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Results for “Program Efficiency”

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At least 1,189 records · Page 66Linked to original sources
PubMed2007

Use of patient flow analysis to improve patient visit efficiency by decreasing wait time in a primary care-based disease management programs for anticoagulation and chronic pain: a quality improvement study.

BACKGROUND: Patients with chronic conditions require frequent care visits. Problems can arise during several parts of the patient visit that decrease efficiency, making it difficult to effectively care for high volumes of patients. The purpose of the study is to test a method to improve patient visit efficiency. METHODS: We used Patient Flow Analysis to identify inefficiencies in the patient visit, suggest areas for improvement, and test the effectiveness of clinic interventions. RESULTS: At baseline, the mean visit time for 93 anticoagulation clinic patient visits was 84 minutes (+/- 50 minutes) and the mean visit time for 25 chronic pain clinic patient visits was 65 minutes (+/- 21 minutes). Based on these data, we identified specific areas of inefficiency and developed interventions to decrease the mean time of the patient visit. After interventions, follow-up data found the mean visit time was reduced to 59 minutes (+/-25 minutes) for the anticoagulation clinic, a time decrease of 25 minutes (t-test 39%; p < 0.001). Mean visit time for the chronic pain clinic was reduced to 43 minutes (+/- 14 minutes) a time decrease of 22 minutes (t-test 34 %; p < 0.001). CONCLUSION: Patient Flow Analysis is an effective technique to identify inefficiencies in the patient visit and efficiently collect patient flow data. Once inefficiencies are identified they can be improved through brief interventions.

Adult↗
PubMed1997

LIGSITE: automatic and efficient detection of potential small molecule-binding sites in proteins.

LIGSITE is a new program for the automatic and time-efficient detection of pockets on the surface of proteins that may act as binding sites for small molecule ligands. Pockets are identified with a series of simple operations on a cubic grid. Using a set of receptor-ligand complexes we show that LIGSITE is able to identify the binding sites of small molecule ligands with high precision. The main advantage of LIGSITE is its speed. Typical search times are in the range of 5 to 20 s for medium-sized proteins. LIGSITE is therefore well suited for identification of pockets in large sets of proteins (e.g., protein families) for comparative studies. For graphical display LIGSITE produces VRML representations of the protein-ligand complex and the binding site for display with a VRML viewer such as WebSpace from SGI.

Algorithms↗
PubMed1981

Implementing a competency-based orientation program.

Competency-based orientation is efficient and effective. It allows individual learning needs to be met without sacrificing achievement of consistent standards. The system does require a large initial investment in the development of learning options and assessment of evaluation tools. It also requires the commitment of nurse managers and administrators to the concept and the implementation process. Orientation is still complex and expensive at Maryland General, but now it meets individual needs and is cost-effective.

Clinical Competence↗
PubMed1993

The evolution of a cytogenetics education program.

An educational program in clinical cytogenetics was initiated in 1983 at the University of Texas Health Science Center at Houston, through the Medical Technology Program in the School of Allied Health Sciences. Through the years the program has evolved into a more efficient curriculum, with the possibility of becoming a part of a master's degree program in allied health sciences. It is hoped that a description of the program will be of help to other educational institutions that may be contemplating the establishment of a similar course of study.

Curriculum↗
PubMed1997

[The efficiency of organizational measures in improving the management of the prior appointment program].

OBJECTIVES: To estimate the organisational impact of the volume of appointments processed in the Primary Care (PC) Administration Units (AU) of Area 10, and to evaluate the effectiveness of organisational measures to correct the excess of appointments processed at particular times of day. DESIGN: Before-and-after intervention study. SETTING: AU of 16 PC teams from Madrid's Area 10. PARTICIPANTS: All the appointments made for users by 78 clerks in the 16 AU in the Area during the two weeks of the study. INTERVENTIONS: Strengthening of administrative staff dealing with the appointment system; and an information campaign for users about the system. MEASUREMENTS AND RESULTS: The percentage of appointments processed by AU was broken down for morning and afternoon, by the way the appointment was made (telephone/counter) and by the scheduling of the list. The hourly development was analysed by a graph. A mean number of appointments per clerk per day was found. The above figures were compared for before and after intervention. CONCLUSIONS: The work load caused by the appointment system was redistributed by internal organisational measures, since user habits did not alter.

Appointments and Schedules↗
PubMed1992

A screening mammography program. Staying alive and making it work.

