The Optimal Workforce Staffing Solutions With Random Patient Demand in Healthcare Settings

2018 ◽  
pp. 3711-3724
Author(s):  
Alexander Kolker
Keyword(s):  
Quality Of Care ◽  
Planning Process ◽  
Accurate Assessment ◽  
Specific Time ◽  
Staffing Level ◽  
Total Cost ◽  
Healthcare Settings ◽  
Time Period ◽  
Cost Efficient

Staffing planning is paramount for cost-efficient workforce management. An accurate assessment of the required staffing level for the specific time period is an integral part of the hospital budgeting and planning process. Daily fluctuations of patient census create staffing planning challenges to many organizations. There is a growing trend for hospitals to use data analytics for determining the optimal staffing solutions. The dynamic nature of the staffing process creates two types of issues: (1) overstaffing vs. the planned budgeted level, which hurts operations margins; or (2) understaffing, which requires costly overtime and/or premium pay that also hurts margins and causes substandard quality of care. The goal of this chapter is providing an overview and examples of application of the methodology called the “newsvendor” framework. This methodology helps developing the optimal nursing and other skill mix staffing solutions that minimize the total cost of over- and understaffing occurrences within the specified time period for the units with random patient census fluctuations.

The Optimal Workforce Staffing Solutions With Random Patient Demand in Healthcare Settings

2019 ◽  
pp. 158-174
Author(s):  
Alexander Kolker
Keyword(s):  
Quality Of Care ◽  
Planning Process ◽  
Accurate Assessment ◽  
Specific Time ◽  
Staffing Level ◽  
Total Cost ◽  
Healthcare Settings ◽  
Time Period ◽  
Cost Efficient

Staffing planning is paramount for cost-efficient workforce management. An accurate assessment of the required staffing level for the specific time period is an integral part of the hospital budgeting and planning process. Daily fluctuations of patient census create staffing planning challenges to many organizations. There is a growing trend for hospitals to use data analytics for determining the optimal staffing solutions. The dynamic nature of the staffing process creates two types of issues: (1) overstaffing vs. the planned budgeted level, which hurts operations margins, or (2) understaffing, which requires costly overtime and/or premium pay that also hurts margins and causes substandard quality of care. The goal of this chapter is providing an overview and examples of application of the methodology called the “newsvendor” framework. This methodology helps to develop the optimal nursing and other skill mix staffing solutions that minimize the total cost of over- and understaffing occurrences within the specified time period for the units with random patient census fluctuations.

Reduced influence of affective disorders on perioperative complication rates, length of hospital stay, and healthcare costs following spinal fusion for adolescent idiopathic scoliosis

2019 ◽  
Vol 24 (6) ◽  
pp. 722-727
Author(s):  
Aladine A. Elsamadicy ◽  
Andrew B. Koo ◽  
Megan Lee ◽  
Adam J. Kundishora ◽  
Christopher S. Hong ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Idiopathic Scoliosis ◽  
Affective Disorder ◽  
Affective Disorders ◽  
Complication Rates ◽  
Total Cost ◽  
Adolescent Patients ◽  
Perioperative Complication ◽  
The Impact

