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Steins, Krisjanis
Publications (10 of 11) Show all publications
Steins, K., Matinrad, N. & Andersson Granberg, T. (2019). Forecasting the Demand for Emergency Medical Services. In: Proceedings of the 52nd Hawaii International Conference on System Sciences, 2019: . Paper presented at the 52nd Hawaii International Conference on System Sciences, 2019, January 8-11, Grand Wailea, Maui, Hawai'i (pp. 1855-1864). University of Hawai'i at Manoa
Open this publication in new window or tab >>Forecasting the Demand for Emergency Medical Services
2019 (English)In: Proceedings of the 52nd Hawaii International Conference on System Sciences, 2019, University of Hawai'i at Manoa , 2019, p. 1855-1864Conference paper, Published paper (Refereed)
Abstract [en]

Accurate forecast of the demand for emergency medical services (EMS) can help in providing quick and efficient medical treatment and transportation of out-of-hospital patients. The aim of this research was to develop a forecasting model and investigate which factors are relevant to include in such model. The primary data used in this study was information about ambulance calls in three Swedish counties during the years 2013 and 2014. This information was processed, assigned to spatial grid zones and complemented with population and zone characteristics. A Zero-Inflated Poisson (ZIP) regression approach was then used to select significant factors and develop the forecasting model. The model was compared to the forecasting model that is currently incorporated in the EMS information system used by the ambulance dispatchers. The results show that the proposed model performs better than the existing one.

Place, publisher, year, edition, pages
University of Hawai'i at Manoa, 2019
National Category
Transport Systems and Logistics Probability Theory and Statistics Communication Systems
Identifiers
urn:nbn:se:liu:diva-157097 (URN)9780998133126 (ISBN)
Conference
the 52nd Hawaii International Conference on System Sciences, 2019, January 8-11, Grand Wailea, Maui, Hawai'i
Available from: 2019-05-28 Created: 2019-05-28 Last updated: 2019-05-28Bibliographically approved
Steins, K. & Walther, S. (2013). A generic simulation model for planning critical care resource requirements. Anaesthesia, 68(11), 1148-1155
Open this publication in new window or tab >>A generic simulation model for planning critical care resource requirements
2013 (English)In: Anaesthesia, ISSN 0003-2409, E-ISSN 1365-2044, Vol. 68, no 11, p. 1148-1155Article in journal (Refereed) Published
Abstract [en]

Intensive care capacity planning based on factual or forecasted mean admission numbers and mean length of stay without taking non-linearity and variability into account is fraught with error. Simulation modelling may allow for a more accurate assessment of capacity needs. We developed a generic intensive care simulation model using data generated from anonymised patient records of all admissions to four different hospital intensive care units. The model was modified and calibrated stepwise to identify important parameters and their values to obtain a match between model predictions and actual data. The most important characteristic of the final model was the dependency of admission rate on actual occupancy. Occupancy, coverage and transfers of the final model were found to be within 2% of the actual data for all four simulated intensive care units. We have shown that this model could provide accurate decision support for planning critical care resource requirements.

National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:liu:diva-102514 (URN)10.1111/anae.12408 (DOI)
Available from: 2013-12-12 Created: 2013-12-12 Last updated: 2017-12-06
Holmberg, M., Steins, K. & Walther, S. (2013). Does high ICU occupancy have adverse effects on patient outcomes? An obeservational multicentre study of the relationship between occupancy, length-of-stay and mortality. In: Intensive Care Medicine: . Paper presented at 26th Annual Congress of the European Society of Intensive Care Medicine, 5–9 October, Paris, France.
Open this publication in new window or tab >>Does high ICU occupancy have adverse effects on patient outcomes? An obeservational multicentre study of the relationship between occupancy, length-of-stay and mortality
2013 (English)In: Intensive Care Medicine, 2013Conference paper, Published paper (Refereed)
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-103389 (URN)
Conference
26th Annual Congress of the European Society of Intensive Care Medicine, 5–9 October, Paris, France
Available from: 2014-01-19 Created: 2014-01-19 Last updated: 2014-02-03
Fryk, P. & Steins, K. (2010). A modern process perspective, process mapping, and simulation in health care: Opportunities and IT infrastructural needs. In: Proceedings of 2010 IEEE Workshop on Health Care Management (WHCM). Paper presented at IEEE Workshop on Health Care Management, February 18-20, Venice, Italy (pp. 1-6).
Open this publication in new window or tab >>A modern process perspective, process mapping, and simulation in health care: Opportunities and IT infrastructural needs
2010 (English)In: Proceedings of 2010 IEEE Workshop on Health Care Management (WHCM), 2010, p. 1-6Conference paper, Published paper (Refereed)
Abstract [en]

