Optimising truck arrival management and number of service gates at container terminals

PurposeTruck appointment systems have been applied in critical container ports in the United States due to their potential to improve handling operations. This paper aims to develop a truck appointment system to optimise the total cost experiencing at the entrance of container terminals by managing truck arrivals and the number of service gates satisfying a given level of service.Design/methodology/approachThe approximation of Mt/G/nt queuing model is applied and integrated into a cost optimisation model to identify (1) the number of arrival trucks allowed at each time slot and (2) the number of service gates operating at each time slot that ensure the average waiting time is less than a designated time threshold. The optimisation model is solved by the Genetic Algorithm and tested with a case study. Its effectiveness is identified by comparing the model's outcomes with observed data and other recent studies.FindingsThe results indicate that the developed truck appointment system can provide more than threefold and twofold reductions of the total cost experiencing at the terminal entrance compared to the actual data and results from previous research, respectively.Originality/valueThe proposed approach provides applicably coordinated truck plans and operating service gates efficiently to decrease congestion, emission and expenses.

Vaccination distribution by community pharmacists under the COVID-19 vaccine appointment system in Taiwan

Pharmacists play a critical role in implementing and promoting public health policies, particularly during pandemics, thanks to their exceptional skills, knowledge, expertise, and accessibility to the public. This study aimed to increase the roll-out of COVID-19 vaccines in a coordinated manner to ensure equal accessibility to all Taiwanese residents. A total of 3301 health insurance special pharmacies, equivalent to 80% of all community pharmacies in Taiwan, are assisting the public in scheduling vaccines. Once pharmacists had ensured adequate vaccine availability, vaccinations were scheduled depending on the time of registration on the platform for vaccination appointments. The roll-out of this program saw a significant number of people register and receive the vaccine throughout the country, and the number of individuals who received both a first and second dose increased significantly. Community pharmacy-based distribution of the vaccine to the public signifies the novel and innovative involvement of pharmacists in government initiatives to promote public health. Our study shows that community pharmacies can potentially enhance the efficiency and equitable distribution of health supplies and resources, particularly during pandemics.

Punctuality of Patients and Physicians in an Outpatient Setting: Which Has a Greater Effect on Waiting Time?

Background: Patients’ waiting time for healthcare services is identified as one of the key measurements of an effective health system. This factor has an important role in patients’ satisfaction as well. One factor that is related to the waiting time is patients’ punctuality. Objectives: the objective of this study was assessing the effect of patients’ and physicians’ punctuality on outpatients’ waiting time. Methods: This was a cross-sectional study. The study population was outpatients that were admitted in clinics of a general non-educational hospital. 3500 samples were selected from all clinics. The sampling method was stratified randomized method. Samples were included after taking the informed consent. Data gathered by check lists that recorded the patients work flow at the clinic and the time of arrival to and departure of each station. Results: About 34% of patients had appointment that 98.5% of them were unpunctual. The correlation of patient unpunctuality (positive and negative) and their waiting time indicated that these variables had positive correlation (P<0.001). Assessing the correlation of physicians’ punctuality and patients’ waiting time indicated that these variables also had positive correlation (P<0.001). Conclusion: Appointment systems are very useful in controlling patients waiting time. This study identified that patient’s unpunctuality will increase patients waiting time. By the way negative punctuality will affect waiting time more that positive punctuality. Other important findings of this study were revealing the relation of physicians’ unpunctuality and patients’ waiting time. Punctuality of patients and providers are very important in the performance of appointment system in outpatient settings.

Organizational Anomie: A Qualitative Research on Educational Institutions

This study, which aims to examine the perceptions of teachers working in primary and secondary schools regarding organizational anomaly, was designed with a phenomenology study from qualitative research designs. The working group of the research consists of 16 teachers working in state schools in the central districts of Erzurum in 2020-2021. The data obtained with the measurement tool consisting of semi-structured open-ended questions prepared by the researchers were analyzed by content analysis method. According to the findings obtained in the study, the main causes of anomie experienced by teachers are corruption in working life, loss of values, lack of certain rules and norms, distrust of administrators, unwillingness, impossibility, dissatisfaction, inefficiency and loss of belonging. It has been concluded that it has consequences such as lack of discipline, self-interest and negligence, and that the teachers generally have uncertain and anxious thoughts about the personal and social future. In order to reduce anomaly in schools, a value-oriented human resources management based on the spirit of teachers and a transition to a merit and justice-based appointment system in manager appointments are the basic proposals.

Recommendations for management of burn patients in context of COVID-19 pandemic

It has been reported from china that burn centers have the highest risk of COVID-19 infection. The virus is highly contagious and damaging and mortality rate as high as 61.5% has been reported. Burn patients have low level of immunity, lack skin barrier and are prone to infections. Due to these facts, they have less ability to fight against the corona virus, so surgical practices for management of burn patients should be modified to prevent the spread of infection and decrease mortality. Keeping these facts in mind, we adopted certain changes in the protocols for management of burn patients at Rawalian burn center, Rawalpindi Pakistan. We are presenting new recommendations which were followed at the burn center during COVID-19 pandemic. These are the first ever recommendations from any burn center of Pakistan since the start of recent pandemic. With help of literature search we identified risk factors for infection during the course of treatment of burn patients. These recommendations include alterations in structural layout, administration procedures, burn patient care like the introduction of telemedicine, online appointment system and use of online messaging applications i.e., WhatsApp, staff training and strategies like online learning system to provide new knowledge regarding COVID-19 continuously. Issues of staff like over work, availability of personal protective equipment (PPEs), and their health-related anxiety and fear should be addressed properly for the prevention of burn out syndrome in them.

