Reduce Wait Times Research Articles

Development and Evaluation of a Comprehensive Web-Based Canteen Food Ordering System

Abstract: This research paper presents the development of a web application aimed at introducing and optimizing the canteen ordering process within institutional and work environments. Focused on reducing wait times and enhancing user experience, the application facilitates menu browsing, order placement, and cashless payments via e-wallet or UPI. By leveraging technology to promote efficiency, the app seeks to address common challenges faced by students, faculty and employees during peak hours. The paper discusses design strategies, technical implementation, and potential implications for canteen operations, emphasizing the importance of user-centric solutions in enhancing overall satisfaction and productivity.

Integrating Artificial Intelligence in Autonomous Cashier Systems: A Study on Functional Schema Design and Its Impact on Supermarket Operations

This integrative literature review (ILR) explores the transformative potential of artificial intelligence (AI) in optimizing in-store logistics, a crucial aspect for retail environments striving to meet growing consumer demands for convenience and quick product availability. It aims to provide retail managers and logistics specialists with actionable insights on AI-driven tools that enhance competitiveness by improving inventory management and space utilization in retail settings. The conceptual framework is framed by functional schema design, user acceptance and experience, operational efficiency, data security and privacy, and equitable access, emphasizing the ethical and inclusive implementation of technology. Key findings suggest that AI improves demand accuracy, reduces inventory mismatches, and enables adaptable store layouts that respond dynamically to real-time consumer behavior, creating a more efficient, responsive, and customer-centered retail environment. Additionally, this study examines the adoption of AI in cashier systems as a response to evolving consumer expectations for efficient digital shopping experiences, revealing that AI-enabled cashier systems significantly reduce wait times and operational costs while providing personalized experiences through real-time analytics. However, challenges such as robust data security protocols, inclusive design for diverse user groups, and employee reskilling remain critical as automation progresses. Recommendations focus on privacy-enhancing data practices, user-friendly interfaces, and hybrid solutions combining human support with automation to foster inclusivity and consumer trust. Future research should address the long-term impacts of AI in retail, cultural adaptability, customer engagement, and secure data handling to support a balanced, customer-centered approach to automation in the retail sector.

A Novel Heuristic Algorithm Integrating Battery Digital-Twin-Based State-of-Charge Estimation for Optimized Electric Vehicle Charging

The increasing need for effective electric vehicle (EV) charging solutions in the context of transportation electrification has become a significant challenge. This system introduces an innovative algorithm, named Energy Distribution and Node Allocation using Evolutionary and Resourceful Optimization (ENDEAVOR), designed to elevate the efficiency of EV charging through the integration of a battery’s digital twin. This cutting-edge algorithm offers precise estimations of EV charging time, seamlessly updating both the State of Charge (SOC) via the Unscented Kalman Filter (UKF) and the internal battery resistance using parameterization, while sending this information to the cloud. ENDEAVOR optimizes charging-node allocation and intelligently distributes energy among incoming EVs based on their specific charging requests, all within the context of renewable-energy-sourced charging stations. The incorporation of a digital twin for the battery confers several benefits, including highly accurate SOC and charging-time estimates that ultimately enhance the overall efficiency of the charging process. This algorithm further optimizes energy distribution, resulting in significantly improved charging-time predictions, reduced wait times for users, and an enhanced overall experience for the user. The day-to-day implications of these enhancements are remarkable, culminating in substantial annual energy savings of approximately 180 units. ENDEAVOR has the potential to revolutionize the landscape of EV charging.

Patient-Centered Care and Process Improvement: A Systematic Review of Impacts on Satisfaction Outcomes

Patient-centered care (PCC) has emerged as a crucial approach in enhancing healthcare delivery, focusing on the needs and preferences of patients. This systematic review explores the impact of process improvement strategies on patient satisfaction outcomes within PCC frameworks. Databases including PubMed, Scopus, and Web of Science were searched for relevant studies published between 2016 and 2024, analyzing the effectiveness of process improvement interventions such as Lean, Six Sigma, and workflow optimization in various healthcare settings. Inclusion criteria focused on studies that specifically measured patient satisfaction as an outcome. The review found that process improvement initiatives positively influence patient satisfaction by streamlining care delivery, reducing wait times, and improving communication between healthcare providers and patients. However, variations in intervention types and healthcare settings highlight the need for context-specific applications. This review underscores the importance of integrating process improvement tools into PCC practices to achieve better satisfaction outcomes and improve overall care quality. Future research should focus on long-term effects and broader applications of these interventions in diverse healthcare environments.

