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Description
Overcrowding of Emergency Departments (EDs) put the safety of patients at risk. Decision makers implement Ambulance Diversion (AD) as a way to relieve congestion and ensure timely treatment delivery. However, ineffective design of AD policies reduces the accessibility to emergency care and adverse events may arise. The objective of this

Overcrowding of Emergency Departments (EDs) put the safety of patients at risk. Decision makers implement Ambulance Diversion (AD) as a way to relieve congestion and ensure timely treatment delivery. However, ineffective design of AD policies reduces the accessibility to emergency care and adverse events may arise. The objective of this dissertation is to propose methods to design and analyze effective AD policies that consider performance measures that are related to patient safety. First, a simulation-based methodology is proposed to evaluate the mean performance and variability of single-factor AD policies in a single hospital environment considering the trade-off between average waiting time and percentage of time spent on diversion. Regression equations are proposed to obtain parameters of AD policies that yield desired performance level. The results suggest that policies based on the total number of patients waiting are more consistent and provide a high precision in predicting policy performance. Then, a Markov Decision Process model is proposed to obtain the optimal AD policy assuming that information to start treatment in a neighboring hospital is available. The model is designed to minimize the average tardiness per patient in the long run. Tardiness is defined as the time that patients have to wait beyond a safety time threshold to start receiving treatment. Theoretical and computational analyses show that there exists an optimal policy that is of threshold type, and diversion can be a good alternative to decrease tardiness when ambulance patients cause excessive congestion in the ED. Furthermore, implementation of AD policies in a simulation model that accounts for several relaxations of the assumptions suggests that the model provides consistent policies under multiple scenarios. Finally, a genetic algorithm is combined with simulation to design effective policies for multiple hospitals simultaneously. The model has the objective of minimizing the time that patients spend in non-value added activities, including transportation, waiting and boarding in the ED. Moreover, the AD policies are combined with simple ambulance destination policies to create ambulance flow control mechanisms. Results show that effective ambulance management can significantly reduce the time that patients have to wait to receive appropriate level of care.
ContributorsRamirez Nafarrate, Adrian (Author) / Fowler, John W. (Thesis advisor) / Wu, Teresa (Thesis advisor) / Gel, Esma S. (Committee member) / Limon, Jorge (Committee member) / Arizona State University (Publisher)
Created2011
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Description
This thesis presents a successful application of operations research techniques in nonprofit distribution system to improve the distribution efficiency and increase customer service quality. It focuses on truck routing problems faced by St. Mary’s Food Bank Distribution Center. This problem is modeled as a capacitated vehicle routing problem to improve the distribution efficiency

This thesis presents a successful application of operations research techniques in nonprofit distribution system to improve the distribution efficiency and increase customer service quality. It focuses on truck routing problems faced by St. Mary’s Food Bank Distribution Center. This problem is modeled as a capacitated vehicle routing problem to improve the distribution efficiency and is extended to capacitated vehicle routing problem with time windows to increase customer service quality. Several heuristics are applied to solve these vehicle routing problems and tested in well-known benchmark problems. Algorithms are tested by comparing the results with the plan currently used by St. Mary’s Food Bank Distribution Center. The results suggest heuristics are quite completive: average 17% less trucks and 28.52% less travel time are used in heuristics’ solution.
ContributorsLi, Xiaoyan (Author) / Askin, Ronald (Thesis advisor) / Wu, Teresa (Committee member) / Pan, Rong (Committee member) / Arizona State University (Publisher)
Created2015
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Description
One of the greatest 21st century challenges is meeting the needs of a growing world population expected to increase 35% by 2050 given projected trends in diets, consumption and income. This in turn requires a 70-100% improvement on current production capability, even as the world is undergoing systemic climate

