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Operations Management In Healthcare Strategy And Practice 1st Edition Corinne M. Karuppan , Nancy E. Dunlap,Michael R. Waldrum - Solutions
2. Read the following article:Boulkedid, R., Abdoul, H., Loustau, M., Sibony, O., & Alberti, C. (2011). Using and reporting the Delphi method for selecting healthcare quality indicators: A systematic review. PLoS ONE, 6(6), e20476. Retrieved
1. If you use an alpha value equal to 1 in exponential smoothing, do you have a stable or responsive forecasting model? What if you use an alpha value equal to 0?
11. Use all 36 months of data in Table 10.1.a. Deseasonalize the data. Use each month as a season.b. Develop the regression equation for the deseasonalized data.c. Formulate the trend forecasts for each month of next year.d. Adjust the trend forecasts for seasonality.e. Plot the surgery volume over
10. Use all 36 months of data in Table 10.1.a. Compute the MAD and MAPE for the 3-month simple moving average.b. Compute the MAD and MAPE for the weighted moving average model with weights of 0.5, 0.3, and 0.2.c. Compute the MAD and MAPE for exponential smoothing with α = 0.8. Use 45 as the
9. The BPH board is considering a partnership with a hospital in Mexico for a limited line of surgical services. The hospital is accredited by The Joint Commission International. BPH has just conducted a survey to determine their patients’likelihood to get surgery at that hospital in Mexico based
8. Because healthcare services provided through workmen’s compensation generate relatively high profit margins, the director of the occupational therapy department wants to increase the number of patients with work-related injuries. He believes that the funds spent to promote BPH’s services to
7. At the BPH pharmacy, the demand (number of tablets) for a particular drug has been declining over the years as new treatments have emerged. Demand is higher in winter and spring, as shown in the following table. The pharmacist wants to make sure that he does not order more tablets than needed.a.
6. Dr. Bumberry is a plastic surgeon at one of BPH’s clinics. He and his partners have the data for the botulinum toxin injections given during each season from 2013 to 2016. He has forecasted that the annual demand for botulinum toxin injections at the clinic will remain rather stable with 3,940
5. Use the data from problem 4.a. Develop a 3-year simple moving average forecast (starting in year 4).b. Develop a weighted moving average forecast using the weights 0.5 and 0.5.c. Develop an exponential smoothing forecast using a forecast of 74,000 visits for year 1 and α = 0.7.d. Develop a
4. BPH is considering an expansion of its ED department. Currently, the maximum capacity is set for 83,000 visits per year. Develop a trend projection for the following data and determine if and when BPH would need the expanded facility.
3. Use the data provided in problem 2.a. Starting with a forecast of 550 for quarter 1, forecast the demand for quarter 13 using exponential smoothing with α = 0.6. Plot the actual data and the exponentially smoothed forecasts on the same graph.b. Forecast demand from quarter 2 to quarter 13 using
2. The actual demand for germicidal chemicals at one of BPH’s clinics is as follows.a. Plot the data in the previous table on a graph. Do you detect any trend, seasonal pattern, or random variations?b. Forecast demand from quarter 5 to quarter 13 using a 4-quarter simple moving average. Plot your
1. The following shows the number of pints of Type O blood used at BPH for the past 7 weeks.a. Forecast the demand for the week of March 21 using a 2-week simple moving average.b. Forecast the demand for the week of March 21 using a weighted moving average with weights of 0.4, 0.3, 0.2, and 0.1.c.
