Predicting hospital bed utilisation for post-surgical care by means of the Monte Carlo method with historical data.

ObjectiveThis study aim was to develop a predictive model of bed utilisation to support the decision process of elective surgery planning and bed management to improve post-surgical care.MethodsThis study undertook a retrospective analysis of de-identified data from a tertiary metropolitan hospital in Southeast Queensland, Australia. With a reference sample from 2years of historical data, a model based on the Monte Carol method has been developed to predict hospital bed utilisation for post-surgical care of patients who have undergone surgical procedures. A separate test sample from comparable data of 8weeks of actual utilisation was employed to assess the performance of the prediction model.ResultsApplying the developed prediction model to an 8-week period test sample, the mean percentage error of the prediction was 1.5% and the mean absolute percentage error 5.4%.ConclusionsThe predictive model developed in this study may assist in bed management and the planning process of elective surgeries, and in so doing also reduce the likelihood of Emergency Department access block.

Multi-objective extensive hypothesis testing for the estimation of advanced crash frequency models.

Analyzing crash data is a complex and labor-intensive process that requires careful consideration of multiple interdependent modeling aspects, such as functional forms, transformations, likely contributing factors, correlations, and unobserved heterogeneity. Limited time, knowledge, and experience may lead to over-simplified, over-fitted, or misspecified models overlooking important insights. This paper proposes an extensive hypothesis testing framework including a multi-objective mathematical programming formulation and solution algorithms to estimate crash frequency models considering simultaneously likely contributing factors, transformations, non-linearities, and correlated random parameters. The mathematical programming formulation minimizes both in-sample fit and out-of-sample prediction. To address the complexity and non-convexity of the mathematical program, the proposed solution framework utilizes a variety of metaheuristic solution algorithms. Specifically, Harmony Search demonstrated minimal sensitivity to hyperparameters, enabling an efficient search for solutions without being influenced by the choice of hyperparameters. The effectiveness of the framework was evaluated using two real-world datasets and one synthetic dataset. Comparative analyses were performed using the two real-world datasets and the corresponding models published in literature by independent teams. The proposed framework showed its capability to pinpoint efficient model specifications, produce accurate estimates, and provide valuable insights for both researchers and practitioners. The proposed approach allows for the discovery of numerous insights while minimizing the time spent on model development. By considering a broader set of contributing factors, models with varied qualities can be generated. For instance, when applied to crash data from Queensland, the proposed approach revealed that the inclusion of medians on sharp curved roads can effectively reduce the occurrence of crashes, when applied to crash data from Washington, the simultaneous consideration of traffic volume and road curvature resulted in a notable reduction in crash variances but an increase in crash means.

A stochastic programming approach to perform hospital capacity assessments.

This article introduces a bespoke risk averse stochastic programming approach for performing a strategic level assessment of hospital capacity (QAHC). We include stochastic treatment durations and length of stay in the analysis for the first time. To the best of our knowledge this is a new capability, not yet provided in the literature. Our stochastic programming approach identifies the maximum caseload that can be treated over a specified duration of time subject to a specified risk threshold in relation to temporary exceedances of capacity. Sample averaging techniques are applied to handle probabilistic constraints, but due to the size and complexity of the resultant mixed integer programming model, a novel two-stage hierarchical solution approach is needed. Our two-stage hierarchical solution approach is novel as it combines the application of a meta-heuristic with a binary search. It is also computationally fast. A case study of a large public hospital has been considered and extensive numerical tests have been undertaken to highlight the nuances and intricacies of the analysis. We conclude that the proposed approach is effective and can provide extra clarity and insights around hospital outputs. It provides a way to better calibrate hospitals and other health care infrastructure to future demands and challenges, like those created by the COVID pandemic.

Managing surgical waiting lists through dynamic priority scoring.

Prioritising elective surgery patients under the Australian three-category system is inherently subjective due to variability in clinician decision making and the potential for extraneous factors to influence category assignment. As a result, waiting time inequities can exist which may lead to adverse health outcomes and increased morbidity, especially for patients deemed to be low priority. This study investigated the use of a dynamic priority scoring (DPS) system to rank elective surgery patients more equitably, based on a combination of waiting time and clinical factors. Such a system enables patients to progress on the waiting list in a more objective and transparent manner, at a rate relative to their clinical need. Simulation results comparing the two systems indicate that the DPS system has potential to assist in managing waiting lists by standardising waiting times relative to urgency category, in addition to improving waiting time consistency for patients of similar clinical need. In clinical practice, this system is likely to reduce subjectivity, increase transparency, and improve overall efficiency of waiting list management by providing an objective metric to prioritise patients. Such a system is also likely to increase public trust and confidence in the systems used to manage waiting lists.

