Wait Times Research Articles

Din-Wave: Dining Interaction with AI for Voice Automation and Efficiency

The rapid growth of the food service industry has led to an overwhelming increase in customer demand, presenting challenges for both small and large businesses. One of the most pressing issues is maintaining a balance between efficient service and customer satisfaction while dealing with labor shortages. Traditional restaurants rely on human waitstaff, but the industry is witnessing a 12.42% decline in waiter job applicants due to low wages and intense physical demands. By 2032, there will be an estimated 7,67,160 waiter job vacancies, yet the supply of workers is insufficient to meet this demand, creating a labor crisis. To address these challenges, this paper explores the integration of Artificial Intelligence (AI) in the restaurant industry through Din-Wave, an AI-driven food ordering and customer service system. Din-Wave leverages AI-powered voice assistants, computer vision, and automation to enhance service efficiency, reduce customer wait times, and improve the overall dining experience. By implementing AI, small and fast-food businesses can handle increased demand with fewer human resources, leading to higher productivity, cost efficiency, and improved customer engagement. AI-driven order management systems can streamline operations, optimize staff workload, and ensure seamless service, positioning the food service industry for a tech-driven future. This research highlights how AI can act as a game-changer, revolutionizing hospitality by bridging the gap between demand and service capacity.

Digital Health Interventions to Improve Vaccination Rates and Awareness Among Immigrant Populations: Barriers, Facilitators, and Outcomes - A Scoping Review

Background: Digital health interventions are suggested to improve vaccine coverage and awareness in the general population. However, given the scarcity of information within migrant populations, this scoping review aims to identify existing evidence on digital health interventions designed to improve vaccination and health outcomes among this social group. Methods: In this scoping review, we searched CENTRAL, PubMed, and Scopus for observational studies and randomized controlled trials (RCT). Two independent reviewers screened articles, performed data extraction and synthesis, and assessed bias risk using CovidenceⓇ. Bias was evaluated with the Cochrane RoB 2, Newcastle-Ottawa Scale (NOS), or JBI tool. We analyzed digital health interventions aiming to boost vaccination rates and awareness among immigrant populations, evaluating barriers and facilitators. The focus was on vaccines such as COVID 19, HPV, Hepatitis B, Influenza, childhood vaccines. Targeting immigrants, primarily from South and East Asia, the Middle East, and Hispanic/Latinx populations. The interventions of interest included digital appointment reminders, mobile applications, messaging platforms, and digital storytelling. Findings: Out of the 673 studies initially identified, 19 met the criteria for data extraction and synthesis. Published between 2012 and 2024, these included six quasi experimental studies, five cross-sectional studies, four randomized control trials, three qualitative studies and one survey. Research spanned several continents and countries such as North America, Germany, China, Jordan,Turkey and Uganda. The role of digital tools in increasing the vaccination rate must be reinforced, with particular emphasis on the personalized content of the message for recipients. The measurement tools influencing vaccination rates are not only diverse but also complex. They encompass a wide range of factors, from knowledge about immunization to emotions and vaccine intention, highlighting the multifaceted nature of the issue. Several factors interfere with vaccination rates (e.g., language barriers, costs, long wait times, scheduling difficulties, lack of transportation, and child support). Some confounders may impact the effectiveness and uptake of vaccination programs in undocumented immigrants from seeking vaccination services, such as socioeconomic status, education level, language barriers, cultural beliefs and practices, distrust in the healthcare system, legal status and fear of deportation. Interpretation: Digital health interventions show promise in enhancing vaccination awareness among migrant populations. Findings from this scoping review suggest that these interventions should be customized for specific populations, taking into account barriers, facilitators, and cultural beliefs.

Improving patient care experience in the pediatric emergency department: a systematic review.

