scholarly journals Cost Objects: The ED Dilemma. How is your ED performing?

2019 ◽  
Author(s):  
Verónica Fuentes ◽  
Liliana Neriz ◽  
Alicia Nunez ◽  
Ricardo Mateo
Keyword(s):  
Decision Making ◽  
Classification Systems ◽  
Cost Comparison ◽  
Case Mix ◽  
Unit Management ◽  
Two Stages ◽  
Cost Object ◽  
Similar Combination

Abstract Background The aim of this study is to propose a list of cost objects that can be used by any ED to compute costs considering that the resulting data must facilitate unit management by improving the information available for decision-making. Methods This study considers two stages, first, We analyzed the case-mix of two hospitals collecting their data to define and diagram their processes, activities and to obtain their cost objects, second, we used four additional hospitals to validate our initial findings. Results We recognized 59 cost objects. Hospitals may have all these cost objects or just a subset of them depending on the services they provide. Conclusions Among the main benefits of our cost objects definition are: the possibility of tracing the processes generated by the services delivered by EDs, the economic sense in its grouping, the chance of using any costing methodology, the flexibility with other classification systems such as DRGs and ICDs, and the opportunity of costing for both diseases and treatments. Furthermore, cost comparison among hospitals using our final 59 cost objects list is more accurate and based on comparable units. In different EDs, each cost object will be the result of a similar combination of activities performed. We also present the results of applying this cost objects list to a particular ED. A total of 54 out of 59 cost objects were identified for that particular unit within a calendar year.

scholarly journals Cost Objects: The ED Dilemma. How is your ED performing?

2020 ◽  
Author(s):  
Verónica Fuentes ◽  
Liliana Neriz ◽  
Alicia Nunez ◽  
Ricardo Mateo
Keyword(s):  
Decision Making ◽  
Classification Systems ◽  
Cost Comparison ◽  
Case Mix ◽  
Unit Management ◽  
Two Stages ◽  
Cost Object ◽  
Similar Combination

Abstract Background: The aim of this study is to a propose a standardized methodology to identify a list of cost objects that can be used by any ED to compute costs considering that the resulting data must facilitate unit management by improving the information available for decision-making. Methods: This study considers two stages, first, we analyzed the case-mix of two hospitals collecting their data to define and diagram their processes, activities and to obtain their cost objects, second, we used four additional hospitals to validate our initial findings. Results: We recognized 59 cost objects. Hospitals may have all these cost objects or just a subset of them depending on the services they provide. Conclusions: Among the main benefits of our cost objects definition are: the possibility of tracing the processes generated by the services delivered by EDs, the economic sense in its grouping, the chance of using any costing methodology, the flexibility with other classification systems such as DRGs and ICDs, and the opportunity of costing for both diseases and treatments. Furthermore, cost comparison among hospitals using our final 59 cost objects list is more accurate and based on comparable units. In different EDs, each cost object will be the result of a similar combination of activities performed. We also present the results of applying this cost objects list to a particular ED. A total of 53 out of 59 cost objects were identified for that particular unit within a calendar year.

scholarly journals Cost Objects: The ED Dilemma. How is your ED performing?

2019 ◽  
Author(s):  
Verónica Fuentes ◽  
Liliana Neriz ◽  
Alicia Nunez ◽  
Ricardo Mateo
Keyword(s):  
Decision Making ◽  
Classification Systems ◽  
Cost Comparison ◽  
Case Mix ◽  
Unit Management ◽  
Two Stages ◽  
Cost Object ◽  
Similar Combination

