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Health care delivery systems are inherently complex, consisting of multiple tiers of interdependent subsystems and processes that are adaptive to changes in the environment and behave in a nonlinear fashion. Traditional health technology assessment and modeling methods often neglect the wider health system impacts that can be critical for achieving desired(More)
Patient classification systems (PCSs) are commonly used in nursing units to assess how many nursing care hours are needed to care for patients. These systems then provide staffing and nurse-patient assignment recommendations for a given patient census based on these acuity scores. Our hypothesis is that such systems do not accurately capture workload and we(More)
Simulation is a powerful tool for modeling complex systems with intricate relationships between various entities and resources. Simulation optimization refers to methods that search the design space (i.e., the set of all feasible system configurations) to find a system configuration (also called a design point) that gives the best performance. Since(More)
Most nursing homes lack information technology (IT) for supporting clinical work in spite of its potential to improve the safety, quality, and efficiency of nursing home care in the United States. Increased attention to medical error and concern for patient safety have prompted general recommendations to develop sophisticated technologies to support(More)
Sociometers are wearable sensors that continuously measure body movements, interactions, and speech. The purpose of this study is to test sociometers in a smart environment in a live clinical setting, to assess their reliability in capturing and quantifying data. The long-term goal of this work is to create an intelligent emergency department that captures(More)
In a previous report, the ISPOR Task Force on Dynamic Simulation Modeling Applications in Health Care Delivery Research Emerging Good Practices introduced the fundamentals of dynamic simulation modeling and identified the types of health care delivery problems for which dynamic simulation modeling can be used more effectively than other modeling methods.(More)
BACKGROUND The role of nursing home (NH) information technology (IT) in quality improvement has not been clearly established, and its impacts on communication between care givers and patient outcomes in these settings deserve further attention. OBJECTIVES In this research, we describe a mixed method approach to explore communication strategies used by(More)
This paper presents a scheduling policy that aims to reduce patient wait time for surgical treatment by coordinating clinical and surgical appointments. This study is of interest since the lack of coordination of these resources could lead to an inefficient utilization of available capacity, and most importantly, could cause delays in patient access to(More)
INTRODUCTION An increasing number of behavioral health (BH) patients are presenting to the emergency department (ED) while BH resources continue to decline. This situation-may lead to more external transfers to find care. METHODS This is a retrospective cohort study of consecutive patients presenting to a tertiary care academic ED from February 1, 2013,(More)