scholarly journals Development and implementation of technology to measure truck crossing time at international land ports of entry

2015 ◽  
Vol 34 (2) ◽  
pp. 75-86
Author(s):  
Juan Carlos Villa
Keyword(s):  
Supply Chain ◽  
Wait Time ◽  
The United States ◽  
Border Crossing ◽  
Wait Times ◽  
Border Crossings ◽  
Time Data ◽  
Public And Private ◽  
Crossing Time ◽  
Mexico Border

Public and private stakeholders that operate land border crossings are increasingly concerned about long wait times for trucks crossing from Mexico into the United States. Long wait times are detrimental to the regional competiveness, supply chain operations, the environment in the region adjacent to the border crossings, and to the overall economic development. In order to have reliable and systematic information on border crossing time and delay, a system to measure travel time through the border is required. This paper describes the basic border crossing operations at the Texas/Mexico border that serves as the foundation to identify a technology that could be used to collect border crossing information. The design and deployment processes that were used for the implementation of the border crossing time measurement system for U.S.-bound commercial vehicles are described. The paper also presents the results of the system that was developed to disseminate border crossing and wait time data. Benefits to supply chain operators at land border crossings and next steps in the development of more border-related performance measures are described.

Risky Border Crossings

2019 ◽  
pp. 19-31
Author(s):  
Jason De León
Keyword(s):  
The United States ◽  
Children And Youth ◽  
Border Crossings ◽  
Undocumented Migrants ◽  
Border Enforcement ◽  
Killing Field ◽  
Risk Of Death ◽  
Enforcement Policy ◽  
Mexico Border ◽  
Border Crossers

De León provides a critique of “Prevention through Deterrence,” the federal border enforcement policy that encourages migrants to cross in areas characterized by extreme environmental conditions and a high risk of death. This policy has failed to deter border crossers while successfully turning the rugged terrain of southern Arizona into a killing field for all undocumented migrants. The threatening space of the U.S.-Mexico border poses particular threats to children and youth who are attempting to cross, especially when crossing without adult family members. Guides and smugglers typically facilitate the movement of young people, or—which is equally dangerous—children increasingly attempt to cross alone or with groups of other children. As children and youth are apprehended trying to enter the United States, they also enter a complicated system of immigration enforcement and detention.

‘Into A Mirror Darkly’

2020 ◽  
pp. 243-264
Author(s):  
Judith Rauscher
Keyword(s):  
United States ◽  
21St Century ◽  
The United States ◽  
Star Trek ◽  
Border Crossing ◽  
The Political ◽  
Feminist Critique ◽  
Border Crossings ◽  
Cultural Changes ◽  
Trump Administration

This chapter argues that contemporary representations of border crossing on screen engage with a specifically 21st-century U.S. manifestation of what Lora Wildenthal in following Valerie Amos and Pratibha Parmar calls “imperial feminism.” It examines how the most recent product of the Star Trek franchise, the TV series Star Trek: Discovery (2017–ongoing), interrogates the legacies of U.S. imperialism and, less overtly so, of U.S. imperial feminism. The analysis focuses on the geographical as well as the metaphorical border crossings that occur in the series when the crew of the Federation starship Discovery jumps to an alternative universe which is dominated by the fascist Terran Empire. It argues that Star Trek: Discovery can be read as a feminist text that exposes the limits of two very different kinds of post-sexist futures: one, the Mirror Universe, in which the empowerment of women depends on openly imperialist and racist ideologies and another, the Prime Universe, in which these ideologies threaten to make a comeback in the context of violent conflict. By contrasting these two possible futures and by connecting them through instances of border crossing, Star Trek: Discovery not only speaks to issues of intersectional feminist critique, it also responds to the political, social, and cultural changes in the United States leading up to and associated with the Trump administration.

scholarly journals Wait Times for Sleep Apnea Care in Ontario: A Multidisciplinary Assessment

2010 ◽  
Vol 17 (4) ◽  
pp. 170-174 ◽  
Author(s):  
Brian W Rotenberg ◽  
Charles F George ◽  
Kevin M Sullivan ◽  
Eric Wong
Keyword(s):  
Sleep Apnea ◽  
Wait Time ◽  
Simplified Model ◽  
Wait Times ◽  
Sleep Laboratory ◽  
Time Data ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Survey Tool ◽  
Obstructive Sleep

