Matching Items (3)
- All Subjects: Hospitals
- All Subjects: Transmission Engineering
- Creators: Shunk, Dan
Harm during hospitalizations for heart failure: adverse events as a reliability measure of hospital policies and procedures
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.
This thesis presents research on innovative AC transmission design concepts and focused mathematics for electric power transmission design. The focus relates to compact designs, high temperature low sag conductors, and high phase order design. The motivation of the research is to increase transmission capacity with limited right of way.
Regarding compact phase spacing, insight into the possibility of increasing the security rating of transmission lines is the primary focus through increased mutual coupling and decreased positive sequence reactance. Compact design can reduce the required corridor width to as little as 31% of traditional designs, especially with the use of inter-phase spacers. Typically transmission lines are built with conservative clearances, with difficulty obtaining right of way, more compact phase spacing may be needed. With design consideration significant compaction can produce an increase by 5-25% in the transmission line security (steady state stability) rating. In addition, other advantages and disadvantages of compact phase design are analyzed. Also, the next two topics: high temperature low sag conductors and high phase order designs include the use of compact designs.
High temperature low sag (HTLS) conductors are used to increase the thermal capacity of a transmission line up to two times the capacity compared to traditional conductors. HTLS conductors can operate continuously at 150-210oC and in emergency at 180-250oC (depending on the HTLS conductor). ACSR conductors operate continuously at 50-110oC and in emergency conditions at 110-150oC depending on the utility, line, and location. HTLS conductors have decreased sag characteristics of up to 33% compared to traditional ACSR conductors at 100oC and up to 22% at 180oC. In addition to what HTLS has to offer in terms of the thermal rating improvement, the possibility of using HTLS conductors to indirectly reduce tower height and compact the phases to increase the security limit is investigated. In addition, utilizing HTLS conductors to increase span length and decrease the number of transmission towers is investigated. The phase compaction or increased span length is accomplished by utilization of the improved physical sag characteristics of HTLS conductors.
High phase order (HPO) focuses on the ability to increase the power capacity for a given right of way. For example, a six phase line would have a thermal rating of approximately 173%, a security rating of approximately 289%, and the SIL would be approximately 300% of a double circuit three phase line with equal right of way and equal voltage line to line. In addition, this research focuses on algorithm and model development of HPO systems. A study of the impedance of HPO lines is presented. The line impedance matrices for some high phase order configurations are circulant Toeplitz matrices. Properties of circulant matrices are developed for the generalized sequence impedances of HPO lines. A method to calculate the sequence impedances utilizing unique distance parameter algorithms is presented. A novel method to design the sequence impedances to specifications is presented. Utilizing impedance matrices in circulant form, a generalized form of the sequence components transformation matrix is presented. A generalized voltage unbalance factor in discussed for HPO transmission lines. Algorithms to calculate the number of fault types and number of significant fault types for an n-phase system are presented. A discussion is presented on transposition of HPO transmission lines and a generalized fault analysis of a high phase order circuit is presented along with an HPO analysis program.
The work presented has the objective of increasing the use of rights of way for bulk power transmission through the use of innovative transmission technologies. The purpose of this dissertation is to lay down some of the building blocks and to help make the three technologies discussed practical applications in the future.
The current Enterprise Requirements and Acquisition Model (ERAM), a discrete event simulation of the major tasks and decisions within the DoD acquisition system, identifies several what-if intervention strategies to improve program completion time. However, processes that contribute to the program acquisition completion time were not explicitly identified in the simulation study. This research seeks to determine the acquisition processes that contribute significantly to total simulated program time in the acquisition system for all programs reaching Milestone C. Specifically, this research examines the effect of increased scope management, technology maturity, and decreased variation and mean process times in post-Design Readiness Review contractor activities by performing additional simulation analyses. Potential policies are formulated from the results to further improve program acquisition completion time.