Multichannel Healthcare: Impact of Asynchronous Telemedicine Adoption on Patient Flow

Problem definition: This paper studies a multichannel healthcare system where physicians diagnose patients and prescribe treatment in-person or through asynchronous telemedicine (AT), a widely adopted yet relatively under-explored form of telemedicine. In collaboration with physicians at the Veterans Healthcare Administration (VHA), we examine the impact of introducing an AT channel on the existing in-person channel and on overall system performance. Methodology/results: VHA implemented AT at select clinics in the state of Georgia in 2012. Using a difference-in-differences design, we find that the introduction of the AT channel led to a sorting process whereby more complex patients were seen in the in-person channel. AT implementation led to a 20% increase in recommended visit time and an 8.5% increase in required clinical resources for in-person consultations. In addition, the adoption of AT resulted in higher throughput—more patients seen by the specialists per month across both channels. Using a fixed-effects model we find a reduction in average wait time for in-person referrals (37.5%), and for the most common medically necessary procedure (43%) despite an increase in the total number of consultations at the specialist clinic. We attribute the improved efficiency to early patient triage, better match between patient needs and treatment modality, and reduction of setup and switching costs in physicians’ workflow. Managerial implications: This paper contributes to our understanding of a rapidly expanding form of healthcare delivery: multichannel healthcare with in-person and AT channels. Our results suggest that healthcare managers and physicians can adopt AT to improve overall system efficiency. At the same time, they should take into account the additional impact of AT on the in-person channel when making capacity decisions and developing guidance on patient referrals. Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2022.0235 .

62 Outcomes from a randomized controlled trial of a brief virtual group intervention for adolescents with mild to moderate suicidal ideation and their caregivers: The BRAVA study

Abstract Background Building Resilience and Attachment in Vulnerable Adolescents (BRAVA) is a brief virtual group intervention designed for adolescents with mild to moderate suicidal ideation (SI) and their caregivers. The goal of BRAVA is to reduce SI in adolescents and increase family connection. The intervention consists of six independent, 90 minute modules that are delivered in a group setting on a weekly basis. Independent modules allow for rolling admission thereby reducing wait time to start the intervention. The modules include components of Dialectical Behaviour Therapy. Attachment Based Family Therapy, Cognitive Behavioral Therapy, Collaborative Problem Solving and psychoeducation. Adolescents and their parents attend separate groups. Adolescents focus on emotional regulation, coping skills, managing crisis situations and caregivers focus on connecting with their teen, validation and crisis management Objectives This randomized controlled trial (RCT) assessed the efficacy of BRAVA in reducing symptoms of SI, depression and anxiety in adolescents, and improving life stress and competency in caregivers. Design/Methods Ninety-nine eligible youth (13-17.5 years) presenting with mild to moderate SI (rated 1 on the suicide item of HEADS-ED MH screening tool) and their caregivers were recruited from hospital and community services. Families were randomized to BRAVA (n=50) or the control group (n=49). The control group intervention consisted of weekly text messages and the opportunity to join the BRAVA group post-exit assessment). Outcome measures were administered at intake and exit for adolescents (Suicidal Ideation Questionnaire-Junior, SIQ-JR; Revised Children’s Anxiety and Depression Scale, RCADS) and caregivers (Perceived Stress Scale, PSS; Parent Sense of Competency Scale, PSOC). Outcomes were analyzed using repeated measures of multivariable analysis of variance (MANOVA). Results Preliminary analyses showed no significant differences between groups at intake for any demographic or clinical variables. Most adolescents and caregivers completed their exit assessment (nBRAVA=37; nControl=39). Adolescents and caregivers attended a median of six and five groups, respectively. Comparing to the control group, BRAVA was superior in reducing SI (p = 0.05) and depression (p = 0.005) in adolescents and caregiver life stress (p = 0.026). Preliminary MANOVA of adolescent outcomes were significant for time [p <0.01, Effect size (ES) = 0.98] and between groups (p = 0.03, ES = 0.11). Caregiver outcomes were significant for time (p=0.051, ES=0.70). Conclusion This study demonstrates that a brief virtual group intervention can have a significant impact on adolescent SI and depression compared to an enhanced treatment as usual control group. In addition, BRAVA can reduce caregiver perceived stress, helping them view their lives as less unpredictable, uncontrollable and overloaded.

