Browsing by Author "Claudio, David"

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Association Between Perceived Workload and Adverse Body Posture
(2019-09) Nino, Valentina; Marchak, Frank; Claudio, David
Work Related Musculoskeletal Disorders (WMSDs) can be a result of complex interactions between physical, psychosocial, biological, and individual characteristics. However, the evidence on specific associations is still inconclusive. A previous study conducted at a Sterile Processing Department (SPD) in a local hospital established an association between perceived job demands and adverse body postures. However, causal inferences were not possible to establish given the study design. Consequently, the objective of this study was to determine if perception of mental workload causes workers to use more risky body postures. Objective and subjective assessment tools (REBA and NASA-TLX scores) were used as indicators of body postures and mental workload. The findings indicated that there is a positive relationship between the perception of workload (NASA-TLX scores) and adverse body postures (REBA scores) suggesting that people tend to adopt more awkward postures when they feel they are in a rush condition or they have more things to do.
Coupling Wearable Devices and Decision Theory in the United States Emergency Department Triage Process: A Narrative Review
(2020-12) Nino, Valentina; Claudio, David; Schiel, Christie; Bellows, Brendan
This research was motivated by the nurses’ decision-making process in the current emergency department (ED) triage process in the United States. It explores how continuous vital signs monitoring can be integrated into the ED. The article presents four shortcomings on current ED triage systems and proposes a new conceptual clinical decision support model that exploits the benefits of combining wireless wearable devices with Multi-Attribute Utility Theory to address those shortcomings. A literature review was conducted using various engineering and medical research databases, analyzing current practices and identifying potential improvement opportunities. The results from the literature review show that advancements in wireless wearable devices provide opportunities to enhance current ED processes by monitoring patients while they wait after triage and, therefore, reduce the risk of an adverse event. A dynamic mathematical decision support model to prioritize patients is presented, creating a feedback loop in the ED. The coupling of wearable devices (to collect data) with decision theory (to synthesize and organize the information) can assist in reducing sources of uncertainty inherent to ED systems. The authors also address the feasibility of the proposed conceptual model.
Engaging Latinos in an Academic-Community Partnership in Montana through a Health Screening Event
(Informa UK Limited, 2021-03) Moyce, Sally C.; Sisson, Nathaniel; Thompson, Sophia; Velazqueaz, Maria; Claudio, David; Aghbashian, Elizabeth; Demorest, Heather; Vanderwood, Karl
Background: Engaging minorities in research especially in Montana where Latinos make up a small percentage of the population can be a challenge. We describe an effort to recruit Latinos into a research study by hosting a health screening event. Purpose: This event served as the first step in the creation of an academic-community partnership. Methods: We formed an interdisciplinary research team and involved key community stakeholders in planning a health screening event. We provided lunch, flu vaccinations, and screening measures including blood pressure, body mass index, and diabetes status. We also asked for volunteers to sign up to participate in future focus groups. Results: Thirty five people participated in the health screening event, and 29 people volunteered to engage in future research. The majority of participants reported not having health insurance or a regular medical provider, were overweight or obese, and did not have diabetes. Discussion: Engaging the Latino community in research is important, and this paper describes the first step in the creation of an academic-community partnership. Translation to Health Education Practice: Attention to community needs through active partnership and adherence to the responsibilities and competencies for health education specialists provides an example of a successful study that can be adapted to other populations.
Exploring a rural Latino community’s perception of the COVID-19 pandemic
(Informa UK Limited, 2020-10) Moyce, Sally; Velazquez, Maria; Claudio, David; Thompson, Sophia; Metcalf, Madeline; Aghbashian, Elizabeth; Vanderwood, Karl; Sisson, Nathaniel
Objectives The purpose of our study was to understand the perception of the Latino community in a rural state regarding COVID-19. Over one third of national COVID-19 cases are among Latinos, likely due to an increased prevalence of comorbid risk factors and social determinants of health that make following precautions difficult. Design Respondents were recruited using snowball sampling as part of a previous effort to establish an academic-community partnership with Latinos in the area. In April 2020, we conducted 14 semi-structured interviews in Spanish with participants over the phone. Interviews were audio-recorded, transcribed into Spanish, and translated to English. We employed the framework approach in a thematic analysis using NVivo 12. Results Common themes were a wariness of news appearing on social media, generalized worry, and the use of natural medicines to maintain health. Respondents followed recommended guidelines to protect their own health, though expressed concern that members of their community were not. Conclusions We offer insights into the perception of Latinos of the COVID-19 pandemic in a rural state. Our findings may influence communication techniques of local health departments and offer a way to understand how this often-overlooked community deals with the pandemic.
Identifying service quality gaps between patients and providers in a Native American outpatient clinic
(Springer Science and Business Media LLC, 2022-02) Dorsey, Robert; Claudio, David; Velázquez, María A.; Petersen, Polly
Background. Native American communities in Montana reservations have reported low-level satisfaction in health services. This research explored if the services provided at a Blackfeet Indian Reservation outpatient clinic were designed to meet patient expectations. Methods. Staff and patient interviews and surveys allowed service expectations to be assessed according to the clinic’s ability to meet those expectations. A total of 48 patients and ten staff members (83% of the staff at this clinic) participated in the study voluntarily. Results. We found a disconnect between what patients anticipate for care and what staff think they are anticipating. We also found a discontent between what staff believes patients need versus what the patients feel is needed. Conclusions. These gaps combine to increase the breach between patient expectations and perceptions of their healthcare services. With better insight that captures what patients are looking for from a service, the potential to meet those needs increases, and patients feel that their voice is respected and valued.
