A methodology for decisionmaking in project evaluation in land management planning

Treesearch

A. Weintraub

1978-01-01

In order to evaluate alternative plans, wildland management planners must consider many objectives, such as timber production, recreational use, and community stability. The method presented utilizes the type of qualitative and intuitive information widely available to wildland management planners, and structures this information into a format suitable for...

Management Information System Project.

ERIC Educational Resources Information Center

Foley, Walter J.; Harr, Gordon G.

The Management Information System (MIS) described in this report represents a plan to utilize modern management techniques to facilitate the goal of a learner-responsive school system. The MIS component is being developed to meet the need for the coordination of the resources of staff, facilities, and time with the long range planning and…

9 CFR 54.8 - Requirements for flock plans and post-exposure management and monitoring plans.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Requirements for flock plans and post... and post-exposure management and monitoring plans. (a) The owner of the flock or his or her agent must...: Utilization of a live-animal screening test; restrictions on the animals that may be moved from the flock...

9 CFR 54.8 - Requirements for flock plans and post-exposure management and monitoring plans.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Requirements for flock plans and post... and post-exposure management and monitoring plans. (a) The owner of the flock or his or her agent must...: Utilization of a live-animal screening test; restrictions on the animals that may be moved from the flock...

9 CFR 54.8 - Requirements for flock plans and post-exposure management and monitoring plans.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Requirements for flock plans and post... and post-exposure management and monitoring plans. (a) The owner of the flock or his or her agent must...: Utilization of a live-animal screening test; restrictions on the animals that may be moved from the flock...

9 CFR 54.8 - Requirements for flock plans and post-exposure management and monitoring plans.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Requirements for flock plans and post... and post-exposure management and monitoring plans. (a) The owner of the flock or his or her agent must...: Utilization of a live-animal screening test; restrictions on the animals that may be moved from the flock...

9 CFR 54.8 - Requirements for flock plans and post-exposure management and monitoring plans.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Requirements for flock plans and post... and post-exposure management and monitoring plans. (a) The owner of the flock or his or her agent must...: Utilization of a live-animal screening test; restrictions on the animals that may be moved from the flock...

Generalizable open source urban water portfolio simulation framework demonstrated using a multi-objective risk-based planning benchmark problem.

NASA Astrophysics Data System (ADS)

Trindade, B. C.; Reed, P. M.

2017-12-01

The growing access and reduced cost for computing power in recent years has promoted rapid development and application of multi-objective water supply portfolio planning. As this trend continues there is a pressing need for flexible risk-based simulation frameworks and improved algorithm benchmarking for emerging classes of water supply planning and management problems. This work contributes the Water Utilities Management and Planning (WUMP) model: a generalizable and open source simulation framework designed to capture how water utilities can minimize operational and financial risks by regionally coordinating planning and management choices, i.e. making more efficient and coordinated use of restrictions, water transfers and financial hedging combined with possible construction of new infrastructure. We introduce the WUMP simulation framework as part of a new multi-objective benchmark problem for planning and management of regionally integrated water utility companies. In this problem, a group of fictitious water utilities seek to balance the use of the mentioned reliability driven actions (e.g., restrictions, water transfers and infrastructure pathways) and their inherent financial risks. Several traits of this problem make it ideal for a benchmark problem, namely the presence of (1) strong non-linearities and discontinuities in the Pareto front caused by the step-wise nature of the decision making formulation and by the abrupt addition of storage through infrastructure construction, (2) noise due to the stochastic nature of the streamflows and water demands, and (3) non-separability resulting from the cooperative formulation of the problem, in which decisions made by stakeholder may substantially impact others. Both the open source WUMP simulation framework and its demonstration in a challenging benchmarking example hold value for promoting broader advances in urban water supply portfolio planning for regions confronting change.

Using Global Climate Data to Inform Long-Term Water Planning Decisions

NASA Astrophysics Data System (ADS)

Groves, D. G.; Lempert, R.

2008-12-01

Water managers throughout the world are working to consider climate change in their long-term water planning processes. The best available information regarding plausible future hydrologic conditions are largely derived from global circulation models and from paleoclimate data. To date there lacks a single approach for (1) utilizing these data in water management planning tools for analysis and (2) evaluating the myriad of possible adaptation options. This talk will describe several approaches being used at RAND to incorporate global projections of climate change into local, regional, and state-wide long-term water planning. It will draw on current work with the California Department of Water Resources and other local Western water agencies, and a recently completed project with the Inland Empire Utilities Agency. Work to date suggests that climate information can be assimilated into local water planning tools to help identify robust climate adaptation water management strategies.

International utilization and operations

NASA Technical Reports Server (NTRS)

Goldberg, Stanley R.

1989-01-01

The international framework of the Space Station Freedom Program is described. The discussion covers the U.S. space policy, international agreements, international Station elements, overall program management structure, and utilization and operations management. Consideration is also given to Freedom's user community, Freedom's crew, pressurized payload and attached payload accommodations, utilization and operations planning, user integration, and user operations.

Characteristics of health plans that treat psychiatric patients.

PubMed

Zarin, D A; West, J C; Pincus, H A; Tanielian, T L

1999-01-01

Nationally representative data regarding the organizational, financial, and procedural features of health plans in which psychiatric patients receive treatment indicate that fewer privately insured, Medicaid, and Medicare managed care enrollees receive care from a psychiatrist than is true for "nonmanaged" enrollees. Financial considerations were reported to adversely affect treatment for one-third of all patients. Although utilization management techniques and financial/resource constraints commonly applied to patients in both managed and nonmanaged plans, performance-based incentives were rare in nonmanaged plans. The traditional health plan categories provide limited information to identify salient plan characteristics and guide policy decisions regarding the provision of care.

Productivity enhancement planning using participative management concepts

NASA Technical Reports Server (NTRS)

White, M. E.; Kukla, J. C.

1985-01-01

A productivity enhancement project which used participative management for both planning and implementation is described. The process and results associated with using participative management to plan and implement a computer terminal upgrade project where the computer terminals are used by research and development (R&D) personnel are reported. The upgrade improved the productivity of R&D personnel substantially, and their commitment of the implementation is high. Successful utilization of participative management for this project has laid a foundation for continued style shift toward participation within the organization.

Improving the relevance and impact of decision support research: A co-production framework and water management case study

NASA Astrophysics Data System (ADS)

Smith, R.; Kasprzyk, J. R.; Dilling, L.; Basdekas, L.; Kaatz, L.

2016-12-01

In light of the unpredictable effects of climate change and population shifts, responsible resource management will require new types of information and strategies going forward. For water utilities, this means that water supply infrastructure systems must be expanded and/or managed for changes in overall supply and increased extremes. Utilities have begun seeking innovative tools and methods to support planning and decision making, but there are limited channels through which they can gain exposure to emerging tools from the research world, and for researchers to uptake important real-world planning and decision context. A transdisciplinary team of engineers, social and climate scientists, and water managers designed this study to develop and apply a co-production framework which explores the potential of an emerging decision support tool to enhance flexibility and adaptability in water utility planning. It also demonstrates how to improve the link between research and practice in the water sector. In this study we apply the co-production framework to the use of Multiobjective Evolutionary Algorithms (MOEAs). MOEAs have shown promise in being able to generate and evaluate new planning alternatives but they have had little testing or application in water utilities. Anchored by two workshops, this study (1) elicited input from water managers from six water suppliers on the Front Range of Colorado, USA, to create a testbed MOEA application, and (2) evaluated the managers' responses to multiobjective optimization results. The testbed consists of a Front Range-relevant hypothetical water supply model, the Borg MOEA, hydrology and demand scenarios, and a set of planning decisions and performance objectives that drive the link between the algorithm and the model. In this presentation we describe researcher-manager interactions at the initial workshop that served to establish relationships and provide in-depth information to researchers about regional water management context. We also describe the development of, and experiences from, the second workshop which included activities for water managers to interact directly with MOEA testbed results. Finally, we evaluate the co-production framework itself and the potential for the feedback from managers to shape future development of decision support tools.

Characteristics of private-sector managed care for mental health and substance abuse treatment.

PubMed

Garnick, D W; Hendricks, A M; Dulski, J D; Thorpe, K E; Horgan, C

1994-12-01

This study examined diversity during the late 1980s in managed care programs for mental health, alcohol abuse, and drug abuse to identify ways in which research can generate more meaningful data on the effectiveness of utilization review programs. Telephone interviews were conducted with representatives of utilization review programs for employee health insurance plans in 31 firms that employed 2.1 million people in 1990. Questions addressed qualifications of personnel, clinical criteria to authorize care, integration with employee assistance plans, penalties for not complying with utilization review procedures, outpatient review, and carve out of mental health and substance abuse review. Large variations in utilization review programs were found. Programs employed a range of review personnel and used a variety of clinical criteria to authorize care. More than two-thirds did not carve out mental health and substance abuse review from medical-surgical review. Some firms' employee assistance plans were integrated with utilization review programs, while others remained unintegrated. Penalties for not following program procedures varied widely, as did review of outpatient services. Because of trends toward even more diversity in utilization review programs in the 1990s, research that identifies the specific features of managed care programs that hold most promise for controlling costs while maintaining quality of care will increasingly be needed.

Improving Care for Children With Complex Needs

ClinicalTrials.gov

2017-10-10

Medically Complex Children; Care Coordination; Case Manager; Care Manager; Collaborative Care; Disease Management; Patient Care Team or Organization; Managed Care; Children With Chronic Conditions; Children With Special Health Care Needs; Shared Care Plan; Patient Care Plan; Health Care and Resource Utilization; Adherence to Care; Functional Status and Productivity; Health Related Quality of Life; Satisfaction With Care; Care Coordinator; Family Experience of Care; Quality Health Care

Automated Telephone Self-Management Support for Diabetes in a Low-Income Health Plan: A Health Care Utilization and Cost Analysis.

PubMed

Quan, Judy; Lee, Alexandra K; Handley, Margaret A; Ratanawongsa, Neda; Sarkar, Urmimala; Tseng, Samuel; Schillinger, Dean

2015-12-01

The objective was to determine whether automated telephone self-management support (ATSM) for low-income, linguistically diverse health plan members with diabetes affects health care utilization or cost. A government-sponsored managed care plan for low-income patients implemented a demonstration project between 2009 and 2011 that involved a 6-month ATSM intervention for 362 English-, Spanish-, or Cantonese-speaking members with diabetes from 4 publicly funded clinics. Participants were randomized to immediate intervention or a wait-list. Medical and pharmacy claims used in this analysis were obtained from the managed care plan. Medical claims included hospitalizations, ambulance use, emergency department visits, and outpatient visits. In the 6-month period following enrollment, intervention participants generated half as many emergency department visits and hospitalizations (rate ratio 0.52, 95% CI 0.26, 1.04) compared to wait-listed participants, but these differences did not reach statistical significance (P=0.06). With adjustment for prior year cost, intervention participants also had a nonsignificant reduction of $26.78 in total health care costs compared to wait-listed individuals (P=0.93). The observed trends suggest that ATSM could yield potential health service benefits for health plans that provide coverage for chronic disease patients in safety net settings. ATSM should be further scaled up to determine whether it is associated with a greater reduction in health care utilization and costs.

Careful Planning Key to Accurate Fixed Reports Assets.

ERIC Educational Resources Information Center

MaRous, Arnold M.

1986-01-01

Only with careful planning can school business managers develop fixed asset information and good recordkeeping. Use of a simple inventory system and discussion with school districts already utilizing this system will assist planning. (CJH)

Opioid management strategy decreases admissions in high-utilizing adults with sickle cell disease.

PubMed

Mager, Amy; Pelot, Kristin; Koch, Kathryn; Miller, Lawrence; Hubler, Collin; Ndifor, Anisah; Coan, Canice; Leonard, Cynthia; Field, Joshua J

A subset of adults with sickle cell disease (SCD) heavily utilizes the emergency department (ED) and hospital. The objective of our study was to determine the efficacy of a multidisciplinary strategy to address unmet needs in highly utilizing adults with SCD. In a prospective study, adults with SCD with ≥10 admissions per year were assessed by a multidisciplinary team for gaps in medical, social, and psychological care. Thereafter, the team decided upon the subject's predominant domain that drove admissions and instituted an interventional plan. All plans included an opioid management strategy. Preintervention and postintervention admission rate, as well as opioid use, was compared. Twelve subjects were enrolled. Median rate of ED and hospital admissions preintervention was 25 per year. The predominant domains identified were social needs (n = 6), psychological disorder (n = 1), and substance use disorder (n = 5). Multifaceted interventional plans were developed to address a wide range of gaps in care, but an opioid management strategy was the only intervention successfully completed. Even so, when the preintervention versus postintervention admission rate was compared, regardless of the domain, there was a 40 percent decline in hospital admissions (p = 0.03). Consistent with the successful implementation of an opioid management plan, the decrease in admissions was accompanied by a 37 percent decrease in intravenous opioid use (p = 0.02) and 10 percent decrease in oral opioid use (p = 0.04). An opioid management strategy, as part of a larger effort to improve care for high-utilizing adults with SCD, decreased rate of admissions and opioid use.

A Critical Examination of Senior Executive Leadership Succession Planning and Management with Implications for Underrepresented Minorities

ERIC Educational Resources Information Center

Jackson, LeKeisha D.

2017-01-01

Guided by the research questions, this study utilized a sequential explanatory mixed methods research design to examine senior executive leadership succession planning at four-year, predominately white, doctoral universities in the state of Georgia. Utilizing the Representative Bureaucracy theory and the Mateso SPM conceptual model, this study…

Methodological Issues in the Study of Air Force Organizational Structures,

DTIC Science & Technology

MOTIVATION, MORALE, PERFORMANCE(HUMAN), LEADERSHIP , SKILLS, MANAGEMENT PLANNING AND CONTROL, MODEL THEORY , SYMPOSIA...RESOURCE MANAGEMENT , *HUMAN RESOURCES, *MANPOWER UTILIZATION, *JOB ANALYSIS, *ORGANIZATIONS, STRUCTURES, PERSONNEL MANAGEMENT , DECISION MAKING

Linear Programming for Vocational Education Planning. Interim Report.

ERIC Educational Resources Information Center

Young, Robert C.; And Others

The purpose of the paper is to define for potential users of vocational education management information systems a quantitative analysis technique and its utilization to facilitate more effective planning of vocational education programs. Defining linear programming (LP) as a management technique used to solve complex resource allocation problems…

Using Knowledge Management to Revise Software-Testing Processes

ERIC Educational Resources Information Center

Nogeste, Kersti; Walker, Derek H. T.