Improved access and care through the implementation of virtual Hallway, a consultation platform in Nova Scotia: preliminary findings from a feasibility evaluation

BackgroundWhile previous studies have examined various platforms that enable providers to connect, Virtual Hallway (VH) stands out with its unique features. The value add is that this online platform connects primary care providers and specialists for synchronous phone-based conversations and aims to reduce referrals and enhance the quality of referrals. VH allows providers to easily log in, select the required specialty, book call times, receive reminders, and have calls documented, ensuring a high connection rate. In May 2022, the provincial health authority in Nova Scotia, a Canadian province, and VH initiated a feasibility study facilitated through the Health Innovation Hub in Nova Scotia. The goal was to enable primary care providers to connect with specialists, thereby reducing wait times and unnecessary referrals, and facilitating timely access to relevant clinical direction for patients. The current evaluation assessed utilization, value for money in economic analysis, and consultation experiences.MethodsThe study used post, cross-sectional, and cost-benefit study designs. We collected data through various methods, including administratively recorded utilization, theory-driven surveys, and cost data. Utilization was measured by the number of completed consults and the number of healthcare professionals using the VH platform. We analyzed the data using a combination of descriptive statistics and a cost-benefit analysis, which also involved conducting probabilistic sensitivity analysis.ResultsThe study found that approximately 84% of the VH consultations avoided needing in-person specialist referrals. The return on investment was 1.8 (95% CI: 0.8 to 3.0), indicating that the monetary value of the measurable benefits associated with VH exceeded the value of the resources invested. The provider experience survey revealed high satisfaction levels with VH across user groups, with 92% of specialists and 96% of primary care providers reporting being satisfied or highly satisfied with their experience. These positive indicators of provider experience were further supported by the fact that 97% of respondents agreed or strongly agreed that they intended to continue to use VH in their practice, and 97% of respondents agreed or strongly agreed that they would recommend VH to a colleague.ConclusionsThe study suggests that VH was well-received by users, with high levels of satisfaction reported and a reduced need for in-person referrals. It also represented value for money. Further research could explore how the availability of virtual health services can lead to reduced utilization of healthcare resources among different groups of patients.

Hospital to community in Wales: What is the value of optometrists playing a greater role in managing neovascular AMD and glaucoma in primary care?

To evaluate the value of enhanced optometric services for managing neovascular age-related macular degeneration (nAMD) and glaucoma in primary care optometry services, instead of hospital eye services (HES). Seven enhanced optometric service pathways in primary care in Wales were assessed with a mixed-methods approach: three for nAMD and four for glaucoma. The methods were a patient-related experience measure (PREM), a Realist Review and Evaluation involving both patients and staff, a discrete event simulation model estimating the economic impact of the pathways and a workforce survey of optometrists to gauge capability and capacity. Patient-related experience measure responses (802) indicated that primary care experience was comparable to that of HES. Utilising enhanced optometric services in primary care resulted in reduced wait times compared with HES, with suspected nAMD shortened to 4-5 days and glaucoma monitoring to 5 days. Waiting lists were dramatically reduced with primary care-based services to just three people waiting for nAMD and five for glaucoma, compared with 216 and 5691 people, respectively, in HES. Consultant ophthalmologist time was reduced from 57% to 15%-16% for nAMD services and from 48% to 22%-23% for glaucoma services. Integrating enhanced optometric services into primary care incurred a similar cost. The workforce survey confirms that optometrists possess the skills and qualifications and are willing to deliver these enhanced optometric services. The Realist Review and Evaluation revealed that clear patient communication, effective coordination and strong interprofessional communication between optometrists and ophthalmologists along with a shared electronic record are crucial to the success of this change. Providing enhanced optometric services in primary care for nAMD and glaucoma brings substantial benefits for the UK National Health Service and patients, including reduced waiting times, waiting lists and released HES capacity. The success of this transition hinges on clear patient communication, administrative co-ordination and effective interprofessional communication.

Current Capacity for Diagnosing Alzheimer's Disease in Germany and Implications for Wait Times.

