scholarly journals Virtual Evaluation of a Hospital Congestion Prevention Method

2021 ◽  
Author(s):  
Wanxin Hou ◽  
Shaowen Qin ◽  
Campbell Henry Thompson
Keyword(s):  
Cost Effective ◽  
Simulation Modelling ◽  
Healthcare Sector ◽  
Risk Level ◽  
Coding System ◽  
Medical Patients ◽  
Affected Patient ◽  
Medical Department ◽  
Prevention Method ◽  
The Impact

Abstract Background: Hospital congestion is a common problem for the healthcare sector. Numerous studies explored reasons for crowding within some parts of the hospital. However, to deal with more general, hospital-wide problems, examining the hospital as a connected whole is necessary. The purpose of this study was to evaluate de-congestion interventions through a whole hospital simulation model and offer objective reasoning to support hospital management decisions.Method: This study tested a congestion prevention method that estimates the current day’s hospital congestion risk level R at a set time every morning, and activates minimum intervention when R is above certain threshold R(C), using a virtual hospital created by simulation modelling. The color-coding system was adopted to demonstrate the impact and the extent of effectiveness of this method in preventing hospital congestions.Results: The results indicated that adding 8 flex beds to the medical department resulted in more reductions (70.93%) of red-days comparing with the surgical ward (37.15%). Red days reduction per affected patient when discharging two medical patients was 0.1 which was higher than when discharging two surgical (0.04) or two long-stay patients (0.07). Also, the efficiency of red days reduction per affected patient is always greater if removing 2 patients than if discharging more patients. Conclusions: The expected outcome based on theoretical prediction of this method was confirmed, that is, applying a less disruptive intervention is often enough, and more cost effective, to reduce the risk level of hospital congestion. Making a small number of extra beds available was a superior solution compared to discharging approaches to reduce crowding in hospitals. In addition, the virtual implementation approach enabled testing of the method at a more detailed level, thereby revealed some interesting findings difficult to achieve theoretically, such as discharging extra two medical inpatients, rather than surgical inpatients, a day earlier on days when R>R(C), would bring more benefits in terms of congestion reduction for the hospital.

scholarly journals The impact of the collaborative workplace on the production system capacity: Simulation modelling vs. real-world application approach

2021 ◽  
Vol 16 (4) ◽  
pp. 431-442
Author(s):  
R. Ojstersek ◽  
A. Javernik ◽  
B. Buchmeister
Keyword(s):  
Real World ◽  
Production System ◽  
Manufacturing Systems ◽  
Cost Effective ◽  
Simulation Modelling ◽  
System Capacity ◽  
Manual Assembly ◽  
Production Capacities ◽  
Assembly Operations ◽  
The Impact

In recent years, there have been more and more collaborative workplaces in different types of manufacturing systems. Although the introduction of collaborative workplaces can be cost-effective, there is still much uncertainty about how such workplaces affect the capacity of the rest of production system. The article presents the importance of introducing collaborative workplaces in manual assembly operations where the production capacities are already limited. With the simulation modelling method, the evaluation of the introduction impact of collaborative workplaces on manual assembly operations that represent bottlenecks in the production process is presented. The research presents two approaches to workplace performance evaluation, both simulation modelling and a real-world collaborative workplace example, as a basis of a detailed time study. The main findings are comparisons of simulation modelling results and a study of a real-world collaborative workplace, with graphically and numerically presented parameters describing the utilization of production capacities, their efficiency and financial justification. The research confirms the expediency of the collaborative workplaces use and emphasise the importance of further research in the field of their technological and sociological impacts.

Marine Traffic Analysis

1982 ◽  
Vol 35 (3) ◽  
pp. 479-481 ◽  
Author(s):  
T. P. Whalley
Keyword(s):  
Computer Simulation ◽  
Cost Effective ◽  
Irish Sea ◽  
Risk Level ◽  
Computer Simulation Model ◽  
Traffic Patterns ◽  
Marine Traffic ◽  
The Irish Sea ◽  
The Impact ◽  
General Method

Many nations are debating the implementation of vessel traffic services (VTS) and it is envisaged that some regulation of the movement of marine traffic may soon be imposed. It is highly desirable that prior to any change a rigorous appraisal of the existing traffic be carried out to establish the level of risk in the area; this level can then be used to evaluate any proposed change. The following note describes a research project concerned with establishing a general method of determining the base risk level, developed from earlier research by M. Degré and M. Lefèvre who used a computer simulation of marine traffic in the Dover Strait to assess the impact of various suggested traffic separation schemes. A cost-effective tool has been developed at Liverpool which will enable traffic patterns to be studied in areas remote from the land. This is a computer simulation model which is being used to establish dynamic areas of risk in the Irish Sea, which could easily be transposed to study traffic patterns in any other area.