BACKGROUND: Obstructive sleep apnea (OSA) is a highly prevalent disorder that is associated with significant patient morbidity and societal burden. In general, wait times for health care in Ontario are believed to be lengthy; however, many diseases lack specific corroborative wait time data.OBJECTIVE: To characterize wait times for OSA care in Ontario.METHODS: Cross-sectional survey. A survey tool was designed and validated to question physicians involved in OSA care about the length of the wait times their patients experience while traversing a simplified model of OSA care. The survey was sent to all otolaryngologists and respirologists in the province, as well as to a random sample of provincial family physicians.RESULTS: Patients waited a mean of 11.6 months to initiate medical therapy (continuous positive airway pressure), and 16.2 months to initiate surgical therapy. Sleep laboratory availability appeared to be the major restriction in the patient management continuum, with each additional sleep laboratory in a community associated with a 20% decrease in overall wait times. Smaller community sizes were paradoxically associated with shorter wait times for sleep studies (P<0.01) but longer wait times for OSA surgery (P<0.05). Regression analysis yielded an r2of 0.046; less than 5% of the wait time variance could be explained by the simplified model.CONCLUSION: Patients experienced considerable wait times when undergoing management for OSA. This has implications for both individual patient care and public health in general.

Seeking the American Dream Along the United States – Mexico Border

2018 ◽  
Vol 40 (3) ◽  
pp. 31-34 ◽  
Author(s):  
Maria Cristina Morales ◽  
Juan Mendoza
Keyword(s):  
El Paso ◽  
The United States ◽  
Border Crossing ◽  
Start Time ◽  
Political Implications ◽  
Transnational Students ◽  
Mexico Border ◽  
American Schools ◽  
United States Mexico ◽  
K 12

Abstract Largely missing from public policy discussions on education and border crossing at the U.S. Mexico border are the experiences of transnational students. In this article, we illustrate some of the struggles of transnational students crossing from Ciudad Juárez, Chihuahua, México to El Paso, Texas, U.S.A. in pursue of an American education. These students are in K-12 and higher education and their daily commute (or almost daily) entail a start time before sunrise to cross the international port of entry to attend American schools. The majority of these students are U.S. citizens that reside on the Mexican side of the border. In this paper, we provide a glimpse into these students struggles for a U.S. education and discuss some political implications of this phenomena.

Wait time reduction for patients awaiting chemotherapy infusion using a formal process improvement approach and sequential.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 92-92
Author(s):  
Andrew David Norden ◽  
Lori A. Buswell ◽  
Meg Amorati ◽  
Lois Arthur ◽  
Antoinette Bernard ◽  
...  
Keyword(s):  
Wait Time ◽  
Baseline Data ◽  
Cancer Center ◽  
Wait Times ◽  
Time Data ◽  
Statistical Process ◽  
Effect Analysis ◽  
Process Improvements ◽  
Reminder System ◽  
Exam Room

92 Background: At a community hospital satellite of an academic cancer center, baseline data indicated that 49% of patients waited longer than 30 minutes from arrival in the treatment chair until treatment was started, resulting in dissatisfaction and decreased chair turnover. Methods: A team was assembled, including physicians, nurses, pharmacists, and administrative staff. The team constructed a detailed process flow map and performed a cause-and-effect analysis. Wait time data were collected using the electronic scheduling system and time sheets. Additionally, nurses used a structured data collection sheet to categorize the reasons for prolonged wait times. A p-type statistical process control chart was constructed to track the proportion of infusion visits per day with wait times longer than 30 minutes. The team brainstormed process improvements and selected ones to implement by employing a priority/pay-off matrix. Results: Baseline data were assessed for 403 visits over a 3 week period. Of 232 visits with wait times longer than 30 minutes, 98 (42%) involved excessive waiting for the physician to see the patient or write orders. One of 4 physicians was responsible for 56 (57%) of these. This physician’s patients were seen exclusively in the infusion room, while the other physicians saw patients in the exam room before sending them to the infusion area. Three PDSA cycles were conducted: (1) All physicians started seeing patients in the exam room before sending them to infusion chairs, (2) Specific treatments were selected that could be routinely administered without the physician seeing the patient, and (3) A reminder system prompted physicians to enter treatment orders within 24 hours of each patient’s visit. After 6 months, 29% of patients waited longer than 30 minutes, down from 49% at baseline. Conclusions: These interventions implemented using PDSA cycles successfully reduced wait times. Measurement and presentation of data were critical in persuading physicians to practice in a more homogeneous fashion.

