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.     

Fitting Lanchester equations to the battles of Kursk and Ardennes

Lanchester equations and their extensions are widely used to calculate attrition in models of warfare. This paper examines how Lanchester models fit detailed daily data on the battles of Kursk and Ardennes. The data on Kursk, often called the greatest tank battle in history, was only recently made available. A new approach is used to find the optimal parameter values and gain an understanding of how well various parameter combinations explain the battles. It turns out that a variety of Lanchester models fit the data about as well. This explains why previous studies on Ardennes, using different minimization techniques and data formulations, have found disparate optimal fits. We also find that none of the basic Lanchester laws (i.e., square, linear, and logarithmic) fit the data particularly well or consistently perform better than the others. This means that it does not matter which of these laws you use, for with the right coefficients you will get about the same result. Furthermore, no constant attrition coefficient Lanchester law fits very well. The failure to find a good‐fitting Lanchester model suggests that it may be beneficial to look for new ways to model highly aggregated attrition. © 2003 Wiley Periodicals, Inc. Naval Research Logistics, 2004.     

Dynamic proximity calculations for situation awareness

We apply dynamic proximity calculations (density and clustering) from dynamic computational geometry to a military application. The derived proximity information serves as an abstract view of a current situation in the battlefield that can help a military commander achieve situation awareness. We employ Delaunay triangulation as a computational tool in our framework, and study its dynamic update in depth. © 2003 Wiley Periodicals, Inc. Naval Research Logistics, 2004.