One of the greatest 21st century challenges is meeting the needs of a growing world population expected to increase 35% by 2050 given projected trends in diets, consumption and income. This in turn requires a 70-100% improvement on current production capability, even as the world is undergoing systemic climate pattern changes. This growth not only translates to higher demand for staple products, such as rice, wheat, and beans, but also creates demand for high-value products such as fresh fruits and vegetables (FVs), fueled by better economic conditions and a more health conscious consumer. In this case, it would seem that these trends would present opportunities for the economic development of environmentally well-suited regions to produce high-value products. Interestingly, many regions with production potential still exhibit a considerable gap between their current and ‘true’ maximum capability, especially in places where poverty is more common. Paradoxically, often high-value, horticultural products could be produced in these regions, if relatively small capital investments are made and proper marketing and distribution channels are created. The hypothesis is that small farmers within local agricultural systems are well positioned to take advantage of existing sustainable and profitable opportunities, specifically in high-value agricultural production. Unearthing these opportunities can entice investments in small farming development and help them enter the horticultural industry, thus expand the volume, variety and/or quality of products available for global consumption. In this dissertation, the objective is three-fold: (1) to demonstrate the hidden production potential that exist within local agricultural communities, (2) highlight the importance of supply chain modeling tools in the strategic design of local agricultural systems, and (3) demonstrate the application of optimization and machine learning techniques to strategize the implementation of protective agricultural technologies.

As part of this dissertation, a yield approximation method is developed and integrated with a mixed-integer program to estimate a region’s potential to produce non-perennial, vegetable items. This integration offers practical approximations that help decision-makers identify technologies needed to protect agricultural production, alter harvesting patterns to better match market behavior, and provide an analytical framework through which external investment entities can assess different production options.
ContributorsFlores, Hector M. (Author) / Villalobos, Rene (Thesis advisor) / Pan, Rong (Committee member) / Wu, Teresa (Committee member) / Parker, Nathan (Committee member) / Arizona State University (Publisher)
Created2017
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Description
This research develops heuristics to manage both mandatory and optional network capacity reductions to better serve the network flows. The main application discussed relates to transportation networks, and flow cost relates to travel cost of users of the network. Temporary mandatory capacity reductions are required by maintenance activities. The objective

This research develops heuristics to manage both mandatory and optional network capacity reductions to better serve the network flows. The main application discussed relates to transportation networks, and flow cost relates to travel cost of users of the network. Temporary mandatory capacity reductions are required by maintenance activities. The objective of managing maintenance activities and the attendant temporary network capacity reductions is to schedule the required segment closures so that all maintenance work can be completed on time, and the total flow cost over the maintenance period is minimized for different types of flows. The goal of optional network capacity reduction is to selectively reduce the capacity of some links to improve the overall efficiency of user-optimized flows, where each traveler takes the route that minimizes the traveler’s trip cost. In this dissertation, both managing mandatory and optional network capacity reductions are addressed with the consideration of network-wide flow diversions due to changed link capacities.

This research first investigates the maintenance scheduling in transportation networks with service vehicles (e.g., truck fleets and passenger transport fleets), where these vehicles are assumed to take the system-optimized routes that minimize the total travel cost of the fleet. This problem is solved with the randomized fixed-and-optimize heuristic developed. This research also investigates the maintenance scheduling in networks with multi-modal traffic that consists of (1) regular human-driven cars with user-optimized routing and (2) self-driving vehicles with system-optimized routing. An iterative mixed flow assignment algorithm is developed to obtain the multi-modal traffic assignment resulting from a maintenance schedule. The genetic algorithm with multi-point crossover is applied to obtain a good schedule.

Based on the Braess’ paradox that removing some links may alleviate the congestion of user-optimized flows, this research generalizes the Braess’ paradox to reduce the capacity of selected links to improve the efficiency of the resultant user-optimized flows. A heuristic is developed to identify links to reduce capacity, and the corresponding capacity reduction amounts, to get more efficient total flows. Experiments on real networks demonstrate the generalized Braess’ paradox exists in reality, and the heuristic developed solves real-world test cases even when commercial solvers fail.
ContributorsPeng, Dening (Author) / Mirchandani, Pitu B. (Thesis advisor) / Sefair, Jorge (Committee member) / Wu, Teresa (Committee member) / Zhou, Xuesong (Committee member) / Arizona State University (Publisher)
Created2017
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Description
Mathematical modeling and decision-making within the healthcare industry have given means to quantitatively evaluate the impact of decisions into diagnosis, screening, and treatment of diseases. In this work, we look into a specific, yet very important disease, the Alzheimer. In the United States, Alzheimer’s Disease (AD) is the 6th leading