Abstract Background The aim of this study is to propose a list of cost objects that can be used by any ED to compute costs considering that the resulting data must facilitate unit management by improving the information available for decision-making. Methods This study considers two stages, first, We analyzed the case-mix of two hospitals collecting their data to define and diagram their processes, activities and to obtain their cost objects, second, we used four additional hospitals to validate our initial findings. Results We recognized 59 cost objects. Hospitals may have all these cost objects or just a subset of them depending on the services they provide. Conclusions Among the main benefits of our cost objects definition are: the possibility of tracing the processes generated by the services delivered by EDs, the economic sense in its grouping, the chance of using any costing methodology, the flexibility with other classification systems such as DRGs and ICDs, and the opportunity of costing for both diseases and treatments. Furthermore, cost comparison among hospitals using our final 59 cost objects list is more accurate and based on comparable units. In different EDs, each cost object will be the result of a similar combination of activities performed. We also present the results of applying this cost objects list to a particular ED. A total of 54 out of 59 cost objects were identified for that particular unit within a calendar year.

scholarly journals Toward the Development of a Comprehensive Clinically Oriented Patient Profile: A Systematic Review of the Purpose, Characteristic, and Methodological Quality of Classification Systems of Adult Spinal Deformity

Neurosurgery ◽  
2021 ◽  
Author(s):  
Kenny Yat Hong Kwan ◽  
J Naresh-Babu ◽  
Wilco Jacobs ◽  
Marinus de Kleuver ◽  
David W Polly ◽  
...  
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Classification System ◽  
Methodological Quality ◽  
Literature Search ◽  
Adult Spinal Deformity ◽  
Classification Systems ◽  
Systematic Literature Search ◽  
Patient Profile

Abstract BACKGROUND Existing adult spinal deformity (ASD) classification systems are based on radiological parameters but management of ASD patients requires a holistic approach. A comprehensive clinically oriented patient profile and classification of ASD that can guide decision-making and correlate with patient outcomes is lacking. OBJECTIVE To perform a systematic review to determine the purpose, characteristic, and methodological quality of classification systems currently used in ASD. METHODS A systematic literature search was conducted in MEDLINE, EMBASE, CINAHL, and Web of Science for literature published between January 2000 and October 2018. From the included studies, list of classification systems, their methodological measurement properties, and correlation with treatment outcomes were analyzed. RESULTS Out of 4470 screened references, 163 were included, and 54 different classification systems for ASD were identified. The most commonly used was the Scoliosis Research Society-Schwab classification system. A total of 35 classifications were based on radiological parameters, and no correlation was found between any classification system levels with patient-related outcomes. Limited evidence of limited quality was available on methodological quality of the classification systems. For studies that reported the data, intraobserver and interobserver reliability were good (kappa = 0.8). CONCLUSION This systematic literature search revealed that current classification systems in clinical use neither include a comprehensive set of dimensions relevant to decision-making nor did they correlate with outcomes. A classification system comprising a core set of patient-related, radiological, and etiological characteristics relevant to the management of ASD is needed.

Letter to the editor: Using classification systems to integrate ecosystem services with decision making tools

2021 ◽  
Vol 48 ◽  
pp. 101257
Author(s):  
John Finisdore ◽  
Karl A. Lamothe ◽  
Charles R. Rhodes ◽  
Carl Obst ◽  
Pieter Booth ◽  
...  
Keyword(s):  
Decision Making ◽  
Ecosystem Services ◽  
Classification Systems ◽  
Letter To The Editor

Abstract W P266: A Simple Score for Prediction of Outcome after Cerebral Venous Thrombosis

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Miguel A Barboza ◽  
Erwin Chiquete ◽  
Antonio Arauz ◽  
Jonathan Colín ◽  
Alejandro Quiroz-Compean ◽  
...  
Keyword(s):  
Decision Making ◽  
Venous Thrombosis ◽  
Predictive Value ◽  
Cerebral Venous Thrombosis ◽  
Goodness Of Fit ◽  
Clinical Decision Making ◽  
Case Fatality ◽  
Clinical Decision ◽  
Classification Systems ◽  
Cox Proportional Hazards Model

