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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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Description
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

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.
ContributorsWorger, Danielle Marie (Author) / Wu, Teresa (Thesis director) / Shunk, Dan (Committee member) / Wirthlin, J. Robert (Committee member) / Industrial, Systems (Contributor) / Barrett, The Honors College (Contributor)
Created2013-05
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Description
Hospitals constitute 9 percent of commercial energy consumption in the U.S. annually, though they only make up 2 percent of the U.S. commercial floor space. Consuming an average of 259,000 Btu per square foot, U.S. hospitals spend about 8.3 billion dollars on energy every year. Utilizing collaborative delivery method for

Hospitals constitute 9 percent of commercial energy consumption in the U.S. annually, though they only make up 2 percent of the U.S. commercial floor space. Consuming an average of 259,000 Btu per square foot, U.S. hospitals spend about 8.3 billion dollars on energy every year. Utilizing collaborative delivery method for hospital construction can effectively save healthcare business owners thousands of dollars while reducing construction time and resulting in a better product: a building that has fewer operational deficiencies and requires less maintenance. Healthcare systems are integrated by nature, and are rich in technical complexity to meet the needs of their various patients. In addition to being technologically and energy intensive, hospitals must meet health regulations while maintaining human comfort. The interdisciplinary nature of hospitals suggests that multiple perspectives would be valuable in optimizing the building design. Integrated project delivery provides a means to reaching the optimal design by emphasizing group collaboration and expertise of the architect, engineer, owner, builder, and hospital staff. In previous studies, IPD has proven to be particularly beneficial when it comes to highly complex projects, such as hospitals. To assess the effects of a high level of team collaboration in the delivery of a hospital, case studies were prepared on several hospitals that have been built in the past decade. The case studies each utilized some form of a collaborative delivery method, and each were successful in saving and/or redirecting time and money to other building components, achieving various certifications, recognitions, and awards, and satisfying the client. The purpose of this research is to determine key strategies in the construction of healthcare facilities that allow for quicker construction, greater monetary savings, and improved operational efficiency. This research aims to communicate the value of both "green building" and a high level of team collaboration in the hospital-building process.
ContributorsHansen, Hannah Elizabeth (Author) / Parrish, Kristen (Thesis director) / Bryan, Harvey (Committee member) / Civil, Environmental and Sustainable Engineering Programs (Contributor) / Barrett, The Honors College (Contributor)
Created2017-05