OBJECTIVEIn the past decade, a gradual transition of health policy to value-based healthcare has brought increased attention to measuring the quality of care delivered. In spine surgery, adolescents with scoliosis are a population particularly at risk for depression, anxious feelings, and impaired quality of life related to back pain and cosmetic appearance of the deformity. With the rising prevalence of mental health ailments, it is necessary to evaluate the impact of concurrent affective disorders on patient care after spinal surgery in adolescents. The aim of this study was to investigate the impact that affective disorders have on perioperative complication rates, length of stay (LOS), and total costs in adolescents undergoing elective posterior spinal fusion (PSF) (≥ 4 levels) for idiopathic scoliosis.METHODSA retrospective study of the Kids’ Inpatient Database for the year 2012 was performed. Adolescent patients (age range 10–17 years old) with AIS undergoing elective PSF (≥ 4 levels) were selected using the International Classification of Diseases, Ninth Revision, Clinical Modification coding system. Patients were categorized into 2 groups at discharge: affective disorder or no affective disorder. Patient demographics, comorbidities, complications, LOS, discharge disposition, and total cost were assessed. The primary outcomes were perioperative complication rates, LOS, total cost, and discharge dispositions.RESULTSThere were 3759 adolescents included in this study, of whom 164 (4.4%) were identified with an affective disorder (no affective disorder: n = 3595). Adolescents with affective disorders were significantly older than adolescents with no affective disorders (affective disorder: 14.4 ± 1.9 years vs no affective disorder: 13.9 ± 1.8 years, p = 0.001), and had significantly different proportions of race (p = 0.005). Aside from hospital region (p = 0.016), no other patient- or hospital-level factors differed between the cohorts. Patient comorbidities did not differ significantly between cohorts. The number of vertebral levels involved was similar between the cohorts, with the majority of patients having 9 or more levels involved (affective disorder: 76.8% vs no affective disorder: 79.5%, p = 0.403). Postoperative complications were similar between the cohorts, with no significant difference in the proportion of patients experiencing a postoperative complication (p = 0.079) or number of complications (p = 0.124). The mean length of stay and mean total cost were similar between the cohorts. Moreover, the routine and nonroutine discharge dispositions were also similar between the cohorts, with the majority of patients having routine discharges (affective disorder: 93.9% vs no affective disorder: 94.9%, p = 0.591).CONCLUSIONSThis study suggests that affective disorders may not have a significant impact on surgical outcomes in adolescent patients undergoing surgery for scoliosis in comparison with adults. Further studies are necessary to elucidate how affective disorders affect adolescent patients with idiopathic scoliosis, which may improve provider approach in managing these patients perioperatively and at follow-up in hopes to better the overall patient satisfaction and quality of care delivered.

The ENT emergency clinic: does senior input matter?

2012 ◽  
Vol 127 (1) ◽  
pp. 15-19 ◽  
Author(s):  
A Mirza ◽  
L McClelland ◽  
M Daniel ◽  
N Jones
Keyword(s):  
Quality Of Care ◽  
Discharge Rate ◽  
Surrogate Marker ◽  
Operating Theatre ◽  
Number Of Children ◽  
Discharge Rates ◽  
Time Period ◽  
Number Of Patients

AbstractBackground:Many ENT conditions can be treated in the emergency clinic on an ambulatory basis. Our clinic traditionally had been run by foundation year two and specialty trainee doctors (period one). However, with perceived increasing inexperience, a dedicated registrar was assigned to support the clinic (period two). This study compared admission and discharge rates for periods one and two to assess if greater registrar input affected discharge rate; an increase in discharge rate was used as a surrogate marker of efficiency.Method:Data was collected prospectively for patients seen in the ENT emergency clinic between 1 August 2009 and 31 July 2011. Time period one included data from patients seen between 1 August 2009 and 31 July 2010, and time period two included data collected between 1 August 2010 and 31 July 2011.Results:The introduction of greater registrar support increased the number of patients that were discharged, and led to a reduction in the number of children requiring the operating theatre.Conclusion:The findings, which were determined using clinic outcomes as markers of the quality of care, highlighted the benefits of increasing senior input within the ENT emergency clinic.

scholarly journals Exploring the Relationship between Window View Quantity, Quality, and Ratings of Care in the Hospital

2021 ◽  
Vol 18 (20) ◽  
pp. 10677
Author(s):  
Sahar Mihandoust ◽  
Anjali Joseph ◽  
Sara Kennedy ◽  
Piers MacNaughton ◽  
May Woo
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Care ◽  
Healthcare Settings ◽  
Hospital Access ◽  
Room Design ◽  
Unit Increase ◽  
Set Up ◽  
Perception Of Care ◽  
Satisfaction Measures