The success of a mammography screening program requires thorough planning. A dependably high volume and a streamlined efficient operation are essential to survival of the program. Factors that warrant consideration prior to designing such a program include the following: Distinction between screening and diagnostic mammography examinations. Selection of a site that will meet the needs of the community and yet provide a consistently high volume. Low examination cost for screening mammography coupled with a detailed financial analysis and reappraisal on an ongoing basis. A customized marketing program that incorporates methods to increase awareness, compliance, and utilization by women and referring physicians. Well-trained, efficient, and dedicated personnel. An operation that is designed for rapid throughput and expeditious patient flow. An efficient plan for film handling, interpretation, reporting, and storage. Timely communication of examination results. A reliable mechanism for follow-up evaluation and outcome data collection. Establishment of a consistent and reliable quality assurance program and the production of high quality mammograms.

Advertising↗
PubMed2003

A novel linear programming approach to fluence map optimization for intensity modulated radiation therapy treatment planning.

We present a novel linear programming (LP) based approach for efficiently solving the intensity modulated radiation therapy (IMRT) fluence-map optimization (FMO) problem to global optimality. Our model overcomes the apparent limitations of a linear-programming approach by approximating any convex objective function by a piecewise linear convex function. This approach allows us to retain the flexibility offered by general convex objective functions, while allowing us to formulate the FMO problem as a LP problem. In addition, a novel type of partial-volume constraint that bounds the tail averages of the differential dose-volume histograms of structures is imposed while retaining linearity as an alternative approach to improve dose homogeneity in the target volumes, and to attempt to spare as many critical structures as possible. The goal of this work is to develop a very rapid global optimization approach that finds high quality dose distributions. Implementation of this model has demonstrated excellent results. We found globally optimal solutions for eight 7-beam head-and-neck cases in less than 3 min of computational time on a single processor personal computer without the use of partial-volume constraints. Adding such constraints increased the running times by a factor of 2-3, but improved the sparing of critical structures. All cases demonstrated excellent target coverage (> 95%), target homogeneity (< 10% overdosing and < 7% underdosing) and organ sparing using at least one of the two models.

Algorithms↗
PubMed1982

A structured BASIC database computer code for track meet management.

This paper describes a program coded in BASIC, which efficiently provides management of certain track meet functions. In addition to generating heat and lane assignments, recording results, and scoring on an individual and team basis, the program allows coaches and officials to retrieve information on teams, participants, and events which are completed, in-progress, or upcoming. Utilization of the program requires neither computer programming experience, nor any related expertise.

Computers↗
PubMed2001

In a complex sequential movement, what component of the motor program is improved with intensive practice, sequence timing or ensemble motor learning?

We investigated whether the higher maximum speed of complex athletic movements attained by experts compared with novices might solely be ascribed to the acquisition of a more efficient timing of the initiation of the simple movements that comprise complex sporting gestures. Six novices in fencing and five experts in fencing performed three experimental series: 7 trials of touche, 7 trials of lunge (control series) and 50 trials of lunge + touche (test series), where the touche and lunge were initiated with different chronological sequences imposed by the experimenter. The lunge and the touche can be assimilated to a fast forward step and to a pointing task, respectively. We compared the maximum speed of touche between the two groups, recorded by an accelerometer fixed to the hand guard of the foil, and the speed of the centre of mass obtained from a force plate. The speed of the centre of mass was not statistically different between the two groups in the control and in the test series. The maximum speed of touche was not statistically different between the two groups in the control series. In contrast, in the test series, the maximum speed of touche was higher in the fencers' than in novices' groups, while the timing of initiation of the lunge and the touche was similar. The results of the test series show that the higher maximum speed of touche of fencers compared with novices cannot solely be ascribed to the acquisition of a more efficient initiation timing in motor programming. In a complex fencing gesture, the higher maximum speed of touche following intensive practice is discussed with regard to the inhibition of negative effects linked to the "refractory period" associated with the initiation of two closely spaced motor programs.

Adult↗
PubMed2003

Integer/linear mathematical programming models: a tool for allocating healthcare resources.

In today's environment, the demand for efficient healthcare resource allocation is increasing. As new technologies become available, allocation decisions become more complex and tools to assist decision makers in determining efficient allocations of healthcare resources are encouraged. Mathematical programs have multiple properties that are desirable for healthcare decision makers such as the simultaneous consideration of multiple constraints and a built-in sensitivity analysis. These models have been well researched and are considered invaluable in other industries. Mathematical programming has also become increasingly visible in facilitating the allocation of healthcare resources in the health services research sector. However, the use of mathematical programming tools has been limited in economic evaluations of new technologies. Budget allocations, such as formulary, drug development, and pricing decisions may benefit greatly from the use of mathematical programs. As an increasing number of expensive new technologies become available and pressure grows to contain healthcare costs, these tools may help guide a more efficient allocation of resources for technologies under budgetary and other constraints.

