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Discovering the impact of preceding units' characteristics on the wait time of cardiac surgery unit from statistic data.

Liu J, Tao L, Xiao B - PLoS ONE (2011)

Bottom Line: Results show that: (i) wait time of CU has a direct positive impact on wait time of SU (β = 0.330, p < 0.01); (ii) capacity of CU has a direct positive impact on demand of SU (β = 0.644, p < 0.01); (iii) within each unit, there exist significant relationships among different characteristics (except for the effect of throughput on wait time in SU).This suggests that considering such cross-unit effects is necessary when alleviating wait time in a health care system.Further, different patient risk profiles may affect wait time in different ways (e.g., positive or negative effects) within SU.

View Article: PubMed Central - PubMed

Affiliation: Computer Science Department, Hong Kong Baptist University, Hong Kong, Special Administrative Region, People's Republic of China. jiming@comp.hkbu.edu.hk

ABSTRACT

Introduction: Prior research shows that clinical demand and supplier capacity significantly affect the throughput and the wait time within an isolated unit. However, it is doubtful whether characteristics (i.e., demand, capacity, throughput, and wait time) of one unit would affect the wait time of subsequent units on the patient flow process. Focusing on cardiac care, this paper aims to examine the impact of characteristics of the catheterization unit (CU) on the wait time of cardiac surgery unit (SU).

Methods: This study integrates published data from several sources on characteristics of the CU and SU units in 11 hospitals in Ontario, Canada between 2005 and 2008. It proposes a two-layer wait time model (with each layer representing one unit) to examine the impact of CU's characteristics on the wait time of SU and test the hypotheses using the Partial Least Squares-based Structural Equation Modeling analysis tool.

Results: Results show that: (i) wait time of CU has a direct positive impact on wait time of SU (β = 0.330, p < 0.01); (ii) capacity of CU has a direct positive impact on demand of SU (β = 0.644, p < 0.01); (iii) within each unit, there exist significant relationships among different characteristics (except for the effect of throughput on wait time in SU).

Conclusion: Characteristics of CU have direct and indirect impacts on wait time of SU. Specifically, demand and wait time of preceding unit are good predictors for wait time of subsequent units. This suggests that considering such cross-unit effects is necessary when alleviating wait time in a health care system. Further, different patient risk profiles may affect wait time in different ways (e.g., positive or negative effects) within SU. This implies that the wait time management should carefully consider the relationship between priority triage and risk stratification, especially for cardiac surgery.

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The research framework with the summarization of the impact factors for throughput and wait time.
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pone-0021959-g002: The research framework with the summarization of the impact factors for throughput and wait time.

Mentions: In sum, the impact factors for a health care unit's performance (i.e., wait time, and throughput) have been studied from the demand-side and capacity-side perspectives (shown in Figure 2). The relationships among demand, capacity, throughput, and wait time have been investigated within a unit. However, little attention has been paid to the relationships among the characteristics in a cross-unit context, a gap this study aims to fill. In this study, we explore whether and how the characteristics of one unit exert an influence on the characteristics (wait time in particular) of other temporally related units (Figure 2 shows the overall research framework). We choose the CU and the SU as our research context, because (i) they both provide key services [25][28], (ii) they are temporally connected [51], and (iii) published data about the two units are available (http://www.ccn.on.ca/). We propose a two-layer wait time model (see detailed discussion in the next section) to investigate the CU's characteristics on the wait time of SU, with each layer representing a unit. Both within-unit and cross-unit relationships are represented in the model.


Discovering the impact of preceding units' characteristics on the wait time of cardiac surgery unit from statistic data.

Liu J, Tao L, Xiao B - PLoS ONE (2011)

The research framework with the summarization of the impact factors for throughput and wait time.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3139594&req=5

pone-0021959-g002: The research framework with the summarization of the impact factors for throughput and wait time.
Mentions: In sum, the impact factors for a health care unit's performance (i.e., wait time, and throughput) have been studied from the demand-side and capacity-side perspectives (shown in Figure 2). The relationships among demand, capacity, throughput, and wait time have been investigated within a unit. However, little attention has been paid to the relationships among the characteristics in a cross-unit context, a gap this study aims to fill. In this study, we explore whether and how the characteristics of one unit exert an influence on the characteristics (wait time in particular) of other temporally related units (Figure 2 shows the overall research framework). We choose the CU and the SU as our research context, because (i) they both provide key services [25][28], (ii) they are temporally connected [51], and (iii) published data about the two units are available (http://www.ccn.on.ca/). We propose a two-layer wait time model (see detailed discussion in the next section) to investigate the CU's characteristics on the wait time of SU, with each layer representing a unit. Both within-unit and cross-unit relationships are represented in the model.

Bottom Line: Results show that: (i) wait time of CU has a direct positive impact on wait time of SU (β = 0.330, p < 0.01); (ii) capacity of CU has a direct positive impact on demand of SU (β = 0.644, p < 0.01); (iii) within each unit, there exist significant relationships among different characteristics (except for the effect of throughput on wait time in SU).This suggests that considering such cross-unit effects is necessary when alleviating wait time in a health care system.Further, different patient risk profiles may affect wait time in different ways (e.g., positive or negative effects) within SU.

View Article: PubMed Central - PubMed

Affiliation: Computer Science Department, Hong Kong Baptist University, Hong Kong, Special Administrative Region, People's Republic of China. jiming@comp.hkbu.edu.hk

ABSTRACT

Introduction: Prior research shows that clinical demand and supplier capacity significantly affect the throughput and the wait time within an isolated unit. However, it is doubtful whether characteristics (i.e., demand, capacity, throughput, and wait time) of one unit would affect the wait time of subsequent units on the patient flow process. Focusing on cardiac care, this paper aims to examine the impact of characteristics of the catheterization unit (CU) on the wait time of cardiac surgery unit (SU).

Methods: This study integrates published data from several sources on characteristics of the CU and SU units in 11 hospitals in Ontario, Canada between 2005 and 2008. It proposes a two-layer wait time model (with each layer representing one unit) to examine the impact of CU's characteristics on the wait time of SU and test the hypotheses using the Partial Least Squares-based Structural Equation Modeling analysis tool.

Results: Results show that: (i) wait time of CU has a direct positive impact on wait time of SU (β = 0.330, p < 0.01); (ii) capacity of CU has a direct positive impact on demand of SU (β = 0.644, p < 0.01); (iii) within each unit, there exist significant relationships among different characteristics (except for the effect of throughput on wait time in SU).

Conclusion: Characteristics of CU have direct and indirect impacts on wait time of SU. Specifically, demand and wait time of preceding unit are good predictors for wait time of subsequent units. This suggests that considering such cross-unit effects is necessary when alleviating wait time in a health care system. Further, different patient risk profiles may affect wait time in different ways (e.g., positive or negative effects) within SU. This implies that the wait time management should carefully consider the relationship between priority triage and risk stratification, especially for cardiac surgery.

Show MeSH