2006-01-01

Purpose: This paper aims to use a knowledge management (KM) approach to effectively revise a utility retailer's software testing process. This paper presents a case study of how the utility organisation's customer services IT production support group improved their test planning skills through applying the American Productivity and Quality Center…

Remote Sensing for Inland Water Quality Monitoring: A U.S. Army Corps of Engineers Perspective

DTIC Science & Technology

2011-10-01

outlined in Water Quality Management Plans , including traditional field sampling (water, sediment, and biological) and measure- ment of physical...at one time, a more comprehen- sive historical record or trend analysis, a planning tool for prioritizing field surveying and sampling, and accurate...estimations of optically active constituents used to characterize water quality. Furthermore, when utilized in water quality management planning

Integrating market processes into utility resource planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kahn, E.P.

1992-11-01

Integrated resource planning has resulted in an abundance of alternatives for meeting existing and new demand for electricity services: (1) utility demand-side management (DSM) programs, (2) DSM bidding, (3) competitive bidding for private power supplies, (4) utility re-powering, and (5) new utility construction. Each alternative relies on a different degree of planning for implementation and, therefore, each alternative relies on markets to a greater or lesser degree. This paper shows how the interaction of planning processes and market forces results in resource allocations among the alternatives. The discussion focuses on three phenomena that are driving forces behind the unanticipated consequences'more » of contemporary integrated resource planning efforts. These forces are: (1) large-scale DSM efforts, (2) customer bypass, and (3) large-scale independent power projects. 22 refs., 3 figs., 2 tabs.« less

Moving beyond the Typologies of Managed Care: The Example of Health Plan Predictors of Screening Mammography

PubMed Central

Tye, Sherilyn; Phillips, Kathryn A; Liang, Su-Ying; Haas, Jennifer S

2004-01-01

Objectives To develop a framework of factors to characterize health plans, to identify how plan characteristics were measured in a national survey, and to apply our findings to an analysis of the predictors of screening mammography. Data Source The primary data were from the 1996 Medical Expenditure Panel Survey. Study Design Women ages 40+, with private insurance, and no history of breast cancer were included in the study (N=2,909). We used multivariate logistic regression to estimate mammography utilization in the past two years relative to health plan and demographic factors. Health plan measures included whether there is a defined provider network, whether coverage is restricted to a network, use of gatekeepers, level of cost containment, copayment and deductible amounts, coinsurance rate, and breadth of benefit coverage. Principal Findings We found no significant difference in reported mammography utilization using a dichotomous comparison of individuals enrolled in managed care versus indemnity plans. However, women in health plans with a defined provider network were more likely to report having received a mammogram in the past two years than those without networks (adjusted OR=1.21, 95 percent CI=1.07–1.36), and women in gatekeeper plans were more likely to report receiving mammography than those without gatekeepers (adjusted OR=1.18, 95 percent CI=1.03–1.36). Restricted out-of-network coverage, use of cost containment, enrollee cost sharing, and breadth of benefit coverage did not appear to affect mammography use. Conclusions It is important to examine the effect of individual health plan components on the utilization of health care, rather than use the traditional broader categorizations of managed versus nonmanaged care or simple health plan typologies. PMID:14965083

Visual Decision Support Tool for Supporting Asset ...

EPA Pesticide Factsheets

Abstract:Managing urban water infrastructures faces the challenge of jointly dealing with assets of diverse types, useful life, cost, ages and condition. Service quality and sustainability require sound long-term planning, well aligned with tactical and operational planning and management. In summary, the objective of an integrated approach to infrastructure asset management is to assist utilities answer the following questions:•Who are we at present?•What service do we deliver?•What do we own?•Where do we want to be in the long-term?•How do we get there?The AWARE-P approach (www.aware-p.org) offers a coherent methodological framework and a valuable portfolio of software tools. It is designed to assist water supply and wastewater utility decision-makers in their analyses and planning processes. It is based on a Plan-Do-Check-Act process and is in accordance with the key principles of the International Standards Organization (ISO) 55000 standards on asset management. It is compatible with, and complementary to WERF’s SIMPLE framework. The software assists in strategic, tactical, and operational planning, through a non-intrusive, web-based, collaborative environment where objectives and metrics drive IAM planning. It is aimed at industry professionals and managers, as well as at the consultants and technical experts that support them. It is easy to use and maximizes the value of information from multiple existing data sources, both in da

An empty toolbox? Changes in health plans' approaches for managing costs and care.

PubMed

Mays, Glen P; Hurley, Robert E; Grossman, Joy M

2003-02-01

To examine how health plans have changed their approaches for managing costs and utilization in the wake of the recent backlash against managed care. Semistructured interviews with health plan executives, employers, providers, and other health care decision makers in 12 metropolitan areas that were randomly selected to be nationally representative of communities with more than 200,000 residents. Longitudinal data were collected as part of the Community Tracking Study during three rounds of site visits in 1996-1997, 1998-1999, and 2000-2001. Interviews probed about changes in the design and operation of health insurance products--including provider contracting and network development, benefit packages, and utilization management processes--and about the rationale and perceived impact of these changes. Data from more than 850 interviews were coded, extracted, and analyzed using computerized text analysis software. Health plans have begun to scale back or abandon their use of selected managed care tools in most communities, with selective contracting and risk contracting practices fading most rapidly and completely. In turn, plans increasingly have sought cost savings by shifting costs to consumers. Some plans have begun to experiment with new provider networks, payment systems, and referral practices designed to lower costs and improve service delivery. These changes promise to lighten administrative and financial burdens for physicians and hospitals, but they also threaten to increase consumers' financial burdens.

Case management in an acute-care hospital: collaborating for quality, cost-effective patient care.

PubMed

Grootveld, Kim; Wen, Victoria; Bather, Michelle; Park, Joan

2014-01-01

Case management has recently been advanced as a valuable component in achieving quality patient care that is also cost-effective. At St. Michael's Hospital, in Toronto, Ontario, case managers from a variety of professional backgrounds are central to a new care initiative--Rapid Assessment and Planning to Inform Disposition (RAPID)--in the General Internal Medicine (GIM) Unit that is designed to improve patient care and reconcile high emergency department volumes through "smart bed spacing." Involved in both planning and RAPID, GIM's case managers are the link between patient care and utilization management. These stewards of finite resources strive to make the best use of dollars spent while maintaining a commitment to quality care. Collaborating closely with physicians and others across the hospital, GIM's case managers have been instrumental in bringing about significant improvements in care coordination, utilization management and process redesign. Copyright © 2014 Longwoods Publishing.

78 FR 57651 - Habitat Conservation Plan for the Community of Los Osos, San Luis Obispo County, CA; Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-19

..., management, maintenance, and monitoring of conservation lands used to mitigate the effects of the other.... The LOHCP is a comprehensive plan designed to provide long-term conservation and management of... Maintenance: Public and private utility company activities to operate and maintain, including repair and...

Development and Application of Climate Services for Water Resources Planning and Management within the Department of Interior Bureau of Reclamation

NASA Astrophysics Data System (ADS)

Raff, D. A.; Morgan, A.; Brekke, L. D.

2014-12-01

The Bureau of Reclamation is the nation's largest wholesale water supplier and the second largest producer of hydropower. Reclamation operates 337 reservoirs with a total storage capacity of 245 million acre-feet and operates 53 hydroelectric powerplants that annually produce, on average for the past 10 years, 40 billion kilowatt-hours. Reclamation is adapting to the impacts and future challenges posed by the changing climate through the development of new climate services as well as through cooperation with Federal, state, local, tribal, academic, and non-governmental partners in the use of climate and water resource information that may be available. Reclamation is utilizing this information within a strategy that has four goals: 1) Increase Water Management Flexibility, 2) Enhance Climate Adaptation Planning, 3) Improve Infrastructure Resiliency, and 4) Expand Information Sharing. Within this presentation we will focus on the utilization of climate services within each of these key goals of Reclamation's strategy. This includes the utilization of climate information to track and potentially improve reservoir management to increase water management flexibility, the development of climate informed hydrology that supports climate adaptation planning, use of climate information to inform decisions of infrastructure resilience, and climate services use for jointly informed water management decisions through education and web based services.

Total Water Management: A Watershed Based Approach

EPA Science Inventory

In this urbanizing world, municipal water managers need to develop planning and management frameworks to meet challenges such as limiting fresh water supplies, degrading receiving waters, increasing regulatory requirements, flooding, aging infrastructure, rising utility (energy) ...

Total Water Management: A Watershed Based Approach - slides

EPA Science Inventory

ABSTRACT In this urbanizing world, municipal water managers need to develop planning and management frameworks to meet challenges such as limiting fresh water supplies, degrading receiving waters, increasing regulatory requirements, flooding, aging infrastructure, rising utility...

Management of Newer Medications for Attention-Deficit Hyperactivity Disorder In Commercial Health Plans

PubMed Central

Hodgkin, Dominic; Horgan, Constance M.; Quinn, Amity E.; Merrick, Elizabeth; Stewart, Maureen T.; Leslie, Laurel K.

2014-01-01

Purpose In the US, many individuals with attention deficit hyperactivity disorder (ADHD) pay for their medications using private health insurance coverage. As in other drug classes, private insurers are actively seeking to influence utilization and costs, particularly for newer and costlier medications. The approaches that insurers use may have important effects on patients’ access to medications. This paper examines approaches (e.g., copayments, prior authorization, and step therapy) that commercial health plans are employing to manage newer medications used to treat ADHD and changes in approaches since 2003. Methods Data are from a nationally representative survey of commercial health plans in 60 market areas regarding alcohol, drug abuse and mental health services in 2010. Responses were obtained from 389 plans (89% response rate), reporting on 925 insurance products. For each of six branded ADHD medications, respondents were asked whether the plan covered the medication and if so, on what copayment tier each medication was placed, and whether it was subject to prior authorization or step therapy. Measures of management approach were constructed for each medication and for the group of medications. Bivariate and multivariate analyses were used to test for association of the management approach with various health plan characteristics. Findings There was considerable variation across these 6 medications in how tightly they were managed by health plans, with newer medications being subject to more stringent management. The proportion of insurance products relying solely on copay tiering to manage novel ADHD medications appears to have decreased since 2003. Less than half of insurance products (43%) managed these 6 medications solely by use of Tier 3/4 placement, and most of the remainder (48%) used other restrictions (with or without Tier 3/4 placement). The average insurance product restricted access to at least 3 of the 6 brand-only medications examined, whether through copayment tier placement or other approaches. More ADHD medications were left unrestricted in HMO products than in PPO ones; products with internal or hybrid-internal contracts for behavioral health; those not contracting with pharmacy benefits managers; and those with for-profit ownership. Implications Many plans have supplemented copayment tiering with other approaches such as prior authorization and step therapy to influence utilization and decrease costs. It may be that plans have found copayments to be less effective in redirecting utilization in this medication class. The impact on clinical outcomes was not examined in this study but should be prioritized using other data sources. PMID:25450473

Research Management--Of What Nature Is the Concept?

ERIC Educational Resources Information Center

Cook, Desmond L.

Research management is defined as the application of both management and management science to a particular field of research and development activities. Seven components of research management include theory and methodology; the planning, implementation, and evaluation of research programs; communications; utilization; and special applications.…

Integrated EAP/Managed Behavioral Health Plan Utilization by Persons with Substance Use Disorders

PubMed Central

Levy Merrick, Elizabeth S.; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M.; Greenfield, Shelly F.; McCann, Bernard

2011-01-01

New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral healthcare organization's integrated EAP/managed behavioral health care product (N=1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. PMID:21185684

Watershed-scale evaluation of Humboldt Redwood Company’s Habitat Conservation Plan timber harvest best management practices, Railroad Gulch, Elk River, California

Treesearch

Andrew Stubblefield; Shane Beach; Nicolas M. Harrison; Michelle Haskins

2017-01-01

The objective of this study is to test the effectiveness of California Forest Practice Rules and additional best management practices implemented as part of Humboldt Redwood Company’s Habitat Conservation Plan and Watershed Analysis prescriptions, in limiting the delivery of management-derived sediment. A paired watershed study format is being utilized to...

Telecommunications: Opportunities in the emerging technologies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schultheis, R.W.

1994-12-31

A series of slides present opportunities for Utility Telecommunications. The following aspects are covered: (1) Technology in a period of revolution; (2) Technology Management by the Energy Utility, (3) Contemporary Telecommunication Network Architectures, (4) Opportunity Management, (5) Strategic Planning for Profits and Growth, (6) Energy Industry in a period of challenge. Management topics and applications are presented in a matrix for generation, transmission, distribution, customer service and new business revenue growth subjects.

Cooperative drought adaptation: Integrating infrastructure development, conservation, and water transfers into adaptive policy pathways

NASA Astrophysics Data System (ADS)

Zeff, Harrison B.; Herman, Jonathan D.; Reed, Patrick M.; Characklis, Gregory W.

2016-09-01

A considerable fraction of urban water supply capacity serves primarily as a hedge against drought. Water utilities can reduce their dependence on firm capacity and forestall the development of new supplies using short-term drought management actions, such as conservation and transfers. Nevertheless, new supplies will often be needed, especially as demands rise due to population growth and economic development. Planning decisions regarding when and how to integrate new supply projects are fundamentally shaped by the way in which short-term adaptive drought management strategies are employed. To date, the challenges posed by long-term infrastructure sequencing and adaptive short-term drought management are treated independently, neglecting important feedbacks between planning and management actions. This work contributes a risk-based framework that uses continuously updating risk-of-failure (ROF) triggers to capture the feedbacks between short-term drought management actions (e.g., conservation and water transfers) and the selection and sequencing of a set of regional supply infrastructure options over the long term. Probabilistic regional water supply pathways are discovered for four water utilities in the "Research Triangle" region of North Carolina. Furthermore, this study distinguishes the status-quo planning path of independent action (encompassing utility-specific conservation and new supply infrastructure only) from two cooperative formulations: "weak" cooperation, which combines utility-specific conservation and infrastructure development with regional transfers, and "strong" cooperation, which also includes jointly developed regional infrastructure to support transfers. Results suggest that strong cooperation aids utilities in meeting their individual objectives at substantially lower costs and with less overall development. These benefits demonstrate how an adaptive, rule-based decision framework can coordinate integrated solutions that would not be identified using more traditional optimization methods.