The primary objective of the project was to summarize existing evidence on patient experiences in pediatric emergency departments (EDs). The secondary objectives were to characterize patient care experience in pediatric EDs, identify barriers to optimal patient care in pediatric EDs, and identify equity, diversity, and inclusion (EDI) principles influencing pediatric emergency care. We performed a systematic review of cohort, cross-sectional, and controlled clinical studies on children's (≤ 21years) experience in the pediatric ED. We searched MEDLINE (Ovid), Embase (Ovid), PsycInfo (Ovid), Cochrane Database of Systematic Reviews (Ovid), CENTRAL (Ovid), and CINAHL (EBSCO) from inception until September 7, 2023. Two reviewers independently screened articles for primary outcomes involving any health care outcome or health care utilization, along with secondary outcomes of EDI factors influencing patient care. Data were obtained from included studies using narrative and descriptive analysis. The process was strengthened by input from patients, families, and providers on the Manitoba Emergency Advisory Committee, who proposed additional areas for consideration. Six articles were included, assessing 12 experiences. All studies were from high-volume centers. The primary outcome data indicated an overall satisfaction being rated positively, with satisfaction levels exceeding 70% despite lower ratings in privacy, communication, and waiting areas. Wait times and speed of care were significantly correlated with satisfaction (r = -0.48, P < 0.01 and r = 0.38, P < 0.01, respectively), noting wait times and privacy as barriers to care. The EDI factor impacting patient experience was race, showing decreased scores for privacy and patient voice for those identifying as non-white. Even with a high overall satisfaction in the pediatric EDs, aspects influencing the experience can be improved. Wait times, waiting areas, privacy and EDI factor such as race should be addressed to help overcome barriers and improve the care patients receive.

Factors affecting patient length of stay in the emergency unit: A scoping review.

Factors affecting patient length of stay in the emergency unit: A scoping review.

The medical radiation technologist model: a streamlined process for procedural sedations

ObjectiveProcedural sedations are a growing and routine form of sedation. Some of them may not require the presence of a nurse. The purpose of this study is to assess the impact of the Medical Radiation Technologists (MRT) model, which forgo the presence of a Registered Nurse (RN), for procedural sedations in Computed Tomography biopsies. The setting was a teaching hospital that moved from an RN to an MRT model. We compared staff utilization, turnaround times and incident reports between pre and post implementation, over 19 months overall.ResultsNo adverse events were observed under either model. Wait times were reduced by 25% from 131 to 98 min. Turnaround times were reduced by 2 min from 52 to 50 min. The joint cost of RN/MRIT was reduced by 37% per procedure, from $141 to $88.ConclusionThese results suggest that the MRT model is more cost-effective without compromising quality of care. The MRT model is promising and should be extended to more facilities and other routine procedural sedations to save time and resources.

Refresher training for emergency department triage nurses - A scoping review.

Refresher training for emergency department triage nurses - A scoping review.

Population-level Outcomes of Ex-vivo Lung Perfusion (EVLP) in Lung Transplantation.

Ex-vivo Lung Perfusion (EVLP) is a novel organ preservation technique introduced to assess extended lung donors and determine their suitability for human use. This retrospective cohort study analyzed lung transplant recipients in the U.S. from 2011 to 2021, using data from the Scientific Registry of Transplant Recipients (SRTR). Kaplan Meier Curves were used for time-to-event survival analysis, and the cox-proportional hazards model was used to determine hazard ratios for overall survival. Of 23,261 patients, 608 had EVLP-donor lungs. Five-year survival was similar across groups. Centers with EVLP access had median wait times of 48 days (SD 260.80) versus 68 days (SD 273.73) at other centers. Cox Proportional Hazards model showed no significant disparity in five-year survival with EVLP (HR 1.14, p 0.08), gender (HR 1.04, p 0.07), and high volume (HR 0.8, p 0.07). Perioperative ECMO (HR 1.29, p<0.01) and black recipient race (HR 1.15, p <0.01) influenced survival; there were no statistical differences in any other race. Black EVLP-assessed recipients showed a nonsignificant trend toward a survival benefit (p=0.26) with a 14.2% higher 5-year survival (95% CI 2.7-28.7). EVLP has not adversely affected five-year survival rates in lung transplantation recipients and is associated with shorter wait times. A survival advantage in black recipients with EVLP-assessed lungs needs further research.

Wrist and elbow fracture detection and segmentation by artificial intelligence using point-of-care ultrasound.

Distal radius (wrist) and supracondylar (elbow) fractures are common in children presenting to Pediatric Emergency Departments (EDs). These fractures are treated conservatively or surgically depending on deformity severity. Radiographs are typically used for diagnosis but can increase wait times due to the need for radiation-safe rooms. Ultrasound (US) offers a radiation-free, faster alternative that can be performed at triage, but its noisy images are challenging to interpret. We developed an artificial intelligence (AI) technique for the automatic diagnosis of fractures at the wrist and elbow. While most AI for diagnosis focuses on classification results only, we applied a more explainable pipeline that used US bony region segmentation from a CNN as the basis of fracture detection. Our approach was validated on 3,822 wrist US images and 1487 elbow US images. We compared the fracture detection results from classification models and multi-channel segmentation models. Combining the segmentation results with the original images showed superior performance in fracture detection at the individual patient level, achieving an accuracy of 0.889 and 0.750, sensitivity of 0.818 and 1.000, and specificity of 1.000 and 0.714 on the wrist and elbow dataset respectively. Besides, the multi-channel U-Net architecture effectively detected bony fracture regions in wrist US images. These findings demonstrate that AI models can enable reliable, automatic wrist and elbow fracture detection in pediatric EDs, potentially reducing wait times and optimizing medical resource use.