A regional model of sheep lice management practices for predicting the impact of treatment for lice when no lice are detected

2016 ◽  
Vol 56 (1) ◽  
pp. 24 ◽  
Author(s):  
Brian J. Horton ◽  
Andrew Bailey ◽  
Anna L. Carew
Keyword(s):  
Management Practices ◽  
Previous Treatment ◽  
Cost Effective ◽  
Regional Model ◽  
Treatment Costs ◽  
Risk Level ◽  
Sheep Industry ◽  
Intervention Level ◽  
The Impact

A model of sheep lice management incorporating different assumed levels of lice prevalence in different regions of Australia was used to determine the conditions under which it would be cost-effective to treat sheep for lice at shearing when no lice had been detected. The probability that a flock might be infested was calculated from the probability that the previous treatment had failed to eradicate lice, purchased sheep may have introduced lice, or lice may have entered on straying sheep. The model showed that a flock should be treated if the probability of infestation is greater than 10%. It was projected that acceptance of a risk level greater than 10% would reduce treatment of flocks where no lice were present, thus reducing treatment costs. This higher risk level, however, would increase the proportion of louse-infested flocks that remained untreated, resulting in increased direct lice costs and an increase in the regional prevalence of lice, but little overall change in costs to the sheep industry. The model indicated that treatment of sheep at lower levels of risk (less than 10%) would incur unnecessary costs due to treatment of flocks where no lice were present and would not reduce the regional prevalence of lice more effectively than a 10% intervention level. The model suggested that more accurate methods of detecting lice at shearing would allow higher levels of risk, reduce the use of treatment and hence reduce overall costs associated with managing lice, without increasing the prevalence of lice.

Regulatory and sustainability initiatives lead to improved polyaminopolyamide epichlorohydrin (PAE) wet-strength resins and paper products

TAPPI Journal ◽  
2018 ◽  
Vol 17 (09) ◽  
pp. 519-532 ◽  
Author(s):  
Mark Crisp ◽  
Richard Riehle
Keyword(s):  
Health And Safety ◽  
Cost Effective ◽  
Worker Safety ◽  
Regulatory Requirements ◽  
Wet Strength ◽  
The Past ◽  
Consumer Safety ◽  
Federal Institute ◽  
Sustainability Initiatives ◽  
The Impact

Polyaminopolyamide-epichlorohydrin (PAE) resins are the predominant commercial products used to manufacture wet-strengthened paper products for grades requiring wet-strength permanence. Since their development in the late 1950s, the first generation (G1) resins have proven to be one of the most cost-effective technologies available to provide wet strength to paper. Throughout the past three decades, regulatory directives and sustainability initiatives from various organizations have driven the development of cleaner and safer PAE resins and paper products. Early efforts in this area focused on improving worker safety and reducing the impact of PAE resins on the environment. These efforts led to the development of resins containing significantly reduced levels of 1,3-dichloro-2-propanol (1,3-DCP) and 3-monochloropropane-1,2-diol (3-MCPD), potentially carcinogenic byproducts formed during the manufacturing process of PAE resins. As the levels of these byproducts decreased, the environmental, health, and safety (EH&S) profile of PAE resins and paper products improved. Recent initiatives from major retailers are focusing on product ingredient transparency and quality, thus encouraging the development of safer product formulations while maintaining performance. PAE resin research over the past 20 years has been directed toward regulatory requirements to improve consumer safety and minimize exposure to potentially carcinogenic materials found in various paper products. One of the best known regulatory requirements is the recommendations of the German Federal Institute for Risk Assessment (BfR), which defines the levels of 1,3-DCP and 3-MCPD that can be extracted by water from various food contact grades of paper. These criteria led to the development of third generation (G3) products that contain very low levels of 1,3-DCP (typically <10 parts per million in the as-received/delivered resin). This paper outlines the PAE resin chemical contributors to adsorbable organic halogens and 3-MCPD in paper and provides recommendations for the use of each PAE resin product generation (G1, G1.5, G2, G2.5, and G3).