Estimates of wood energy demand for residential use in Alaska: an update

Treesearch

Jean M. Daniels; Michael D. Paruszkiewicz

2016-01-01

Efforts to amend the Tongass National Forest Land Management Plan have necessitated the development of several management scenarios to assist with planning efforts. One scenario focuses on increasing the utilization of sawmill residues and low-grade material as feedstock for expanding biomass energy markets. The development of a biomass industry is viewed as a solution...

Planning and Implementing Social Service Information Systems: A Guide for Management and Users. Human Services Monograph Series Number 25. Project Share.

ERIC Educational Resources Information Center

Cotter, Barbara

Intended to aid administrators and users of social services in establishing information systems, this comprehensive guide to the design of such systems identifies the elements, effective strategies, and potential pitfalls involved in their planning, implementation, and utilization. Detailed discussions of management strategies for system…

Defining the role of silvicultural research in the Northeastern Forest Experiment Station

Treesearch

Chris Nowak; Susan Stout; John Brissette; Laura Kenefic; Gary Miller; Bill Leak; Dan Yaussy; Tom Schuler; Kurt Gottschalk

1997-01-01

Research planning in the Northeastern Forest Experiment Station has followed a grass roots model for more than two years-ROADMAP, a research and development management plan. The goals for research within ROADMAP include understanding, protecting, managing, and utilizing forest ecosystems. There are nine research themes set to help achieve these goals, each with a set...

Conference on asbestos control and replacement for electric utilities: Proceedings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

An EPRI conference on Asbestos Control and Replacement for Electric Utilities was held April 9, 1992 in conjunction with the National Asbestos Council's Environmental Management 192 Conference and Exposition. The high cost and potential liabilities of asbestos removal projects, compounded by concerns over the health effects of asbestos replacement materials, was the main motivation for the conference. The objective of the conference was to assemble guidance and information that will help utilities manage asbestos and to effectively prioritize EPRI research in this area. Ten papers covered such topics as computer-aided asbestos management, utility experience with asbestos management, asbestos monitoring andmore » disposal, and asbestos replacement materials. Utility feedback received at the conference indicates that present and planned EPRI research activities in this area will effectively meet industry needs.« less

Utilization of Information Provided by the Wisconsin Management System.

ERIC Educational Resources Information Center

Rossmiller, Richard A.

The management system developed by the Wisconsin Center for Cognitive Learning (CCL) is useful to principal investigators of individual projects for proposal development, project management, and project reporting, as well as to the CCL management for program planning, program management, and reporting to funding agencies. The system aids proposal…

Managed care redux: health plans shift responsibilities to consumers.

PubMed

Draper, Debra A; Claxton, Gary

2004-03-01

Confronted with conflicting pressures to stem double-digit premium increases and provide unfettered access to care, health plans are developing products that shift more financial and care management responsibilities to consumers, according to findings from the Center for Studying Health System Change's (HSC) 2002-03 site visits to 12 nationally representative communities. Plans are pursuing these strategies in collaboration with employers that want to gain control over rapidly rising premiums while continuing to respond to employee demands for less restrictive managed care practices. Mindful of the managed care backlash, health plans also are stepping up utilization management activities for high-cost services and focusing care management on high-cost patients. While the move toward greater consumer engagement is clear, the impact on costs and consumer willingness to assume these new responsibilities remain to be seen.

Quality Improvement Initiatives: The Missed Opportunity for Health Plans

PubMed Central

Fernandez-Lopez, Sara; Lennert, Barbara

2009-01-01

Background The increase in healthcare cost without direct improvements in health outcomes, coupled with a desire to expand access to the large uninsured population, has underscored the importance of quality initiatives and organizations that provide more affordable healthcare by maximizing value. Objectives To determine the knowledge of managed care organizations about quality organizations and initiatives and to identify potential opportunities in which pharmaceutical companies could collaborate with health plans in the development and implementation of quality initiatives. Methods We conducted a survey of 36 pharmacy directors and 15 medical directors of different plans during a Managed Care Network meeting in 2008. The represented plans cover almost 74 million lives in commercial, Medicare, and Medicaid programs, or a combination of them. Results The responses show limited knowledge among pharmacy and medical directors about current quality organizations and initiatives, except for quality organizations that provide health plan quality accreditation. The results also reveal an opportunity for pharmaceutical companies to collaborate with private health plans in the development of quality initiatives, especially those related to drug utilization, such as patient adherence and education and correct drug utilization. Conclusion Our survey shows clearly that today's focus for managed care organizations is mostly limited to the organizations that provide health plan quality accreditation, with less focus on other organizations. PMID:25126303

Quality improvement initiatives: the missed opportunity for health plans.

PubMed

Fernandez-Lopez, Sara; Lennert, Barbara

2009-11-01

The increase in healthcare cost without direct improvements in health outcomes, coupled with a desire to expand access to the large uninsured population, has underscored the importance of quality initiatives and organizations that provide more affordable healthcare by maximizing value. To determine the knowledge of managed care organizations about quality organizations and initiatives and to identify potential opportunities in which pharmaceutical companies could collaborate with health plans in the development and implementation of quality initiatives. We conducted a survey of 36 pharmacy directors and 15 medical directors of different plans during a Managed Care Network meeting in 2008. The represented plans cover almost 74 million lives in commercial, Medicare, and Medicaid programs, or a combination of them. The responses show limited knowledge among pharmacy and medical directors about current quality organizations and initiatives, except for quality organizations that provide health plan quality accreditation. The results also reveal an opportunity for pharmaceutical companies to collaborate with private health plans in the development of quality initiatives, especially those related to drug utilization, such as patient adherence and education and correct drug utilization. Our survey shows clearly that today's focus for managed care organizations is mostly limited to the organizations that provide health plan quality accreditation, with less focus on other organizations.

Managing biotechnology in a network-model health plan: a U.S. private payer perspective.

PubMed

Watkins, John B; Choudhury, Sanchita Roy; Wong, Ed; Sullivan, Sean D

2006-01-01

Emerging biotechnology poses challenges to payers, including access, coverage, reimbursement, patient selection, and affordability. Premera Blue Cross, a private regional health plan, developed an integrated cross-functional approach to managing biologics, built around a robust formulary process that is fast, flexible, fair, and transparent to stakeholders. Results are monitored by cost and use reporting from merged pharmacy and medical claims. Utilization management and case management strategies will integrate with specialty pharmacy programs to improve outcomes and cost-effectiveness. Creative approaches to provider reimbursement can align providers' incentives with those of the plan. Redesign of member benefits can also encourage appropriate use of biotechnology.

The Spillover Effects of Medicare Managed Care: Medicare Advantage and Hospital Utilization

PubMed Central

Baicker, Katherine; Chernew, Michael; Robbins, Jacob

2013-01-01

More than a quarter of Medicare beneficiaries are enrolled in Medicare Advantage, which was created in large part to improve the efficiency of health care delivery by promoting competition among private managed care plans. This paper explores the spillover effects of the Medicare Advantage program on the traditional Medicare program and other patients, taking advantage of changes in Medicare Advantage payment policy to isolate exogenous increases in Medicare Advantage enrollment and trace out the effects of greater managed care penetration on hospital utilization and spending throughout the health care system. We find that when more seniors enroll in Medicare managed care, hospital costs decline for all seniors and for commercially insured younger populations. Greater managed care penetration is not associated with fewer hospitalizations, but is associated with lower costs and shorter stays per hospitalization. These spillovers are substantial – offsetting more than 10% of increased payments to Medicare Advantage plans. PMID:24308880

What Is Effective School Management.

ERIC Educational Resources Information Center

De Cicco, James M.

Effective school management requires managers who succeed in carrying out the organizational goals of their schools, utilizing the following leadership skills: planning (deciding how to accomplish the organization's goals); organizing (doing the necessary preparation); staffing (filling positions with the right people); directing (motivating staff…

7 CFR 622.2 - Scope.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., water quality management, ground water supply, agricultural pollution control, and other water management. (d) After a final plan for works of improvement is agreed upon between NRCS and the sponsors and... proper utilization of land, flood prevention, agricultural water management including irrigation and...

The Utilization of Project Management in the Pharmaceutical Industry.

ERIC Educational Resources Information Center

Krusko, Diane; Cangemi, Robert R.

1987-01-01

A survey of 99 pharmaceutical companies concerning their organization and use of project management techniques for research and development found that the industry is using project management increasingly in a variety of ways for better business planning and operations. (MSE)

Optimization in the utility maximization framework for conservation planning: a comparison of solution procedures in a study of multifunctional agriculture

PubMed Central

Stoms, David M.; Davis, Frank W.

2014-01-01

Quantitative methods of spatial conservation prioritization have traditionally been applied to issues in conservation biology and reserve design, though their use in other types of natural resource management is growing. The utility maximization problem is one form of a covering problem where multiple criteria can represent the expected social benefits of conservation action. This approach allows flexibility with a problem formulation that is more general than typical reserve design problems, though the solution methods are very similar. However, few studies have addressed optimization in utility maximization problems for conservation planning, and the effect of solution procedure is largely unquantified. Therefore, this study mapped five criteria describing elements of multifunctional agriculture to determine a hypothetical conservation resource allocation plan for agricultural land conservation in the Central Valley of CA, USA. We compared solution procedures within the utility maximization framework to determine the difference between an open source integer programming approach and a greedy heuristic, and find gains from optimization of up to 12%. We also model land availability for conservation action as a stochastic process and determine the decline in total utility compared to the globally optimal set using both solution algorithms. Our results are comparable to other studies illustrating the benefits of optimization for different conservation planning problems, and highlight the importance of maximizing the effectiveness of limited funding for conservation and natural resource management. PMID:25538868

Optimization in the utility maximization framework for conservation planning: a comparison of solution procedures in a study of multifunctional agriculture

USGS Publications Warehouse

Kreitler, Jason R.; Stoms, David M.; Davis, Frank W.

2014-01-01

Quantitative methods of spatial conservation prioritization have traditionally been applied to issues in conservation biology and reserve design, though their use in other types of natural resource management is growing. The utility maximization problem is one form of a covering problem where multiple criteria can represent the expected social benefits of conservation action. This approach allows flexibility with a problem formulation that is more general than typical reserve design problems, though the solution methods are very similar. However, few studies have addressed optimization in utility maximization problems for conservation planning, and the effect of solution procedure is largely unquantified. Therefore, this study mapped five criteria describing elements of multifunctional agriculture to determine a hypothetical conservation resource allocation plan for agricultural land conservation in the Central Valley of CA, USA. We compared solution procedures within the utility maximization framework to determine the difference between an open source integer programming approach and a greedy heuristic, and find gains from optimization of up to 12%. We also model land availability for conservation action as a stochastic process and determine the decline in total utility compared to the globally optimal set using both solution algorithms. Our results are comparable to other studies illustrating the benefits of optimization for different conservation planning problems, and highlight the importance of maximizing the effectiveness of limited funding for conservation and natural resource management.

Remote-sensing applications as utilized in Florida's coastal zone management program

NASA Technical Reports Server (NTRS)

Worley, D. R.

1975-01-01

Land use maps were developed from photomaps obtained by remote sensing in order to develop a comprehensive state plan for the protection, development, and zoning of coastal regions. Only photographic remote sensors have been used in support of the coastal council's planning/management methodology. Standard photointerpretation and cartographic application procedures for map compilation were used in preparing base maps.

7 CFR 4280.42 - Application evaluation and selection.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Project plans, its management, and, if applicable, its products and operating plans. (The business plan...) Nature of the Project. Rural Development will award up to 60 points based on whether the Project: (i) Is... connection project (such as streets or utilities)—20 points; (ii) Provides Technical Assistance to rural...

Dynamic Strategic Planning in a Professional Knowledge-Based Organization

ERIC Educational Resources Information Center

Olivarius, Niels de Fine; Kousgaard, Marius Brostrom; Reventlow, Susanne; Quelle, Dan Grevelund; Tulinius, Charlotte

2010-01-01

Professional, knowledge-based institutions have a particular form of organization and culture that makes special demands on the strategic planning supervised by research administrators and managers. A model for dynamic strategic planning based on a pragmatic utilization of the multitude of strategy models was used in a small university-affiliated…

State Network Utilization Study: Mississippi Educational Television.

ERIC Educational Resources Information Center

Wilson, Savan; And Others

This document is the result of a utilization study of Mississippi Educational Television where 27 target audiences were identified and surveyed. The following information is included: a draft of and updated state network utilization studies; planning and management strategies; a profile of the survey populations; a distance learning survey report;…

Are implicit policy assumptions about climate adaptation trying to push drinking water utilities down an impossible path?

NASA Astrophysics Data System (ADS)

Klasic, M. R.; Ekstrom, J.; Bedsworth, L. W.; Baker, Z.

2017-12-01

Extreme events such as wildfires, droughts, and flooding are projected to be more frequent and intense under a changing climate, increasing challenges to water quality management. To protect and improve public health, drinking water utility managers need to understand and plan for climate change and extreme events. This three year study began with the assumption that improved climate projections were key to advancing climate adaptation at the local level. Through a survey (N = 259) and interviews (N = 61) with California drinking water utility managers during the peak of the state's recent drought, we found that scientific information was not a key barrier hindering adaptation. Instead, we found that managers fell into three distinct mental models based on their interaction with, perceptions, and attitudes, towards scientific information and the future of water in their system. One of the mental models, "modeled futures", is a concept most in line with how climate change scientists talk about the use of information. Drinking water utilities falling into the "modeled future" category tend to be larger systems that have adequate capacity to both receive and use scientific information. Medium and smaller utilities in California, that more often serve rural low income communities, tend to fall into the other two mental models, "whose future" and "no future". We show evidence that there is an implicit presumption that all drinking water utility managers should strive to align with "modeled future" mental models. This presentation questions this assumption as it leaves behind many utilities that need to adapt to climate change (several thousand in California alone), but may not have the technical, financial, managerial, or other capacity to do so. It is clear that no single solution or pathway to drought resilience exists for water utilities, but we argue that a more explicit understanding and definition of what it means to be a resilient drinking water utility is necessary. By highlighting, then questioning, the assumption that all utility managers should strive to have "modeled future" mentalities, this presentation seeks to foster an open dialogue around which pathway or pathways are most feasible for supporting drinking water utility managers planning for climate change.