Innovation in Providing Equitable Pre-exposure Prophylaxis Services in the United States: Expanding Access in Nontraditional Settings.

Pre-exposure prophylaxis (PrEP) usage has slowly increased in the United States, but significant disparities persist across race, ethnicity, sex, gender, age, and geography. Determinants of PrEP inequities include stigma and medical mistrust, lack of patient-centered services, lack of access to clinical care, and organizational resistance to change-within a health care system that neglects these barriers. We describe 5 implementation strategies to providing PrEP in nontraditional settings to underserved populations, using an equity-based approach to address key structural determinants. The alternative settings used in these Ending the HIV Epidemic projects (community-based organizations, telePrEP, mobile clinics, pharmacies, emergency departments) were chosen for the setting characteristics and their serving structurally underserved populations. Community-based organizations have earned trust within communities and can serve as hubs for comprehensive sexual health services, including PrEP. Telehealth, which expanded significantly because of COVID-19, can help overcome transportation and scheduling barriers to PrEP access. Mobile clinics can also broaden PrEP delivery by bringing tailored services directly to communities, often providing shorter wait times and extended hours. Pharmacists can prescribe PrEP in certain states through legislation or collaborative practice agreements, offering a convenient, community-based option. Emergency departments provide an alternative site for PrEP delivery, with the potential to reach individuals not currently engaged in regular care. These alternative PrEP approaches can expand options for accessing PrEP and alleviate key barriers to care in traditional settings, although they may not eliminate all inequities. Offering more choices increases the likelihood that a broader population will be reached, thereby enhancing overall access to PrEP.

Towards a better understanding of NHS secondary and social care backlogs: qualitative perspectives on waiting lists, deferrals and delays by disabled people from minoritised ethnic groups

ObjectivesTo explore how backlogs in health and social care were perceived by and impacted disabled people from minoritised ethnic groups, with a view to improving their experiences and social, health...

Virtual urgent care in an integrated value based healthcare system

Virtual urgent care (VUC) is not well understood when delivered through an integrated value-based healthcare system. The Southern California Permanente Medical Group operates Get Care Now (GCN), a VUC program complementing its urgent care clinics (UCC). Quality and patient experience dimensions are included in this study, comparing GCN and UCC patients. Females and Hispanics/Latinos were predominant in both groups and proportions of patients with chronic conditions were nearly identical within the leading 30–49 age band. Wait times for GCN were 21.19 min lower than for UCC, and positive patient survey results align with GCN’s average Net Promoter Score of 87. 3-day return rates to the ED (2.53% GCN vs. 3.26% UCC) and to UCC (5.44% GCN vs. 2.42% UCC) were comparable between GCN and UCC utilizers. Findings demonstrate that 24/7 VUC sustainably supports meeting patient demand for urgent care services in an integrated value-based system.

Pediatric Respiratory Score in the Triage Form.

Pediatric Respiratory Score in the Triage Form.

PATIENT AND PARENT EXPERIENCE DURING ELECTIVE PAEDIATRIC ORTHOPAEDIC SURGERY: ARE WE MEETING THEIR EXPECTATIONS?

IntroductionThe aim of the current study was to evaluate patient and caregiver's experience with nurses, doctors, and hospital in the peri-operative period and during discharge when admitted for elective surgery.Method30 patients undergoing elective paediatric orthopaedic surgery over a 3-month period were invited to take part in the study using a self-administered anonymised Modified CAHPS hospital experience survey on Microsoft Forms. The score consisted of 7 sections focussing on satisfaction with nursing/medical care, experience with healthcare provider, care in hospital, surgical care, discharge process and overall satisfaction. The responses were graded and each section had a weighted score giving a total overall score of 110.Results20 parents responded to the survey giving a response rate of 66%. Overall mean score 74.64 (range 54 to 104). Satisfaction was higher with surgical care, medical care, and nursing care and lower with hospital care. 2 patients were particularly unhappy with all aspects of care and 2 patients were delighted, with most patients being somewhere in between. Bed shortage was a particular concern that resulted in parent dissatisfaction due to prolonged wait times and surgery cancellations. Lack of communication emerged as key theme from the comments section in the survey.ConclusionsPatient/Parent satisfaction is multi-factorial and depends on overall care received in hospital and not just the surgical care. There is scope for improvement in these domains and a patient information leaflet is being developed to improve communication and provide guidance during admission.