Exploring the Benefits of Early Contractor Involvement (ECI) and the Mechanism for Automated 5D BIM Quantification Process in Offsite Modular Construction

2016 ◽  
Author(s):  
Tochukwu Moses ◽  
David Heesom ◽  
David Oloke ◽  
Martin Crouch
Keyword(s):  
Effective Means ◽  
Cost Effective ◽  
Modular Construction ◽  
Automated Quantification ◽  
Building Information ◽  
Project Risks ◽  
Value Add ◽  
The Uk ◽  
The Impact ◽  
Level 2

The UK Construction Industry through its Government Construction Strategy has recently been mandated to implement Level 2 Building Information Modelling (BIM) on public sector projects. This move, along with other initiatives is key to driving a requirement for 25% cost reduction (establishing the most cost-effective means) on. Other key deliverables within the strategy include reduction in overall project time, early contractor involvement, improved sustainability and enhanced product quality. Collaboration and integrated project delivery is central to the level 2 implementation strategy yet the key protocols or standards relative to cost within BIM processes is not well defined. As offsite construction becomes more prolific within the UK construction sector, this construction approach coupled with BIM, particularly 5D automated quantification process, and early contractor involvement provides significant opportunities for the sector to meet government targets. Early contractor involvement is supported by both the industry and the successive Governments as a credible means to avoid and manage project risks, encourage innovation and value add, making cost and project time predictable, and improving outcomes. The contractor is seen as an expert in construction and could be counter intuitive to exclude such valuable expertise from the pre-construction phase especially with the BIM intent of äóÖbuild it twiceäó», once virtually and once physically. In particular when offsite construction is used, the contractoräó»s construction expertise should be leveraged for the virtual build in BIM-designed projects to ensure a fully streamlined process. Building in a layer of automated costing through 5D BIM will bring about a more robust method of quantification and can help to deliver the 25% reduction in overall cost of a project. Using a literature review and a case study, this paper will look into the benefits of Early Contractor Involvement (ECI) and the impact of 5D BIM on the offsite construction process.

Pound Wise and Penny Foolish? Weight Loss and The Dynamics of Health Care Spending

2011 ◽  
Vol 14 (2) ◽  
Author(s):  
Thomas G Koch
Keyword(s):  
Weight Loss ◽  
Cost Savings ◽  
Cost Effective ◽  
Economic Consequences ◽  
Health Care Spending ◽  
Order Of Magnitude ◽  
Dynamic Measures ◽  
The Cost ◽  
The Impact ◽  
The Relationship

Current estimates of obesity costs ignore the impact of future weight loss and gain, and may either over or underestimate economic consequences of weight loss. In light of this, I construct static and dynamic measures of medical costs associated with body mass index (BMI), to be balanced against the cost of one-time interventions. This study finds that ignoring the implications of weight loss and gain over time overstates the medical-cost savings of such interventions by an order of magnitude. When the relationship between spending and age is allowed to vary, weight-loss attempts appear to be cost-effective starting and ending with middle age. Some interventions recently proven to decrease weight may also be cost-effective.

Motivating Compliance: Firm Response to Mandatory Disclosure Policies

2018 ◽  
Vol 32 (2) ◽  
pp. 103-119
Author(s):  
Colleen M. Boland ◽  
Chris E. Hogan ◽  
Marilyn F. Johnson
Keyword(s):  
Conflict Of Interest ◽  
Low Cost ◽  
Cost Effective ◽  
Data Availability ◽  
Policy Adoption ◽  
Future Research ◽  
Regulated Firms ◽  
Firm Response ◽  
Disclosure Rules ◽  
The Impact

SYNOPSIS Mandatory existence disclosure rules require an organization to disclose a policy's existence, but not its content. We examine policy adoption frequencies in the year immediately after the IRS required mandatory existence disclosure by nonprofits of various governance policies. We also examine adoption frequencies in the year of the subsequent change from mandatory existence disclosure to a disclose-and-explain regime that required supplemental disclosures about the content and implementation of conflict of interest policies. Our results suggest that in areas where there is unclear regulatory authority, mandatory existence disclosure is an effective and low cost regulatory device for encouraging the adoption of policies desired by regulators, provided those policies are cost-effective for regulated firms to implement. In addition, we find that disclose-and-explain regulatory regimes provide stronger incentives for policy adoption than do mandatory existence disclosure regimes and also discourage “check the box” behavior. Future research should examine the impact of mandatory existence disclosure rules in the year that the regulation is implemented. Data Availability: Data are available from sources cited in the text.