Background and purpose: Cerebral venous thrombosis (CVT) not always implies a good prognosis. There is a need for robust and simple classification systems of severity after CVT that help in clinical decision-making. Methods: We studied 467 patients (81.6% women, median age: 29 years, interquartile range: 22-38 years) with CVT who were hospitalized from 1980 to 2014 in two third-level referral hospitals. Bivariate analyses were performed to select variables associated with 30-day mortality to integrate a further multivariate analysis. The resultant model was evaluated with the Hosmer-Lemeshow test for goodness of fit, and on Cox proportional hazards model for reliability of the effect size. After the scale was configured, security and validity were tested for 30-day mortality and modified Rankin scale (mRS) >2. The prognostic performance was compared with that of the CVT risk score (CVT-RS, 0-6 points) as the reference system. Results: The 30-day case fatality rate was 8.7%. The CVT grading scale (CVT-GS, 0-9 points) was integrated by stupor/coma (4 points), parenchymal lesion >6 cm (2 points), mixed (superficial and deep systems) CVT (1 point), meningeal syndrome (1 point) and seizures (1 point). CVT-GS was categorized into mild (0-3 points, 1.1% mortality), moderate (4-6 points, 19.6% mortality) and severe (7-9 points, 61.4% mortality). For 30-day mortality prediction, as compared with CVT-RS (cut-off 4 points), CVT-GS (cut-off 5 points) was globally better in sensitivity (85% vs 37%), specificity (90% vs 95%), positive predictive value (44% vs 40%), negative predictive value (98% vs 94%), and accuracy (94% vs 80%). For 30-day mRS >2 the performance of CVT-GS over CVT-RS was comparably improved. Conclusion: The CVT-GS is a simple and reliable score for predicting outcome that may help in clinical decision-making and that could be used to stratify patients recruited into clinical trials.

scholarly journals Methodology of Integration for Competitive Technical Intelligence with Blue Ocean Strategy: Application to an exotic fruit

2011 ◽  
Vol 1 (1) ◽  
Author(s):  
Marisela Rodríguez Salvador ◽  
Manuel Alejandro Bautista Reyes
Keyword(s):  
Decision Making ◽  
The State ◽  
Anacardium Occidentale ◽  
Critical Factors ◽  
The South ◽  
Strategic Development ◽  
Technical Intelligence ◽  
New Business ◽  
Two Stages ◽  
The University

This article presents a new methodology that integrates Competitive Technical Intelligence with Blue Ocean Strategy. We explore new business niches taking advantage of the synergy that both areas offer, developing a model based on cyclic interactions through a process developed in two stages: Understanding opportunity that arise from idea formulation to decision making and strategic development. The validity of our approach (first stage) was observed in the evaluation of an exotic fruit, Anacardium Occidentale, in the South of the State of Veracruz, Mexico with the support of the university ITESM, Campus Monterrey. We identified critical factors for success, opportunities and threats. Results confirm the attractiveness of this crop.

“ABCD” Implant Classification: A Comprehensive Philosophy for Treatment Planning in Completely Edentulous Arches

2020 ◽  
Vol 46 (2) ◽  
pp. 93-99 ◽  
Author(s):  
Ali Tunkiwala ◽  
Udatta Kher ◽  
Nupur H. Vaidya
Keyword(s):  
Decision Making ◽  
Treatment Planning ◽  
Present Article ◽  
Treatment Plan ◽  
Bone Volume ◽  
Classification Systems ◽  
Decision Making Process ◽  
Careful Attention ◽  
Treatment Needs ◽  
Vital Parameters

A thorough and precise treatment plan that considers various factors such as age, availability of bone, interarch space for prosthesis design, smile line, lip support, patient desires, and economics is a necessity before implant surgery. Many previous classification systems for treatment planning in edentulous situations tend to focus on only a certain parameter such as esthetics, or available bone volume, or are specifically designed for the maxilla or mandible. The authors have proposed a simplified and universal ABCD classification that uses the 4 vital parameters of age, bone volume, cosmetic display, and degree of resorption to create an algorithm that satisfies the treatment needs of every patient. Various permutations of the 4 parameters can be used to arrive at a solution that streamlines the further phases of the rehabilitative process. The aim of the present article is to provide a science-driven approach to understand a patient's individual needs with careful attention to the interplay of all the aforementioned factors in the decision-making process.

