ETDs

This collection includes most of the ASU Theses and Dissertations from 2011 to present. ASU Theses and Dissertations are available in downloadable PDF format; however, a small percentage of items are under embargo. Information about the dissertations/theses includes degree information, committee members, an abstract, supporting data or media.

In addition to the electronic theses found in the ASU Digital Repository, ASU Theses and Dissertations can be found in the ASU Library Catalog.

Dissertations and Theses granted by Arizona State University are archived and made available through a joint effort of the ASU Graduate College and the ASU Libraries. For more information or questions about this collection contact or visit the Digital Repository ETD Library Guide or contact the ASU Graduate College at gradformat@asu.edu.

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Harm during hospitalizations for heart failure: adverse events as a reliability measure of hospital policies and procedures

Description
For more than twenty years, clinical researchers have been publishing data regarding incidence and risk of adverse events (AEs) incurred during hospitalizations. Hospitals have standard operating policies and procedures (SOPP) to protect patients from AE. The AE specifics (rates, SOPP failures, timing and risk factors) during heart failure (HF) hospitalizations…

For more than twenty years, clinical researchers have been publishing data regarding incidence and risk of adverse events (AEs) incurred during hospitalizations. Hospitals have standard operating policies and procedures (SOPP) to protect patients from AE. The AE specifics (rates, SOPP failures, timing and risk factors) during heart failure (HF) hospitalizations are unknown. There were 1,722 patients discharged with a primary diagnosis of HF from an academic hospital between January 2005 and December 2007. Three hundred eighty-one patients experienced 566 AEs, classified into four categories: medication (43.9%), infection (18.9%), patient care (26.3%), or procedural (10.9%). Three distinct analyses were performed: 1) patient's perspective of SOPP reliability including cumulative distribution and hazard functions of time to AEs; 2) Cox proportional hazards model to determine independent patient-specific risk factors for AEs; and 3) hospital administration's perspective of SOPP reliability through three years of the study including cumulative distribution and hazard functions of time between AEs and moving range statistical process control (SPC) charts for days between failures of each type. This is the first study, to our knowledge, to consider reliability of SOPP from both the patient's and hospital administration's perspective. AE rates in hospitalized patients are similar to other recently published reports and did not improve during the study period. Operations research methodologies will be necessary to improve reliability of care delivered to hospitalized patients.
ContributorsHuddleston, Jeanne (Author) / Fowler, John (Thesis advisor) / Montgomery, Douglas C. (Thesis advisor) / Gel, Esma (Committee member) / Shunk, Dan (Committee member) / Arizona State University (Publisher)
Created2012
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An analytical approach to lean six sigma deployment strategies: project identification and prioritization

Description
The ever-changing economic landscape has forced many companies to re-examine their supply chains. Global resourcing and outsourcing of processes has been a strategy many organizations have adopted to reduce cost and to increase their global footprint. This has, however, resulted in increased process complexity and reduced customer satisfaction. In order…

The ever-changing economic landscape has forced many companies to re-examine their supply chains. Global resourcing and outsourcing of processes has been a strategy many organizations have adopted to reduce cost and to increase their global footprint. This has, however, resulted in increased process complexity and reduced customer satisfaction. In order to meet and exceed customer expectations, many companies are forced to improve quality and on-time delivery, and have looked towards Lean Six Sigma as an approach to enable process improvement. The Lean Six Sigma literature is rich in deployment strategies; however, there is a general lack of a mathematical approach to deploy Lean Six Sigma in a global enterprise. This includes both project identification and prioritization. The research presented here is two-fold. Firstly, a process characterization framework is presented to evaluate processes based on eight characteristics. An unsupervised learning technique, using clustering algorithms, is then utilized to group processes that are Lean Six Sigma conducive. The approach helps Lean Six Sigma deployment champions to identify key areas within the business to focus a Lean Six Sigma deployment. A case study is presented and 33% of the processes were found to be Lean Six Sigma conducive. Secondly, having identified parts of the business that are lean Six Sigma conducive, the next steps are to formulate and prioritize a portfolio of projects. Very often the deployment champion is faced with the decision of selecting a portfolio of Lean Six Sigma projects that meet multiple objectives which could include: maximizing productivity, customer satisfaction or return on investment, while meeting certain budgetary constraints. A multi-period 0-1 knapsack problem is presented that maximizes the expected net savings of the Lean Six Sigma portfolio over the life cycle of the deployment. Finally, a case study is presented that demonstrates the application of the model in a large multinational company. Traditionally, Lean Six Sigma found its roots in manufacturing. The research presented in this dissertation also emphasizes the applicability of the methodology to the non-manufacturing space. Additionally, a comparison is conducted between manufacturing and non-manufacturing processes to highlight the challenges in deploying the methodology in both spaces.
ContributorsDuarte, Brett Marc (Author) / Fowler, John W (Thesis advisor) / Montgomery, Douglas C. (Thesis advisor) / Shunk, Dan (Committee member) / Borror, Connie (Committee member) / Konopka, John (Committee member) / Arizona State University (Publisher)
Created2011
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The development of a validated clinically meaningful endpoint for the evaluation of tear film stability as a measure of ocular surface protection for use in the diagnosis and evaluation of dry eye disease

Description
This dissertation presents methods for the evaluation of ocular surface protection during natural blink function. The evaluation of ocular surface protection is especially important in the diagnosis of dry eye and the evaluation of dry eye severity in clinical trials. Dry eye is a highly prevalent disease affecting vast numbers…

This dissertation presents methods for the evaluation of ocular surface protection during natural blink function. The evaluation of ocular surface protection is especially important in the diagnosis of dry eye and the evaluation of dry eye severity in clinical trials. Dry eye is a highly prevalent disease affecting vast numbers (between 11% and 22%) of an aging population. There is only one approved therapy with limited efficacy, which results in a huge unmet need. The reason so few drugs have reached approval is a lack of a recognized therapeutic pathway with reproducible endpoints. While the interplay between blink function and ocular surface protection has long been recognized, all currently used evaluation techniques have addressed blink function in isolation from tear film stability, the gold standard of which is Tear Film Break-Up Time (TFBUT). In the first part of this research a manual technique of calculating ocular surface protection during natural blink function through the use of video analysis is developed and evaluated for it's ability to differentiate between dry eye and normal subjects, the results are compared with that of TFBUT. In the second part of this research the technique is improved in precision and automated through the use of video analysis algorithms. This software, called the OPI 2.0 System, is evaluated for accuracy and precision, and comparisons are made between the OPI 2.0 System and other currently recognized dry eye diagnostic techniques (e.g. TFBUT). In the third part of this research the OPI 2.0 System is deployed for use in the evaluation of subjects before, immediately after and 30 minutes after exposure to a controlled adverse environment (CAE), once again the results are compared and contrasted against commonly used dry eye endpoints. The results demonstrate that the evaluation of ocular surface protection using the OPI 2.0 System offers superior accuracy to the current standard, TFBUT.
ContributorsAbelson, Richard (Author) / Montgomery, Douglas C. (Thesis advisor) / Borror, Connie (Committee member) / Shunk, Dan (Committee member) / Pan, Rong (Committee member) / Arizona State University (Publisher)
Created2012