Optimizing infusion wait time: Redesigning medication order verification/approval at a comprehensive cancer center.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14042-e14042
Author(s):  
Neda Hashemi-Sadraei ◽  
Zoneddy R. Dayao ◽  
Shenthol Sasankan ◽  
Andrea Cox ◽  
Sandra Peacock ◽  
...  
Keyword(s):  
Wait Time ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Wait Times ◽  
Medication Order ◽  
Time Data ◽  
Safety Standards ◽  
University Of New Mexico ◽  
Flat Dose ◽  
Nurse Assessment

e14042 Background: Nationwide, many cancer centers experience challenges with infusion center efficiency while maintaining high safety standards. Many factors contribute to long wait times for patients on the day of their infusion appointments. At University of New Mexico Comprehensive Cancer Center (UNMCCC), a contributing factor is the delays in verification or approval of medications. We conducted a project to improve order verification/approval workflow within a Plan-Do-Study-Act (PDSA) framework with the objective to decrease the infusion wait time. Methods: A multidisciplinary working group was formed consisting of the infusion floor physician lead, nurse lead, pharmacy lead, and analytics and process improvement leads. Upon exploring the infusion workflow database, disruptions in verification or approval of orders had a large impact on wait times. Order verification workflow was broken down into 3 steps: 1) physician assessment of patient and approval of orders, 2) infusion nurse assessment of patient, 3) pharmacist verification of order. Beginning Feb 2019, the following interventions were implemented in each section: 1) once patient was assessed by physician and orders approved, the patient was marked as “ready-to-treat”. 2) Pharmacist verified the order once “ready-to-treat” was communicated and initiated preparation of medications prior to arrival of patient to the infusion suit. 3) Infusion nurse assessment occurred once patient was seated on infusion chair. 4) Physicians were encouraged to pre-approve selected injections by the morning of patient appointment. Results: Prospective wait time was gathered for May 2019 using the real-time data available in the electronic medical record. Wait times were analyzed for patients receiving chemotherapy or flat dose injections. By marking appropriate patients “ready-to-treat” and moving pharmacist verification prior to infusion nurse assessment, there was an immediate decrease in wait time from 79 to 60 min. Selected injections which did not require mixing were pre-approved by the physician and stored in the medication dispensing system (Pyxis). This resulted in decrease in the injection wait time by 8.5 minutes, without wasting of drugs. Conclusions: Redesigning the medication order verification/approval workflow resulted in reduced wait times for patients receiving infusions or injections. We aim to further refine our PDSA cycles and ensure sustainability of change.

scholarly journals Specialist Wait Time Reporting Using Family Physicians’ Electronic Medical Record Data: A Mixed Method Study of Feasibility and Clinical Utility

2021 ◽  
Author(s):  
Michelle Naimer ◽  
Babak Aliarzadeh ◽  
Chaim M. Bell ◽  
Noah Ivers ◽  
Liisa Jaakkimainen ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Method ◽  
Clinical Utility ◽  
Family Physicians ◽  
Wait Time ◽  
Mixed Method Study ◽  
Wait Times ◽  
Specialist Care ◽  
Time Data ◽  
Time Information

Abstract Background: More than 50% of Canadian patients wait longer than four weeks to see a specialist after referral from primary care. Access to accurate wait time information may help primary care physicians choose the timeliest specialist to address a patient’s specific needs. We conducted a mixed-methods study to assess if primary to specialist care wait times can be extracted from electronic medical records (EMR), analyzed the wait time information, and used focus groups and interviews to assess the potential clinical utility of the wait time information. Methods: Two family practices were recruited to examine primary care physician to specialist wait times between 2016 and 2017, using EMR data. The primary outcome was the median wait time from physician referral to specialist appointment for each specialty service. Secondary outcomes included the physician and patient characteristics associated with wait times as well as qualitative analyses of physician interviews about the resulting wait time reports.Results: Wait time data can be extracted from the primary care EMR and converted to a report format for family physicians and specialists to review. After data cleaning, there were 7141 referrals included from 4967 unique patients. The 5 most common specialties referred to were Dermatology, Gastroenterology, Ear Nose and Throat, Obstetrics and Gynecology and Urology. Half of the patients were seen by a specialist within 42 days, 75% seen within 80 days and all patients within 760 days. There were few patient or provider differences amongst the wait times for referrals. Overall, wait time reports were perceived to be important since they could help family physicians decide how to triage referrals and might lead to system improvements. Conclusions: Wait time information from primary to specialist care can aid in decision-making around specialist referrals, identify bottlenecks, and help with system planning. This mixed method study is a starting point to review the importance of providing wait time data for both family physicians and local health systems. Future work can be directed towards developing wait time reporting functionality and evaluating if wait time information will help increase system efficiency and/or improve provider and patient satisfaction.