Conference on asbestos control and replacement for electric utilities: Proceedings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

An EPRI conference on Asbestos Control and Replacement for Electric Utilities was held April 9, 1992 in conjunction with the National Asbestos Council`s Environmental Management 192 Conference and Exposition. The high cost and potential liabilities of asbestos removal projects, compounded by concerns over the health effects of asbestos replacement materials, was the main motivation for the conference. The objective of the conference was to assemble guidance and information that will help utilities manage asbestos and to effectively prioritize EPRI research in this area. Ten papers covered such topics as computer-aided asbestos management, utility experience with asbestos management, asbestos monitoring andmore » disposal, and asbestos replacement materials. Utility feedback received at the conference indicates that present and planned EPRI research activities in this area will effectively meet industry needs.« less

Evaluation Planning, Evaluation Management, and Utilization of Evaluation Results within Adult Literacy Campaigns, Programs and Projects (with Implications for Adult Basic Education and Nonformal Education Programs in General). A Working Paper.

ERIC Educational Resources Information Center

Bhola, H. S.

Addressed to professionals involved in program evaluation, this working paper covers various aspects of evaluation planning, including the following: planning as a sociotechnical process, steps in evaluation planning, program planning and implementation versus evaluation planning and implementation, the literacy system and its subsystems, and some…

Project management plan : Dallas Integrated Corridor Management (ICM) demonstration project.

DOT National Transportation Integrated Search

2010-12-01

The Dallas Integrated Corridor Management System Demonstration Project is a multi-agency, de-centralized operation which will utilize a set of regional systems to integrate the operations of the corridor. The purpose of the Dallas ICM System is to im...

Utilizing a Health Impact Assessment (HIA) to Connect Natural Resource Management and Community

EPA Science Inventory

Marrying scientific and health research with natural resource management should be a straightforward process. However, differences in purpose, goals, language, levels of detail and implementation authority between the scientists who conduct research and resource managers who plan...

Utilizing a Health Impact Assessment (HIA) to Connect Natural Resource Management and Community(presentation)

EPA Science Inventory

Marrying scientific and health research with natural resource management should be a straightforward process. However, differences in purpose, goals, language, levels of detail and implementation authority between the scientists who conduct research and resource managers who plan...

Knowledge Management ERP Curriculum Design/Mapping (Theory and Development Tools)

ERIC Educational Resources Information Center

Swanson, Zane; Hepner, Michelle

2011-01-01

This study proposes a knowledge management framework for developing and managing enterprise resource planning (ERP) curriculum within business schools. Both theory and a practical implementation are addressed. The knowledge management (KM) framework has two components which utilize ERP from a big picture curriculum overview and a ground level…

Stakeholder benefit from depression disease management: differences by rurality?

PubMed

Xu, Stanley; Rost, Kathryn; Dong, Fran; Dickinson, L Miriam

2011-01-01

Despite increasing consensus about the value of depression disease management programs, the field has not identified which stakeholders should absorb the relatively small additional costs associated with these programs. This paper investigates whether two proposed stakeholders (health plans and employer purchasers) economically benefit from depression care management (reduced outpatient utilization and work costs, respectively) in two delivery systems (rural and urban). This study examined the main and differential effects of depression care management on outpatient utilization and work costs over 24 months in a preplanned secondary analysis of 479 depressed patients from rural and urban primary care practices in a randomized controlled trial. Over 24 months, the intervention did not significantly reduce outpatient utilization costs in the entire cohort (-$191, 95% confidence interval (CI)=-$2,083 to $1,647), but it did decrease work costs (-$1,970, 95% CI=-$3,934 to -$92). While not statistically significant, rural-urban differences in work costs were in the same direction, while rural-urban differences in utilization costs differed in direction. These findings provide preliminary evidence that employers who elect to cover depression care management costs should receive comparable economic benefits in the rural and urban employees they insure. Given the limited sample size, further research may be needed to determine whether health plans who elect to cover depression care management costs will receive comparable economic benefits in the rural and urban enrollees they insure.

Taming B.C. Hydro: Site C and the implementation of the B.C. Utilities Commission Act

NASA Astrophysics Data System (ADS)

Smith, L. Graham

1988-07-01

Public policy making in resources management is greatly influenced by the institutional arrangements that arise out of the legal powers, administrative structures, and financial provisions of the decision system. In British Columbia, the institutional arrangements for energy planning in the province have been greatly altered by the passage of the Utilities Commission Act in 1980. This act redefines the policy implementation process for energy in British Columbia and provides for the regulation of the province's power utility, B.C. Hydro. This is the first time that the hitherto autonomous utility has been subject to regulation and the Utilities Commission Act represents a major reform in the institutional arrangements for energy planning in the province. The article evaluates the effectiveness of the 1980 B.C. Utilities Commission Act and assesses the impact of the legislation upon the institutional arrangements for energy planning in the province. Data for the article were derived from written sources and a series of personal interviews with key participants involved with energy planning in B.C. It is shown that the act represented a major departure in the management of energy resources in B.C. Moreover the implementation of the act's provisions, particularly in regard to B.C. Hydro, had a dramatic impact on the development of new energy projects in the province. It is suggested that while the political and economic climate during the period also favored restraint, the major influence on “taming” the utility was passage of the Utilities Commission Act. The article concludes by exploring the implications of policy changes that have occurred as a consequence of the act's impact on B.C. Hydro.

Population-based medical and disease management: an evaluation of cost and quality.

PubMed

Wise, Christopher G; Bahl, Vinita; Mitchell, Rita; West, Brady T; Carli, Thomas

2006-02-01

Reports by the Institute of Medicine and the Health Care Financing Administration have emphasized that the integration of medical care delivery, evidence-based medicine, and chronic care disease management may play a significant role in improving the quality of care and reducing medical care costs. The specific aim of this project is to assess the impact of an integrated set of care coordination tools and chronic disease management interventions on utilization, cost, and quality of care for a population of beneficiaries who have complementary health coverage through a plan designed to apply proactive medical and disease management processes. The utilization of health care services by the study population was compared to another population from the same geographic service area and covered by a traditional fee-for-service indemnity insurance plan that provided few medical or disease management services. Evaluation of the difference in utilization was based on the difference in the cost per-member-per-month (PMPM) in a 1-year measurement period, after adjusting for differences in fee schedules, case-mix and healthcare benefit design. After adjustments for both case-mix and benefit differences, the study group is $63 PMPM less costly than the comparison population for all members. Cost differences are largest in the 55-64 and 65 and above age groups. The study group is $115 PMPM lower than the comparison population for the age category of 65 years and older, after adjustments for case-mix and benefits. Health Plan Employer and Data Information Set (HEDIS)-based quality outcomes are near the 90th percentile for most indications. The cost outcomes of a population served by proactive, population-based disease management and complex care management, compared to an unmanaged population, demonstrates the potential of coordinated medical and disease management programs. Further studies utilizing appropriate methodologies would be beneficial.

Liability for managed care decisions: the Employee Retirement Income Security Act (ERISA) and the uneven playing field.

PubMed

Mariner, W K

1996-06-01

As managed care organizations expand their programs of quality assurance and physician evaluation, more medical malpractice lawsuits may be brought against managed care organizations on the ground that, like hospitals, they are legally responsible for negligent corporate acts that injure patients. However, the federal Employee Retirement Income Security Act (ERISA) shields managed care organizations from liability when they are part of an employee group health plan governed by ERISA. Unlike patients with other types of insurance, patients in ERISA health plans do not have a malpractice remedy for a managed care organization's negligence. A few federal appeals courts recently recognized that ERISA plans can be vicariously liable for their physicians' medical malpractice, but only if the physician is the plan's employee or agent. Yet ERISA still prohibits negligence claims against ERISA health plans for injuries resulting from denial of plan benefits, failure to use qualified physicians, utilization review, or improper plan administration. Current managed care operations do not neatly distinguish between administering benefits and controlling quality of care. Neither should the law. ERISA should be amended to provide employees with the same remedies that patients in non-ERISA plans enjoy.

Liability for managed care decisions: the Employee Retirement Income Security Act (ERISA) and the uneven playing field.

PubMed Central

Mariner, W K

1996-01-01

As managed care organizations expand their programs of quality assurance and physician evaluation, more medical malpractice lawsuits may be brought against managed care organizations on the ground that, like hospitals, they are legally responsible for negligent corporate acts that injure patients. However, the federal Employee Retirement Income Security Act (ERISA) shields managed care organizations from liability when they are part of an employee group health plan governed by ERISA. Unlike patients with other types of insurance, patients in ERISA health plans do not have a malpractice remedy for a managed care organization's negligence. A few federal appeals courts recently recognized that ERISA plans can be vicariously liable for their physicians' medical malpractice, but only if the physician is the plan's employee or agent. Yet ERISA still prohibits negligence claims against ERISA health plans for injuries resulting from denial of plan benefits, failure to use qualified physicians, utilization review, or improper plan administration. Current managed care operations do not neatly distinguish between administering benefits and controlling quality of care. Neither should the law. ERISA should be amended to provide employees with the same remedies that patients in non-ERISA plans enjoy. PMID:8659664

When the 'soft-path' gets hard: demand management and financial instability for water utilities

NASA Astrophysics Data System (ADS)

Zeff, H. B.; Characklis, G. W.

2014-12-01

In the past, cost benefit analysis (CBA) has been viewed as an effective means of evaluating water utility strategies, particularly those that were dependent on the construction of new supply infrastructure. As water utilities have begun to embrace 'soft-path' approaches as a way to reduce the need for supply-centric development, CBA fails to recognize some important financial incentives affected by reduced water consumption. Demand management, both as a short-term response to drought and in longer-term actions to accommodate demand growth, can introduce revenue risks that adversely affect a utility's ability to repay debt, re-invest in aging infrastructure, or maintain reserve funds for use in a short-term emergency. A utility that does not generate sufficient revenue to support these functions may be subject to credit rating downgrades, which in turn affect the interest rate it pays on its debt. Interest rates are a critical consideration for utility managers in the capital-intensive water sector, where debt payments for infrastructure often account for a large portion of a utility's overall costs. Even a small increase in interest rates can add millions of dollars to the cost of new infrastructure. Recent studies have demonstrated that demand management techniques can lead to significant revenue variability, and credit rating agencies have begun to take notice of drought response plans when evaluating water utility credit ratings, providing utilities with a disincentive to fully embrace soft-path approaches. This analysis examines the impact of demand management schemes on key credit rating metrics for a water utility in Raleigh, North Carolina. The utility's consumer base is currently experiencing rapid population growth, and demand management has the potential to reduce the dependence on costly new supply infrastructure but could lead to financial instability that will significantly increase the costs of financing future projects. This work analyzes how 'soft-path' approaches might be more efficiently integrated with investment in supply-side infrastructure and suggests how financial hedging tools could be used to improve long-term utility planning objectives.

Beyond optimality: Multistakeholder robustness tradeoffs for regional water portfolio planning under deep uncertainty

NASA Astrophysics Data System (ADS)

Herman, Jonathan D.; Zeff, Harrison B.; Reed, Patrick M.; Characklis, Gregory W.

2014-10-01

While optimality is a foundational mathematical concept in water resources planning and management, "optimal" solutions may be vulnerable to failure if deeply uncertain future conditions deviate from those assumed during optimization. These vulnerabilities may produce severely asymmetric impacts across a region, making it vital to evaluate the robustness of management strategies as well as their impacts for regional stakeholders. In this study, we contribute a multistakeholder many-objective robust decision making (MORDM) framework that blends many-objective search and uncertainty analysis tools to discover key tradeoffs between water supply alternatives and their robustness to deep uncertainties (e.g., population pressures, climate change, and financial risks). The proposed framework is demonstrated for four interconnected water utilities representing major stakeholders in the "Research Triangle" region of North Carolina, U.S. The utilities supply well over one million customers and have the ability to collectively manage drought via transfer agreements and shared infrastructure. We show that water portfolios for this region that compose optimal tradeoffs (i.e., Pareto-approximate solutions) under expected future conditions may suffer significantly degraded performance with only modest changes in deeply uncertain hydrologic and economic factors. We then use the Patient Rule Induction Method (PRIM) to identify which uncertain factors drive the individual and collective vulnerabilities for the four cooperating utilities. Our framework identifies key stakeholder dependencies and robustness tradeoffs associated with cooperative regional planning, which are critical to understanding the tensions between individual versus regional water supply goals. Cooperative demand management was found to be the key factor controlling the robustness of regional water supply planning, dominating other hydroclimatic and economic uncertainties through the 2025 planning horizon. Results suggest that a modest reduction in the projected rate of demand growth (from approximately 3% per year to 2.4%) will substantially improve the utilities' robustness to future uncertainty and reduce the potential for regional tensions. The proposed multistakeholder MORDM framework offers critical insights into the risks and challenges posed by rising water demands and hydrological uncertainties, providing a planning template for regions now forced to confront rapidly evolving water scarcity risks.

Information Technology: Making It All Fit. Track I: Policy and Planning.

ERIC Educational Resources Information Center

CAUSE, Boulder, CO.

Seven papers from the 1988 CAUSE conference's Track I, Policy and Planning, are presented. They include: "Developing a Strategic Plan for Academic Computing" (Arthur S. Gloster II); "New Technologies Are Presenting a Crisis for Middle Management" (M. Lewis Temares and Ruben Lopez); "An Information Utility: The Light, Gas,…

An Empty Toolbox? Changes in Health Plans’ Approaches for Managing Costs and Care

PubMed Central

Mays, Glen P; Hurley, Robert E; Grossman, Joy M

2003-01-01

Objective To examine how health plans have changed their approaches for managing costs and utilization in the wake of the recent backlash against managed care. Data Sources/Study Setting Semistructured interviews with health plan executives, employers, providers, and other health care decision makers in 12 metropolitan areas that were randomly selected to be nationally representative of communities with more than 200,000 residents. Longitudinal data were collected as part of the Community Tracking Study during three rounds of site visits in 1996–1997, 1998–1999, and 2000–2001. Study Design Interviews probed about changes in the design and operation of health insurance products—including provider contracting and network development, benefit packages, and utilization management processes—and about the rationale and perceived impact of these changes. Data Collection/Extraction Methods Data from more than 850 interviews were coded, extracted, and analyzed using computerized text analysis software. Principal Findings Health plans have begun to scale back or abandon their use of selected managed care tools in most communities, with selective contracting and risk contracting practices fading most rapidly and completely. In turn, plans increasingly have sought cost savings by shifting costs to consumers. Some plans have begun to experiment with new provider networks, payment systems, and referral practices designed to lower costs and improve service delivery. Conclusions These changes promise to lighten administrative and financial burdens for physicians and hospitals, but they also threaten to increase consumers’ financial burdens. PMID:12650372

The Impact of Coverage Restrictions on Antipsychotic Utilization Among Low-Income Medicare Part D Enrollees.