Design of a Truck Appointment System Considering Drayage Scheduling and Stochastic Turn Time

This paper develops a truck appointment system (TAS) considering variability in turn time at the container terminals. The consideration of this operational characteristic is crucial for optimal drayage scheduling. The TAS is formulated as a stochastic model and solved using the sample averaging approximation (SAA) algorithm. Using turn time distributions obtained from actual data from a U.S. port, a series of experiments is designed to evaluate the effectiveness of the proposed stochastic TAS model compared with the deterministic version where an average turn time is used instead of a distribution. Results of the numerical experiment demonstrate the benefit of the stochastic TAS model given that its drayage cost error was 3.9% lower compared with the deterministic TAS model. This result implies that the schedules produced by the stochastic TAS model are more robust and are able to accommodate a wider range of turn time scenarios. Another key takeaway from the experiment results is that the stochastic TAS model is more beneficial to utilize when the ratio of quotas to requested appointments is lower. Thus, in practice, when this ratio is more likely to be on the lower end, drayage companies would benefit more if the appointment schedule adopts the stochastic approach described in this paper.

Waiting times, patient flow, and occupancy density in South African primary health care clinics: implications for infection prevention and control

Background Transmission of respiratory pathogens, such as Mycobacterium tuberculosis and severe acute respiratory syndrome coronavirus 2, is more likely during close, prolonged contact and when sharing a poorly ventilated space. In clinics in KwaZulu-Natal (KZN) and Western Cape (WC) provinces, South Africa, we estimated clinic visit duration, time spent indoors and outdoors, and occupancy density of waiting rooms. Methods We used unique barcodes to track attendees' movements in 11 clinics in two provinces, multiple imputation to estimate missing arrival and departure times, and mixed-effects linear regression to examine associations with visit duration. Results 2,903 attendees were included. Median visit duration was 2 hours 36 minutes (interquartile range [IQR] 01:36–3:43). Longer mean visit times were associated with being female (13.5 minutes longer; p<0.001) and attending with a baby (18.8 minutes longer; p<0.01), and shorter mean times with later arrival (14.9 minutes shorter per hour after 0700; p<0.001) and attendance for tuberculosis or ante/postnatal care (24.8 and 32.6 minutes shorter, respectively, than HIV/acute care; p<0.01). Overall, attendees spent more of their time indoors (median 95.6% [IQR 46–100]) than outdoors (2.5% [IQR 0–35]). Attendees at clinics with outdoor waiting areas spent a greater proportion (median 13.7% [IQR 1–75]) of their time outdoors. In two clinics in KZN (no appointment system), occupancy densities of ~2.0 persons/m2 were observed in smaller waiting rooms during busy periods. In one clinic in WC (appointment system), occupancy density did not exceed 1.0 persons/m2 despite higher overall attendance. Conclusions Longer waiting times were associated with early arrival, being female, and attending with a young child. Attendees generally waited where they were asked to. Regular estimation of occupancy density (as patient flow proxy) may help staff assess for risk of infection transmission and guide intervention to reduce time spent in risky spaces.

Evaluation of patients' satisfaction on booking appointment system in dental school of Isfahan during (Preprint)

BACKGROUND With the development of technology in recent years, booking appointment software systems have gained special and significant popularity among physicians and patients. As Medical university of Isfahan is one of the leading universities of the country the results of this study could be very important for the use of other health systems in different states of country. OBJECTIVE This research aimed to assess the patients’ satisfaction of the booking appointment system services of Isfahan dentistry faculty, considering its different types of booking systems and patient satisfaction. METHODS The study was descriptive and cross-sectional. The questionnaire was prepared using Zhang study in 2014 and the standard Forward-Backward translation method. In order to investigate the validity, the opinions of the professors of Isfahan Dental School were taken and the professional opinions of the individuals were applied. The questionnaire was distributed among patients referring to the dental school who had undergone the initial examination. After completing the data, SPSS software version 20 and descriptive and analytical statistical tests were used to analyze the data (a = 0.05). RESULTS In this study, independent t-test, Kruscal-Wallis test and Pearson correlation test were used to investigate the data. The Kruscal-Wallis test showed that overall satisfaction was significantly higher in patients who booked appointment online than in other patients (P = 0.003). The independent t-test showed that the mean scores of patient satisfaction with staff behavior (P = 0.03) and satisfaction with the waiting time (P = 0.01) were significantly different between native, non-native and passenger patients. CONCLUSIONS Most of the people surveyed were generally relatively satisfied with the booking appointment services. Most of them surveyed came in person to queue. Most people cited cheap services as the main reason for their visits. Most people cited telephone busy signal as the reason for not using the telephone booking system. CLINICALTRIAL Not require

A Research Paper on Study of Performance of Online Appointment System with Respect to Traditional System from Patient’s Perspective

Planning appointments has become a daunting task especially for health professionals in hospitals and clinics. Failure of appointment appointments can also result in dispersed appointments, increased number of shows, general patient dissatisfaction and financial losses for health organizations. Many day-to-day medical centers now use a combination of telephone-based planning and computer-based appointments but there is still a technical and human error gap. This online facility can add power to any hospital or clinic website. Reduces the hard work associated with managing a medical environment. More time to commit to patient care, better patient compliance and financial efficiency are other rewards. The integration of covid time, technology and rapid population growth has been strongly driven to introduce patient planning online. In this used project, you sometimes experience minor problems where you need to consult a doctor about your health problems or nearby and follow their meetings. The Online Doctor System will provide one authorized direct communication between the doctors of your choice if necessary for your minor problems. Using the web Online Healthcare System, patients will be able to complete online forms in seconds before entering the virtual office room. It will also allow you to upload your lab results such as x-ray copies, medical history etc which your doctors may refer you for.