scholarly journals Process mining to optimize palliative patient flow in a high-volume radiotherapy department

2021 ◽  
Vol 17 ◽  
pp. 32-39
Author(s):  
L. Placidi ◽  
L. Boldrini ◽  
J. Lenkowicz ◽  
S. Manfrida ◽  
R. Gatta ◽  
...  
Keyword(s):  
Process Mining ◽  
Patient Flow ◽  
High Volume ◽  
Radiotherapy Department ◽  
Palliative Patient

scholarly journals Description of the effect of patient flow, junior doctor supervision and pandemic preparation on the ability of emergency physicians to provide direct patient care

2020 ◽  
Vol 44 (5) ◽  
pp. 741
Author(s):  
Andy Lim ◽  
Namankit Gupta ◽  
Alvin Lim ◽  
Wei Hong ◽  
Katie Walker
Keyword(s):  
Pilot Study ◽  
Patient Care ◽  
Patient Flow ◽  
High Volume ◽  
Direct Patient Care ◽  
Published Data ◽  
Emergency Physicians ◽  
Cross Sectional ◽  
Number Of Patients ◽  
Process Factors

ObjectiveA pilot study to: (1) describe the ability of emergency physicians to provide primary consults at an Australian, major metropolitan, adult emergency department (ED) during the COVID-19 pandemic when compared with historical performance; and (2) to identify the effect of system and process factors on productivity. MethodsA retrospective cross-sectional description of shifts worked between 1 and 29 February 2020, while physicians were carrying out their usual supervision, flow and problem-solving duties, as well as undertaking additional COVID-19 preparation, was documented. Effect of supervisory load, years of Australian registration and departmental flow factors were evaluated. Descriptive statistical methods were used and regression analyses were performed. ResultsA total of 188 shifts were analysed. Productivity was 4.07 patients per 9.5-h shift (95% CI 3.56–4.58) or 0.43 patients per h, representing a 48.5% reduction from previously published data (P<0.0001). Working in a shift outside of the resuscitation area or working a day shift was associated with a reduction in individual patient load. There was a 2.2% (95% CI: 1.1–3.4, P<0.001) decrease in productivity with each year after obtaining Australian medical registration. There was a 10.6% (95% CI: 5.4–15.6, P<0.001) decrease in productivity for each junior physician supervised. Bed access had no statistically significant effect on productivity. ConclusionsEmergency physicians undertake multiple duties. Their ability to manage their own patients varies depending on multiple ED operational factors, particularly their supervisory load. COVID-19 preparations reduced their ability to see their own patients by half. What is known about the topic?An understanding of emergency physician productivity is essential in planning clinical operations. Medical productivity, however, is challenging to define, and is controversial to measure. Although baseline data exist, few studies examine the effect of patient flow and supervision requirements on the emergency physician’s ability to perform primary consults. No studies describe these metrics during COVID-19. What does this paper add?This pilot study provides a novel cross-sectional description of the effect of COVID-19 preparations on the ability of emergency physicians to provide direct patient care. It also examines the effect of selected system and process factors in a physician’s ability to complete primary consults. What are the implications for practitioners?When managing an emergency medical workforce, the contribution of emergency physicians to the number of patients requiring consults should take into account the high volume of alternative duties required. Increasing alternative duties can decrease primary provider tasks that can be completed. COVID-19 pandemic preparation has significantly reduced the ability of emergency physicians to manage their own patients.

scholarly journals Detecting Attacks Using Big Data with Process Mining

2017 ◽  
Vol 2 (2) ◽  
pp. 5 ◽  
Author(s):  
Ved Prakash Mishra ◽  
Yogeshwaran Sivasubramanian ◽  
Subheshree Jeevanandham
Keyword(s):  
Big Data ◽  
Intrusion Detection ◽  
Process Mining ◽  
Detection System ◽  
Big Data Analytics ◽  
High Volume ◽  
False Alarms ◽  
Digital World ◽  
Data Process ◽  
System Logs

Abstract- In current digital world, Security has become the major issue for the organization. Every day the amount of data is growing in the world. Processing and analyzing of the data is becoming the new challenge for the analyzers. For this purpose, big data is useful to process the high volume of data in less time. Current security tools like existing firewalls and Intrusion Detection Systems are still not able to detect and prevent the attacks and intrusions in full proof manner and giving many false alarms. Big Data analytics concept could be very useful for analyzing, detection and providing full security to the organization because of the ability of handling the large amount of data. In this paper, we have described the concept and the roll of big data. We have also proposed a model using process mining to generate the alerts in the case of attacks.   Index Terms— Big Data, Process Mining, Intrusion Detection System, Logs.

scholarly journals Candidate Digital Tasks Selection Methodology for Automation with Robotic Process Automation

2021 ◽  
Vol 13 (16) ◽  
pp. 8980
Author(s):  
Daehyoun Choi ◽  
Hind R’bigui ◽  
Chiwoon Cho
Keyword(s):  
New Technologies ◽  
Performance Metrics ◽  
Process Mining ◽  
High Volume ◽  
Process Automation ◽  
Robotic Process Automation ◽  
Business Environments ◽  
Main Challenge ◽  
Routine Tasks ◽  
Selection Methodology