PubMed

Roberto, Pamela N; Brandt, Nicole; Onukwugha, Eberechukwu; Perfetto, Eleanor; Powers, Christopher; Stuart, Bruce

2017-11-01

Prior research demonstrates substantial access problems associated with utilization management and formulary exclusions for antipsychotics in Medicaid, but the use and impact of coverage restrictions for these medications in Medicare Part D remains unknown. We assess the effect of coverage restrictions on antipsychotic utilization in Part D by exploiting a unique natural experiment in which low-income beneficiaries are randomly assigned to prescription drug plans with varying levels of formulary generosity. Despite considerable variation in use of coverage restrictions across Part D plans, we find no evidence that these restrictions significantly deter utilization or reduce access to antipsychotics for low-income beneficiaries.

Coosa River Storage Annex, Talladega, Alabama Environmental Investigation, Final Management and Resources Utilization Plan

DTIC Science & Technology

1991-02-01

to adequately assess the health and environmental risks associated with the closure and transfer of the Annex forI other use; and 3) identification of...1990); Draft Final Technical Plan, Draft Final Sampling Design Plan and Draft Final Health and Safety Plan, USATHAMA, June 1990. 2.1.2 Draft Final...Final Technical Plan, Sampling Design Plan and Health and Safety Plan) supplied by USATHAMA. The estimate may be revised, with USATHAMA approval, as

Management information systems in the HMO environment.

PubMed

Neal, P A

1982-01-01

Realization of the unique potential of a health maintenance organization is dependent on the availability of adequate, accurate, and timely information. The particular data needed are determined by the structure of the organization; the physician compensation plans; requirements for state, federal, or other reporting; and many other factors. The author introduces the concept and objectives of the HMO, and presents the management information systems necessary for planning and monitoring HMO performance: patient information, utilization information, and management information for the staff and nonstaff HMO.

Traffic flow characteristic and capacity in intelligent work zones.

DOT National Transportation Integrated Search

2009-10-15

Intellgent transportation system (ITS) technologies are utilized to manage traffic flow and safety in : highway work zones. Traffic management plans for work zones require queuing analyses to determine : the anticipated traffic backups, but the predi...

Risk management for drinking water safety in low and middle income countries - cultural influences on water safety plan (WSP) implementation in urban water utilities.

PubMed

Omar, Yahya Y; Parker, Alison; Smith, Jennifer A; Pollard, Simon J T

2017-01-15

We investigated cultural influences on the implementation of water safety plans (WSPs) using case studies from WSP pilots in India, Uganda and Jamaica. A comprehensive thematic analysis of semi-structured interviews (n=150 utility customers, n=32 WSP 'implementers' and n=9 WSP 'promoters'), field observations and related documents revealed 12 cultural themes, offered as 'enabling', 'limiting', or 'neutral', that influence WSP implementation in urban water utilities to varying extents. Aspects such as a 'deliver first, safety later' mind set; supply system knowledge management and storage practices; and non-compliance are deemed influential. Emergent themes of cultural influence (ET1 to ET12) are discussed by reference to the risk management, development studies and institutional culture literatures; by reference to their positive, negative or neutral influence on WSP implementation. The results have implications for the utility endorsement of WSPs, for the impact of organisational cultures on WSP implementation; for the scale-up of pilot studies; and they support repeated calls from practitioner communities for cultural attentiveness during WSP design. Findings on organisational cultures mirror those from utilities in higher income nations implementing WSPs - leadership, advocacy among promoters and customers (not just implementers) and purposeful knowledge management are critical to WSP success. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Facilities Management: A Program for the 1980s.

ERIC Educational Resources Information Center

Kaiser, Harvey H.

1980-01-01

Successful facilities management is described as based on a 10-point comprehensive program including: (1) physical planning policy; (2) facilities analysis; (3) management audit; (4) space utilization; (5) capital programs; (6) deferred maintenance; (7) controlled maintenance; (8) energy conservation; (9) environmental quality, health, and safety;…

San Juan National Forest Land Management Planning Support System (LMPSS) requirements definition

NASA Technical Reports Server (NTRS)

Werth, L. F. (Principal Investigator)

1981-01-01

The role of remote sensing data as it relates to a three-component land management planning system (geographic information, data base management, and planning model) can be understood only when user requirements are known. Personnel at the San Juan National Forest in southwestern Colorado were interviewed to determine data needs for managing and monitoring timber, rangelands, wildlife, fisheries, soils, water, geology and recreation facilities. While all the information required for land management planning cannot be obtained using remote sensing techniques, valuable information can be provided for the geographic information system. A wide range of sensors such as small and large format cameras, synthetic aperture radar, and LANDSAT data should be utilized. Because of the detail and accuracy required, high altitude color infrared photography should serve as the baseline data base and be supplemented and updated with data from the other sensors.

Application of a risk management system to improve drinking water safety.

PubMed

Jayaratne, Asoka

2008-12-01

The use of a comprehensive risk management framework is considered a very effective means of managing water quality risks. There are many risk-based systems available to water utilities such as ISO 9001 and Hazard Analysis and Critical Control Point (HACCP). In 2004, the World Health Organization's (WHO) Guidelines for Drinking Water Quality recommended the use of preventive risk management approaches to manage water quality risks. This paper describes the framework adopted by Yarra Valley Water for the development of its Drinking Water Quality Risk Management Plan incorporating HACCP and ISO 9001 systems and demonstrates benefits of Water Safety Plans such as HACCP. Copyright IWA Publishing 2008.

Utility and Scope of Rapid Prototyping in Patients with Complex Muscular Ventricular Septal Defects or Double-Outlet Right Ventricle: Does it Alter Management Decisions?

PubMed

Bhatla, Puneet; Tretter, Justin T; Ludomirsky, Achi; Argilla, Michael; Latson, Larry A; Chakravarti, Sujata; Barker, Piers C; Yoo, Shi-Joon; McElhinney, Doff B; Wake, Nicole; Mosca, Ralph S

2017-01-01

Rapid prototyping facilitates comprehension of complex cardiac anatomy. However, determining when this additional information proves instrumental in patient management remains a challenge. We describe our experience with patient-specific anatomic models created using rapid prototyping from various imaging modalities, suggesting their utility in surgical and interventional planning in congenital heart disease (CHD). Virtual and physical 3-dimensional (3D) models were generated from CT or MRI data, using commercially available software for patients with complex muscular ventricular septal defects (CMVSD) and double-outlet right ventricle (DORV). Six patients with complex anatomy and uncertainty of the optimal management strategy were included in this study. The models were subsequently used to guide management decisions, and the outcomes reviewed. 3D models clearly demonstrated the complex intra-cardiac anatomy in all six patients and were utilized to guide management decisions. In the three patients with CMVSD, one underwent successful endovascular device closure following a prior failed attempt at transcatheter closure, and the other two underwent successful primary surgical closure with the aid of 3D models. In all three cases of DORV, the models provided better anatomic delineation and additional information that altered or confirmed the surgical plan. Patient-specific 3D heart models show promise in accurately defining intra-cardiac anatomy in CHD, specifically CMVSD and DORV. We believe these models improve understanding of the complex anatomical spatial relationships in these defects and provide additional insight for pre/intra-interventional management and surgical planning.

LANDSAT supports data needs for EPA 208 planning. [water quality control and waste treatment management

NASA Technical Reports Server (NTRS)

1979-01-01

Excerpts from federal legislation and regulations mandating areawide waster treatment management as a means of restoring and maintaining the integrity of the nation's water are presented along with requirements for grants to the states for water quality planning, management, and implementation. Experiences using LANDSAT to identify nonpoint sources of water pollution as well as land/use/land cover features in South Dakota, Kentucky, Georgia, New Jersey, and Texas are described. Present activities suggest that this type of remote sensing is an efficient, effective tool for areawide water quality planning. Interaction with cognizant federal, state, and local government personnel involved in EPA section 208 planning activities can guide the development of new capabilities and enhance their utility and prospect for use.

Development of a Medicare Beneficiary Comprehension Test: Assessing Medicare Part D Beneficiaries' Comprehension of Their Benefits

PubMed Central

Aruru, Meghana V.; Salmon, J. Warren

2013-01-01

Background Medicare Part D, the senior prescription drug benefit plan, was introduced through the Medicare Modernization Act of 2003. Medicare beneficiaries receive information about plan options through multiple sources, and it is often assumed by consumer health plans and healthcare providers that beneficiaries can understand and compare plan information. Medicare beneficiaries are older, may have cognitive problems, and may not have a true understanding of managed care. They are more likely than younger persons to have inadequate health literacy, thereby demonstrating significant gaps in knowledge and information about healthcare. Objective To develop a Medicare Beneficiary Comprehension Test (MBCT) to evaluate Medicare beneficiaries' understanding of Part D plan concepts, as presented in the 2008 Medicare & You handbook. Methods A 10-question MBCT was developed using a case-vignette approach that required beneficiaries to read portions of the Medicare & You handbook and answer Part D–related questions associated with healthcare decision-making. The test was divided into 2 sections: (I) insurance concepts and (II) utilization management/appeals and grievances to cover standard terminology, as well as newer utilization management and appeals and grievances procedures that are unique to Part D. The test was administered to 100 beneficiaries at 2 sites—a university geriatrics clinic and a private retirement facility. Beneficiaries were tested for cognition and health literacy before being administered the test. Results The mean score on the MBCT was 3.5 of a maximum of 5, with no statistical difference found between both sites. Ten faculty members and 4 graduate students assessed the content validity of the instrument using a 4-point Likert rating rubric. The construct validity of the instrument was assessed using a principal components analysis with varimax rotation. The principal components analysis yielded 4 factors that were labeled as “Plan D concepts,” “managed care/utilization management,” “cost-sharing,” and “plan comparisons.” The factor analysis indicated that the test is multidimensional and did measure the construct. Conclusions Medicare beneficiaries' understanding of Part D may play a key role in the management of their drug use and health and the associated outcomes. The MBCT and its pending revisions can be administered to beneficiaries with differing health outcomes. Medicare beneficiaries are often faced with several pieces of information involving a complex array of choices amidst bewildering plan options. It is crucial that beneficiaries and/or their family members involved in the decision-making process understand the plan benefits to truly make an informed decision. As the number of Medicare beneficiaries increases over the coming years with the baby boomers, it becomes even more imperative that the elderly have improved access to treatments that can achieve desirable outcomes. Measuring comprehension by Medicare beneficiaries may be an initial step toward understanding more complex issues, such as treatment adherence, decision-making, and, ultimately, trends in healthcare utilization and outcomes. PMID:24991375

Utilization Management in Department of Defense Military Treatment Facilities

DTIC Science & Technology

1992-07-01

Health Affairs) Mendez (1992) clearly states that his plan is for the military health services system’s quality assessment and criteria to become more...also worthy of note that second surgical opinions are not part of Assistant Secretary of Defense (Health Affairs) Mendez ’ (1992) memonrandur on...Affairs) Mendez ’ (1992) quality management policy already states that military medical treatment facilities will begin to implement utilization

State Performance-Based Regulation Using Multiyear Rate Plans for U.S. Electric Utilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lowry, Mark Newton; Makos, Matt; Deason, Jeff

Electric utilities today must contain costs at a time when many need to modernize aging systems and all face major changes in technologies, customer preferences and competitive pressures.Most U.S. electric utility facilities are investor-owned, subject to rate and service regulation by state public utility commissions. Regulatory systems under which these utilities operate affect their performance and ability to meet these challenges. In this business environment, multiyear rate plans have some advantages over traditional rate regulation.The report focuses on key design issues and provides case studies of the multiyear rate plan approach, applicable to both vertically integrated and restructured states. Markmore » Newton Lowry and Matt Makos of Pacific Energy Group Research and Jeff Deason of Berkeley Lab authored the report; Lisa Schwartz, Berkeley Lab, was project manager and technical editor.The report is aimed primarily at state utility regulators and stakeholders in the state regulatory process. The multiyear rate approach also provides ideas on how to streamline oversight of public power utilities and rural electric cooperatives for their governing boards.Two key provisions of multiyear rate plans strengthen cost containment incentives and streamline regulation: 1. Reducing frequency of rate cases, typically to every four or five years 2. Using an attrition relief mechanism to escalate rates or revenue between rate cases to address cost pressures such as inflation and growth in number of customers, independently of the utility’s own cost Better utility performance can be achieved under well-designed multiyear rate plans while achieving lower regulatory costs. Benefits can be shared between utilities and their customers. But plans can be complex and involve significant changes in the regulatory system. Designing plans that stimulate utility performance without undue risk and share benefits fairly can be challenging.This report discusses the rationale for multiyear rate plans and their usefulness under modern business conditions. It then explains critical plan design issues and challenges and presents results from numerical research that considers the extra incentive power achieved under different plan provisions. Next, the report presents several case studies of utilities that have operated under formal multiyear rate plans or, for various reasons, have stayed out of rate cases for more than a decade. These studies consider the effect of multiyear rate plans and rate case frequency on utility cost, reliability and other performance dimensions.« less

Assistive Technology and Older Adults in Disasters: Implications for Emergency Management.

PubMed

McSweeney-Feld, Mary Helen

2017-02-01

This article identifies concepts, trends, and policy gaps in the availability and service delivery of assistive technology utilized by older adults in disasters, as well as implications for emergency management planning and shelter administration. Definitions of types of assistive technology, as well as views of older adults using technology as at-risk individuals for emergency management service provision, are provided. An overview of peer-reviewed articles and gray literature is conducted, focusing on publications from 2001 to the present in the United States. Analytical frameworks used by emergency management organizations as well as regulations such as the Americans with Disabilities Act and recent court decisions on emergency shelter accessibility in disasters are reviewed. Research on the use of assistive technology by older adults during disasters is a neglected issue. The current and potential benefits of defining standards for provision and use of assistive technology for older adults during disasters has received limited recognition in emergency management planning. Older adults with disabilities utilize assistive technology to maintain their independence and dignity, and communities as well as emergency services managers need to become more aware of the needs and preferences of these older adults in their planning processes and drills as well as in service delivery during actual events. (Disaster Med Public Health Preparedness. 2017;11:135-139).

