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" Understanding the Impacts of Nurse to Patient Assignments in a Multidisciplinary Infusion Clinic Using a Simulation-Based Optimization Model "
Richard, Katherine
Wang, Yong
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Latin Dissertation
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English
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| Record Number
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1054014
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TL53131
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| Main Entry
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Richard, Katherine
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| Title & Author
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Understanding the Impacts of Nurse to Patient Assignments in a Multidisciplinary Infusion Clinic Using a Simulation-Based Optimization Model\ Richard, KatherineWang, Yong
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| College
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State University of New York at Binghamton
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| Date
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2020
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| Degree
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M.S.
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2020
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| Note
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134 p.
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| Abstract
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The healthcare industry continues to face many challenges and is continuously growing. An important factor of continuous improvement and optimization for the healthcare systems across the United States is structure and framework. The structure of systems relies on guidelines or protocols put in place for the betterment of the system. If a clinic has multiple parts or stages (i.e. multidisciplinary clinic), the structure becomes more important and valuable for the optimization of the system. This research aims to develop a framework and structure for assigning staff to patients in a multidisciplinary clinic to accommodate infusion appointments. The research was conducted specifically in a pediatric infusion clinic which expects to expand their patient volumes in the near future. A simulation-based optimization model was developed to understand the current utilization of Registered Nurses (RNs) who care for the patients. Observations were conducted in the current state system in order to understand the patient and staff flow in the clinic. Next, time studies were completed on the different tasks of the RNs including, tray prep, placing an IV, administering drugs, and more. The times collected were used to develop processing times for the simulation. The data regarding patient arrivals was collected from the clinic calendar of recent months. Finally, different methods of assigning staff to patients were tested through sensitivity analysis to determine the best strategy for balancing the utilization of the nurses. After balancing the utilization of the nurses, the simulation was then used to understand what constraints were present on the current system. Another part of this research was an analysis of team-based nursing. This was included by adding two team-based assignment heuristics which were then tested in the simulation model. The results of this thesis showed that the most optimal strategy for assigning patients to RNs is to categorize the patients based on specialty and length of service. By utilizing this strategy the ΣΔN was reduced from 23.74% to 2%. Another finding from this thesis was that the main constraint on the system was the capacity. After increasing the capacity of the space the total clinic time was reduced from 16.16 hours to 10.99 hours. Finally, the results from the team-based nursing assignments showed a decrease in the total clinic hours but did not show an optimal solution for the balancing of the RN utilization in the system, however each scenario has its own pros and cons.
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| Descriptor
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Industrial engineering
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Management
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Wang, Yong
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State University of New York at Binghamton
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