Decision Making↗
PubMed2004

Valuing the benefits of weight loss programs: an application of the discrete choice experiment.

OBJECTIVE: Obesity is a leading health threat. Determination of optimal therapies for long-term weight loss remains a challenge. Evidence suggests that successful weight loss depends on the compliance of weight loss program participants with their weight loss efforts. Despite this, little is known regarding the attributes influencing such compliance. The purpose of this study was to assess, using a discrete choice experiment (DCE), the relative importance of weight loss program attributes to its participants and to express these preferences in terms of their willingness to pay for them. RESEARCH METHODS: A DCE survey explored the following weight loss program attributes in a sample of 165 overweight adults enrolled in community weight loss programs: cost, travel time required to attend, extent of physician involvement (e.g., none, monthly, every 2 weeks), components (e.g., diet, exercise, behavior change) emphasized, and focus (e.g., group, individual). The rate at which participants were willing to trade among attributes and the willingness to pay for different configurations of combined attributes were estimated using regression modeling. RESULTS: All attributes investigated appeared to be statistically significant. The most important unit change was "program components emphasized" (e.g., moving from diet only to diet and exercise). DISCUSSION: The majority of participants were willing to pay for weight loss programs that reflected their preferences. The DCE tool was useful in quantifying and understanding individual preferences in obesity management and provided information that could help to maximize the efficiency of existing weight loss programs or the design of new programs.

Adult↗
PubMed1996

Programmed translational frameshifting.

Errors that alter the reading frame occur extremely rarely during translation, yet some genes have evolved sequences that efficiently induce frameshifting. These sequences, termed programmed frameshift sites, manipulate the translational apparatus to promote non-canonical decoding. Frameshifts are mechanistically diverse. Most cause a -1 shift of frames; the first such site was discovered in a metazoan retrovirus, but they are now known to be dispersed quite widely among evolutionarily diverse species. +1 frameshift sites are much less common, but again dispersed widely. The rarest form are the translational hop sites which program the ribosome to bypass a region of several dozen nucleotides. Each of these types of events are stimulated by distinct mechanisms. All of the events share a common phenomenology in which the programmed frameshift site causes the ribosome to pause during elongation so that the kinetically unfavorable alternative decoding event can occur. During this pause most frameshifts occur because one or more ribosome-bound tRNAs slip between cognate or near-cognate codons. However, even this generalization is not entirely consistent, since some frameshifts occur without slippage. Because of their similarity to rarer translational errors, programmed frameshift sites provide a tool with which to probe the mechanism of frame maintenance.

Frameshift Mutation↗
PubMedDate not supplied

Effects of a modified dance-based exercise on cardiorespiratory fitness, psychological state and health status of persons with rheumatoid arthritis.

Cardiorespiratory function and exercise tolerance appear very limited in persons with rheumatoid arthritis (RA). Many studies have demonstrated that aerobic exercise training is beneficial to prevent physical deconditioning without inducing adverse effects on an individual's joints and general health. The present study was conducted to demonstrate that a dance-based exercise program is a safe and efficient activity to improve physical fitness and psychological state in persons with RA. A group of 19 persons (mean age, 49.3 +/- 13 yr) participated in a 12-wk exercise program (twice weekly), whereas 10 persons (mean age, 49.4 +/- 12 yr) served as controls. Health status, use of medication, joint pain and swelling, physical fitness, activity of daily living and psychological state were assessed at baseline, after the 12-wk training program and 6 mo after the end of the program. Exercise training induced a mean improvement of 13% in aerobic power, with the highest values reaching 40%. No significant changes were observed in joint status, even though the count of painful joints tended to decrease in the exercise group. Positive changes in depression, anxiety, fatigue and tension were observed after the 12-wk exercise program. These findings provide some evidences in favor of aerobic exercise in individuals with RA. Furthermore, it is of primary interest to note that a weight-bearing activity with limited ground impacts do not provoke short-term adverse effects on joint status. Further studies, however, are required to determine the long-term effect of weight-bearing exercise on the health status of individuals with RA.

Activities of Daily Living↗
PubMed2005

A tree-decomposition approach to protein structure prediction.

