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- Genre: Doctoral Dissertation
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 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
Description
A Pairwise Comparison Matrix (PCM) is used to compute for relative priorities of criteria or alternatives and are integral components of widely applied decision making tools: the Analytic Hierarchy Process (AHP) and its generalized form, the Analytic Network Process (ANP). However, a PCM suffers from several issues limiting its application to large-scale decision problems, specifically: (1) to the curse of dimensionality, that is, a large number of pairwise comparisons need to be elicited from a decision maker (DM), (2) inconsistent and (3) imprecise preferences maybe obtained due to the limited cognitive power of DMs. This dissertation proposes a PCM Framework for Large-Scale Decisions to address these limitations in three phases as follows. The first phase proposes a binary integer program (BIP) to intelligently decompose a PCM into several mutually exclusive subsets using interdependence scores. As a result, the number of pairwise comparisons is reduced and the consistency of the PCM is improved. Since the subsets are disjoint, the most independent pivot element is identified to connect all subsets. This is done to derive the global weights of the elements from the original PCM. The proposed BIP is applied to both AHP and ANP methodologies. However, it is noted that the optimal number of subsets is provided subjectively by the DM and hence is subject to biases and judgement errors. The second phase proposes a trade-off PCM decomposition methodology to decompose a PCM into a number of optimally identified subsets. A BIP is proposed to balance the: (1) time savings by reducing pairwise comparisons, the level of PCM inconsistency, and (2) the accuracy of the weights. The proposed methodology is applied to the AHP to demonstrate its advantages and is compared to established methodologies. In the third phase, a beta distribution is proposed to generalize a wide variety of imprecise pairwise comparison distributions via a method of moments methodology. A Non-Linear Programming model is then developed that calculates PCM element weights which maximizes the preferences of the DM as well as minimizes the inconsistency simultaneously. Comparison experiments are conducted using datasets collected from literature to validate the proposed methodology.
ContributorsJalao, Eugene Rex Lazaro (Author) / Shunk, Dan L. (Thesis advisor) / Wu, Teresa (Thesis advisor) / Askin, Ronald G. (Committee member) / Goul, Kenneth M (Committee member) / Arizona State University (Publisher)
Created2013
Description
Identifying important variation patterns is a key step to identifying root causes of process variability. This gives rise to a number of challenges. First, the variation patterns might be non-linear in the measured variables, while the existing research literature has focused on linear relationships. Second, it is important to remove noise from the dataset in order to visualize the true nature of the underlying patterns. Third, in addition to visualizing the pattern (preimage), it is also essential to understand the relevant features that define the process variation pattern. This dissertation considers these variation challenges. A base kernel principal component analysis (KPCA) algorithm transforms the measurements to a high-dimensional feature space where non-linear patterns in the original measurement can be handled through linear methods. However, the principal component subspace in feature space might not be well estimated (especially from noisy training data). An ensemble procedure is constructed where the final preimage is estimated as the average from bagged samples drawn from the original dataset to attenuate noise in kernel subspace estimation. This improves the robustness of any base KPCA algorithm. In a second method, successive iterations of denoising a convex combination of the training data and the corresponding denoised preimage are used to produce a more accurate estimate of the actual denoised preimage for noisy training data. The number of primary eigenvectors chosen in each iteration is also decreased at a constant rate. An efficient stopping rule criterion is used to reduce the number of iterations. A feature selection procedure for KPCA is constructed to find the set of relevant features from noisy training data. Data points are projected onto sparse random vectors. Pairs of such projections are then matched, and the differences in variation patterns within pairs are used to identify the relevant features. This approach provides robustness to irrelevant features by calculating the final variation pattern from an ensemble of feature subsets. Experiments are conducted using several simulated as well as real-life data sets. The proposed methods show significant improvement over the competitive methods.