The Impact of Computed Tomography on Decision Making in Tibial Plateau Fractures

2018 ◽  
Vol 31 (10) ◽  
pp. 1007-1014 ◽  
Author(s):  
Marcello Castiglia ◽  
Marcello Nogueira-Barbosa ◽  
Andre Messias ◽  
Rodrigo Salim ◽  
Fabricio Fogagnolo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Decision Making ◽  
Surgical Approach ◽  
Tibial Plateau ◽  
Classification Systems ◽  
Tibial Plateau Fractures ◽  
Surgical Approaches ◽  
Plain Radiographs ◽  
Schatzker Classification ◽  
The Impact

AbstractSchatzker introduced one of the most used classification systems for tibial plateau fractures, based on plain radiographs. Computed tomography brought to attention the importance of coronal plane-oriented fractures. The goal of our study was to determine if the addition of computed tomography would affect the decision making of surgeons who usually use the Schatzker classification to assess tibial plateau fractures. Image studies of 70 patients who sustained tibial plateau fractures were uploaded to a dedicated homepage. Every patient was linked to a folder which contained two radiographic projections (anteroposterior and lateral), three interactive videos of computed tomography (axial, sagittal, and coronal), and eight pictures depicting tridimensional reconstructions of the tibial plateau. Ten attending orthopaedic surgeons, who were blinded to the cases, were granted access to the homepage and assessed each set of images in two different rounds, separated to each other by an interval of 2 weeks. Each case was evaluated in three steps, where surgeons had access, respectively to radiographs, two-dimensional videos of computed tomography, and three-dimensional reconstruction images. After every step, surgeons were asked to present how would they classify the case using the Schatzker system and which surgical approaches would be appropriate. We evaluated the inter- and intraobserver reliability of the Schatzker classification using the Kappa concordance coefficient, as well as the impact of computed tomography in the decision making regarding the surgical approach for each case, by using the chi-square test and likelihood ratio. The interobserver concordance kappa coefficients after each assessment step were, respectively, 0.58, 0.62, and 0.64. For the intraobserver analysis, the coefficients were, respectively, 0.76, 0.75, and 0.78. Computed tomography changed the surgical approach selection for the types II, V, and VI of Schatzker (p < 0.01). The addition of computed tomography scans to plain radiographs improved the interobserver reliability of Schatzker classification. Computed tomography had a statistically significant impact in the selection of surgical approaches for the lateral tibial plateau.

Online decision aids: the role of decision-making styles and decision-making stages

2020 ◽  
Vol 48 (6) ◽  
pp. 555-574
Author(s):  
Preeti Virdi ◽  
Arti D. Kalro ◽  
Dinesh Sharma
Keyword(s):  
Decision Making ◽  
Decision Aids ◽  
Online Retail ◽  
Consideration Set ◽  
Choice Process ◽  
Content Type ◽  
Choice Making ◽  
Search Tool ◽  
Consideration Set Formation ◽  
Two Stages

PurposeDecision aids (DAs) in online retail stores ease consumers' information processing. However, online consumers do not use all decision aids in purchase decision-making. While the literature has documented the effects of individual decision aids or two decision aids at a time, no study has compared the efficacy of multiple decision aids simultaneously. Also, very few studies have looked at the use of decision aids for consumers with maximizing and satisficing tendencies. Hence, this study aims to understand the preferences of maximizers and satisficers towards online decision aids during the choice-making process.Design/methodology/approachThis is an observational study with 60 individuals who were asked to purchase either a search-based or an experience-based product online. Participants' browsing actions and verbalizations during online shopping, were recorded and analysed using NVivo, and later the use of decision aids was mapped along their choice process.FindingsConsumer's preference of decision aids varies across the two stages of the choice process (that is, consideration set formation and evaluation & choice). In their choice formation, maximizers use different decision aids in both stages, that is, filter tool and in-website search tool for search products, and collaborative filtering-based recommender systems and eWOM for experience products. Satisficers used more decision aids as compared to maximizers across the two stages for both product types.Originality/valueThis study is an exploratory attempt to understand how consumers use multiple decision aids present on e-commerce websites.

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