Hospital ratings reflect patient satisfaction, consumer perception of care, and create the context for quality improvement in healthcare settings. Despite an abundance of studies on the health benefits of the presence and content of window views, there is a gap in research examining how these features may impact patient satisfaction and consumer perceptions of the quality of care received. A quantitative exploratory study collected data from 652 participants regarding their previous stay in the hospital, their perception of windows in their room, and their perception of their room, the hospital, and the quality of care received. On a scale of 0–10, participants with access to windows gave a 1-unit higher rating for the hospital. Access to window views from their bed provided a 1-unit increase, and having a view to green spaces resulted in a 2-unit increase in hospital ratings. Statistically significant results were also found for room ratings and care ratings. Windows in the patient rooms impact the key patient satisfaction measures and patient experience during the hospital stay. Patient room design, bed set up, and quantity and quality of window views may play an important role in shaping the patient’s experience.

Towards Efficient Trust Aware E-Marketplace Frameworks

2010 ◽  
pp. 273-283
Author(s):  
Malamati Louta ◽  
Angelos Michalas
Keyword(s):  
Service Providers ◽  
Quality Level ◽  
Service Provisioning ◽  
Key Factors ◽  
Efficient Manner ◽  
Time Period ◽  
Service Operation ◽  
Cost Efficient ◽  
Posted Offer

In the liberalized and deregulated e-marketplace some key factors for service providers’ success are the following. First, the efficiency with which services will be developed. Second, the quality level, in relation with the corresponding cost, of new services. Third, service providers’ reliability with respect to service provisioning. Fourth, the efficiency with which the services will be operated (controlled, maintained, administered, etc.). The aim of this paper is, in accordance with efficient service operation objectives, to propose enhancements to the sophistication of the negotiation functionality that can be offered by e-commerce systems in open competitive communications environments. In the highly competitive and dynamic emarketplaces, Service/Product Requestors (SPRs) should be provided with mechanisms that enable them to find and associate with the most appropriate Service/Product Providers (SPPs), i.e., those offering the desirable quality of service / product at a certain time period, in a cost efficient manner. Such mechanisms may entail a wide variety of negotiation mechanisms, including auctions, bilateral (1 to 1) and/or multilateral (M to N) negotiation models and strategies, as well as posted offer schemes (i.e., a nonnegotiable, take-it-or-leave-it offer) in order to establish the ‘best’ possible contract terms and conditions with respect to service / product access and provision.

scholarly journals Financial cost of elective day of surgery cancellations

2018 ◽  
Vol 7 (5) ◽  
pp. 30
Author(s):  
Elina Turunen ◽  
Merja Miettinen ◽  
Leena Setälä ◽  
Katri Vehviläinen-Julkunen
Keyword(s):  
Healthcare Services ◽  
University Hospital ◽  
Financial Loss ◽  
Financial Cost ◽  
Total Cost ◽  
Operative Care ◽  
Time Period ◽  
Cancellation Rate ◽  
The Cost

Operative care is one of the major areas of healthcare services as over 310 million surgeries are conducted yearly. Surgery cancellations is a widely used indicator when evaluating the quality of preoperative care. Cancellations cause financial lost for organizations, however there is only limited research about the costs. The aim of this study was to evaluate the cost of elective day of surgery (DOS) cancellations in 13 operative specialties at a university hospital in Finland between September 1, 2015 and May 31, 2016 after a structured preoperative protocol was implemented to practice and a cancellation rate of 4.7% was recognized. Procedure prices conducted the data for the research and were collected from the hospital’s invoicing system. Financial loss and savings of cancellations were calculated from the total cost of procedures. As a result the total cost of DOS cancellations during the nine-month time period was 953,374.27 euros and mean loss of a single cancelled operation was 2,459.91 euros. The total of material savings for the hospital were 106,917.33 euros. As a conclusion, DOS cancellations cause unnecessary wastage, and financial aspects should be followed and evaluated systematically by setting goals and providing continuing developments.

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