Today’s business environments face rapid digital transformation, engendering the continuous emerging of new technologies. Robotic Process Automation (RPA) is one of the new technologies rapidly and increasingly grabbing the attention of businesses. RPA tools allow mimicking human tasks by providing a virtual workforce, or digital workers in the form of software bots, for automating manual, high-volume, repetitive, and routine tasks. The goal is to allow human workers to delegate their tedious routine tasks to a software bot, thus allowing them to focus on more difficult tasks. RPA tools are simple and very powerful, according to cost-saving and other performance metrics. However, the main challenge of RPA implementation is to effectively determine the business tasks suitable for automation. This paper provides a methodology for selecting candidate tasks for robotic process automation based on user interface logs and process mining techniques.

Developing a telemedicine triage system to manage patient flow at a high volume cancer center urgent care.

2018 ◽  
Vol 36 (15_suppl) ◽  
pp. e18517-e18517
Author(s):  
Christian Otto ◽  
Diane Lauren Reidy ◽  
Stutman Robin ◽  
Kara Sutton ◽  
Erika Dugan ◽  
...  
Keyword(s):  
Patient Flow ◽  
High Volume ◽  
Urgent Care ◽  
Cancer Center ◽  
Triage System

Modelling Patient Flow in a Radiotherapy Department

OR Insight ◽  
2007 ◽  
Vol 20 (3) ◽  
pp. 6-14 ◽  
Author(s):  
S Proctor ◽  
B Lehaney ◽  
C Reeves ◽  
Z Khan
Keyword(s):  
Patient Flow ◽  
Radiotherapy Department

scholarly journals ANALYSIS OF SURGICAL PATIENT FLOW AT WINNIPEG HEALTH SCIENCES CENTRE

2011 ◽  
Author(s):  
Y. Y. Tan ◽  
T. Y. El Mekkawy ◽  
Q. Peng ◽  
B. Wright
Keyword(s):  
Patient Flow ◽  
Quality Care ◽  
High Volume ◽  
Careful Analysis ◽  
Health Sciences ◽  
Trauma Centre ◽  
Surgical Patient ◽  
Flow Process ◽  
Effective Manner ◽  
Major Trauma Centre

The Health Sciences Centre (HSC) in Winnipeg is the major trauma centre serving the entire province of Manitoba, Northwestern Ontario, and Nunavut. Therefore, it has to handle a high volume of both elective and emergent surgical patients. Because the facility always strives to provide quality care in a fast and effective manner, it initiated a research project to analyze its surgical patient flow and generate ideas on how it could be redesigned to improve the systems performance. After a year of careful analysis, all of the problems identified were grouped into six major categories, showcasing how various departments are affected by each problem. Based on this analysis, the true impact of each problem in the surgical patient flow process can be understood. Steps can now be taken to identify which problems need to be addressed, what changes should be made, and how this will benefit the entire system.

scholarly journals LO009: Impact of physician navigators on measures of emergency department efficiency

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S33-S33
Author(s):  
A. Leung ◽  
Z. Gong ◽  
B. Chen ◽  
M. Duic
Keyword(s):  
Emergency Department ◽  
Length Of Stay ◽  
Patient Flow ◽  
High Volume ◽  
Physician Satisfaction ◽  
Intervention Period ◽  
Post Intervention ◽  
Post Intervention Period ◽  
Secondary Outcomes ◽  
Very High

Introduction: The Physician Navigator (PN) is a novel position created to manage patient flow in real-time at a very-high volume emergency department (ED). When paired with an emergency physician, PNs actively track patient wait times, and direct the physician to see and re-assess patients in a particular order to improve measures of emergency department efficiency, and maximize patient flow. Anecdotal evidence has shown that PNs decrease length-of-stay times for non-resuscitative patients in the setting of increased patient volumes, and without additional nursing or physician hours. The objective was to study the operational impact of PN on emergency department patient flow. Methods: A 48-month pre-/post-intervention retrospective chart review at an urban community emergency department from September 2011 to September 2015. The PN program started on March 1, 2013. The main outcome is emergency department length-of-stay (LOS). Secondary outcomes include time to physician-initial-assessment (PIA), left-without-being-seen rates (LWBS), left-against-medical-advice (LAMA), and physician satisfaction rates. Autoregressive integrated moving average models were generated for Canadian Triage and Acuity Scale (CTAS) 2 to 5 patients to quantify the immediate impact of the intervention on the outcome levels, and whether the impact was sustained over time. Results: Interim results are provided. 399,958 patients attended the ED during the study period. Daily patient volumes increased 11.2% during the post-intervention period. There were no significant increases in the number of physicians shifts/day, and physician hours/day during the post-intervention period. Post-intervention, for CTAS 2-5 patients, there was a reduction in average LOS by 0.04 hours/PN (p<0.05), and 90th-percentile LOS by 0.14 hours/PN (p<0.05). For secondary outcomes, there was a decrease in overall average PIA by 6.37 minutes/PN (p<0.05), and 90th-percentile PIA by 8.29 minutes/PN (p<0.05). LWBS rates decreased by 40.8% (p<0.05). There were no significant changes in LAMA rates. Conclusion: The implementation of Physician Navigators is associated with significant reductions in LOS, PIA, and LWBS rates for non-resuscitative patients at a very-high volume emergency department.