Amyloid-targeting therapies for Alzheimer's disease (AD) might become available in Germany soon. The combination of a large pool of prevalent cases and a complex diagnostic process to determine eligibility for these treatments is likely to challenge health systems' capacity. To analyze Germany's healthcare system capacity to identify treatment-eligible patients in a timely and equitable manner. We modeled patients' diagnostic journey and projects wait times due to capacity constraints for AD specialist visits and PET scans from 2024 to 2043. Model parameters were derived from published data and expert input. Wait times would be ∼50 months over the model horizon, if patients were referred to specialists based on a brief cognitive assessment in primary care. Wait times for patients with social health insurance are projected to be 1.9 times those of patients with private insurance, with peak wait times of around 76 and 40 months, respectively. Adding a blood test for the AD pathology as additional triage step would reduce wait times to below 24 months. In spite of having a well-resourced health system, Germany is projected to be unable to cope with the demand for biomarker-based AD diagnosis, if a disease-modifying AD treatment were introduced. As these treatments might become available by the end of 2024, decisive action, in particular dissemination of high-performing AD blood tests for triage in primary care, will be needed to prevent delays in access and potentially avoidable and inequitable disease progression.

Experiences of abortion care in Australia: a qualitative study examining multiple dimensions of access

BackgroundThe United Nations’ Sustainable Development Goals identify universal access to sexual and reproductive health services as a global priority. Yet barriers to abortion access remain, including legal restrictions, cost, stigma, and limited services and information. The aim was to identify barriers to and facilitators of abortion care access experienced in Australia.MethodsThis qualitative phenomenological study examined abortion access in Australia, where abortion is decriminalised, from March 2020 to December 2022. We used social media and flyers in clinics to recruit adults who had sought abortion care, then interviewed them in-depth. We mapped participant experiences to five dimensions of access identified by Levesque et al.’s patient-centred access to healthcare framework: approachability, acceptability, availability and accommodation, affordability, and appropriateness.ResultsThe 24 participants lived across Australia and sought abortion during the COVID-19 pandemic. Approachability: Before seeking abortion, most did not know where to access information about the service and where to obtain it. Acceptability: Many were uncomfortable disclosing their abortion to family or friends; they reported that healthcare providers demonstrated varying levels of support. Availability and accommodation: Regional participants travelled far and faced long wait-times, exacerbated by pandemic restrictions. Affordability: Participants described financial stress paying for the service, travel, and related expenses. Appropriateness: Most participants expected judgemental care. Experiences varied widely: many participants experienced unempathetic, rushed, or judgemental interactions with healthcare staff, and many also reported at least one non-judgmental and supportive interaction on the same pathway to care.DiscussionAbortion seekers experienced varying obstacles when seeking care. The findings illustrate the need for population- and system-level initiatives such as: providing accurate information about and normalising abortion; implementing system-level strategies to reduce wait times, travel, and costs, especially for rural populations; and developing regulatory and quality improvement initiatives to increase the workforce and its readiness to provide high-quality, non-judgemental abortion care. Challenges seeking care during pandemic restrictions illustrate the importance of social support during care and choice between abortion modalities and service types. Consumer voices can help understand the diverse pathways to abortion care and inform solutions to overcome the multidimensional barriers to access.

Smart Benefits Distribution : Leveraging IoT and Data Analytics for Streamlined Office Efficiency

This article explores the transformative potential of integrating Internet of Things (IoT) devices and advanced data mining techniques in benefits distribution systems. Faced with challenges such as long wait times, inefficient processes, and resource mismanagement, government agencies and private organizations are turning to these technologies to revolutionize service delivery. The article discusses how IoT-enabled smart kiosks, occupancy sensors, and process automation tools can streamline operations and improve client experiences. It further examines how data mining techniques, including predictive analytics, clustering, and anomaly detection, can enhance decision-making and operational efficiency. Through a case study and analysis of benefits and challenges, the article demonstrates how this integrated approach can lead to reduced wait times, improved staff productivity, enhanced fraud detection, and significant cost savings, ultimately transforming the landscape of benefits distribution to be more efficient, responsive, and beneficiary-centric.

Optimizing infusion experience for patients in GI oncology at Hartford Hospital Cancer Institute.

