Quality Control in the Healthcare Industry: An Analysis of Surgery Turnover Times

For virtually all hospitals, utilization rates are a critical managerial indicator of efficiency and are determined in part by turnover time. Turnover time is defined as the time elapsed between surgeries, during which the operating room is cleaned and preparedfor the next surgery. Lengthier turnover times result in lower utilization rates, thereby hindering hospitals’ ability to maximize the numbers of patients that can be attended to. In this thesis, we analyze operating room data from a two year period provided byEvangelical Community Hospital in Lewisburg, Pennsylvania, to understand the variability of the turnover process. From the recorded data provided, we derive our best estimation of turnover time. Recognizing the importance of being able to properly modelturnover times in order to improve the accuracy of scheduling, we seek to fit distributions to the set of turnover times. We find that log-normal and log-logistic distributions are well-suited to turnover times, although further research must validate this finding. Wepropose that the choice of distribution depends on the hospital and, as a result, a hospital must choose whether to use the log-normal or the log-logistic distribution. Next, we use statistical tests to identify variables that may potentially influence turnover time. We find that there does not appear to be a correlation between surgerytime and turnover time across doctors. However, there are statistically significant differences between the mean turnover times across doctors. The final component of our research entails analyzing and explaining the benefits of introducing control charts as a quality control mechanism for monitoring turnover times in hospitals. Although widely instituted in other industries, control charts are notwidely adopted in healthcare environments, despite their potential benefits. A major component of our work is the development of control charts to monitor the stability of turnover times. These charts can be easily instituted in hospitals to reduce the variabilityof turnover times. Overall, our analysis uses operations research techniques to analyze turnover times and identify manners for improvement in lowering the mean turnover time and thevariability in turnover times. We provide valuable insight into a component of the surgery process that has received little attention, but can significantly affect utilization rates in hospitals. Most critically, an ability to more accurately predict turnover timesand a better understanding of the sources of variability can result in improved scheduling and heightened hospital staff and patient satisfaction. We hope that our findings can apply to many other hospital settings.

Increasing Utilization of US Electric Grids via Smart Technologies: Integration of Load Management, Real Time Pricing, Renewables, EVs and Smart Grid Sensors

Electric power grids throughout the world suffer from serious inefficiencies associated with under-utilization due to demand patterns, engineering design and load following approaches in use today. These grids consume much of the world’s energy and represent a large carbon footprint. From material utilization perspectives significant hardware is manufactured and installed for this infrastructure often to be used at less than 20-40% of its operational capacity for most of its lifetime. These inefficiencies lead engineers to require additional grid support and conventional generation capacity additions when renewable technologies (such as solar and wind) and electric vehicles are to be added to the utility demand/supply mix. Using actual data from the PJM [PJM 2009] the work shows that consumer load management, real time price signals, sensors and intelligent demand/supply control offer a compelling path forward to increase the efficient utilization and carbon footprint reduction of the world’s grids. Underutilization factors from many distribution companies indicate that distribution feeders are often operated at only 70-80% of their peak capacity for a few hours per year, and on average are loaded to less than 30-40% of their capability. By creating strong societal connections between consumers and energy providers technology can radically change this situation. Intelligent deployment of smart sensors, smart electric vehicles, consumer-based load management technology very high saturations of intermittent renewable energy supplies can be effectively controlled and dispatched to increase the levels of utilization of existing utility distribution, substation, transmission, and generation equipment. The strengthening of these technology, society and consumer relationships requires rapid dissemination of knowledge (real time prices, costs & benefit sharing, demand response requirements) in order to incentivize behaviors that can increase the effective use of technological equipment that represents one of the largest capital assets modern society has created.

Utilization of Probabilistic Models in Short Read Assembly from Second-Generation Sequencing

With the advent of cheaper and faster DNA sequencing technologies, assembly methods have greatly changed. Instead of outputting reads that are thousands of base pairs long, new sequencers parallelize the task by producing read lengths between 35 and 400 base pairs. Reconstructing an organism’s genome from these millions of reads is a computationally expensive task. Our algorithm solves this problem by organizing and indexing the reads using n-grams, which are short, fixed-length DNA sequences of length n. These n-grams are used to efficiently locate putative read joins, thereby eliminating the need to perform an exhaustive search over all possible read pairs. Our goal was develop a novel n-gram method for the assembly of genomes from next-generation sequencers. Specifically, a probabilistic, iterative approach was utilized to determine the most likely reads to join through development of a new metric that models the probability of any two arbitrary reads being joined together. Tests were run using simulated short read data based on randomly created genomes ranging in lengths from 10,000 to 100,000 nucleotides with 16 to 20x coverage. We were able to successfully re-assemble entire genomes up to 100,000 nucleotides in length.

Examination of Priorities for Therapeutic Drug Utilization Review

Therapeutic Drug Utilization Review (DUR) is an important component of state-level pharmaceutical assistance programs.