14. What are associative models?
13. What are the steps to compute seasonal indices and formulate forecasts that incorporate them?
12. What is a seasonal index?
11. In a regression equation, what is the slope and what is the intercept?
10. What are the two techniques that take trends into account?
9. What are the various ways to determine a forecast’s accuracy?
8. What is the smoothing constant?
7. How does a weighted moving average model differ from a simple moving average model?
6. What is a simple moving average? How can you increase the stability of a simple moving average forecast?
5. What is the naïve approach? When does it work best?
4. Differentiate between stability and responsiveness.
3. What are the components of a time series?
2. What is a time series?
1. List and explain the three qualitative approaches to forecasting.
7. Develop forecasts based on associative models
6. Assess the accuracy of forecasts
5. Modulate the stability and responsiveness of a forecast
4. Adjust forecasts for trend and seasonality
3. Develop forecasts based on time series models: moving averages, weighted moving averages, exponential smoothing, and trend projections
2. Identify the various components of a time series
1. List the most popular qualitative approaches and mention their advantages and disadvantages
4. Add a few other measures to Dr. Baker’s scheduling dashboard (Figure 9.4).
3. Do a search on online appointments and online check-in. Explain how they work.
2. Read Mitchel Zoler’s article (available online), “Novel OR scheduling and staffing boosts efficiency,” in Clinical Psychiatry News, January 17, 2013. Explain how some of the concepts covered in this chapter were used to schedule the OR at the Mayo Clinic in Jacksonville, Florida.
1. Some companies (Teladoc, MDLive, American Well, etc.) offer 24/7 access to doctors via webcam. Go to one of the websites and identify some of the benefits and drawbacks of the company’s services.
9. Dr. Heath (see problem 8) wants to reduce his backlog in no more than 30 business days. How many extra patients will he have to see every day?
8. Dr. Heath is a very jovial PCP whose backlog has increased to 200 appointments.Because he is already working long hours, he figures that he can only work 1 more hour each day and can see four patients during that time. How many business days will it take him to eliminate the backlog?
7. In this chapter, we saw that Dr. Baker was booking patients every 30 minutes over a 6-hour time period, allowing her to see 12 patients a day. No-shows accounted for about 2% of her appointments. The exam time averaged 25 minutes. In her efforts to reduce the backlog, she is now seeing patients
6. Because physicians at a BPH clinic use an EHR system that is not fully interfaced with the system used by the hospital, some patient data have to be manually reinputted into the hospital’s system. The clerk in charge of this task has just received a list of five patient charges. Their
5. The next day, Joel was assigned six more jobs (see problem 4). However, for this set of jobs, Joel’s supervisor told him to minimize tardiness and the number of tardy jobs. All jobs are equally important. Try the following rules: FCFS, SPT, EDD, CR, and Moore’s algorithm. Requests will start
4. Requests for solutions to billing-related IT problems have been received. Six of those jobs were assigned to Joel Williams, one of the support specialists. Joel has latitude in deciding the order in which these requests will be processed, but his performance is evaluated in terms of turnaround
3. The weekly cafeteria cooking staff schedules need to be established. All cooks work 12-hour shifts, 4 days in a row. Then they take 3 consecutive days off. There are seven possible schedules (Monday, Tuesday, Wednesday off; Tuesday, Wednesday, Thursday off; etc.) The following table lists the
2. Besides technicians (see problem 9.1), the lab supervisor also needs to schedule parttime and full-time phlebotomists for Mondays. Some part-time phlebotomists work 2-hour shifts, whereas others work 4-hour shifts. Full-time phlebotomists work 8 hours. The supervisor has divided the day into
1. The lab supervisor needs to establish a weekly schedule for the morning shift. Based on distributions of arrival times and service times, she has conducted a queuing analysis and found that the minimal number of lab technicians for each day is the following:Each technician is also allowed to
13. Briefly explain how artificial variability hinders smooth flow scheduling.
12. Why is TNA an accurate indicator of a scheduling system’s performance?
11. List and explain the six principles of open-access scheduling.
10. What is individual scheduling? What is its main disadvantage?
9. What is block scheduling? What is its main disadvantage?
8. List and briefly describe three performance measures for job scheduling.
7. What is Moore’s algorithm and what is its purpose?
6. Discuss how each of the following rules works:a. FCFSb. SPTc. EDDd. STRe. CR
5. What is job scheduling?
4. How is integer linear programming used to schedule staff?
3. What is the purpose of staff scheduling?
2. List and explain the consequences of care delay.
1. List and explain three threats to timely care.
5. Understand and evaluate various approaches to patient appointment scheduling
4. Use job scheduling rules to speed up the flow of jobs through a process
3. Establish staffing schedules using linear programming
2. Identify the outcomes of excessive waits and delays
1. Determine the major causes of care delays and waits
3. Research the use of the TOC in healthcare. Is it really applicable in that industry?Why or why not?
2. Read this following article:Jun, J. B., Jacobson, S. H., & Swisher, R. (1999). Application of discrete-event simulation in health care clinics: A survey. Journal of the Operational Research Society 50, 109–123.a. What are the primary areas where simulation has been used?b. What are the most