331 Background: Cancer Treatments have become increasingly complex and the volume of patients requiring infusion treatments have increased in the outpatient setting. As a part of our Clinical Care Redesign Quality Initiative, the Hartford Healthcare Team identified that our GI Oncology patients receiving chemotherapy at the Hartford Hospital Infusion Center were experiencing a mean wait time of 81 minutes from the start of check-in to the start of their first medication, resulting in patient and staff dissatisfaction and inefficient use of resources. Our objective was to reduce the mean wait time to less than 60 minutes from the start of check-in to the start of the first medication by December 2023, which in turn would improve patient and staff satisfaction. Methods: By process mapping, creation of a fishbone diagram, and multi-voting, we demonstrated that waiting for laboratory results for patients who had provider and chemotherapy visits on the same day was a large contributor to long wait times. We implemented an Advanced Preparation Process that included Unlinking infusion visits from Provider visits and obtaining patient labs prior to chemotherapy treatment day to achieve the goal. Results: By Unlinking visits beginning mid-October 2023, we were able to decrease the mean wait time from 81 minutes to an average of 53 minutes, reflecting a 54% reduction in wait time. This allowed Pharmacy and Infusion Nurses additional time to review orders and complete safety checks and spend more time with patients at the chairside. An estimated amount of 12.6 hours of chair time was made available per week, representing a potential revenue increase of $188,021 annually. Most patients appreciated the decrease in wait time even if it meant coming in two separate days. Conclusions: The project aim of reducing wait times for GI Oncology patients was achieved. A reduction in time to first drug for other patients receiving chemotherapy during our pilot period was also noted, which we attributed to Hawthorne effect. Patient and staff satisfaction were improved. Our next steps will include continuing to optimizing the process.

Time to Make Early Pregnancy Care a Priority in Canada

Early pregnancy is a critical period often accompanied by complications like early pregnancy loss. Early Pregnancy Assessment Clinics (EPACs) provide specialized and compassionate care to those experiencing these complications. First introduced in the United Kingdom, EPACs have been found to improve quality of care, reduce wait times, and cut costs. In Canada, EPACs are primarily limited to large urban centres at hospital sites. Access in other parts of the country, especially in rural areas, remains limited. Low-volume units managed by specialist nurses and family doctors, with support from specialists, are the best way to bring EPACs to more Canadians in need.

Reviewing the Raters: A Study of Orthopedic Oncology Rating Outcomes During COVID-19.

Background During the 2020 COVID outbreak, telemedicine usage rates skyrocketed. We investigated the effect of telemedicine availability and demographic factors on orthopedic oncologist ratings and review rates. We also investigated patient-reported positive and negative experiences on www.heathgrades.com to determine which physician interaction factors were more importantly perceived by patients. Methods All orthopedic oncologists (n = 141) on www.healthgrades.com were selected for review through October 2020. Information obtained included telemedicine availability, gender, age, location of practice, review rate (number of reviews per 1000 days), mean star rating, and patient-reported positive and negative physician interactions. Mean star ratings and number of ratings were compared with respect to demographic information and telemedicine availability. Mean star ratings and review rates of orthopedic oncologists offering telemedicine were compared before and after January 01, 2020. Patients perceived positive and negative physician interaction factors were reported as a frequency of pooled positive or negative interaction factors, respectively. Results There were no significant differences in mean star rating or review rate with respect to demographic factors, telemedicine availability, or telemedicine offering orthopedic oncologists before and after January 01, 2020. There were increased positive interactions of both physician independent and dependent factors and increased negative interactions of time dependent factors. Conclusion Patients reported an increased frequency of negatively perceived wait times and rushed appointments. Telemedicine availability has been previously cited as a cost-effective means of reducing wait times. Prospective investigations are needed to determine if telemedicine can be utilized as a cost-effective means of improving patient care and satisfaction.

