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Cancer Clinic Redesign: Opportunities for Resource Optimization

2021· preprint· en· W4200471391 on OpenAlexafffund
Michael Fung‐Kee‐Fung, Rachel Ozer, Bill Davies, Stephanie Pick, Kate Duke, David J. Stewart, M. Neil Reaume, Marcus Ward, Katelyn Balchin, Robert M. MacRae, Julie Renaud, Dennis Garvin, Suzanne Madore, Jason Pantarotto

Bibliographic record

VenuePreprints.org · 2021
Typepreprint
Languageen
FieldHealth Professions
TopicHealthcare Operations and Scheduling Optimization
Canadian institutionsUniversity of OttawaOttawa Hospital
FundersUniversity of Ottawa
KeywordsAgile software developmentSoftware deploymentProcess (computing)Operations managementAmbulatoryNegotiationBusinessHealth careConstruct (python library)Resource (disambiguation)Process managementMedicineComputer scienceEngineering

Abstract

fetched live from OpenAlex

Ambulatory cancer centers face fluctuating patient demand and deploy specialized personnel who have variable availability. This undermines operational stability through misalignment of re-sources to patient needs, resulting in overscheduled clinics, high rebooking rates, budget deficits, and wait times exceeding provincial targets. We describe how deploying a Learning Health System framework led to operational improvements within the entire ambulatory center. Known methods of value stream mapping, operations research and statistical process control were applied to achieve organizational high performance that is data-informed, agile and adaptive. Caseload management by disease site emerged as an essential construct that incorporates disease site teams into adaptive, reliable care units, clinically and operationally. This supported clus-tering interdisciplinary teams around groups of patients with similar attributes, while allowing for quarterly recalibration. Systematic efforts were made in the negotiation required to im-plement changes that impacted physicians, nurses, clerks, and administrators. Feedback mecha-nisms were created with learnings curated and disseminated by a core team. The change aligned financial expenditures to the regional demand for specialized services and smoothed clinical operations across 5 weekdays and 2 centers. The impact was predictable, optimized expenditures, increased efficiencies across human and physical resource deployment and improved disease site collaboration in patient care.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.003
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Science and technology studies, Insufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Simulation or modeling · Consensus signal: Simulation or modeling
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.310
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0030.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0010.000
Scholarly communication0.0000.000
Open science0.0000.001
Research integrity0.0010.002
Insufficient payload (model declined to judge)0.0090.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.596
GPT teacher head0.531
Teacher spread0.066 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designSimulation or modeling
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations1
Published2021
Admission routes2
Has abstractyes

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