Modeling and analysis of work flow and staffing level in a computed tomography division of University of Wisconsin Medical Foundation

Wang, Junwen; Quan, Shichuan; Li, Jingshan; Hollis, Amy M.

doi:10.1007/s10729-011-9188-1

Cited by 36 publications

(10 citation statements)

References 21 publications

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“…In manufacturing systems, such a method is referred to as bottleneck analysis, and it has been shown that bottleneck identification and elimination are the most effective approach for continuous improvement [21]. Such a method has also been applied in healthcare delivery systems as well (see, for instance, papers [15], [17], [18], [22] and [23]). Thus, here we intend to apply this idea to discover the disruption type that impedes the system performance in the strongest manner.…”

Section: Performance Evaluationmentioning

confidence: 99%

A Markov chain approach to study flow disruptions on surgery in emergency care

Shao

Wiegmann

2013

2013 IEEE International Conference on Automation Science and Engineering (CASE)

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The work flow of surgical operations in emergency department can be interrupted due to various disruptions. Reducing such disruptions is of significant importance to ensure successful operations. In this paper, we introduce a continuous time Markov chain model to analyze the disruptions and their impacts. Analytical formulas have been derived to evaluate the probabilities of normal operations and disruptions. A continuous improvement method has been developed to identify the disruption that impedes surgical operation in the strongest manner. Such a disruption is referred to as the bottleneck disruption (BN-d). Reducing the interruption time of the BNd can lead to the largest improvement in normal operation. An application of the method at an emergency department of a large academic medical center is presented to illustrate the effectiveness of the model and the improvement approach. It is discovered that the disruption due to coordination problem is the system bottleneck.

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Section: Performance Evaluationmentioning

confidence: 99%

A Markov chain approach to study flow disruptions on surgery in emergency care

Shao

Wiegmann

2013

2013 IEEE International Conference on Automation Science and Engineering (CASE)

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“…[1][2][3][5][6][7][8][9][10][11] One study, using simulated models, found that substituting an assistant for a radiographer can offer substantial cost savings. 12 Despite national calls for allied health assistant (AHA) implementation, 13,14 assistant workforces remain underreported within medical imaging. Medical imaging assistants (MIA) are AHAs specific to medical imaging, performing administrative tasks, restocking and coordination of patient transportation.…”

Section: Introductionmentioning

confidence: 99%

Substitution, delegation or addition? Implications of workforce skill mix on efficiency and interruptions in computed tomography

Cartwright

Pain

Heslop³

2021

Aust. Health Rev.

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Objectives. This study evaluated multiple computed tomography (CT) workforce models to identify any implications on efficiency (length of stay, scan frequency and workforce cost) and scanning radiographer interruptions through substituting or supplementing with a trained CT assistant. Methods. The study was conducted in a CT unit of a tertiary Queensland hospital and prospectively compared four workforce models, including usual practice: Model 1 used an administrative assistant (AA) and one radiographer; Model 2 substituted a medical imaging assistant (MIA) for the AA; Model 3 was usual practice, consisting of two radiographers; and Model 4 included two radiographers, with a supplemented MIA. Observational data were collected over 7 days per model and were cross-checked against electronic records. Data for interruption type and frequency, as well as scan type and duration, were collected. Annual workforce costs were calculated as measures of efficiency. Results. Similar scan frequency and parameters (complexity) occurred across all models, averaging 164 scans (interquartile range 160-172 scans) each. The median times from patient arrival to examination completion in Models 1-4 were 47, 35, 46 and 33 min respectively. There were between 34 and 104 interruptions per day across all models, with the 'assistant role' fielding the largest proportion. Model 4 demonstrated the highest workforce cost, and Model 2 the lowest. Conclusion. This study demonstrated that assistant models offer similar patient throughput to usual practice at a reduced cost. Model 2 was the most efficient of all two-staff models (Models 1-3), offering the cheapest workforce, slightly higher throughput and faster examination times. Not surprisingly, the additional staff model (Model 4) offered greater overall examination times and throughput, with fewer interruptions, although workforce cost and possible role ambiguity were both limitations of this model. These findings may assist decision makers in selecting the optimal workforce design for their own individual contexts. What is known about the topic? Innovative solutions are required to address ongoing health workforce sustainability concerns. Workforce substitution models using trained assistants have demonstrated numerous benefits internationally, with translation to the Australian allied health setting showing promise. What does this paper add? Building on existing research, this study provides clinical workforce alternatives that maintain patient throughput while offering cost efficiencies. This study also quantified the many daily interruptions that occur within the CT setting, highlighting a potential clinical risk. To the best of our knowledge, this study is the first to empirically test the use of allied health assistants within CT.

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“…Zhong et al (2016) utilized the Markov chain model to formulate the mammography testing process of an exam room. Wang et al . (2012) also adopted the Markov chain model to estimate patient length of stay and investigate different configurations of radiology specialists in a computed tomography imaging department to reduce flow time and cost.…”

Section: Introductionmentioning

confidence: 99%

Analysis and optimization of PDF-to-EPUB in the digital publishing process

Zhu

Chen

et al. 2018

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Purpose This paper aims to provide an optimization method of workflow for publishing houses and electronic book (e-book) studies in the field of digital publishing. Design/methodology/approach Based on the studies of publishing houses in Beijing, the present conversion workflow is illustrated using a functional modeling methodology. Then, the workflow is analyzed using 5W1H (why, who, what, where, when, how) methodology and optimized using ECRSI (eliminate, combine, rearrange, simplify and increase) principles. To validate the optimization effect, the workflow before and after optimization are generated and implemented by the ExtendSim® simulation software. Findings The simulation results show that under similar circumstances, both quantity and quality of the products are improved after optimization, which indicate that the optimization method is effective. Practical implications Electronic PUBlication (EPUB) has significant requirements to satisfy the needs of the mobile reading market and to earn increased profits, whereas some e-books are still preserved in a portable document format (PDF). This study results in the enhanced EPUB quality and production efficiency of the PDF-to-EPUB format conversion workflow in publishing houses. Publishing houses around the world can refer to this study to make a similar optimization when handling PDF-to-EPUB. Originality/value This research introduces the traditional industrial engineering analytical techniques to the workflow optimization of e-book conversion. Compared with the most of other methods used to optimize workflow, this method is simpler, more efficient and more suitable for e-book format conversion.

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Modeling and analysis of work flow and staffing level in a computed tomography division of University of Wisconsin Medical Foundation

Cited by 36 publications

References 21 publications

A Markov chain approach to study flow disruptions on surgery in emergency care

A Markov chain approach to study flow disruptions on surgery in emergency care

Substitution, delegation or addition? Implications of workforce skill mix on efficiency and interruptions in computed tomography

Analysis and optimization of PDF-to-EPUB in the digital publishing process

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