Evaluating appointment postponement in scheduling patients at a diagnostic clinic

Diagnostic clinics are among healthcare facilities that suffer from long waiting times which can worsen medical outcomes and increase patient no-shows. Reducing waiting times without significant capital investments is a challenging task. We tackle this challenge by proposing a new appointment scheduling policy that does not require significant investments for diagnostic clinics. The clinic in our study serves outpatients, inpatients, and emergency patients. Emergency patients must be seen on arrival, and inpatients must be given next day appointments. Outpatients, however, can be given later appointments. The proposed policy takes advantage of this by allowing the postponement of the acceptance of appointment requests from outpatients. The appointment scheduling process is modeled as a two-stage stochastic programming problem where a portion of the clinic capacity is allocated to inpatients and emergency patients in the first stage. In the second stage, outpatients are scheduled based on their priority classes. After a detailed analysis of the solutions obtained from the two-stage stochastic model, we develop a simple, non-anticipative policy for patient scheduling. We evaluate the performance of this proposed, easy-to-implement policy in a simulation study which shows significant improvements in outpatient indirect waiting times.     

Maintenance scheduling for modular systems: Modeling and algorithms

We study new models of scheduled maintenance management for modular systems, consisting of multiple components with respective cycle limits. The cycle limit of each component specifies the time interval in which this component must be repaired or replaced. The goal is to compute a feasible maintenance schedule that minimizes the cost associated with component maintenance. Applications of these models arise in Air Force aircraft maintenance as well as in other arenas with required preventive maintenance. The typical cost structures that arise in practical settings are submodular, which make the resulting models computationally challenging. We develop two efficient and operationally tenable approximation algorithms. We prove constant factor worst‐case guarantees for both algorithms, and present computational experiments showing that these algorithms perform within a few percent of optimality on operationally relevant instances. © 2014 Wiley Periodicals, Inc. Naval Research Logistics 61: 472–488, 2014     

Drones,spies, terrorists,and second-class citizenship in Pakistan

This essay reviews seven recent books and reports that focus upon the use of US armed drones in Pakistan's Federally Administered Tribal Areas (FATA). This essay synthesizes a historical account of the program, critically interrogates key arguments and evidence advanced by the authors, and draws attention the particular problems that confront those who live in the FATA and the second-class citizenship that the Pakistani state has bestowed upon them for reasons of domestic and foreign policy concerns. This review essay does not intend to be the final word on any of the ongoing policy debates. But it does hope to enable a wider audience to take part in these important deliberations.     

The evolving menace of baby factories and trafficking in Nigeria

Trafficking in persons in Nigeria has largely targeted adults and children, particularly women and girls. Of growing concern, however, is the recent emergence and growth of sophisticated and syndicated groups involved in baby ‘factories’ and trafficking in Nigeria. This article examines the nature, actors, modus operandi and motives behind this emergent dimension of human trafficking in Nigeria. It concludes that if concerted efforts are not made to deal with the actors and dismantle the market, its profitability will embolden current actors and even encourage new entrants into the booming trade – now and in the future.     

Exact algorithms for integrated facility location and production planning problems

We consider a class of facility location problems with a time dimension, which requires assigning every customer to a supply facility in each of a finite number of periods. Each facility must meet all assigned customer demand in every period at a minimum cost via its production and inventory decisions. We provide exact branch‐and‐price algorithms for this class of problems and several important variants. The corresponding pricing problem takes the form of an interesting class of production planning and order selection problems. This problem class requires selecting a set of orders that maximizes profit, defined as the revenue from selected orders minus production‐planning‐related costs incurred in fulfilling the selected orders. We provide polynomial‐time dynamic programming algorithms for this class of pricing problems, as well as for generalizations thereof. Computational testing indicates the advantage of our branch‐and‐price algorithm over various approaches that use commercial software packages. These tests also highlight the significant cost savings possible from integrating location with production and inventory decisions and demonstrate that the problem is rather insensitive to forecast errors associated with the demand streams. © 2011 Wiley Periodicals, Inc. Naval Research Logistics, 2011     

Pricing bridges to cross a river

We consider a pricing problem in directed, uncapacitated networks. Tariffs must be defined by an operator, the leader, for a subset of m arcs, the tariff arcs. Costs of all other arcs in the network are assumed to be given. There are n clients, the followers, and after the tariffs have been determined, the clients route their demands independent of each other on paths with minimal total cost. The problem is to find tariffs that maximize the operator's revenue. Motivated by applications in telecommunication networks, we consider a restricted version of this problem, assuming that each client utilizes at most one of the operator's tariff arcs. The problem is equivalent to pricing bridges that clients can use in order to cross a river. We prove that this problem is APX‐hard. Moreover, we analyze the effect of uniform pricing, proving that it yields both an m approximation and a (1 + lnD)‐approximation. Here, D is upper bounded by the total demand of all clients. In addition, we consider the problem under the additional restriction that the operator must not reject any of the clients. We prove that this problem does not admit approximation algorithms with any reasonable performance guarantee, unless P = NP, and we prove the existence of an n‐approximation algorithm. © 2007 Wiley Periodicals, Inc. Naval Research Logistics, 2007     

Clustering in defence-related procurement: the case of a Belgian naval construction cluster

ABSTRACT

This paper examines the importance of closer co-operation in defence-related procurement. Led by the decision that Belgium will lead the procurement of 12 Mine CounterMeasures Vessels (MCMV), the case of a potential Belgian naval construction cluster is discussed. The feasibility of a potential cluster is investigated by looking at key elements of a successful naval construction cluster, the Dutch naval construction cluster, and comparing those key elements to the current Belgian situation. Forming a sustainable Belgian naval construction cluster will be difficult. Most of the procurement process of the MCMVs is set on a European tender. In the long run, due to the absence of both a launching customer and leader firms, no party is able to carry the cluster with investments and knowledge spill-overs. In order to keep public support for large defence-related investments, clustering around the MCMV integration system and proactive cluster support is recommended.     

Level product form QSF processes and an analysis of queues with Coxian interarrival distribution

In this article, we study a class of Quasi‐Skipfree (QSF) processes where the transition rate submatrices in the skipfree direction have a column times row structure. Under homogeneity and irreducibility assumptions we show that the stationary distributions of these processes have a product form as a function of the level. For an application, we will discuss the ‐queue that can be modeled as a QSF process on a two‐dimensional state space. In addition, we study the properties of the stationary distribution and derive monotonicity of the mean number of the customers in the queue, their mean sojourn time and the variance as a function of for fixed mean arrival rate. © 2016 Wiley Periodicals, Inc. Naval Research Logisticsxs 66:57–72, 2019