ContributorsSahu, Anshuman (Author) / Runger, George C. (Thesis advisor) / Wu, Teresa (Committee member) / Pan, Rong (Committee member) / Maciejewski, Ross (Committee member) / Arizona State University (Publisher)
Created2013
Description
Buildings (approximately half commercial and half residential) consume over 70% of the electricity among all the consumption units in the United States. Buildings are also responsible for approximately 40% of CO2 emissions, which is more than any other industry sectors. As a result, the initiative smart building which aims to not only manage electrical consumption in an efficient way but also reduce the damaging effect of greenhouse gases on the environment has been launched. Another important technology being promoted by government agencies is the smart grid which manages energy usage across a wide range of buildings in an effort to reduce cost and increase reliability and transparency. As a great amount of efforts have been devoted to these two initiatives by either exploring the smart grid designs or developing technologies for smart buildings, the research studying how the smart buildings and smart grid coordinate thus more efficiently use the energy is currently lacking. In this dissertation, a "system-of-system" approach is employed to develop an integrated building model which consists a number of buildings (building cluster) interacting with smart grid. The buildings can function as both energy consumption unit as well as energy generation/storage unit. Memetic Algorithm (MA) and Particle Swarm Optimization (PSO) based decision framework are developed for building operation decisions. In addition, Particle Filter (PF) is explored as a mean for fusing online sensor and meter data so adaptive decision could be made in responding to dynamic environment. The dissertation is divided into three inter-connected research components. First, an integrated building energy model including building consumption, storage, generation sub-systems for the building cluster is developed. Then a bi-level Memetic Algorithm (MA) based decentralized decision framework is developed to identify the Pareto optimal operation strategies for the building cluster. The Pareto solutions not only enable multiple dimensional tradeoff analysis, but also provide valuable insight for determining pricing mechanisms and power grid capacity. Secondly, a multi-objective PSO based decision framework is developed to reduce the computational effort of the MA based decision framework without scarifying accuracy. With the improved performance, the decision time scale could be refined to make it capable for hourly operation decisions. Finally, by integrating the multi-objective PSO based decision framework with PF, an adaptive framework is developed for adaptive operation decisions for smart building cluster. The adaptive framework not only enables me to develop a high fidelity decision model but also enables the building cluster to respond to the dynamics and uncertainties inherent in the system.
ContributorsHu, Mengqi (Author) / Wu, Teresa (Thesis advisor) / Weir, Jeffery (Thesis advisor) / Wen, Jin (Committee member) / Fowler, John (Committee member) / Shunk, Dan (Committee member) / Arizona State University (Publisher)
Created2012
Description
This research by studies the computational performance of four different mixed integer programming (MIP) formulations for single machine scheduling problems with varying complexity. These formulations are based on (1) start and completion time variables, (2) time index variables, (3) linear ordering variables and (4) assignment and positional date variables. The objective functions that are studied in this paper are total weighted completion time, maximum lateness, number of tardy jobs and total weighted tardiness. Based on the computational results, discussion and recommendations are made on which MIP formulation might work best for these problems. The performances of these formulations very much depend on the objective function, number of jobs and the sum of the processing times of all the jobs. Two sets of inequalities are presented that can be used to improve the performance of the formulation with assignment and positional date variables. Further, this research is extend to single machine bicriteria scheduling problems in which jobs belong to either of two different disjoint sets, each set having its own performance measure. These problems have been referred to as interfering job sets in the scheduling literature and also been called multi-agent scheduling where each agent's objective function is to be minimized. In the first single machine interfering problem (P1), the criteria of minimizing total completion time and number of tardy jobs for the two sets of jobs is studied. A Forward SPT-EDD heuristic is presented that attempts to generate set of non-dominated solutions. The complexity of this specific problem is NP-hard. The computational efficiency of the heuristic is compared against the pseudo-polynomial algorithm proposed by Ng et al. [2006]. In the second single machine interfering job sets problem (P2), the criteria of minimizing total weighted completion time and maximum lateness is studied. This is an established NP-hard problem for which a Forward WSPT-EDD heuristic is presented that attempts to generate set of supported points and the solution quality is compared with MIP formulations. For both of these problems, all jobs are available at time zero and the jobs are not allowed to be preempted.