Optimizing patient flow, capacity, and performance of COVID-19vaccination clinics
(Taylor & Francis, 2022-04) Valladares, Leonardo; Nino, Valentina; Martínez, Kenneth; Sobek, Durward; Claudio, David; Moyce, Sally
Mass vaccination plays an important role in increasing immunization against COVID-19 and decreasing morbidity. Drive-through and traditional walk-through centers have been set up in most cities in the United States and other countries to vaccinate large numbers of people in a short period of time. This article focuses on a pair of mass vaccination clinics conducted on a mid-sized, public university campus. Applying tools from Industrial Engineering, including time study, flow charts, and Queuing Theory, the team identified improvements that resulted in a 40% reduction in the duration of the second clinic while vaccinating almost the same number of patients with no increases in overall staffing. The work resulted in a model for designing mass vaccination clinics in the future and demonstrates that engineers have the ability to support healthcare personnel to increase the performance of the vaccination centers. The inclusion of engineering in the planning and execution of these vaccination clinics can help maximize clinic capacity, reduce the staff and resources needed, and reduce the patients’ waiting time.
Rural Hispanic Perceptions of Mental Health: A Qualitative Study
(SAGE Publications, 2022-01) Moyce, Sally; Thompson, Sophia; Metcalf, Madeline; Velazquez, Maria; Aghbashian, Elizabeth; Sisson, Nathaniel; Claudio, David
Introduction: In 2020, 18.4% of Hispanics experienced mental illness, yet only about a third received treatment compared with nearly half of non-Hispanic Whites. In Montana, where only 11% of the mental health needs are currently met, service utilization is low. The purpose of this study was to determine the perceptions of the Hispanic immigrant population in a rural state on mental health and professional service utilization. Methods: Using a descriptive phenomenological approach, we conducted semi-structured telephone interviews in Spanish. Audio recordings were transcribed, translated to English, and analyzed for themes. Results: We recruited a sample of 14 participants from Mexico, Ecuador, Colombia, and Venezuela ranging in age from 33 to 59. We identified five themes: definitions of mental health, maintaining mental health, familismo/socialization, stigma, and acculturation stress. Discussion: Novel findings point to the need for Spanish-language services focused on reducing stigma around mental illness and incorporating the importance of social connections.
Simulating a sterilization processing department to evaluate block schedules and tray configurations
(Wiley, 2023-06) Harris, Sean; Nino, Valentina; Claudio, David
Discrete event simulation is a well-established tool for examining the effect of different operating room (OR) block schedules on various performance metrics within the OR suite and adjacent units. However, one unit that has rarely been studied is the sterilization processing department (SPD), which cleans and assembles reusable OR instruments. As part of a larger research study, we developed a series of OR block assignment models that sought to reduce the workload of the SPD and developed a tray optimization model to reduce the number of instruments on increasingly bloated instrument trays. While initial numerical experiments were promising, a comprehensive simulation model of the OR and SPD was needed to more thoroughly examine how potential changes to the block schedule and/or more efficient tray configurations could improve SPD processing times. In this article, we incorporate the SPD into an existing simulation model of an OR suite, which is the first of its kind, and examine the effect that different block schedules and tray configurations have on SPD processing times. Simulation results confirm earlier numerical computations. Furthermore, simulation results suggest that more efficient instrument tray configurations are a much better and more viable method for improving SPD processing time than reconfiguring block schedules.
A simulation of variability-oriented sequencing rules on block surgical scheduling
(2016-12) Nino, Luisa; Harris, Sean; Claudio, David
Surgery scheduling has received considerable attention in recent years. Block schedules, in which surgeon groups utilize the OR for whatever surgeries they have scheduled for the day, present additional challenges to schedulers. While mean operation times are often used as the primary factor in scheduling strategies, the variability of these operations is not. Recent research suggests that sequencing surgeries based on their variation may decrease the number of late surgery starts. This article builds upon this emerging methodology of variability-oriented sequencing rules for block schedules. Discrete event simulation was used to examine the effectiveness of different sequencing algorithms in reducing the number of behind schedule surgeries and their magnitude. The number and magnitude of tardy surgeries and the patient waiting time were significantly improved by an average of 40% with the proposed scheduling strategies. Additional simulations explored several variations of the variability-based scheduling methodology.
A Statistical Comparison between Different Multicriteria Scaling and Weighting Combinations
(2020-05) Harris, Sean; Nino, Luisa; Claudio, David
Multicriteria decision making presents several challenges for researchers. These include selecting a technique that will produce accurate results but not require too much time or resources. Researchers have been comparing different techniques for several years, though a comprehensive study of using many different techniques for the same set of problems is relatively new. Additionally, knowing if the difference in scores between alternatives is significant or not presents another challenge. The use of confidence intervals has recently been employed by researchers to examine whether results are actually statistically different from one another. This study uses 21 different scaling-weighting combinations and confidence intervals on six different decision-making problems to measure their ability to produce unambiguous results. Linear normalization as a scaling technique tends to be the best at identifying one or two clear winners while avoiding complete ambiguity. Despite the variety of combinations used, several common themes emerge across the decision problems.