This paper proposes a tree decomposition of protein structures, which can be used to efficiently solve two key subproblems of protein structure prediction: protein threading for backbone prediction and protein side-chain prediction. To develop a unified tree-decomposition based approach to these two subproblems, we model them as a geometric neighborhood graph labeling problem. Theoretically, we can have a low-degree polynomial time algorithm to decompose a geometric neighborhood graph G = (V, E) into components with size O(|V|((2/3))log|V|). The computational complexity of the tree-decomposition based graph labeling algorithms is O(|V|Delta(tw+1)) where Delta is the average number of possible labels for each vertex and tw( = O(|V|((2/3))log|V|)) the tree width of G. Empirically, tw is very small and the tree-decomposition method can solve these two problems very efficiently. This paper also compares the computational efficiency of the tree-decomposition approach with the linear programming approach to these two problems and identifies the condition under which the tree-decomposition approach is more efficient than the linear programming approach. Experimental result indicates that the tree-decomposition approach is more efficient most of the time.

Algorithms↗
PubMed1991

Significant efficiency findings while controlling for the frequent confounders of CAI research in the PlanAlyzer project's computer-based, self-paced, case-based programs in anemia and chest pain diagnosis.

Richard E. Clark in his widely published comprehensive studies and meta-analyses of the literature on computer assisted instruction (CAI) has decried the lack of carefully controlled research, challenging almost every study which shows the computer-based intervention to result in significant post-test proficiency gains over a non-computer-based intervention. We report on a randomized study in a medical school setting where the usual confounders found by Clark to plague most research, were carefully controlled. PlanAlyzer is a microcomputer-based, self-paced, case-based, event-driven system for medical education which was developed and used in carefully controlled trials in a second year medical school curriculum to test the hypothesis that students with access to the interactive programs could integrate their didactic knowledge more effectively and/or efficiently than with access only to traditional textual "nonintelligent" materials. PlanAlyzer presents cases, elicits and critiques a student's approach to the diagnosis of two common medical disorders: anemias and chest pain. PlanAlyzer uses text, hypertext, images and critiquing theory. Students were randomized, one half becoming the experimental group who received the interactive PlanAlyzer cases in anemia, the other half becoming the controls who received the exact same content material in a text format. Later in each year there was a crossover, the controls becoming the experimentals for a similar intervention with the cardiology PlanAlyzer cases. Preliminary results at the end of the first two full trials shows that the programs have achieved most of the proposed instructional objectives, plus some significant efficiency and economy gains. 96 faculty hours of classroom time were saved by using PlanAlyzer in their place, while maintaining high student achievement. In terms of student proficiency and efficiency, the 328 students in the trials over two years were able to accomplish the project's instructional objectives, and the experimentals accomplished this in 43% less time than the controls, achieving the same level of mastery. However, in spite of these significant efficiency findings, there have been no significant proficiency differences (as measured by current factual and higher order multiple choice post-tests) between the experimental and control groups. Very careful controls were used to avoid what Clark has found to be the most common confounders of CAI research. Accordingly, this research proved Clark's rival hypothesis, that the computer, in itself, does not appear to contribute to proficiency gains, at least as measured by our limited post-testing. Clark's position is that the computer is primarily a vehicle--as is either a pill or a hypodermic needle for delivering a drug.(ABSTRACT TRUNCATED AT 400 WORDS)

Anemia↗
PubMed2000

The dragnet of children's feeding programs in Atlantic Canada.

Ivan Illich's 1976 prediction that medical dragnets will continue was correct. Now quasi-health dragnets are being established ostensibly to feed children perceived to be hungry. Our qualitative, multi-site case study found that programs justify their expansion to non-target group children as a means of reducing stigmatization, while reaching only an estimated one-third of targeted children. The dragnet continues as new services are added and franchising is proposed while the purpose of the program feeding healthy foods to children ultimately succumbs to drives for efficiency and the desire to maintain the program itself. In this field of social power relations, children become commodified through dialectical interplays among fundamental needs, manipulated needs, benevolence, and domination.

Canada↗
PubMedDate not supplied

A computerized system for equipment control and preventive maintenance.

The Medical Engineering Laboratory of the University of Rochester-Strong Memorial Hospital is responsible for service of and scheduled preventive maintenance on approximately 6000 pieces of patient-care and laboratory equipment. A database management computer program has been developed t increase the efficiency and accuracy with which equipment control records are maintained. The program has three major divisions: data files, update programs, and report programs. The date files are for storage of all records and tables; the update programs are for convenient data entry, corrections, and changes; the report programs are for creating all the forms, records, and reports associated with the equipment control program. Besides maintaining all of the identifying information, inspection results, and service reports on all of the medical equipment, the system can maintain the department's parts inventory records and prepare itemized bills.

Computers↗