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1.
Peter T. Vanberkel Richard J. Boucherie Erwin W. Hans Johann L. Hurink Nelly Litvak 《OR Spectrum》2012,34(2):371-390
Hospitals traditionally segregate resources into centralized functional departments such as diagnostic departments, ambulatory
care centers, and nursing wards. In recent years this organizational model has been challenged by the idea that higher quality
of care and efficiency in service delivery can be achieved when services are organized around patient groups. Examples include
specialized clinics for breast cancer patients and clinical pathways for diabetes patients. Hospitals are struggling with
the question of whether to become more centralized to achieve economies of scale or more decentralized to achieve economies
of focus. In this paper we examine service and patient group characteristics to study the conditions where a centralized model
is more efficient, and conversely, where a decentralized model is more efficient. This relationship is examined analytically
with a queuing model to determine the most influential factors and then with simulation to fine-tune the results. The tradeoffs
between economies of scale and economies of focus measured by these models are used to derive general management guidelines. 相似文献
2.
输油处作为输油管道中的关键节点,安全形势十分严峻,安全管理工作尤其重要.分析了输油处面临的主要危险因素,并提出了改善输油处安全管理的具体措施,为输油处的安全可靠运行提供参考. 相似文献
3.
This paper shows that some of the recently obtained product form results for stochastic Petri nets can be obtained as a special case of a simple exclusion mechanism for the product process of a collection of Markov chains 相似文献
4.
对ITS_90温标在83.8058-273.16K温区内的温标的非唯一性进行了研究。在高精度低温恒温槽内对九支套管铂电阻温度计进行分度,分析其非唯一性,并研究此温区与13.18-273.16K温区的非一致性。 相似文献
5.
Peter?J.?H.?HulshofEmail author Peter?T.?Vanberkel Richard?J.?Boucherie Erwin?W.?Hans Mark?van?Houdenhoven Jan-Kees?C.?W.?van?Ommeren 《OR Spectrum》2012,34(2):391-405
Outpatient clinics traditionally organize processes such that the doctor remains in a consultation room while patients visit
for consultation, we call this the Patient-to-Doctor policy (PtD-policy). A different approach is the Doctor-to-Patient policy
(DtP-policy), whereby the doctor travels between multiple consultation rooms, in which patients prepare for their consultation.
In the latter approach, the doctor saves time by consulting fully prepared patients. We use a queueing theoretic and a discrete-event
simulation approach to provide generic models that enable performance evaluations of the two policies for different parameter
settings. These models can be used by managers of outpatient clinics to compare the two policies and choose a particular policy
when redesigning the patient process. We use the models to analytically show that the DtP-policy is superior to the PtD-policy
under the condition that the doctor’s travel time between rooms is lower than the patient’s preparation time. In addition,
to calculate the required number of consultation rooms in the DtP-policy, we provide an expression for the fraction of consultations
that are in immediate succession; or, in other words, the fraction of time the next patient is prepared and ready, immediately
after a doctor finishes a consultation. We apply our methods for a range of distributions and parameters and to a case study
in a medium-sized general hospital that inspired this research. 相似文献
6.
7.
本文根据汽-液两相的反应和传质、传热特征,结合两相界面的平衡性质建立了描述反应精馏过程实际板的反应-扩散(非平衡级)模型。从而避免了板效率取值问题和由此带来的计算不确定性。模型方程由汽-液两相质量衡算方程、焓衡算方程、汽-液相界面平衡关系式和组分浓度归一化方程等基础方程以及诸如有关的求算相间传质通量的特征方程组成。利用所提出的两组方程对汽-液两相反应精馏过程的实际板进行了模拟计算。 相似文献
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9.
In this paper it is shown that a necessary and sufficient condition for a Markovian queueing network to have a particular type of closed form transient distribution which is a natural extension of an equilibrium produc-form distribution is that all queues have infinitely many servers. 相似文献
10.