters. These adjustment factors vary as a function of the precipitation type, precipitation intensity, and visibility level. It is intended that these adjustment factors be incorporated into the Highway Capacity Manual.

The research reported in this paper develops a heuristic automated tool (SPD_CAL) for calibrating steady-state traffic stream and car-following models using loop detector data. The performance of the automated procedure is then compared to off-the-shelf optimization software parameter estimates, including the MINOS and Branch and Reduce Optimization Navigator (BARON) solvers. The model structure and optimization procedure is shown to fit data from different roadway types and traffic regimes (uncongested and congested conditions) with a high quality of fit (within 1% of the optimum objective function). Furthermore, the selected functional form is consistent with multiregime models, without the need to deal with the complexities associated with the selection of regime breakpoints. The heuristic SPD_CAL solver, which is available for free, is demonstrated to perform better than the MINOS and BARON solvers in terms of execution time (at least 10 times faster), computational efficiency (better match to field data), and algorithm robustness (always produces a valid and reasonable solution).

The estimation of path or trip travel-time reliability is critical to any Advanced Traveler Information System. The state-of-practice procedures for estimating path travel-time reliability assumes that travel times follow a normal distribution and requires a measure of trip travel-time variance. The study analyzes AVI data from San Antonio and demonstrates through goodness-of-fit tests that the assumption of normality is, from a theoretical standpoint, inconsistent with field travel-time observations and that a lognormal distribution is more representative of roadway travel times. However, visual inspection of the data demonstrates that the normality assumption may be sufficient from a practical standpoint given its computational simplicity. The paper then proposes five methods for the estimation of path travel-time variance from its component segment travel-time variances. The analysis demonstrates that computing the trip travel-time coefficient of variation as the conditional expectation over all realizations of roadway segments provides estimates within 13% of field observations for both uncongested and congested conditions.

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Short discharge time from hospitals increases both bed availability and patients' and families' satisfaction. In this study, the Six Sigma process improvement methodology was applied to reduce patients' discharge time in a cancer treatment hospital. Data on the duration of all activities, from the physician signing the discharge form to the patient leaving the treatment room, were collected through patient shadowing. These data were analyzed using detailed process maps and cause-and-effect diagrams. Fragmented and unstandardized processes and procedures and a lack of communication among the stakeholders were among the leading causes of long discharge times. Categorizing patients by their needs enabled better design of the discharge processes. Discrete event simulation was utilized as a decision support tool to test the effect of the improvements under different scenarios. Simplified and standardized processes, improved communications, and system-wide management are among the proposed improvements, which reduced patient discharge time by 54% from 216 minutes. Cultivating the necessary ownership through stakeholder analysis is an essential ingredient of sustainable improvement efforts.

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Purpose The purpose of this paper is to use Lean Six Sigma (LSS) to reduce patient waiting time in a Kuwaiti private hospital obstetrics and gynaecology clinic. Approach The define, measure, analyse, improve and control methodology was used. The “define” stage involved identifying patients’ needs, system capabilities and project objectives. The “measure” stage assessed the system’s current state through data collection on waiting times. Dunnett’s test, control charts and process capability analysis were used to ensure data accuracy. In the “analyse” stage, an Ishikawa diagram and Pareto chart were constructed, showing that overbooking appointments, doctors’ unscheduled breaks and doctors not arriving on time were the root causes of the problem. The “improve” stage used an Arena simulation model to represent current and improved system status. The proposed solutions were implemented and monitored in the “control” stage. Findings A sigma-level improvement of 300 per cent (0.5–2.0) was realized for appointment patients on Saturdays, with a 67 per cent reduction in waiting time. For walk-ins, the sigma level improved by 288 per cent (0.8–3.1), with a 55 per cent reduction in waiting time. For weekday appointments, the sigma level improved by 111 per cent (0.9–1.9), with a 63 per cent reduction in waiting time. For walk-ins, the sigma level improved by 69 per cent (1.6–2.7), with a 46 per cent reduction in waiting time. A cost–benefit analysis estimated the present project value at $656,459, leading to a total of $5,820,319 in savings by 2025. Originality/value This paper fulfils the need for process improvement, increasing patients’ satisfaction and hospitals’ profitability using LSS.