Optimizing facility location, sizing, and growth time for a cultivated resource: A case study in coral aquaculture.

Production of cultivated resources require additional planning that takes growth time into account. We formulate a mathematical programming model to determine the optimal location and sizing of growth facilities, impacted by resource survival rate as a function of its growth time. Our method informs strategic decisions regarding the number, location, and sizing of facilities, as well as operational decisions of optimal growth time for a cultivated resource in a facility to minimize total costs. We solve this facility location and sizing problem in the context of coral aquaculture for large-scale reef restoration using a two-stage algorithm and a linear mixed-integer solver. We assess growth time in a facility in terms of its impact on survival (post-deployment) considering growth quantity requirements and growth facility production constraints. We explore the sensitivity of optimal facility number, location, and sizing to changes in the geographic distribution of demand and cost parameters computationally. Results show that the relationship between growth time and survival is critical to optimizing operational decisions for grown resources. These results inform the value of data certainty to optimize the logistics of coral aquaculture production.

Statistical modelling of goalkicking performance in the Australian Football League.

OBJECTIVES: Australian football goal kicking is vital to team success, but its study is limited. Develop and apply Bayesian models incorporating temporal, spatial and situational variables to predict shot outcomes. The models aim to (i) rank players on their goal kicking and (ii) create clusters of statistically similar players and rank these clusters to provide generalised recommendations about player types. DESIGN: Retrospective longitudinal study with goal kicking data from three seasons, 2018-2020, 576 official Australian Football League matches, containing 26,818 attempts at goal from 778 players. METHODS: The Bayesian ordinal regression model enables descriptive analysis of goal kicking performance. The models include spatial variables of distance and kick angle, situational variables of shot type and player or cluster with interaction terms. Alternative models included situational variables of weather and player characteristics, spatial variables of stadium location and temporal variables of time and quarter. Approximate leave-one-out cross validation was used to test the model. RESULTS: Overall goal rate of 47% (12,600), behind rate of 35% (9373) with misses the remaining 18% (4845). Accuracy of both player and cluster model achieved 0.51 against an uninformed (predict goal) model result of 0.47. The models allow for analysis of goal kicking accuracy by distance and angle and analysis of player and player-type performance. CONCLUSIONS: While credible intervals for all players for set shots and general play were relatively large, some 95% credible intervals excluded zero. Therefore, it may be concluded that some players' goal kicking skill can be quantified and differentiated from other players.

An Overview of Hospital Capacity Planning and Optimisation.

Health care is uncertain, dynamic, and fast growing. With digital technologies set to revolutionise the industry, hospital capacity optimisation and planning have never been more relevant. The purposes of this article are threefold. The first is to identify the current state of the art, to summarise/analyse the key achievements, and to identify gaps in the body of research. The second is to synthesise and evaluate that literature to create a holistic framework for understanding hospital capacity planning and optimisation, in terms of physical elements, process, and governance. Third, avenues for future research are sought to inform researchers and practitioners where they should best concentrate their efforts. In conclusion, we find that prior research has typically focussed on individual parts, but the hospital is one body that is made up of many interdependent parts. It is also evident that past attempts considering entire hospitals fail to incorporate all the detail that is necessary to provide solutions that can be implemented in the real world, across strategic, tactical and operational planning horizons. A holistic approach is needed that includes ancillary services, equipment medicines, utilities, instrument trays, supply chain and inventory considerations.

Process data analytics for hospital case-mix planning.

The composition and volume of patients treated in a hospital, i.e., the patient case-mix, directly impacts resource utilisation. Despite advances in technology, existing case-mix planning approaches are mostly manual. In this paper, we report on a solution that was developed in collaboration with the Queensland Children's Hospital for supporting its case-mix planning using process mining. We investigated (1) How can process mining capabilities be used to inform hospital case-mix planning?, and (2) How can process data be used to assess hospital capacity assessment and inform hospital case-mix planning? The major contributions of this paper include (i) an automated workflow to support both process mining analysis, and capacity assessment, (ii) a process mining analysis designed to detect process performance and variations, and (iii) a novel capacity assessment model based on limiting-resource saturation.