Establishment of Registered Advanced Nurse Practitioners (RANP) Gerontology Clinics in Two Ambulatory Day Units

Abstract Background Ireland is experiencing substantial growth in the older population. Data from The Irish Longitudinal Study on Ageing (TILDA) suggests that up to 25% of older people in Ireland are living with frailty while a further 45% are at risk of being pre-frail (Roe L et al, 2017). Frailty in older adults can be a predictor to adverse health outcomes including hospitalization, falls, and increased mortality risk. Ambulatory day units proactively identify older adults at risk of frailty living in the community using a comprehensive geriatric assessment (CGA), potentially reducing adverse outcomes. Methods Plan-Do- Study-Act (PDSA) cycle was used. Waiting lists were reviewed with Consultant Geriatricians for the ambulatory units. Referral pathways for RANP Gerontology Clinics with inclusion and exclusion criteria were developed. RANP clinics were established in 2023 in the ambulatory day units utilising Slaíntecare’s strategy. Referrals were triaged by Consultants Geriatricians resulting in the RANP clinic caseload. Results During 2023, 844 older adults were reviewed in the RANP clinics. This contributed to a reduction in Consultant Geriatricians’ waiting lists and allowed reduced wait times for new Consultant Geriatricians’ referrals. This service also enhanced communication pathways between primary and secondary care settings and became a point of contact for families in crisis, with rapid access review and care planning to avoid unnecessary Emergency Department attendances. Patients attending the RANP clinics, if admitted to hospital, were seen by the RANP during their admission, ensuring continuity of care. Conclusion Overall, establishment of RANP Gerontology clinics resulted in a better streamlined service for the older adult. This service ensures continuity of patient care through a working knowledge of patient cohort and rapid access for those known to the service, potentially avoiding an Emergency Department attendance.

The Development and Impact the First Irish Nurse-Led Lumbar Puncture Clinic in a Regional Specialist Memory Clinic

Abstract Background A Regional Specialist Memory service assesses complex cases of cognitive impairment, requiring a comprehensive diagnostic assessment. Lumbar punctures (LP's) are the definitive procedure to identify Alzheimer's Disease. The highest limitation to LP access is shortage and availability of specially trained medical staff. Cognitive centres across Europe have been training nurses (Advanced Nurse Practitioner) to perform LPs since 2006. A nurse led service was established in April 2023 in a large Irish teaching hospital. Methods This analysis data represents a preliminary 5-month audit of an ANP Led LP service (ALLPS) compared to prior service provision (ALLPS n=40, pre-ALLPS n=20). Waiting time for LP prior to ALLPS averaged 25 weeks, which reduced by over 50% (12 weeks). Results CSF results were identified in half the time with ALLPS (3 weeks versus 6 weeks). The initiation of the ALLPS reduced the timeframe to diagnosis from 12 weeks to 5 weeks. This led to an average wait time reduction from date of CSF result to disclosure of diagnosis of 53% (15 weeks pre-ALLPS to 8 weeks). The ALLPS is pioneering the use of a seated upright LP procedural position, reported to be comfortable by this cohort. Analysis of the nurse led LP procedure is comparative with medical LP services. Almost 40% were achieved on 1st attempt, a further 28% on 2nd attempt, with 18% on 3rd attempt. The ANP successfully completed 75% of LPs in this initial cohort with 9 patients requiring supervisor LP performance. One case required x-ray guided LP. Conclusion Appointment of a dedicated ALLPS service has reduced waiting times for diagnostic intervention, leading to early diagnosis, accessing post diagnostic support, meeting best practice guidelines outlined by the National Dementia Office.

Caribbean libraries 2.0: the robotic revolution in Caribbean academic library spaces

Purpose This paper is the genesis for robots and robotic technology and their introduction to the Caribbean Academic library community. This paper aims to explore the specific areas that this technology can improve as well as their adaptability and dynamic yet multifaceted nature it possesses. Design/methodology/approach A thorough assessment of literature was done of all developed libraries that are employing the services of robots and robotic technology in their daily operations. Additionally, a meticulous analysis was done of all Caribbean Libraries that have explored, are currently exploring or actively explored the implementation of robots and robotic technology for effective use in their libraries. Findings Seamless functionality as well as the reduction of mundane repetitive tasks by library staff is at the fore. Efficacy and heightened levels of accuracy are also found to be a great factor for implementation as well as speed of retrieval and offsite storage are further benefits to the implementation of robots and robotic technology. Research limitations/implications This research primarily assessed material on robotics and robotic technology that offers unprecedented efficacy and accuracy in the processing of information and tasks assigned as well as smooth location and retrieval of library material resulting in reduction in wait time for all library users. Originality/value To the best of the author’s knowledge, this paper is the first of its kind and is intended to trigger a “light bulb” in the minds of decision-makers and managers of Library spaces as to the potential robots and robotic technology has on fostering greater levels of efficacy in certain key areas of libraries and help improve user services while adding to the theoretical body of knowledge available in the field on this fast rising area.