AoI-MDP: An AoI Optimized Markov Decision Process Dedicated in the Underwater Task (Student Abstract)

Ocean exploration places high demands on autonomous underwater vehicles, especially when there's observation delay. We propose age of information optimized Markov decision process (AoI-MDP) to enhance underwater tasks by modeling observation delay as signal delay and including it in the state space. AoI-MDP also introduces wait time in the action space and integrates AoI with reward functions, optimizing information freshness and decision-making using reinforcement learning. Simulations show AoI-MDP outperforms the standard MDP, demonstrating superior performance, feasibility, and generalization in underwater tasks. To accelerate relevant research, we have made the codes available as open-source at https://github.com/Xiboxtg/AoI-MDP.

Inter-station travel reliability assessment of public transportation systems: under multimodal transport

ABSTRACT Improving public transportation reliability can enhance travel quality and attract more passengers. However, most existing studies on reliability focus narrowly on a single transportation mode or specific travel time attribute. This paper establishes a comprehensive approach to evaluating travel reliability in multimodal public transportation systems. First, we propose a method to measure inter-station travel time distribution, considering bus, subway, and bike-sharing modes. The travel time encompasses waiting, transfer, and in-vehicle running time. Subsequently, we design a travel reliability indicator that integrates diverse travel choices and corresponding travel time distribution characteristics. Finally, we validate our approach with a case study in Harbin, examining the impact of critical factors on travel reliability through simulation and sensitivity analysis. The results indicate that multimodal transport significantly improves the reliability of public transportation systems. Moreover, effectively guiding passenger travel behavior and enhancing public transportation infrastructure can increase travel reliability.

Looking into opportunities for maternity continuum of care improvement within the primary health care system in Northwest Ethiopia: primary health care-oriented research

BackgroundThe maternity continuum of care (MCC) is an integral component of universal health coverage and a crucial strategy for reducing maternal and neonatal mortality. Despite its importance, MCC coverage remains low in low- and middle-income countries (LMICs), including Ethiopia, which bear the highest burden of maternal and neonatal mortality. This underscores the need for proactive interventions. In this perspective, the primary health care (PHC) approach holds significant potential for enhancing MCC. Exploring demand- and/or supply-side opportunities for improving MCC within the PHC system could help inform policy, practice, and further research. However, there is limited evidence on these aspects in Ethiopia. Therefore, this study aims to explore demand- and/or supply-side opportunities for MCC enhancement within the PHC system in northwest Ethiopia.MethodsWe conducted a qualitative study using an interpretive description approach within the PHC system in northwest Ethiopia from March 3 to November 27, 2022. Data collection included four key informant interviews, three focus group discussions with 29 participants, and 28 in-depth interviews, all selected through maximum variation sampling. Interviews were audio-recorded, transcribed verbatim, translated into English, and analyzed using reflexive thematic analysis in ATLAS.ti version 7.1.4 software.ResultsThree themes and 11 sub-themes have emerged. These include: (1) PHC structural enhancement with its categories: onsite mentorship, decentralized ambulance service platform, structural networks, and expansion of the scope of frontline PHC facilities; (2) PHC input enhancement with its categories: expansion of the maternity service workforce and technological advancements; and (3) PHC maternity service delivery enhancement with its categories: community engagement, approaches for reducing wait times, tailored maternity service provision in conflict-affected communities, flexible schedules for maternity service, and integrated midwifery model of care.ConclusionsThis study finds that there are several structural, input, and service delivery opportunities for enhancing the MCC within the PHC system in northwest Ethiopia. These opportunities indicate potential pathways to strengthen PHC resilience for MCC. Widespread utilization of these opportunities could significantly improve the existing MCC within the PHC system. We also recommend further research to assess the impact of these opportunities on MCC.

Survey and Analysis of the Market Prospects for Autonomous Vehicle Delivery at North China University of Technology

The rapid growth of e-commerce has led to an increased demand for campus express delivery. Traditional self-service parcel collection methods encounter challenges such as time conflicts, long retrieval distances, and extended wait times. Autonomous vehicle delivery presents an efficient and convenient solution for campus logistics. This study utilizes a questionnaire to assess the parcel collection behaviors of faculty and students at North China University of Technology (NCUT), their satisfaction with current services, and their acceptance of autonomous delivery. Results reveal significant advantages for autonomous delivery in campus logistics, with over 60% of respondents citing difficulties due to long distances to collection points and around 50% expressing dissatisfaction with lengthy queues. Many believe autonomous delivery can effectively mitigate these issues. Furthermore, nearly 70% are willing to pay extra for autonomous services, especially in adverse weather conditions. The study also evaluates the economic and social feasibility of the delivery system within the campus context, indicating substantial market potential for autonomous vehicles at NCUT.