Decision Aids for Generating Analytical Review Alternatives: The Impact of Goal Framing and Audit-Risk Level

2002 ◽  
Vol 14 (1) ◽  
pp. 157-177 ◽  
Author(s):  
Jennifer M. Mueller ◽  
John C. Anderson
Keyword(s):  
High Risk ◽  
Cognitive Load ◽  
Information Search ◽  
Decision Aid ◽  
Decision Aids ◽  
Risk Level ◽  
Audit Risk ◽  
Goal Framing ◽  
Analytical Review ◽  
The Impact

An auditor generating potential explanations for an unusual variance in analytical review may utilize a decision aid, which provides many explanations. However, circumstances of budgetary constraints and limited cognitive load deter an auditor from using a lengthy list of explanations in an information search. A two-way between-subjects design was created to investigate the effects of two complementary approaches to trimming down the lengthy list on the number of remaining explanations carried forward into an information search. These two approaches, which represent the same goal (reducing the list) but framed differently, are found to result in a significantly different number of remaining explanations, in both low- and high-risk audit environments. The results of the study suggest that the extent to which an auditor narrows the lengthy list of explanations is important to the implementation of decision aids in analytical review.

scholarly journals Control of Oxygen Impurities in a Continuous-Feeding Czochralski-Silicon Crystal Growth by the Double-Crucible Method

Crystals ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 264
Author(s):  
Wenhan Zhao ◽  
Jiancheng Li ◽  
Lijun Liu
Keyword(s):  
Oxygen Concentration ◽  
Silicon Crystal ◽  
Cost Effective ◽  
Czochralski Method ◽  
Crucible Wall ◽  
Oxygen Impurity ◽  
Continuous Feeding ◽  
The Impact ◽  
Oxygen Impurities ◽  
Crystal Interface

The continuous-feeding Czochralski method is a cost-effective method to grow single silicon crystals. An inner crucible is used to prevent the un-melted silicon feedstock from transferring to the melt-crystal interface in this method. A series of global simulations were carried out to investigate the impact of the inner crucible on the oxygen impurity distributions at the melt-crystal interface. The results indicate that, the inner crucible plays a more important role in affecting the O concentration at the melt-crystal interface than the outer crucible. It can prevent the oxygen impurities from being transported from the outer crucible wall effectively. Meanwhile, it also introduces as a new source of oxygen impurity in the melt, likely resulting in a high oxygen concentration zone under the melt-crystal interface. We proposed to enlarge the inner crucible diameter so that the oxygen concentration at the melt-crystal interface can be controlled at low levels.

scholarly journals Cost-effectiveness and feasibility of conditional economic incentives and motivational interviewing to improve HIV health outcomes of adolescents living with HIV in Anambra State, Nigeria

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Obinna Ikechukwu Ekwunife ◽  
Chinelo Janefrances Ofomata ◽  
Charles Ebuka Okafor ◽  
Maureen Ugonwa Anetoh ◽  
Stephen Okorafor Kalu ◽  
...  
Keyword(s):  
Viral Load ◽  
Cost Effectiveness ◽  
Service Delivery ◽  
Motivational Interviewing ◽  
Cost Effective ◽  
Economic Incentives ◽  
Additional Patient ◽  
Incentive Scheme ◽  
The Cost ◽  
The Impact

Abstract Background In sub-Saharan Africa, there is increasing mortality and morbidity of adolescents due to poor linkage, retention in HIV care and adherence to antiretroviral therapy (ART). This is a result of limited adolescent-centred service delivery interventions. This cost-effectiveness and feasibility study were piggybacked on a cluster-randomized trial that assessed the impact of an adolescent-centred service delivery intervention. The service delivery intervention examined the impact of an incentive scheme consisting of conditional economic incentives and motivational interviewing on the health outcomes of adolescents living with HIV in Nigeria. Method A cost-effectiveness analysis from the healthcare provider’s perspective was performed to assess the cost per additional patient achieving undetected viral load through the proposed intervention. The cost-effectiveness of the incentive scheme over routine care was estimated using the incremental cost-effectiveness ratio (ICER), expressed as cost/patient who achieved an undetectable viral load. We performed a univariate sensitivity analysis to examine the effect of key parameters on the ICER. An in-depth interview was conducted on the healthcare personnel in the intervention arm to explore the feasibility of implementing the service delivery intervention in HIV treatment hospitals in Nigeria. Result The ICER of the Incentive Scheme intervention compared to routine care was US$1419 per additional patient with undetectable viral load. Going by the cost-effectiveness threshold of US$1137 per quality-adjusted life-years suggested by Woods et al., 2016, the intervention was not cost-effective. The sensitivity test showed that the intervention will be cost-effective if the frequency of CD4 count and viral load tests are reduced from quarterly to triannually. Healthcare professionals reported that patients’ acceptance of the intervention was very high. Conclusion The conditional economic incentives and motivational interviewing was not cost-effective, but can become cost-effective if the frequency of HIV quality of life indicator tests are performed 1–3 times per annum. Patients’ acceptance of the intervention was very high. However, healthcare professionals believed that sustaining the intervention may be difficult unless factors such as government commitment and healthcare provider diligence are duly addressed. Trial registration This trial is registered in the WHO International Clinical Trials Registry through the WHO International Registry Network (PACTR201806003040425).

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