UTILITY DATA ARCHIVING FOR RISK MANAGEMENT

EPA Science Inventory

EPA let a contract for a consultant to collect information about historical changes in operations and maintenance, design and construction, and planning and siting for water and wastewater infrastructure. The goal of this research study is to determine risk management alternativ...

Insights into managed care--operational, legal and actuarial.

PubMed

Melek, S P; Johnson, B A; Schryver, D

1997-01-01

Understanding the operational, legal and actuarial dimensions of managed care is essential to developing managed care contracts between managed care organizations and individual health care providers or groups such as provider-sponsored organizations or independent practice associations. Operationally, it is important to understand managed care and its trends, emphasizing business issues, knowing your practice and defining acceptable levels of reimbursement and risk. Legally, there are a number of common themes or issues relevant to all managed care contracts, including primary care vs. specialist contracts, services offered, program policies and procedures, utilization review, physician reimbursement and compensation, payment schedule, terms and conditions, term and termination, continuation of care requirements, indemnification, amendment of contract and program policies, and stop-loss insurance. Actuarial issues include membership, geography, age-gender distribution, degree of health care management, local managed care utilization levels, historical utilization levels, health plan benefit design, among others.

Ecology and management of pinyon-juniper ecosystems in the Bureau of Indian Affairs Southwestern Region

Treesearch

John Waconda

2008-01-01

The large acreages of the woodland forest cover type on tribal lands continues to post challenges to this agency's overall management strategies. The development of management plans, evaluation of growth study plots, and anticipated biomass utilization can help resolve some of the challenges.

41 CFR 102-75.80 - What are an Executive agency's responsibilities before requesting a transfer of excess real...

Code of Federal Regulations, 2011 CFR

2011-01-01

...) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 75-REAL PROPERTY DISPOSAL Utilization of Excess Real Property... utilization of existing real property; however, the utilization must be for purposes that are consistent with... sustained period of time than the acquisition of a new facility specifically planned for the purpose. ...

The spillover effects of Medicare managed care: Medicare Advantage and hospital utilization.

PubMed

Baicker, Katherine; Chernew, Michael E; Robbins, Jacob A

2013-12-01

More than a quarter of Medicare beneficiaries are enrolled in Medicare Advantage, which was created in large part to improve the efficiency of health care delivery by promoting competition among private managed care plans. This paper explores the spillover effects of the Medicare Advantage program on the traditional Medicare program and other patients, taking advantage of changes in Medicare Advantage payment policy to isolate exogenous increases in Medicare Advantage enrollment and trace out the effects of greater managed care penetration on hospital utilization and spending throughout the health care system. We find that when more seniors enroll in Medicare managed care, hospital costs decline for all seniors and for commercially insured younger populations. Greater managed care penetration is not associated with fewer hospitalizations, but is associated with lower costs and shorter stays per hospitalization. These spillovers are substantial - offsetting more than 10% of increased payments to Medicare Advantage plans. Copyright © 2013 Elsevier B.V. All rights reserved.

Integrated planning for regional development planning and water resources management under uncertainty: A case study of Xining, China

NASA Astrophysics Data System (ADS)

Fu, Z. H.; Zhao, H. J.; Wang, H.; Lu, W. T.; Wang, J.; Guo, H. C.

2017-11-01

Economic restructuring, water resources management, population planning and environmental protection are subjects to inner uncertainties of a compound system with objectives which are competitive alternatives. Optimization model and water quality model are usually used to solve problems in a certain aspect. To overcome the uncertainty and coupling in reginal planning management, an interval fuzzy program combined with water quality model for regional planning and management has been developed to obtain the absolutely ;optimal; solution in this study. The model is a hybrid methodology of interval parameter programming (IPP), fuzzy programing (FP), and a general one-dimensional water quality model. The method extends on the traditional interval parameter fuzzy programming method by integrating water quality model into the optimization framework. Meanwhile, as an abstract concept, water resources carrying capacity has been transformed into specific and calculable index. Besides, unlike many of the past studies about water resource management, population as a significant factor has been considered. The results suggested that the methodology was applicable for reflecting the complexities of the regional planning and management systems within the planning period. The government policy makers could establish effective industrial structure, water resources utilization patterns and population planning, and to better understand the tradeoffs among economic, water resources, population and environmental objectives.

Proposal to the National Science Foundation for a retrospective technology assessment of submarine telegraphy

NASA Technical Reports Server (NTRS)

Coates, V. T.; Finn, B. S.

1975-01-01

The conceptual and methodological importance of doing retrospective technology assessments is summarized. The rationale for the study of submarine telegraphy is briefly summarized along with the study plan, the management plan, and dissemination and utilization of the results.

Scale and modeling issues in water resources planning

USGS Publications Warehouse

Lins, H.F.; Wolock, D.M.; McCabe, G.J.

1997-01-01

Resource planners and managers interested in utilizing climate model output as part of their operational activities immediately confront the dilemma of scale discordance. Their functional responsibilities cover relatively small geographical areas and necessarily require data of relatively high spatial resolution. Climate models cover a large geographical, i.e. global, domain and produce data at comparatively low spatial resolution. Although the scale differences between model output and planning input are large, several techniques have been developed for disaggregating climate model output to a scale appropriate for use in water resource planning and management applications. With techniques in hand to reduce the limitations imposed by scale discordance, water resource professionals must now confront a more fundamental constraint on the use of climate models-the inability to produce accurate representations and forecasts of regional climate. Given the current capabilities of climate models, and the likelihood that the uncertainty associated with long-term climate model forecasts will remain high for some years to come, the water resources planning community may find it impractical to utilize such forecasts operationally.

Concurrent planning and execution for a walking robot

NASA Astrophysics Data System (ADS)

Simmons, Reid

1990-07-01

The Planetary Rover project is developing the Ambler, a novel legged robot, and an autonomous software system for walking the Ambler over rough terrain. As part of the project, we have developed a system that integrates perception, planning, and real-time control to navigate a single leg of the robot through complex obstacle courses. The system is integrated using the Task Control Architecture (TCA), a general-purpose set of utilities for building and controlling distributed mobile robot systems. The walking system, as originally implemented, utilized a sequential sense-plan-act control cycle. This report describes efforts to improve the performance of the system by concurrently planning and executing steps. Concurrency was achieved by modifying the existing sequential system to utilize TCA features such as resource management, monitors, temporal constraints, and hierarchical task trees. Performance was increased in excess of 30 percent with only a relatively modest effort to convert and test the system. The results lend support to the utility of using TCA to develop complex mobile robot systems.

Integrated employee assistance program/managed behavioral health plan utilization by persons with substance use disorders.

PubMed

Merrick, Elizabeth S Levy; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M; Greenfield, Shelly F; McCann, Bernard

2011-04-01

New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral health care (MBHC) organization's integrated EAP/MBHC product (N = 1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan, and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of the clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. Copyright © 2011 Elsevier Inc. All rights reserved.

Construction Management for Educational Facilities: Professional Services' Procurement and Competitive Bid Statutes.

ERIC Educational Resources Information Center

Goldblatt, Steven M.; Wood, R. Craig

Construction management is utilized when a school district engages a firm to coordinate a total project. The construction management seeks to save an owner time and cost primarily through better contractor coordination and project management. These services may include the planning and design phases of the project as well as the actual…

Effective planning and management as critical factors in urban water supply and management in Umuahia and Aba, Abia State, Nigeria

NASA Astrophysics Data System (ADS)

Uchegbu, Smart N.

Plan and policy development usually define the course, goal, execution, success or failure of any public utilities initiative. Urban water supply is not an exception. Planning and management in public water supply systems often determine the quality of service the water supply authorities can render. This paper, therefore, addresses the issue of effective planning and management as critical determinants of urban water supply and management with respect to two Nigerian cities Umuahia and Aba both in Abia State. Appropriate sampling methods systematic sampling and cluster techniques were employed in order to collect data for the study. The collected data were analyzed using multiple linear regression. The findings of the study indicate that planning and management indices such as funding, manpower, water storage tank capacity greatly influence the volume of water supplied in the study areas. Funding was identified as a major determinant of the efficiency of the water supply system. Therefore, the study advocates the need for sector reforms that would usher in private participants in the water sector both for improved funding and enhanced productivity.

Connection Development: Web Lessons from Westchester.

ERIC Educational Resources Information Center

Freedman, Maurice J.

1996-01-01

Committed to utilizing information technology, the Westchester Library System (New York) made the World Wide Web publicly accessible. Describes the planning, implementation, and management process; obstacles involving financing; establishing Internet connectivity; and vendor negotiations. Westchester hired a Web manager, created Internet use…

Evolution of strategic risks under future scenarios for improved utility master plans.

PubMed

Luís, Ana; Lickorish, Fiona; Pollard, Simon

2016-01-01

Integrated, long-term risk management in the water sector is poorly developed. Whilst scenario planning has been applied to singular issues (e.g. climate change), it often misses a link to risk management because the likelihood of impacts in the long-term are frequently unaccounted for in these analyses. Here we apply the morphological approach to scenario development for a case study utility, Empresa Portuguesa das Águas Livres (EPAL). A baseline portfolio of strategic risks threatening the achievement of EPAL's corporate objectives was evolved through the lens of three future scenarios, 'water scarcity', 'financial resource scarcity' and 'strong economic growth', built on drivers such as climate, demographic, economic, regulatory and technological changes and validated through a set of expert workshops. The results represent how the baseline set of risks might develop over a 30 year period, allowing threats and opportunities to be identified and enabling strategies for master plans to be devised. We believe this to be the first combined use of risk and futures methods applied to a portfolio of strategic risks in the water utility sector. Copyright © 2015 Elsevier Ltd. All rights reserved.

MATRIS Indexing and Retrieval Thesaurus (MIRT): Definitions of Indexing Terms

DTIC Science & Technology

1994-08-01

use strategies ; may include simple manual systems for personnel management. • Bgc Marginal manpower utilization The utilization of various types of...resources. Bgg Manpower management evaluation Evaluation process including manpower plans, strategies , methods of execution, and decision making with...specialties. I I I I I I I I I U I I I I 6 MANPOWER I I I RECRUITMENT I C RECRUITMENT Process involving developing requirements and strategies for

Impact of a Value-based Formulary on Medication Utilization, Health Services Utilization, and Expenditures.

PubMed

Yeung, Kai; Basu, Anirban; Hansen, Ryan N; Watkins, John B; Sullivan, Sean D

2017-02-01

Value-based benefit design has been suggested as an effective approach to managing the high cost of pharmaceuticals in health insurance markets. Premera Blue Cross, a large regional health plan, implemented a value-based formulary (VBF) for pharmaceuticals in 2010 that explicitly used cost-effectiveness analysis (CEA) to inform medication copayments. The objective of the study was to determine the impact of the VBF. Interrupted time series of employer-sponsored plans from 2006 to 2013. Intervention group: 5235 beneficiaries exposed to the VBF. 11,171 beneficiaries in plans without any changes in pharmacy benefits. The VBF-assigned medications with lower value (estimated by CEA) to higher copayment tiers and assigned medications with higher value to lower copayment tiers. Primary outcome was medication expenditures from member, health plan, and member plus health plan perspectives. Secondary outcomes were medication utilization, emergency department visits, hospitalizations, office visits, and nonmedication expenditures. In the intervention group after VBF implementation, member medication expenditures increased by $2 per member per month (PMPM) [95% confidence interval (CI), $1-$3] or 9%, whereas health plan medication expenditures decreased by $10 PMPM (CI, $18-$2) or 16%, resulting in a net decrease of $8 PMPM (CI, $15-$2) or 10%, which translates to a net savings of $1.1 million. Utilization of medications moved into lower copayment tiers increased by 1.95 days' supply (CI, 1.29-2.62) or 17%. Total medication utilization, health services utilization, and nonmedication expenditures did not change. Cost-sharing informed by CEA reduced overall medication expenditures without negatively impacting medication utilization, health services utilization, or nonmedication expenditures.

Design and analysis of advanced flight planning concepts

NASA Technical Reports Server (NTRS)

Sorensen, John A.

1987-01-01

The objectives of this continuing effort are to develop and evaluate new algorithms and advanced concepts for flight management and flight planning. This includes the minimization of fuel or direct operating costs, the integration of the airborne flight management and ground-based flight planning processes, and the enhancement of future traffic management systems design. Flight management (FMS) concepts are for on-board profile computation and steering of transport aircraft in the vertical plane between a city pair and along a given horizontal path. Flight planning (FPS) concepts are for the pre-flight ground based computation of the three-dimensional reference trajectory that connects the city pair and specifies the horizontal path, fuel load, and weather profiles for initializing the FMS. As part of these objectives, a new computer program called EFPLAN has been developed and utilized to study advanced flight planning concepts. EFPLAN represents an experimental version of an FPS. It has been developed to generate reference flight plans compatible as input to an FMS and to provide various options for flight planning research. This report describes EFPLAN and the associated research conducted in its development.

Water safety plans: bridges and barriers to implementation in North Carolina.

PubMed

Amjad, Urooj Quezon; Luh, Jeanne; Baum, Rachel; Bartram, Jamie

2016-10-01

First developed by the World Health Organization, and now used in several countries, water safety plans (WSPs) are a multi-step, preventive process for managing drinking water hazards. While the beneficial impacts of WSPs have been documented in diverse countries, how to successfully implement WSPs in the United States remains a challenge. We examine the willingness and ability of water utility leaders to implement WSPs in the US state of North Carolina. Our findings show that water utilities have more of a reactive than preventive organizational culture, that implementation requires prioritization of time and resources, perceived comparative advantage to other hazard management plans, leadership in implementation, and identification of how WSPs can be embedded in existing work practices. Future research could focus on whether WSP implementation provides benefits such as decreases in operational costs, and improved organization of records and communication.

Nine steps towards a better water meter management.

PubMed

Arregui, F J; Soriano, J; Cabrera, E; Cobacho, R

2012-01-01

The paper provides a comprehensive perspective of the critical aspects to be taken into account when planning the long-term management of water meters in a utility. In order to facilitate their quick understanding and practical implementation, they have been structured into nine steps. Ranging from an initial audit up to the final periodic meter replacement planning, these steps cover three aspects of the problem - field work, laboratory work and management tasks; and each one is developed in detail paying attention to the particular data needed and noting the practical outcome it will yield.

Approaches to pharmacy benefit management and the impact of consumer cost sharing.

