scholarly journals Reusable Derivation of Operational Metrics for Architectural Optimization

2014 ◽  
Vol 28 ◽  
pp. 481-488 ◽  
Author(s):  
Michael Masin ◽  
Henry Broodney ◽  
Candace Brown ◽  
Lior Limonad ◽  
Nir Mashkif ◽  
...  
Keyword(s):  
Operational Metrics

Predictors of Delayed Recognition of Critical Illness in Emergency Department Patients and Its Effect on Morbidity and Mortality

2020 ◽  
pp. 088506662096790
Author(s):  
Neha N. Goel ◽  
Matthew S. Durst ◽  
Carmen Vargas-Torres ◽  
Lynne D. Richardson ◽  
Kusum S. Mathews
Keyword(s):  
Emergency Department ◽  
Critical Illness ◽  
Census Data ◽  
Severity Of Illness ◽  
Improved Outcomes ◽  
Chart Abstraction ◽  
System Factors ◽  
Delayed Recognition ◽  
Emergency Department Patients ◽  
Operational Metrics

Purpose: Timely recognition of critical illness is associated with improved outcomes, but is dependent on accurate triage, which is affected by system factors such as workload and staffing. We sought to first study the effect of delayed recognition on patient outcomes after controlling for system factors and then to identify potential predictors of delayed recognition. Methods: We conducted a retrospective cohort study of Emergency Department (ED) patients admitted to the Intensive Care Unit (ICU) directly from the ED or within 48 hours of ED departure. Cohort characteristics were obtained through electronic and standardized chart abstraction. Operational metrics to estimate ED workload and volume using census data were matched to patients’ ED stays. Delayed recognition of critical illness was defined as an absence of an ICU consult in the ED or declination of ICU admission by the ICU team. We employed entropy-balanced multivariate models to examine the association between delayed recognition and development of persistent organ dysfunction and/or death by hospitalization day 28 (POD+D), and multivariable regression modeling to identify factors associated with delayed recognition. Results: Increased POD+D was seen for those with delayed recognition (OR 1.82, 95% CI 1.13-2.92). When the delayed recognition was by the ICU team, the patient was 2.61 times more likely to experience POD+D compared to those for whom an ICU consult was requested and were accepted for admission. Lower initial severity of illness score (OR 0.26, 95% CI 0.12-0.53) was predictive of delayed recognition. The odds for delayed recognition decreased when ED workload is higher (OR 0.45, 95% CI 0.23-0.89) compared to times with lower ED workload. Conclusions: Increased POD+D is associated with delayed recognition. Patient and system factors such as severity of illness and ED workload influence the odds of delayed recognition of critical illness and need further exploration.

Quantifying distributions of freeway operational metrics

2011 ◽  
Vol 3 (1) ◽  
pp. 21-36 ◽  
Author(s):  
Stephen Boyles ◽  
Avinash Voruganti ◽  
S. Waller
Keyword(s):  
Operational Metrics

Benchmarking and pondering ASERL interlibrary loan operations, 2010 and 2013

2014 ◽  
Vol 42 (1) ◽  
pp. 16-25 ◽  
Author(s):  
David P. Atkins ◽  
Judy T. Greenwood ◽  
Pambanisha Whaley
Keyword(s):  
Mixed Methods ◽  
Resource Sharing ◽  
Interlibrary Loan ◽  
Content Type ◽  
Research Libraries ◽  
Document Delivery ◽  
Staffing Levels ◽  
Comparative Case Studies ◽  
Support Resource ◽  
Operational Metrics

Purpose – In 2010 and 2013, the libraries in the Association of Southeastern Research Libraries (ASERL) were surveyed to identify benchmarks and programs to support resource sharing. Benchmarks and challenges identified generate discussions regarding programming, networking, and other support to improve resource sharing operations. This paper seeks to address these issues. Design/methodology/approach – This study compares and contrasts the two surveys using mixed methods data analysis. This study assesses ILL performance and explores the challenges and trends interlibrary loan practitioners see today. Findings – The article identifies changes and trends in consortia-wide transaction volumes; staffing levels; campus document delivery; professional issues and challenges; and library organizational schemes. Research limitations/implications – The study did not include data from constituencies outside of interlibrary loan. It also did not include interview follow-ups with survey participants to discuss challenges and reorganizations in greater detail. Future interlibrary loan research could focus less on operational metrics and more on broader issues such as e-resources and change management. Mixed methods are effect tools for benchmarking and comparative case studies. Practical implications – Individual libraries can compare themselves to the operational benchmarks and use insights drawn from comment analysis to stimulate conversations regarding current and future roles for interlibrary loan. Consortia can duplicate the study to understand their operational benchmarks and their particular contexts. Originality/value – The study provides comparative benchmarks for research libraries and consortia spanning three years. It demonstrates substantial shifts in issues faced by libraries and librarians.