scholarly journals Sensors, Cameras, and the New ‘Normal’ in Clandestine Migration: How Undocumented Migrants Experience Surveillance at the U.S.-Mexico Border

2017 ◽  
Vol 15 (1) ◽  
pp. 21-41 ◽  
Author(s):  
Bryce Clayton Newell ◽  
Ricardo Gomez ◽  
Verónica E. Guajardo
Keyword(s):  
Technology Use ◽  
The United States ◽  
Border Crossing ◽  
Undocumented Migrants ◽  
Irregular Migrants ◽  
State Surveillance ◽  
Mexico Border ◽  
Government Surveillance ◽  
Border Surveillance ◽  
The U.S

This paper presents findings from an exploratory qualitative study of the experiences and perceptions of undocumented (irregular) migrants to the United States with various forms of surveillance in the borderlands between the U.S. and Mexico. Based on fieldwork conducted primarily in a migrant shelter in Nogales, Mexico, we find that migrants generally have a fairly sophisticated understanding about U.S. Border Patrol surveillance and technology use and that they consciously engage in forms of resistance or avoidance. Heightened levels of border surveillance may be deterring a minority of migrants from attempting immediate future crossings, but most interviewees were undeterred in their desire to enter the U.S., preferring to find ways to avoid government surveillance. Furthermore, migrants exhibit a general lack of trust in the “promise” of technology to improve their circumstances and increase their safety during clandestine border-crossing—often due to fears that technology use makes them vulnerable to state surveillance, tracking, and arrest.

scholarly journals Shopping and Working in the Borderlands: Enforcement, Surveillance and Marketing in Tijuana, Mexico

2010 ◽  
Vol 8 (3) ◽  
pp. 355-373 ◽  
Author(s):  
Magalí Murià ◽  
Sergio Chávez
Keyword(s):  
The United States ◽  
Border Crossing ◽  
Border Enforcement ◽  
Legal Documents ◽  
Tech Nologies ◽  
Consumption Practices ◽  
Mexico Border ◽  
The Rich ◽  
International Border ◽  
The City

This article examines how border enforcement at the U.S.-Mexico border affects the border crossing and consumption practices of Tijuana residents.  Drawing on three years of combined ethnographic research, we focus on the experiences of Tijuana residents who cross the international border with legal documents to work and consume in the United States.  We argue that the tech-nologies of surveillance and deterrence that regulate cross-border transit also reshape the geographical and social landscape of Tijuana. We explain how identities and patterns of difference among border residents are reconstructed by a legal taxonomy that identifies and classifies crossers according to categories of legality. We find that these categories are locally framed and translated into a binary distinction between consumers and workers that reflect a growing gap between the rich and poor in the city. Finally, we conclude that this distinction ignores the transnational character of the city, and in particular, that consumers and workers are not mutually exclusive categories at the borderlands.

At the Border between Public and Private: U.S. Immigration Policy for Victims of Domestic Violence

2013 ◽  
Vol 7 (1) ◽  
pp. 109-153
Author(s):  
Nina Rabin
Keyword(s):  
Domestic Violence ◽  
The United States ◽  
Small Data ◽  
Data Set ◽  
Public And Private ◽  
Domestic Violence Victims ◽  
Mexico Border ◽  
The Government ◽  
Private Matter ◽  
The U.S

Abstract This article examines the treatment of women in flight from domestic violence at the U.S. – Mexico border. It compares the robust state protections available to domestic violence victims in the interior of the country with the hostile landscape women encounter at the border. The article draws on three sources for information about the treatment at the border of domestic violence victims: an in-depth case study of one woman’s experience of domestic violence and flight, a small data set of domestic violence victims detained in the Eloy Detention Center in Arizona during 2010 and 2011, and a detailed analysis of the policies and practices at play when a woman in flight from domestic violence comes to the U.S. border. From these sources, a grim picture emerges that may surprise many. Women fleeing violence whose lives entangle with the border confront a bureaucracy and justice system that harkens back to the time, 50 years ago, when domestic violence was seen as a private matter about which there was little the government could or should do to respond. Building on this descriptive account, the article draws on political theories of citizenship and membership to highlight the moral and legal inconsistencies between the immigration policies of the United States and its national values and commitments regarding violence against women. It suggests that language about the “private” nature of the violence at issue for women in flight from domestic violence should not be used to cloak underlying concerns about immigration admissions policies. Transparent discussion of the considerations at issue lays bare the irrationality of applying fundamentally different conceptions of domestic violence depending on which side of the geographic border it occurs.

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