PubMed

Olson, Bridget M

2003-01-01

Numerous mechanisms have been introduced to deliver prescription drug benefits while controlling pharmaceutical costs. An understanding of the most prominent mechanisms of benefit management is an important step in determining the most effective approach to take in future years. The aims of this review were to illustrate the mechanisms by which managed care has attempted to efficiently and equitably deliver pharmacy benefits and to discuss the impact of such programs, including consumer cost sharing. A review of the literature was conducted using the PreMedline and MEDLINE databases from the years 1966 to 2002, reference lists from relevant articles, and online sources, including news releases, conference materials, and pharmacy benefit management reports. Numerous pharmacy benefit management tools and their impact on utilization, expenditures, and health outcomes are reviewed, including disease state management; utilization management (ie, quantity limitations and prior authorization); drug utilization review; formulary management (ie, open and closed); delivery systems (ie, retail and mail order); and mechanisms for implementing consumer cost sharing (ie, generic incentives, multitiered copayments, and co-insurance). Although there is some evidence to suggest that certain benefit management tools have been successful in reducing health plan expenditures, a more thorough investigation of their potential unintended consequences is needed. Implementing adequate levels of consumer cost sharing is necessary if employers and health plans are to continue offering prescription drug benefits. It is important to remember, however, that quality health care cannot be forfeited for the sake of short-term cost savings.

The recreation opportunity spectrum: a framework for planning, management, and research.

Treesearch

Roger N. Clark; George H. Stankey

1979-01-01

The end product of recreation management is a diverse range of opportunities from which people can derive various experiences. This paper offers a framework for managing recreation opportunities based on six physical, biological, social, and managerial factors that, when combined, can be utilized by recreationists to obtain diverse experiences.

42 CFR 423.153 - Drug utilization management, quality assurance, and medication therapy management programs (MTMPs).

Code of Federal Regulations, 2011 CFR

2011-10-01

... pharmacist or other qualified provider; and (iv) May distinguish between services in ambulatory and... pharmacist or other qualified provider unless the beneficiary is in a long-term care setting and may result... with licensed and practicing pharmacists and physicians. (4) Coordination with care management plans...

15 CFR 923.43 - Direct State land and water use planning and regulation-Technique B.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF COMMERCE OCEAN AND COASTAL RESOURCE MANAGEMENT COASTAL ZONE MANAGEMENT PROGRAM REGULATIONS... subsection 306(d)(11) of the Act for control of land and water uses within the coastal zone. The second such... specific to coastal management and the requirements of this Act. (2) Networking—The utilization of...

Improving watershed management practices in humid regions

USDA-ARS?s Scientific Manuscript database

Understanding the basic hydrology and erosion is vital for effective management and utilization of water resources and soil conservation planning. To improve the understanding we used watershed studies on three continents. The results show that in well vegetated (sub) humid and temperate watersheds ...

Land Use Management for Solid Waste Programs

ERIC Educational Resources Information Center

Brown, Sanford M., Jr.

1974-01-01

The author discusses the problems of solid waste disposal and examines various land use management techniques. These include the land use plan, zoning, regionalization, land utilities, and interim use. Information concerning solid waste processing site zoning and analysis is given. Bibliography included. (MA)

Reducing regional vulnerabilities and multi-city robustness conflicts using many-objective optimization under deep uncertainty

NASA Astrophysics Data System (ADS)

Reed, Patrick; Trindade, Bernardo; Jonathan, Herman; Harrison, Zeff; Gregory, Characklis

2016-04-01

Emerging water scarcity concerns in southeastern US are associated with several deeply uncertain factors, including rapid population growth, limited coordination across adjacent municipalities and the increasing risks for sustained regional droughts. Managing these uncertainties will require that regional water utilities identify regionally coordinated, scarcity-mitigating strategies that trigger the appropriate actions needed to avoid water shortages and financial instabilities. This research focuses on the Research Triangle area of North Carolina, seeking to engage the water utilities within Raleigh, Durham, Cary and Chapel Hill in cooperative and robust regional water portfolio planning. Prior analysis of this region through the year 2025 has identified significant regional vulnerabilities to volumetric shortfalls and financial losses. Moreover, efforts to maximize the individual robustness of any of the mentioned utilities also have the potential to strongly degrade the robustness of the others. This research advances a multi-stakeholder Many-Objective Robust Decision Making (MORDM) framework to better account for deeply uncertain factors when identifying cooperative management strategies. Results show that the sampling of deeply uncertain factors in the computational search phase of MORDM can aid in the discovery of management actions that substantially improve the robustness of individual utilities as well as the overall region to water scarcity. Cooperative water transfers, financial risk mitigation tools, and coordinated regional demand management must be explored jointly to decrease robustness conflicts between the utilities. The insights from this work have general merit for regions where adjacent municipalities can benefit from cooperative regional water portfolio planning.

Reducing regional vulnerabilities and multi-city robustness conflicts using many-objective optimization under deep uncertainty

NASA Astrophysics Data System (ADS)

Trindade, B. C.; Reed, P. M.; Herman, J. D.; Zeff, H. B.; Characklis, G. W.

2015-12-01

Emerging water scarcity concerns in southeastern US are associated with several deeply uncertain factors, including rapid population growth, limited coordination across adjacent municipalities and the increasing risks for sustained regional droughts. Managing these uncertainties will require that regional water utilities identify regionally coordinated, scarcity-mitigating strategies that trigger the appropriate actions needed to avoid water shortages and financial instabilities. This research focuses on the Research Triangle area of North Carolina, seeking to engage the water utilities within Raleigh, Durham, Cary and Chapel Hill in cooperative and robust regional water portfolio planning. Prior analysis of this region through the year 2025 has identified significant regional vulnerabilities to volumetric shortfalls and financial losses. Moreover, efforts to maximize the individual robustness of any of the mentioned utilities also have the potential to strongly degrade the robustness of the others. This research advances a multi-stakeholder Many-Objective Robust Decision Making (MORDM) framework to better account for deeply uncertain factors when identifying cooperative management strategies. Results show that the sampling of deeply uncertain factors in the computational search phase of MORDM can aid in the discovery of management actions that substantially improve the robustness of individual utilities as well as of the overall region to water scarcity. Cooperative water transfers, financial risk mitigation tools, and coordinated regional demand management should be explored jointly to decrease robustness conflicts between the utilities. The insights from this work have general merit for regions where adjacent municipalities can benefit from cooperative regional water portfolio planning.

Outpatient Utilization by Infants Auto-assigned to Medicaid Managed Care Plans

PubMed Central

Cohn, Lisa M.; Clark, Sarah J.

2013-01-01

To test the hypothesis that infants auto-assigned to a Medicaid managed care plan would have lower primary care and higher emergency department (ED) utilization compared to infants with a chosen plan. Retrospective cohort study. Medicaid administrative data were used to identify all children 0–3 months of age at enrollment in Michigan Medicaid managed care in 2005–2008 with 18-months of subsequent enrollment. Medicaid encounter and state immunization registry data were then acquired. Auto-assigned infants were compared versus chosen plan infants on: (1) well-child visits (WCVs); (2) immunizations; (3) acute office visits; and (4) ED visits. Chi squared and rank-sum tests and logistic and negative binomial regression were used in bivariate and multivariable analyses for dichotomous and count data, respectively. 18 % of infants were auto-assigned. Auto-assigned infants were less likely to meet goal number of WCVs in 18-months of managed care enrollment (32 vs. 53 %, p < 0.001) and to be up-to-date on immunizations at 12 months of age (75 vs. 85 %, p < 0.001). Auto-assigned infants had fewer acute office visits (median: 4 vs. 5, p < 0.001) but were only slightly more likely to have 2 or more ED visits (51 vs. 46 %, p < 0.001) in 18-months of enrollment. All results were significant in multivariable analyses. Auto-assigned infants were less likely to use preventive and acute primary care but only slightly more likely to use emergency care. Future work is needed to understand mechanisms of differences in utilization, but auto-assigned children may represent a target group for efforts to promote pediatric preventive care in Medicaid. PMID:23775252

Outpatient utilization by infants auto-assigned to Medicaid managed care plans.

PubMed

Zickafoose, Joseph S; Cohn, Lisa M; Clark, Sarah J

2014-04-01

To test the hypothesis that infants auto-assigned to a Medicaid managed care plan would have lower primary care and higher emergency department (ED) utilization compared to infants with a chosen plan. Retrospective cohort study. Medicaid administrative data were used to identify all children 0-3 months of age at enrollment in Michigan Medicaid managed care in 2005-2008 with 18-months of subsequent enrollment. Medicaid encounter and state immunization registry data were then acquired. Auto-assigned infants were compared versus chosen plan infants on: (1) well-child visits (WCVs); (2) immunizations; (3) acute office visits; and (4) ED visits. Chi squared and rank-sum tests and logistic and negative binomial regression were used in bivariate and multivariable analyses for dichotomous and count data, respectively. 18% of infants were auto-assigned. Auto-assigned infants were less likely to meet goal number of WCVs in 18-months of managed care enrollment (32 vs. 53%, p < 0.001) and to be up-to-date on immunizations at 12 months of age (75 vs. 85%, p < 0.001). Auto-assigned infants had fewer acute office visits (median: 4 vs. 5, p < 0.001) but were only slightly more likely to have 2 or more ED visits (51 vs. 46%, p < 0.001) in 18-months of enrollment. All results were significant in multivariable analyses. Auto-assigned infants were less likely to use preventive and acute primary care but only slightly more likely to use emergency care. Future work is needed to understand mechanisms of differences in utilization, but auto-assigned children may represent a target group for efforts to promote pediatric preventive care in Medicaid.

Assessment of Institutional Strategic Goal Realization: A Case Study

ERIC Educational Resources Information Center

Holwick, Jana W.

2009-01-01

Strategic planning is a common tool utilized at colleges and universities to assist in achieving institutional goals. Leaders in higher education have taken best practices from corporate management and adapted them in an effort to develop comprehensive approaches to institutional planning, assessment and accountability. Various models for planning…

Formulation of consumables management models. Consumables flight planning worksheet utilization

NASA Technical Reports Server (NTRS)

Newman, C. M.

1977-01-01

The updated and reformatted consumables flight planning worksheet is documented. An instruction set for applying the worksheet, and a sample application of the worksheet is disclosed. The particular application is for the STS interfacing with sortie payloads and typifies the interfacing of the delivery system and payloads.

Addressing Climate Change in Long-Term Water Planning Using Robust Decisionmaking

NASA Astrophysics Data System (ADS)

Groves, D. G.; Lempert, R.

2008-12-01

Addressing climate change in long-term natural resource planning is difficult because future management conditions are deeply uncertain and the range of possible adaptation options are so extensive. These conditions pose challenges to standard optimization decision-support techniques. This talk will describe a methodology called Robust Decisionmaking (RDM) that can complement more traditional analytic approaches by utilizing screening-level water management models to evaluate large numbers of strategies against a wide range of plausible future scenarios. The presentation will describe a recent application of the methodology to evaluate climate adaptation strategies for the Inland Empire Utilities Agency in Southern California. This project found that RDM can provide a useful way for addressing climate change uncertainty and identify robust adaptation strategies.

Marketing a managed care plan: achieving product differentiation.

PubMed

Romeo, N C

1996-01-01

The health care marketplace is changing dramatically, even without federal reform measures. This is a volatile, yet promising, time to market a managed care plan. Before marketing the product, it is critical that the competition is thoroughly evaluated and consumer and employer needs are researched. The final product should be distinguishable from the competition and address market needs. Promotion can then begin, utilizing a proactive public relations and advertising campaign in addition to traditional methods of marketing.

Reading the Tea Leaves: How Utilities in the West Are Managing Carbon Regulatory Risk in their Resource Plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barbose, Galen; Wiser, Ryan; Phadke, Amol

2008-02-01

The long economic lifetime and development lead-time of many electric infrastructure investments requires that utility resource planning consider potential costs and risks over a lengthy time horizon. One long-term -- and potentially far-reaching -- risk currently facing the electricity industry is the uncertain cost of future carbon dioxide (CO2) regulations. Recognizing the importance of this issue, many utilities (sometimes spurred by state regulatory requirements) are beginning to actively assess carbon regulatory risk within their resource planning processes, and to evaluate options for mitigating that risk. However, given the relatively recent emergence of this issue and the rapidly changing political landscape,more » methods and assumptions used to analyze carbon regulatory risk, and the impact of this analysis on the selection of a preferred resource portfolio, vary considerably across utilities. In this study, we examine the treatment of carbon regulatory risk in utility resource planning, through a comparison of the most-recent resource plans filed by fifteen investor-owned and publicly-owned utilities in the Western U.S. Together, these utilities account for approximately 60percent of retail electricity sales in the West, and cover nine of eleven Western states. This report has two related elements. First, we compare and assess utilities' approaches to addressing key analytical issues that arise when considering the risk of future carbon regulations. Second, we summarize the composition and carbon intensity of the preferred resource portfolios selected by these fifteen utilities and compare them to potential CO2 emission benchmark levels.« less

Decision Support Systems for Research and Management in Advanced Life Support

NASA Technical Reports Server (NTRS)

Rodriquez, Luis F.

2004-01-01

Decision support systems have been implemented in many applications including strategic planning for battlefield scenarios, corporate decision making for business planning, production planning and control systems, and recommendation generators like those on Amazon.com(Registered TradeMark). Such tools are reviewed for developing a similar tool for NASA's ALS Program. DSS are considered concurrently with the development of the OPIS system, a database designed for chronicling of research and development in ALS. By utilizing the OPIS database, it is anticipated that decision support can be provided to increase the quality of decisions by ALS managers and researchers.

Strategic plan to optimize the management of right-of-way parcel and utility information at FDOT.

DOT National Transportation Integrated Search

2013-05-01

The Florida Department of Transportation (FDOT) manages a huge right-of-way asset. Examples of core : processes related to this asset include determining right-of-way boundaries; inventorying roadside features; : preparing right-of-way maps; acquirin...