ContributorsKhowala, Ketan (Author) / Fowler, John (Thesis advisor) / Keha, Ahmet (Thesis advisor) / Balasubramanian, Hari J (Committee member) / Wu, Teresa (Committee member) / Zhang, Muhong (Committee member) / Arizona State University (Publisher)
Created2012
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 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
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 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
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 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
Description
This dissertation consists of three chapters that investigate the rapid adoption and complex implementation of city commitments to transition to 100% renewable energy (100RE). The first paper uses a two-stage, mixed methods approach to examine 100RE commitments across the US, combining a multivariate regression of demographic, institutional, and policy factors in adoption and six interview-based state case studies to discuss implementation. Adoption of this non-binding commitment progressed rapidly for city councils around the US. Results show that many cities passed 100RE commitments with no implementation plan and minimal understanding of implementation challenges. This analysis highlights that many cities will need new institutions and administrative capacities for successful implementation of these ambitious new policies. While many cities abandoned the commitment soon after adoption, collaboration allowed cities in a few states to break through and pursue implementation, examined further in the next two studies. The second paper is a qualitative case study examining policymaking for the Utah Community Renewable Energy Act. Process tracing methods are used to identify causal factors in enacting this legislation at the state level and complementary resolutions at the local level. This Act was passed through the leadership and financial backing of major cities and committed the investor-owned utility to fulfill any city 100RE resolutions passed through 2019. Finally, the third paper is a mixed-methods, descriptive case study of the benefits of Community Choice Aggregation (CCA) in California, which many cities are using to fulfill their 100RE commitments. Cities have adopted CCAs to increase their local voice in the energy process, while fulfilling climate and energy goals. Overall, this research shows that change in the investor-owned utility electricity system is in fact possible from the city scale, though many cities will need institutional innovation to implement these policies and achieve the change they desire. While cities with greater resources are better positioned to make an impact, smaller cities can collaborate to similarly influence the energy system. Communities are interested in lowering energy costs for customers where possible, but the central motivations in these cases were the pursuit of sustainability and increasing local voice in energy decision-making.
ContributorsKunkel, Leah Christine (Author) / Breetz, Hanna L (Thesis advisor) / Parker, Nathan (Committee member) / Salon, Deborah (Committee member) / Arizona State University (Publisher)
Created2022
Description
Beta-Amyloid(Aβ) plaques and tau protein tangles in the brain are now widely recognized as the defining hallmarks of Alzheimer’s disease (AD), followed by structural atrophy detectable on brain magnetic resonance imaging (MRI) scans. However, current methods to detect Aβ/tau pathology are either invasive (lumbar puncture) or quite costly and not widely available (positron emission tomography (PET)). And one of the particular neurodegenerative regions is the hippocampus to which the influence of Aβ/tau on has been one of the research projects focuses in the AD pathophysiological progress.
In this dissertation, I proposed three novel machine learning and statistical models to examine subtle aspects of the hippocampal morphometry from MRI that are associated with Aβ /tau burden in the brain, measured using PET images. The first model is a novel unsupervised feature reduction model to generate a low-dimensional representation of hippocampal morphometry for each individual subject, which has superior performance in predicting Aβ/tau burden in the brain. The second one is an efficient federated group lasso model to identify the hippocampal subregions where atrophy is strongly associated with abnormal Aβ/Tau. The last one is a federated model for imaging genetics, which can identify genetic and transcriptomic influences on hippocampal morphometry. Finally, I stated the results of these three models that have been published or submitted to peer-reviewed conferences and journals.
ContributorsWu, Jianfeng (Author) / Wang, Yalin (Thesis advisor) / Li, Baoxin (Committee member) / Liang, Jianming (Committee member) / Wang, Junwen (Committee member) / Wu, Teresa (Committee member) / Arizona State University (Publisher)
Created2022