Mathematical modeling and decision-making within the healthcare industry have given means to quantitatively evaluate the impact of decisions into diagnosis, screening, and treatment of diseases. In this work, we look into a specific, yet very important disease, the Alzheimer. In the United States, Alzheimer’s Disease (AD) is the 6th leading cause of death. Diagnosis of AD cannot be confidently confirmed until after death. This has prompted the importance of early diagnosis of AD, based upon symptoms of cognitive decline. A symptom of early cognitive decline and indicator of AD is Mild Cognitive Impairment (MCI). In addition to this qualitative test, Biomarker tests have been proposed in the medical field including p-Tau, FDG-PET, and hippocampal. These tests can be administered to patients as early detectors of AD thus improving patients’ life quality and potentially reducing the costs of the health structure. Preliminary work has been conducted in the development of a Sequential Tree Based Classifier (STC), which helps medical providers predict if a patient will contract AD or not, by sequentially testing these biomarker tests. The STC model, however, has its limitations and the need for a more complex, robust model is needed. In fact, STC assumes a general linear model as the status of the patient based upon the tests results. We take a simulation perspective and try to define a more complex model that represents the patient evolution in time.

Specifically, this thesis focuses on the formulation of a Markov Chain model that is complex and robust. This Markov Chain model emulates the evolution of MCI patients based upon doctor visits and the sequential administration of biomarker tests. Data provided to create this Markov Chain model were collected by the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. The data lacked detailed information of the sequential administration of the biomarker tests and therefore, different analytical approaches were tried and conducted in order to calibrate the model. The resulting Markov Chain model provided the capability to conduct experiments regarding different parameters of the Markov Chain and yielded different results of patients that contracted AD and those that did not, leading to important insights into effect of thresholds and sequence on patient prediction capability as well as health costs reduction.



The data in this thesis was provided from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database (adni.loni.usc.edu). ADNI investigators did not contribute to any analysis or writing of this thesis. A list of the ADNI investigators can be found at: http://adni.loni.usc.edu/about/governance/principal-investigators/ .
ContributorsCamarena, Raquel (Author) / Pedrielli, Giulia (Thesis advisor) / Li, Jing (Thesis advisor) / Wu, Teresa (Committee member) / Arizona State University (Publisher)
Created2018
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Description
In this thesis, a single-level, multi-item capacitated lot sizing problem with setup carryover, setup splitting and backlogging is investigated. This problem is typically used in the tactical and operational planning stage, determining the optimal production quantities and sequencing for all the products in the planning horizon. Although the capacitated lot

In this thesis, a single-level, multi-item capacitated lot sizing problem with setup carryover, setup splitting and backlogging is investigated. This problem is typically used in the tactical and operational planning stage, determining the optimal production quantities and sequencing for all the products in the planning horizon. Although the capacitated lot sizing problems have been investigated with many different features from researchers, the simultaneous consideration of setup carryover and setup splitting is relatively new. This consideration is beneficial to reduce costs and produce feasible production schedule. Setup carryover allows the production setup to be continued between two adjacent periods without incurring extra setup costs and setup times. Setup splitting permits the setup to be partially finished in one period and continued in the next period, utilizing the capacity more efficiently and remove infeasibility of production schedule.

The main approaches are that first the simple plant location formulation is adopted to reformulate the original model. Furthermore, an extended formulation by redefining the idle period constraints is developed to make the formulation tighter. Then for the purpose of evaluating the solution quality from heuristic, three types of valid inequalities are added to the model. A fix-and-optimize heuristic with two-stage product decomposition and period decomposition strategies is proposed to solve the formulation. This generic heuristic solves a small portion of binary variables and all the continuous variables rapidly in each subproblem. In addition, the case with demand backlogging is also incorporated to demonstrate that making additional assumptions to the basic formulation does not require to completely altering the heuristic.

The contribution of this thesis includes several aspects: the computational results show the capability, flexibility and effectiveness of the approaches. The average optimality gap is 6% for data without backlogging and 8% for data with backlogging, respectively. In addition, when backlogging is not allowed, the performance of fix-and-optimize heuristic is stable regardless of period length. This gives advantage of using such approach to plan longer production schedule. Furthermore, the performance of the proposed solution approaches is analyzed so that later research on similar topics could compare the result with different solution strategies.
ContributorsChen, Cheng-Lung (Author) / Zhang, Muhong (Thesis advisor) / Mohan, Srimathy (Thesis advisor) / Wu, Teresa (Committee member) / Arizona State University (Publisher)
Created2015
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Description
This dissertation carries out an inter-disciplinary research of operations research, statistics, power system engineering, and economics. Specifically, this dissertation focuses on a special power system scheduling problem, a unit commitment problem with uncertainty. This scheduling problem is a two-stage decision problem. In the first stage, system operator determines the binary