scholarly journals Multidrug-Resistant Organism Infections in US Nursing Homes: A National Study of Prevalence, Onset, and Transmission across Care Settings, October 1, 2010-December 31, 2011

2014 ◽  
Vol 35 (S3) ◽  
pp. S48-S55 ◽  
Author(s):  
Daver Kahvecioglu ◽  
Kalpana Ramiah ◽  
Darcy McMaughan ◽  
Steven Garfinkel ◽  
Veronica E. McSorley ◽  
...  
Keyword(s):  
Patient Flow ◽  
High Volume ◽  
Multidrug Resistant ◽  
National Study ◽  
Resistant Organism ◽  
Term Care ◽  
Data Set ◽  
Urban Rural ◽  
Diagnosis Of Infection

Objective.To understand the prevalence of multidrug-resistant organism (MDRO) infections among nursing home (NH) residents and the potential for their spread between NHs and acute care hospitals (ACHs).Methods.Descriptive analyses of MDRO infections among NH residents using all NH residents in the Long-Term Care Minimum Data Set (MDS) 3.0 between October 1, 2010 and December 31, 2011.Results.Analysis of MDS data revealed a very high volume of bidirectional patient flow between NHs and ACHs, indicating the need to study MDRO infections in NHs as well as in hospitals. A total of 4.24% of NH residents had an active MDRO diagnosis on at least 1 MDS assessment during the study period. This rate significantly varied by sex, age, urban/rural status, and state. Approximately 2% of NH discharges to ACHs involved a resident with an active diagnosis of infection due to MDROs. Conversely, 1.8% of NH admissions from an ACH involved a patient with an active diagnosis of infection due to MDROs. Among residents who acquired an MDRO infection during the study period, 57% became positive in the NH, 41% in the ACH, and 2% in other settings (eg, at a private home or apartment).Conclusion.Even though NHs are the most likely setting where residents would acquire MDROs after admission to an NH (accounting for 57% of cases), a significant fraction of NH residents acquire MDRO infection at ACHs (41%). Thus, effective MDRO infection control for NH residents requires simultaneous, cooperative interventions among NHs and ACHs in the same community.

scholarly journals Modeling the impact of COVID-19 on Retina Clinic Performance

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Karan Sethi ◽  
Emily S. Levine ◽  
Shiyoung Roh ◽  
Jeffrey L. Marx ◽  
David J. Ramsey
Keyword(s):  
Patient Satisfaction ◽  
Patient Flow ◽  
Wait Time ◽  
High Volume ◽  
Clinical Encounter ◽  
Operational Performance ◽  
Discrete Events ◽  
Flow Through ◽  
The Impact ◽  
Total Visit

Abstract Background COVID-19, a highly contagious respiratory virus, presents unique challenges to ophthalmology practice as a high-volume, office-based specialty. In response to the COVID-19 pandemic, many operational changes were adopted in our ophthalmology clinic to enhance patient and provider safety while maintaining necessary clinical operations. The aim of this study was to evaluate how measures adopted during the pandemic period affected retina clinic performance and patient satisfaction, and to model future clinic flow to predict operational performance under conditions of increasing patient and provider volumes. Methods Clinic event timestamps and demographics were extracted from the electronic medical records of in-person retina encounters from March 15 to May 15, 2020 and compared with the same period in 2019 to assess patient flow through the clinical encounter. Patient satisfaction was evaluated by Press Ganey patient experience surveys obtained from randomly selected outpatient encounters. A discrete-events simulation was designed to model the clinic with COVID-era restrictions to assess operational performance under conditions of increasing patient and provider volumes. Results Retina clinic volume declined by 62 % during the COVID-19 health emergency. Average check-in-to-technician time declined 79 %, total visit length declined by 46 %, and time in the provider phase of care declined 53 %. Patient satisfaction regarding access nearly doubled during the COVID-period compared with the prior year (p < 0.0001), while satisfaction with overall care and safety remained high during both periods. A model incorporating COVID-related changes demonstrated that wait time before rooming reached levels similar to the pre-COVID era by 30 patients-per-provider in a 1-provider model and 25 patients-per-provider in a 2-provider model (p < 0.001). Capacity to maintain distancing between patients was exceeded only in the two 2-provider model above 25 patients-per-provider. Conclusions Clinic throughput was optimized in response to the COVID-19 health emergency. Modeling these clinic changes can help plan for eventual volume increases in the setting of limits imposed in the COVID-era.

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