Does receipt of social housing impact mental health? Results of a quasi-experimental study in the Greater Toronto Area

Affordable housing is commonly described as an important determinant of health, but there are relatively few intervention studies of the effects of housing on health. In this paper, we describe the results of a quasi-experimental, longitudinal study investigating the impacts of receiving social housing among a cohort of 502 people on waitlists for social housing in the Greater Toronto Area, Canada. Specifically, we sought to determine if adults who received housing were more likely than a control group to show improvements in depression, psychological distress, and self-rated mental health 6, 12 and 18 months after moving to housing. Amongst the participants, 137 received social housing and completed at least one follow-up interview; 304 participants did not receive housing and completed at least one follow-up interview and were treated as a control group (47 people provided data to both groups). The difference-in-differences technique was used to estimate the effect of receiving housing by comparing changes in the outcomes over time in the housed (intervention) group and the group that remained on the waitlist for social housing (control group). Adjusted mixed effects linear models showed that receiving housing resulted in significant decreases in psychological distress and self-rated mental health between the groups. Improvements in self-rated mental health between the groups were observed 6, 12 and 18 months after receiving housing (6 months, +2.9, p < 0.05; 12 months, +2.6, p < 0.05; 18 months, +3.0, p < 0.05). Reductions in psychological distress (−1.4, p < 0.05) were observed 12 months after receiving housing. Overall findings suggest that receiving subsidized housing improves mental health over a 6-to-18-month time horizon. This has policy and funding implications suggesting a need to reduce wait times and expand access to subsidized housing.

Real-Time Location Systems: Revolutionizing Porter Services for Improving Patient Care Efficiency.

Transport porters (TPTs) are essentially involved in supporting hospital operations and maintaining high-quality patient care. The traditional porter management lacks transmission of temporal and spatial information of the porters thus affecting porter operations. In this work, we investigate the barriers in traditional porter management and the impact of a real-time location system (RTLS) in improving time and cost efficiency for porter operations. A six-month study was conducted at Medanta - The Medicity, Gurugram investigating the limitations of traditional management and efficiency of indoor porter tracking system (IPTS) on TPTs operational activities by assessing the waiting time and total turnaround time (TAT). The cost-effectiveness of IPTS was determined based on capital expenditure and return on investment (ROI) post-technology implementation. This study highlights that improvements are required in porter management as 175 out of 285 (62%) calls were unanswered by TPTs. Post deployment of IPTS, the TAT for A-wing was reduced from 28 minutes to 20 minutes, and for B-wing, it was reduced from 26 minutes to 18 minutes. Staff optimization of three and four porters was done for A-wing and B-wing, respectively. The capital expenditure was recovered by reduced wait time and optimization of staff, thereby anticipating a monthly saving of ₹0.18 million (US$ 2150). The effective outcome of IPTS porter management envisaged its expansion to inpatient medicine delivery with a substantial cost reduction of ₹8.0 million (US$ 96,000) over three years. The implementation of IPTS improved the operational activities of porters and improved staff utilization. Cost savings from staff optimization lays the groundwork for new technology integrations for long-term operational advancements.

Improving the management of hospital waiting lists by using nudges in letters: A Randomised controlled trial

ObjectiveA commonly adopted intervention to help to reduce wait times for hospital treatment is administrative validation, where administrators write to patients to check if a procedure is still required. The did not return (DNR) rate to validation letters is substantial. We tested whether the DNR rate was reduced by introducing nudges to validation letters. MethodsParticipants from eight public hospitals (N = 2855; in 2017) in Ireland were randomized to receive an existing (control group) or a redesigned validation letter including nudges (intervention group). ResultsParticipants in the intervention group were less likely not to return it than those in the control group, OR = .756, SE = .069, p = .002. Control and intervention group DNR rates were 23.97% and 19.24%. This is equivalent to 1 in 5 non-responders changing their behaviour because of the redesigned letter. ConclusionsThe redesigned letter increased patient compliance with the validation process. The redesign has subsequently been adopted by public hospitals in Ireland.