This dissertation carries out an inter-disciplinary research of operations research, statistics, power system engineering, and economics. Specifically, this dissertation focuses on a special power system scheduling problem, a unit commitment problem with uncertainty. This scheduling problem is a two-stage decision problem. In the first stage, system operator determines the binary commitment status (on or off) of generators in advance. In the second stage, after the realization of uncertainty, the system operator determines generation levels of the generators. The goal of this dissertation is to develop computationally-tractable methodologies and algorithms to solve large-scale unit commitment problems with uncertainty.

In the first part of this dissertation, two-stage models are studied to solve the problem. Two solution methods are studied and improved: stochastic programming and robust optimization. A scenario-based progressive hedging decomposition algorithm is applied. Several new hedging mechanisms and parameter selections rules are proposed and tested. A data-driven uncertainty set is proposed to improve the performance of robust optimization.

In the second part of this dissertation, a framework to reduce the two-stage stochastic program to a single-stage deterministic formulation is proposed. Most computation of the proposed approach can be done by offline studies. With the assistance of offline analysis, simulation, and data mining, the unit commitment problems with uncertainty can be solved efficiently.

Finally, the impacts of uncertainty on energy market prices are studied. A new component of locational marginal price, a marginal security component, which is the weighted shadow prices of the proposed security constraints, is proposed to better represent energy prices.
ContributorsLi, Chao (Author) / Hedman, Kory W (Thesis advisor) / Zhang, Muhong (Thesis advisor) / Mirchandani, Pitu B. (Committee member) / Wu, Teresa (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Optimization of surgical operations is a challenging managerial problem for surgical suite directors. This dissertation presents modeling and solution techniques for operating room (OR) planning and scheduling problems. First, several sequencing and patient appointment time setting heuristics are proposed for scheduling an Outpatient Procedure Center. A discrete event simulation model

Optimization of surgical operations is a challenging managerial problem for surgical suite directors. This dissertation presents modeling and solution techniques for operating room (OR) planning and scheduling problems. First, several sequencing and patient appointment time setting heuristics are proposed for scheduling an Outpatient Procedure Center. A discrete event simulation model is used to evaluate how scheduling heuristics perform with respect to the competing criteria of expected patient waiting time and expected surgical suite overtime for a single day compared to current practice. Next, a bi-criteria Genetic Algorithm is used to determine if better solutions can be obtained for this single day scheduling problem. The efficacy of the bi-criteria Genetic Algorithm, when surgeries are allowed to be moved to other days, is investigated. Numerical experiments based on real data from a large health care provider are presented. The analysis provides insight into the best scheduling heuristics, and the tradeoff between patient and health care provider based criteria. Second, a multi-stage stochastic mixed integer programming formulation for the allocation of surgeries to ORs over a finite planning horizon is studied. The demand for surgery and surgical duration are random variables. The objective is to minimize two competing criteria: expected surgery cancellations and OR overtime. A decomposition method, Progressive Hedging, is implemented to find near optimal surgery plans. Finally, properties of the model are discussed and methods are proposed to improve the performance of the algorithm based on the special structure of the model. It is found simple rules can improve schedules used in practice. Sequencing surgeries from the longest to shortest mean duration causes high expected overtime, and should be avoided, while sequencing from the shortest to longest mean duration performed quite well in our experiments. Expending greater computational effort with more sophisticated optimization methods does not lead to substantial improvements. However, controlling daily procedure mix may achieve substantial improvements in performance. A novel stochastic programming model for a dynamic surgery planning problem is proposed in the dissertation. The efficacy of the progressive hedging algorithm is investigated. It is found there is a significant correlation between the performance of the algorithm and type and number of scenario bundles in a problem instance. The computational time spent to solve scenario subproblems is among the most significant factors that impact the performance of the algorithm. The quality of the solutions can be improved by detecting and preventing cyclical behaviors.
ContributorsGul, Serhat (Author) / Fowler, John W. (Thesis advisor) / Denton, Brian T. (Thesis advisor) / Wu, Teresa (Committee member) / Zhang, Muhong (Committee member) / Arizona State University (Publisher)
Created2010
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Description
Surgery is one of the most important functions in a hospital with respect to operational cost, patient flow, and resource utilization. Planning and scheduling the Operating Room (OR) is important for hospitals to improve efficiency and achieve high quality of service. At the same time, it is a complex task