Today, health care organizations often claim that theyare “process oriented”, and that one should approach health carefrom a process perspective in order to utilize the present ITrelated benefits; such as increased service quality, cost efficiency,and enhanced communication. In this paper we investigate howwell founded the concept of process orientation really is – byexamining IT/IS infrastructures, and procedures for processdefinition, visualization, and evaluation – at a prominent hospitalin Stockholm, Sweden. A case study of the organization and theinteraction of the emergency and radiology departments at thesame hospital (using process mapping and data analysis) revealsdata fragmentation, incompatible data, and disparateinformation systems. This results in difficulties regarding processdefinition and analysis, which makes the use of innovative toolssuch as simulation, problematic. The implications of this, and thecontextual factors, are also discussed and some finalrecommendations for smooth digitization are put forth.Today, health care organizations often claim that theyare “process oriented”, and that one should approach health carefrom a process perspective in order to utilize the present ITrelated benefits; such as increased service quality, cost efficiency,and enhanced communication. In this paper we investigate howwell founded the concept of process orientation really is – byexamining IT/IS infrastructures, and procedures for processdefinition, visualization, and evaluation – at a prominent hospitalin Stockholm, Sweden. A case study of the organization and theinteraction of the emergency and radiology departments at thesame hospital (using process mapping and data analysis) revealsdata fragmentation, incompatible data, and disparateinformation systems. This results in difficulties regarding processdefinition and analysis, which makes the use of innovative toolssuch as simulation, problematic. The implications of this, and thecontextual factors, are also discussed and some finalrecommendations for smooth digitization are put forth.

Keywords
IT, digitization, process mapping, process orientation, data analysis, discrete event simulation (DES), health care.
National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-56553 (URN)10.1109/WHCM.2010.5441276 (DOI)978-1-4244-4998-9 (ISBN)978-1-4244-4997-2 (ISBN)
Conference
IEEE Workshop on Health Care Management, February 18-20, Venice, Italy
Available from: 2010-05-21 Created: 2010-05-21 Last updated: 2017-08-14
Steins, K. (2010). Discrete-Event Simulation for Hospital Resource Planning: Possibilities and Requirements. (Licentiate dissertation). Linköping: Linköping University Electronic Press
Open this publication in new window or tab >>Discrete-Event Simulation for Hospital Resource Planning: Possibilities and Requirements
2010 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

The delivery of health care services has been under pressure due to limited funding and increasing demand. This has highlighted the need to increase not only the effectiveness but also the efficiency of health care delivery. Discrete-event simulation has been suggested as an analysis tool in health care management to support the planning of health care resources.

The overall purpose of this thesis is to investigate the possibilities and requirements for using discrete-event simulation in analyzing and planning the use of hospital resources. This is achieved by three case studies that focus on improvements in patient flow of emergency patients that require a radiology examination, intensive care unit capacity planning and operating room allocation strategies, respectively.

The first case investigates the current stage of digitization and process orientation in hospital care as a prerequisite for efficient process simulation and analysis. The study reveals an emergency-radiology patient flow process that is not very well measured and uncovers disparate information systems storing incompatible and fragmented data. These results indicate that the current degree of process orientation and the current IT infrastructure does not enable efficient use of quantitative process analysis and management tools like simulation.

In the second case the possibilities to develop generic hospital unit simulation models by building and validating a generic intensive care unit (ICU) model are explored. The results show that some of the modeling approaches described in literature cannot replicate the actual behavior observed in all studied ICUs. It is important to identify patient groups for different admission priorities, to account for over-utilizations in the model logic, and to discover and properly model dependencies in the input data. The research shows that it is possible to develop a generic ICU simulation model that could realistically describe the performance of different real ICUs in terms of occupancy, coverage and transfers.

The value of simulation modeling in health care management is examined in the third case through the development and use of a simulation model for optimal resource allocation and patient flow in a hospital operating department. The goal of the simulation modeling in this case was to identify bottlenecks in the patient flow and to try different alternatives for allocation of operating room capacity in order to increase the utilization of operating room resources. The final model was used to evaluate four different proposed changes to operating room time allocation.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2010. p. 25
Series
Linköping Studies in Science and Technology. Thesis, ISSN 0280-7971 ; 1446
Keywords
Discrete-event simulation (DES), health care, resource planning
National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-56556 (URN)LIU-TEK-LIC-2010:17 (Local ID)978-91-7393-360-5 (ISBN)LIU-TEK-LIC-2010:17 (Archive number)LIU-TEK-LIC-2010:17 (OAI)
Presentation
2010-06-10, TP2, Täppan, Campus Norrköping., Linköpings universitet, Norrköping, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2010-06-14 Created: 2010-05-21 Last updated: 2020-03-10Bibliographically approved
Steins, K., Persson, F. & Holmer, M. (2010). Increasing Utilization in a Hospital Operating Department Using Simulation Modeling. Simulation (San Diego, Calif.), 86(8-9), 463-480
Open this publication in new window or tab >>Increasing Utilization in a Hospital Operating Department Using Simulation Modeling
2010 (English)In: Simulation (San Diego, Calif.), ISSN 0037-5497, E-ISSN 1741-3133, Vol. 86, no 8-9, p. 463-480Article in journal (Refereed) Published
Abstract [en]