1. Give examples of process and flow units.
15. Using StatFit in ExtendSim, find the probability distributions of the interarrival times and processing times at Steps A, B, C, D, E, and F in the supplemental BPH Queuing Simulation data set. In the process depicted below, Activities C and D, and E are performed in parallel. Simulate the
14. Use ExtendSim to simulate the data entry process for audit claims presented in Figure 8.23. Release the work every 4 minutes, every 6 minutes, and every 6.5 minutes at a constant rate. Which system shows the best performance in terms of (a) average time in the queue at the bottleneck and (b)
13. Charlotte Browning, the manager of BPH’s hair salon (available to both patients and staff), has three chairs and two employees in her salon. She is contemplating hiring a third employee. Charlotte has observed that customers appear to arrive randomly; the data shown in the following table
12. Arrivals to an information desk have an interarrival time that follows the distribution shown in the next table. Service times follow another empirical distribution, also shown in the table. There is only one customer service representative who starts work at time 0.Using the following table of
11. Each month, the billing department of a nursing home where BPH sends some of its patients reviews each patient’s bill for accuracy. This inspection process involves only two steps. The processing times in minutes at each step are described by the following probability distributions. Because
10. Calls requiring information technology (IT) support arrive at the help desk every 3 minutes (exponential distribution). The time it takes to troubleshoot the problem over the phone is exponentially distributed with a mean of 6 minutes. IT support staff is paid an average of $25 an hour. The
9. At one of the clinics, an employee calls patients to remind them of their upcoming appointments and to verify their insurance. The number of patients to call follows a Poisson distribution with a mean of six per hour. The time it takes to complete a call follows a normal distribution with a mean
7. On New Year’s Eve, during the night shift, emergency calls to paramedics arrive at a rate of three per hour. The director of operations can dispatch multiple vehicles separately. Each nurse averages 7 minutes with a patient.• Four medical assistants do the triage, separately. Each one has an
6. Patients needing appointments call a central scheduling office. Calls arrive at an average rate of 20 per hour according to a Poisson distribution. The average time it takes an employee to schedule the appointment is 1/12 hr. Time in the system is valued at $30 per hour, and a scheduler is paid
5. The deli counter in BPH’s cafeteria has a ticket dispenser in order to maintain FCFS processing. The mean arrival rate during the morning hours is 84 per hour. Each server can handle an average of 30 customers per hour. Arrival and service rates can be reasonably well described by Poisson
4. One clerk is on duty at the information desk of a BPH clinic. The clerk can process information requests in an average time of 3 minutes, and this can be described by a negative exponential distribution that has a mean of 3. Requests are received at a rate of 15 per hour (Poisson distribution).
3. At a BPH walk-in clinic, patients arrive every 15 minutes on average (negative exponential distribution), and it takes about 10 minutes for the physician to diagnose the patient (negative exponential distribution).a. What are λ and μ?b. On average, how long do patients wait to see the
2. Fill in the blanks (do not forget to indicate the units). Also give the definition of the item for which you provide an answer.
1. Using the Kendall notation scheme (e.g., M/M/1), describe each of the following queuing systems:a. Clerks arrive according to a Poisson distribution to use a copy machine. Each clerk copies only one page.b. Syringes come off an assembly line at a constant rate to be inspected. The inspection
14. What are the five steps of the TOC?
13. In ExtendSim, what are:a. The Executive block?b. The Create block?c. The Queue block?d. The Activity block?e. The Exit block?
12. What is the difference between an empirical and a theoretical probability distribution?
11. What are the five steps in conducting a simulation?
10. What is risk?
9. What are the two types of cost used in the cost formula? Describe their behavior.
8. What is the primary goal of queuing analysis?
7. What are Little’s flow equations?
6. What are the assumptions of the M/M/1 model?
5. When using the Kendall notation, what do the letters M, D, and G represent?
4. What are the various queue configurations?
3. What is the relationship between the arrival rate and the interarrival time?
2. What is the “average service rate?”
1. What is the “average arrival rate?”
6. Identify bottleneck issues and understand the Theory of Constraints (TOC)
5. Use simulation to analyze different process configurations and formulate design improvements
4. Develop and run simulation models
3. Extend the concepts of queuing theory to queuing simulation
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