Surgery is one of the most important functions in a hospital with respect to operational cost, patient flow, and resource utilization. Planning and scheduling the Operating Room (OR) is important for hospitals to improve efficiency and achieve high quality of service. At the same time, it is a complex task due to the conflicting objectives and the uncertain nature of surgeries. In this dissertation, three different methodologies are developed to address OR planning and scheduling problem. First, a simulation-based framework is constructed to analyze the factors that affect the utilization of a catheterization lab and provide decision support for improving the efficiency of operations in a hospital with different priorities of patients. Both operational costs and patient satisfaction metrics are considered. Detailed parametric analysis is performed to provide generic recommendations. Overall it is found the 75th percentile of process duration is always on the efficient frontier and is a good compromise of both objectives. Next, the general OR planning and scheduling problem is formulated with a mixed integer program. The objectives include reducing staff overtime, OR idle time and patient waiting time, as well as satisfying surgeon preferences and regulating patient flow from OR to the Post Anesthesia Care Unit (PACU). Exact solutions are obtained using real data. Heuristics and a random keys genetic algorithm (RKGA) are used in the scheduling phase and compared with the optimal solutions. Interacting effects between planning and scheduling are also investigated. Lastly, a multi-objective simulation optimization approach is developed, which relaxes the deterministic assumption in the second study by integrating an optimization module of a RKGA implementation of the Non-dominated Sorting Genetic Algorithm II (NSGA-II) to search for Pareto optimal solutions, and a simulation module to evaluate the performance of a given schedule. It is experimentally shown to be an effective technique for finding Pareto optimal solutions.
ContributorsLi, Qing (Author) / Fowler, John W (Thesis advisor) / Mohan, Srimathy (Thesis advisor) / Gopalakrishnan, Mohan (Committee member) / Askin, Ronald G. (Committee member) / Wu, Teresa (Committee member) / Arizona State University (Publisher)
Created2010
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Description
In today's global market, companies are facing unprecedented levels of uncertainties in supply, demand and in the economic environment. A critical issue for companies to survive increasing competition is to monitor the changing business environment and manage disturbances and changes in real time. In this dissertation, an integrated framework is

In today's global market, companies are facing unprecedented levels of uncertainties in supply, demand and in the economic environment. A critical issue for companies to survive increasing competition is to monitor the changing business environment and manage disturbances and changes in real time. In this dissertation, an integrated framework is proposed using simulation and online calibration methods to enable the adaptive management of large-scale complex supply chain systems. The design, implementation and verification of the integrated approach are studied in this dissertation. The research contributions are two-fold. First, this work enriches symbiotic simulation methodology by proposing a framework of simulation and advanced data fusion methods to improve simulation accuracy. Data fusion techniques optimally calibrate the simulation state/parameters by considering errors in both the simulation models and in measurements of the real-world system. Data fusion methods - Kalman Filtering, Extended Kalman Filtering, and Ensemble Kalman Filtering - are examined and discussed under varied conditions of system chaotic levels, data quality and data availability. Second, the proposed framework is developed, validated and demonstrated in `proof-of-concept' case studies on representative supply chain problems. In the case study of a simplified supply chain system, Kalman Filtering is applied to fuse simulation data and emulation data to effectively improve the accuracy of the detection of abnormalities. In the case study of the `beer game' supply chain model, the system's chaotic level is identified as a key factor to influence simulation performance and the choice of data fusion method. Ensemble Kalman Filtering is found more robust than Extended Kalman Filtering in a highly chaotic system. With appropriate tuning, the improvement of simulation accuracy is up to 80% in a chaotic system, and 60% in a stable system. In the last study, the integrated framework is applied to adaptive inventory control of a multi-echelon supply chain with non-stationary demand. It is worth pointing out that the framework proposed in this dissertation is not only useful in supply chain management, but also suitable to model other complex dynamic systems, such as healthcare delivery systems and energy consumption networks.
ContributorsWang, Shanshan (Author) / Wu, Teresa (Thesis advisor) / Fowler, John (Thesis advisor) / Pfund, Michele (Committee member) / Li, Jing (Committee member) / Pavlicek, William (Committee member) / Arizona State University (Publisher)
Created2010