Patient experiences of waiting for orthopaedic care and priorities for ‘waiting well’: a qualitative study in a London NHS trust

BackgroundFollowing the COVID- 19 pandemic, patients are facing larger waiting lists and longer waiting times than ever before. Long waits for orthopaedic treatment can negatively impact patients’ quality of life due to pain, reduced mobility, and the psychological effects of waiting itself. Initial analysis at a London National Health Service (NHS) Trust showed that patients living in the most deprived areas were more likely to face longer waiting times for joint replacement surgery. This study aimed to understand what would support people to live well while waiting for orthopaedic treatment, focusing on those in the most deprived areas.MethodsWe conducted semi-structured interviews with patients living in deprived areas in North West London who were currently waiting or had recently waited over 18 weeks for an orthopaedic procedure. Data were analysed using inductive thematic analysis. Key insights from this analysis were brought to a co-design workshop, where patients developed targeted and bespoke support initiatives and identified how these might help people to live well while waiting. We worked with two public partners throughout, who shaped the interview questions, analysis, and workshop.ResultsSeven patients were interviewed, and a further six patients participated in the co-design workshop. The interviews identified four immediate impacts of waiting on wellbeing, including physical pain, limitations on daily activities, greater reliance on friends and family, and anxiety around the wait; as well as four long-term consequences of an extended wait time, including physical deterioration, delays of life plans, changes in hopefulness, and reduced trust in the NHS. Additionally, they identified four sub-themes around patients’ support needs while waiting: medical support, practical support, informational support, and emotional support. Based on these thematic insights, patients at the workshop developed four potential interventions to support people waiting for orthopaedic treatment.ConclusionThis study highlights the negative impacts that prolonged waits for orthopaedic treatment can have on patients’ physical, mental, and social wellbeing, and notes that patients with caring or financial responsibilities may be disproportionately affected. The support needs expressed by patients focused more on acknowledgement of their concerns and management of their expectations by health professionals, rather than on advice around lifestyle changes and coping mechanisms. Our study offers a number of support ideas proposed by patients which can be further developed and implemented by health services to better support patients to live well while waiting for orthopaedic treatment.

Digital Pathways to Discovery: A QR-Driven Ticketless System for Untapped Tourist Destinations

This research paper introduces A technological solution that utilizes QR codes for entry without tickets has been designed for unexplored tourist destinations. Numerous off-beat destinations fail to utilize digital entrance passes because they lack required technological systems for visitor management. Our system aims to eliminate the digital divide by developing inexpensive technology which operates on current structural elements. The platform integrates Cashfree payment gateway for safe financial operations while the system targets authorized tourism destinations selected by regional tourism authorities. The project utilizes innovative crowd prediction models that help control guest numbers at protected heritage sites and sites in natural settings which might encounter limitations in capacity. This ticketless system enables lesser-known locations to save operational funds on paper ticket production (while making estimated cost savings of 25%) while simultaneously reducing wait times for guests and delivering valuable data about site development. The extensive field study performed in 14 designated test sites verifies how the system resolves remote areas issues while enabling sustainable tourism advancement. The e-ticket system and paper-free operations combined with the focus on underexplored travel locations and crowd monitoring and sustainable tourism practices and digital authentication methods linked to Cashfree payment services

Improving efficiency of steel converter facility: a digital twin and reinforcement learning approach

The steel converter facility is an essential part of the steel manufacturing process and is responsible for converting molten iron into steel. The material movement within the facility depends on the effective overhead crane scheduling. However, the traditional approach of crane scheduling at these facilities leads to inefficiencies. To understand this need, we propose an integrated approach using Simulation modelling, Digital Twin (DT) and Reinforcement Learning (RL) to improve the crane scheduling operation of the steelmaking process. We developed a simulation model using discrete event and agent-based simulation and connected it with real-time data by applying the digital twin approach. Further, a Deep Reinforcement Learning (DRL) agent is trained in a stochastic environment with multiple feedback loops and complex interactions for crane scheduling. The DRL agent recommends the sequences of crane movement to reduce the wait time in bottleneck operation. The experimental results demonstrate that the proposed method gives results within 3.6% of the optimal on average. A case of the steel converter facility illustrates this approach, which is also applicable to other industries requiring complex scheduling, such as construction, automotive, and logistics, to improve operational efficiency.