This article focuses on the planning and scheduling of operating rooms (ORs) in a regional hospital in Sweden. A simulation study was carried out to find new ideas and new planning and scheduling techniques to improve the overall process of surgery, including pre- and post-operating activities. This study mainly addresses the problem of low utilization of the ORs, and also takes into consideration problems with variation in workload, both in ORs and in post-anesthesia care units. The final simulation model includes pre-operative care carried out in the operating department and all ORs, as well as post-operative care units. It was driven by a number of input parameters, such as the volume and specific characteristics of actual cases, opening hours and number of ORs, and the number of beds for pre- and post-operative care. The model also includes logic for prioritizing and allocating cases to available ORs, planning operating schedules and the utilization of medical equipment limited in quantity. Output performance measures from simulation experiments include the utilization of allocated OR times, waiting time for patients, queue dynamics, number of cancellations, and variation of finishing times, as well as occupancy statistics in the post-operative care unit. Four different change alternatives were evaluated using the simulation model. Simulation experiments showed that with the implementation of the proposed changes it is possible to achieve slightly better and more even resource utilization, as well as provide greater flexibility in scheduling operations.

Place, publisher, year, edition, pages
SAGE, 2010
Keywords
Healthcare, operating department, operating rooms, utilization, discrete-event simulation, planning, scheduling
National Category
Engineering and Technology
Identifiers
urn:nbn:se:liu:diva-56554 (URN)10.1177/0037549709359355 (DOI)000280765600002 ()
Available from: 2010-05-21 Created: 2010-05-21 Last updated: 2017-12-12
Steins, K., Lundin, M. & Walter, S. (2006). Planning Intensive Care Resource Need Using Discrete Event Simulation Modelling. In: ESICM 2006 ¿- 19th Annual Congress of European Society of Intensive Care Medicine,2006. Barcelona, Spanien: Congress of European Society of Intensive Care Medicine
Open this publication in new window or tab >>Planning Intensive Care Resource Need Using Discrete Event Simulation Modelling
2006 (English)In: ESICM 2006 ¿- 19th Annual Congress of European Society of Intensive Care Medicine,2006, Barcelona, Spanien: Congress of European Society of Intensive Care Medicine , 2006Conference paper, Published paper (Other academic)
Place, publisher, year, edition, pages
Barcelona, Spanien: Congress of European Society of Intensive Care Medicine, 2006
National Category
Computer Sciences
Identifiers
urn:nbn:se:liu:diva-35841 (URN)28690 (Local ID)28690 (Archive number)28690 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2018-01-13
Steins, K., Glenros, J., Lundin, M. & Walter, S. (2006). Planning Intensive Care Resource Need Using Discrete Event Simulation Modelling. Intensive Care Medicine
Open this publication in new window or tab >>Planning Intensive Care Resource Need Using Discrete Event Simulation Modelling
2006 (English)Other (Other (popular science, discussion, etc.))
Abstract [en]

        

Place, publisher, year, pages
Intensive Care Medicine, 2006
National Category
Computer Sciences
Identifiers
urn:nbn:se:liu:diva-35843 (URN)28692 (Local ID)28692 (Archive number)28692 (OAI)
Note
Volume 32, Supplement 13. September, 2006, abstractAvailable from: 2009-10-10 Created: 2009-10-10 Last updated: 2018-01-13
Holmer, M. & Steins, K. (2006). Visuell modellering av patientflödet på en operationsavdelning. In: Utvecklingskraft 2006 - konferensen för utveckling av arbetssätt i svensk hälso- och sjukvård,2006.
Open this publication in new window or tab >>Visuell modellering av patientflödet på en operationsavdelning
2006 (Swedish)In: Utvecklingskraft 2006 - konferensen för utveckling av arbetssätt i svensk hälso- och sjukvård,2006, 2006Conference paper, Published paper (Other academic)
Abstract [sv]

   

National Category
Computer Sciences
Identifiers
urn:nbn:se:liu:diva-35842 (URN)28691 (Local ID)28691 (Archive number)28691 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2018-01-13
Rapp, B. & Steins, K. (2002). Using Simulation Gaming in Logistic Training. In: Proceedings Transbaltica,2002.
Open this publication in new window or tab >>Using Simulation Gaming in Logistic Training
2002 (English)In: Proceedings Transbaltica,2002, 2002Conference paper, Published paper (Other academic)
National Category
Computer Sciences
Identifiers
urn:nbn:se:liu:diva-36521 (URN)31506 (Local ID)31506 (Archive number)31506 (OAI)
Available from: 2009-10-10 Created: 2009-10-10 Last updated: 2018-01-13
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