Aligning strategic profiles with operational metrics in after‐sales service

2007 ◽  
Vol 56 (5/6) ◽  
pp. 436-455 ◽  
Author(s):  
Sergio Cavalieri ◽  
Paolo Gaiardelli ◽  
Stefano Ierace
Keyword(s):  
Operational Metrics

Feasibility of screening hospitalized cancer patients for palliative care.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9094-9094
Author(s):  
Paul A. Glare ◽  
Mary K. Plakovic ◽  
Anna Schloms ◽  
Barbara Egan ◽  
Leonard Saltz ◽  
...  
Keyword(s):  
Palliative Care ◽  
Clinical Judgment ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Nursing Satisfaction ◽  
Referral Criteria ◽  
Operational Metrics ◽  
Cancer Network ◽  
Seriously Ill ◽  
Extent Of Disease

9094 Background: The National Comprehensive Cancer Network Palliative Care (PC) Guideline recommends screening all oncology patients for PC needs, and to call a PC consult when referral criteria are met. There are no data on the feasibility or impact of this approach. The aim of this pilot study was to assess the feasibility of PC screening in patients admitted to a comprehensive cancer center (CCC). Methods: Design: Observational study. From 11/1/10 to 1/31/11, floor nurses screened all patients the day after admission under the two teams (“Team A” and “Team B”) of the Gastrointestinal Oncology Service at Memorial Sloan-Kettering Cancer Center. Team A patients were also evaluated by the referral criteria. Endpoints: Patients screened ‘positive’ if they had advanced disease and any of the clinical situations nominated in the Guideline. The referral criteria triggered PC consults in Team A patients; clinical judgment triggered Team B consults. Outcomes: Screening rates, nursing satisfaction survey, clinical and operational metrics. Results: Ninety percent (229 of 254) of admissions were screened. Both Teams’ patients were seriously ill (see Table), and it was no surprise that 63% (145 of 229) screened positive. Survey respondents (response rate 50%) rated screening as simple, quick and helpful, although nurses scored the extent of disease wrong in 16%. Sixty eight percent (55 of 780) of Team A patients who screened positive met the referral criteria. This generated more consults on Team A, but the effect on key outcomes was not significant (n.s.). Conclusions: Screening for PC was feasible in this setting, but is a challenging concept in terms of reliability, validity and timing. The value to a CCC of increasing PC access via referral criteria needs evaluation in well-designed trials. [Table: see text]

An Overview of King Hussein Cancer Center Institutional Review Board Over 12 Years (2009–2020), Successes and Challenges, Including Those Imposed by the COVID-19 Pandemic

2021 ◽  
pp. 155626462110532
Author(s):  
Linda Kateb ◽  
Sawsan El-Jayousi ◽  
Maysa Al-Hussaini
Keyword(s):  
Turnaround Time ◽  
Institutional Review Board ◽  
Annual Reports ◽  
Cancer Center ◽  
Research Subjects ◽  
Female Ratio ◽  
Institutional Review ◽  
Operational Metrics ◽  
Successes And Challenges ◽  
Male To Female

The problem: Running an efficient institutional review board (IRB) can be challenging. The research subjects: To ensure an efficient committee, our IRB adopted several operational metrics. Methods: Analysis of retrospective data from the IRB records, database, and annual reports over 12 years. Results: The IRB roster comprises 11 members. The average medical to nonmedical member ratio is 5:6, and the male to female ratio is 4:7, which has not been consistent over the years. One thousand three hundred and twenty-four proposals were reviewed including 1077 exempt (81.3%), 126 expedited (9.5%), and 121 full board (9.2%) with a median turnaround time to approval of 4.0, 35.0, and 68.0 days, respectively. Training of the IRB members was conducted to enhance their knowledge and skills. IRB at King Hussein Cancer Center has managed to stay abreast and efficient during the COVID-19 pandemic, by working remotely. Conclusion: Running an efficient IRB mandates implementing a number of operational metrics.

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