Proceedings: Conference on asbestos control and replacement for electric utilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

An EPRI conference on Asbestos Control and Replacement for Electric Utilities was held April 6--7, 1993 in conjunction with the Environmental Information Association`s (formerly National Asbestos Council) Environmental Management `93 Conference and Exposition. The high cost and potential liabilities of asbestos removal projects, compounded by concerns over the health effects of asbestos replacement materials, was the main motivation for the conference. The objective of the conference was to assemble guidance and information that will help utilities manage asbestos and to effectively prioritize EPRI research in this area. Eleven papers covered such topics as changes in the Environmental Protection Agency`s (EPA)more » ban on asbestos, utility experience with asbestos management and abatement, asbestos monitoring and disposal, and asbestos replacement materials. Utility feedback received at the conference indicates that present and planned EPRI research activities in this area will effectively meet industry needs.« less

Simulating Mission Command for Planning and Analysis

DTIC Science & Technology

2015-06-01

mission plan. 14. SUBJECT TERMS Mission Planning, CPM , PERT, Simulation, DES, Simkit, Triangle Distribution, Critical Path 15. NUMBER OF...Battalion Task Force CO Company CPM Critical Path Method DES Discrete Event Simulation FA BAT Field Artillery Battalion FEL Future Event List FIST...management tools that can be utilized to find the critical path in military projects. These are the Critical Path Method ( CPM ) and the Program Evaluation and

Utilization of ERTS-1 data in geological evaluation, regional planning, forest management, and water management in North Carolina

NASA Technical Reports Server (NTRS)

Welby, C. W. (Principal Investigator); Lammi, J. O.; Carson, R. J., III

1974-01-01

The author has identified the following significant results. ERTS-1 imagery has been evaluated for use in resource planning and management in North Carolina, and found to be useful for general reconnaissance purposes in forestry, geology, and water resources work. It has also been used for studying large-scale transient phenomena such as river plumes and movement of sediment in the sounds. ERTS-1 imagery has been an aid to geologic and land-use mapping. Stereoscopes, projectors of various kinds, and microscopes have proved useful instruments for the kinds of data acquisition needed by resource planners and managers.

People, planning, predictions pull DP&L to pinnacle

DOE Office of Scientific and Technical Information (OSTI.GOV)

Beaty, W.; Warkentin, D.

Dayton Power and Light was chosen as the 26th utility to receive Electric Light and Power`s annual Utility of the Year award for investor-owned electric utilities. The award not only recognizes management for having guided the company to a high level of achievement, but to each employee for their contribution to the company`s success. Using its formula of three Ps to success - people, planning, and predict and prevent - this West Central Ohio utility plans on using its current plain vanilla approach to business to carve out its own pattern for the years ahead. DP&L`s employees have gone abovemore » and beyond the call of duty to serve its customers and shareholders. The utility`s operations are epitomized by the excellent fuel efficiency of its generating plants. DP&L has been in Electric Light & Power`s top 10 heat rate rankings for nine out of the past 10 years. Investor earnings per share increased from $1.15 in 1991 to $1.34 in 1992, with earnings per share rising by 6% to $1.42 in 1993.« less

Does competition by health maintenance organizations affect the adoption of cost-containment measures by fee-for-service plans?

PubMed

Joesch, J M; Wickizer, T M; Feldstein, P J

1998-06-01

How groups insured by fee-for-service health plans react to increased competition from health maintenance organizations (HMOs) is an unresolved question. We investigated whether groups insured by indemnity plans respond to HMO market competition by changing selected health insurance features, such as deductible amounts, stop loss levels, and coinsurance rates, or by adopting utilization management or preferred provider organization (PPO) benefit options. We collected benefit design data for the years 1985 through 1992 from 95 insured groups in 62 US metropolitan statistical areas. Multivariate hazard analysis showed that groups located in markets with higher rates of change in HMO enrollment were less likely to increase deductibles or stop loss levels. Groups located in markets with higher HMO enrollment were more likely to adopt utilization management or PPO benefit options. A group located in a market with an HMO penetration rate of 20% was 65% more likely to have included a PPO option as part of its insurance benefit plan than a group located in a market with an HMO penetration rate of 15% (p < 0.05). Concern about possible adverse selection effects may deter some fee-for-service groups from changing their health insurance coverage. Under some conditions, however, groups insured under fee-for-service plans do respond to managed care competition by changing their insurance benefits to achieve greater cost containment.

Impact of a Value-Based Formulary on Medication Utilization, Health Services Utilization, and Expenditures

PubMed Central

Yeung, Kai; Basu, Anirban; Hansen, Ryan N.; Watkins, John B.; Sullivan, Sean D.

2016-01-01

Background Value-based benefit design has been suggested as an effective approach to managing the high cost of pharmaceuticals in health insurance markets. Premera Blue Cross, a large regional health plan, implemented a Value-Based Formulary (VBF) for pharmaceuticals in 2010 that explicitly used cost-effectiveness analysis (CEA) to inform medication copayments. Objective To determine the impact of the VBF. Design Interrupted time-series of employer-sponsored plans from 2006 to 2013. Subjects Intervention group: 5,235 beneficiaries exposed to the VBF. Control group: 11,171 beneficiaries in plans without any changes in pharmacy benefits. Intervention The VBF assigned medications with lower value (estimated by CEA) to higher copayment tiers and assigned medications with higher value to lower copayment tiers. Measures Primary outcome was medication expenditures from member, health plan, and member plus health plan perspectives. Secondary outcomes were medication utilization, emergency department visits, hospitalizations, office visits, and non-medication expenditures. Results In the intervention group after VBF implementation, member medication expenditures increased by $2 per member per month (PMPM) (95% CI, $1 to $3) or 9%, while health plan medication expenditures decreased by $10 PMPM (CI, $18 to $2) or 16%, resulting in a net decrease of $8 PMPM (CI, $15 to $2) or 10%, which translates to a net savings of $1.1 million. Utilization of medications moved into lower copayment tiers increased by 1.95 days’ supply (CI, 1.29 to 2.62) or 17%. Total medication utilization, health services utilization and non-medication expenditures did not change. Conclusions Cost-sharing informed by CEA reduced overall medication expenditures without negatively impacting medication utilization, health services utilization or non-medication expenditures. PMID:27579915

24 CFR 905.10 - Capital Fund formula (CFF).

Code of Federal Regulations, 2013 CFR

2013-04-01

... projects; (ii) Vacancy reduction; (iii) Addressing deferred maintenance needs and the replacement of obsolete utility systems and dwelling equipment; (iv) Planned code compliance; (v) Management improvements...

24 CFR 905.10 - Capital Fund formula (CFF).

Code of Federal Regulations, 2012 CFR

2012-04-01

... projects; (ii) Vacancy reduction; (iii) Addressing deferred maintenance needs and the replacement of obsolete utility systems and dwelling equipment; (iv) Planned code compliance; (v) Management improvements...

Integrated watershed management for saturation excess generated runoff, erosion and nutrient control

USDA-ARS?s Scientific Manuscript database

Understanding the basic hydrology and erosion is vital for effective management and utilization of water resources and soil conservation planning. An important question for judging effectiveness of soil and water conservation practices is whether runoff erosion and nutrient loss is affected by infil...

Working Notes from the 1992 AAAI Spring Symposium on Practical Approaches to Scheduling and Planning

NASA Technical Reports Server (NTRS)

Drummond, Mark; Fox, Mark; Tate, Austin; Zweben, Monte

1992-01-01

The symposium presented issues involved in the development of scheduling systems that can deal with resource and time limitations. To qualify, a system must be implemented and tested to some degree on non-trivial problems (ideally, on real-world problems). However, a system need not be fully deployed to qualify. Systems that schedule actions in terms of metric time constraints typically represent and reason about an external numeric clock or calendar and can be contrasted with those systems that represent time purely symbolically. The following topics are discussed: integrating planning and scheduling; integrating symbolic goals and numerical utilities; managing uncertainty; incremental rescheduling; managing limited computation time; anytime scheduling and planning algorithms, systems; dependency analysis and schedule reuse; management of schedule and plan execution; and incorporation of discrete event techniques.

Operations management: a tool to increase profitability.

PubMed

Mulvehill, M J

2001-03-01

Operations management enables the efficient utilization of the production systems in a business. This paper will address several key elements in the business competency of operations management. Specifically, this discussion will review the components of a material requirement planning system and a "just-in-time" system for inventory control and time management to enable the dentist to monitor a portion of the practice's overhead costs.

Succession Planning in the Iranian Health System: A Case Study of the Ministry of Health and Medical Education

PubMed Central

Mehrtak, Mohamad; Vatankhah, Soodabeh; Delgoshaei, Bahram; Gholipour, Arian

2014-01-01

Background: Succession planning promotes the culture of private ownership, staff loyalty to the organization and develops organizational commitment, and increases organizational stability. The study was conducted to examine the status of succession planning in the Iranian health system in order to highlight the key concepts, provide new insight, and attract the attention of senior managers of the Ministry of Health and Medical Education to the importance of succession planning in achieving organizational goals. Methods: In a qualitative study with a framework analysis approach, semi-structured interviews were conducted with a sample selected using purposive and snowball sampling procedure. The MAXQDA-10 was used to apply the codes and manage the data. The codes were extracted using inductive and deductive methods. Results: Fourteen themes and six main subthemes were identified, including planning, organizational culture, system approach, competency model, career path, and senior managers. Our findings indicate a lack of succession planning in the Iranian health system. Conclusion: lack of succession planning could lead to inefficiency and ineffectiveness in health services provision. Implementation of succession planning could maximize human resources utilization. PMID:25168998

Succession planning in the Iranian health system: a case study of the Ministry of Health and Medical Education.

PubMed

Mehrtak, Mohamad; Vatankhah, Soodabeh; Delgoshaei, Bahram; Gholipour, Arian

2014-05-30

Succession planning promotes the culture of private ownership, staff loyalty to the organization and develops organizational commitment, and increases organizational stability. The study was conducted to examine the status of succession planning in the Iranian health system in order to highlight the key concepts, provide new insight, and attract the attention of senior managers of the Ministry of Health and Medical Education to the importance of succession planning in achieving organizational goals. In a qualitative study with a framework analysis approach, semi-structured interviews were conducted with a sample selected using purposive and snowball sampling procedure. The MAXQDA-10 was used to apply the codes and manage the data. The codes were extracted using inductive and deductive methods. Fourteen themes and six main subthemes were identified, including planning, organizational culture, system approach, competency model, career path, and senior managers. Our findings indicate a lack of succession planning in the Iranian health system. lack of succession planning could lead to inefficiency and ineffectiveness in health services provision. Implementation of succession planning could maximize human resources utilization.

Design and utilization of a Flight Test Engineering Database Management System at the NASA Dryden Flight Research Facility

NASA Technical Reports Server (NTRS)

Knighton, Donna L.

1992-01-01

A Flight Test Engineering Database Management System (FTE DBMS) was designed and implemented at the NASA Dryden Flight Research Facility. The X-29 Forward Swept Wing Advanced Technology Demonstrator flight research program was chosen for the initial system development and implementation. The FTE DBMS greatly assisted in planning and 'mass production' card preparation for an accelerated X-29 research program. Improved Test Plan tracking and maneuver management for a high flight-rate program were proven, and flight rates of up to three flights per day, two times per week were maintained.

42 CFR 423.128 - Dissemination of Part D plan information.

Code of Federal Regulations, 2010 CFR

2010-10-01

... tiered formulary structure and utilization management procedures used) functions; (iii) The process for... under § 423.564 et. seq. (8) Quality assurance policies and procedures. A description of the quality assurance policies and procedures required under § 423.153(c), as well as the medication therapy management...

45 CFR 205.35 - Mechanized claims processing and information retrieval systems; definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... State plan requirements for an automated statewide management information system, conditions for FFP and... produce utilization and management information about such aid and services as required by the single State... 45 Public Welfare 2 2010-10-01 2010-10-01 false Mechanized claims processing and information...

42 CFR 51c.305 - Grant evaluation and award.

Code of Federal Regulations, 2010 CFR

2010-10-01

... potential of the center for the development of new and effective methods for health services delivery and management; (d) The soundness of the fiscal plan for assuring effective utilization of grant funds and maximizing non-grant revenue; (e) The administrative and management capability of the applicant; (f) The...

Defense Infrastructure: Actions Needed to Strengthen Utility Resilience Planning

DTIC Science & Technology

2016-11-01

and design , historical architecture and materials, and overhead; and inflation adjustments. 6We obtained and analyzed records from DOD’s Real...the impacts of those disruptions, and the characteristics of the DOD-owned utility systems, among other things. To inform the design of our survey...managing and operating DOD-owned utility systems. Furthermore, the survey instrument was independently reviewed by a survey design expert within GAO. We

An Advanced Microcosting System for Forecasting and Managing Radiology Expenses

PubMed Central

Arenson, Ronald; Viale, Richard; van der Voorde, Frans

1985-01-01

The new prospective payment system encourages hospital cost containment and necessitates understanding actual costs for radiology procedures. The automated microcosting system described here, utilizing data from the Radiology Information Management System, hospital expense reports, and payroll management reports, calculates an accurate unit cost for each procedure type. This data is very useful for cost control, enhancement of department efficiency, and planning.

A fuel cycle assessment guide for utility and state energy planners

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1994-07-01

This guide, one in a series of documents designed to help assess fuel cycles, is a framework for setting parameters, collecting data, and analyzing fuel cycles for supply-side and demand-side management. It provides an automated tool for entering comparative fuel cycle data that are meaningful to state and utility integrated resource planning, collaborative, and regional energy planning activities. It outlines an extensive range of energy technology characteristics and environmental, social, and economic considerations within each stage of a fuel cycle. The guide permits users to focus on specific stages or effects that are relevant to the technology being evaluated andmore » that meet the user`s planning requirements.« less

What Climate Information Do Water Managers Need to Make Robust, Long-Term Plans?

NASA Astrophysics Data System (ADS)

Duran, R.; Lempert, R.; Groves, D.

2008-12-01

What climate information do water managers need to respond to threat of climate change? Southern California's Inland Empire Utilities Agency (IEUA) completed a long-range water resource management plan in 2005 that addressed expected economic and population growth in their service region, but did not consider the potential impacts of climate change. Using a robust decision making (RDM) approach for policy under deep uncertainty, we recently worked with IEUA to conduct a climate-change vulnerability and response options analysis of the agency's long-range plans. This analysis suggests that IEUA is vulnerable to future climate change, but can significantly reduce this vulnerability by increasing their near-term conservation programs and careful monitoring and updating to adjust their plan in the years ahead. In addition to helping IEUA, this analysis provides important guidance on the types of climate and other information that can be most useful for water managers as they attempt to take robust, near-term actions to increaase their resilience to climate change.

Implementing program-wide awareness about recovery in a large mental health and addictions program.

PubMed

McVanel-Viney, Sarah; Younger, Jodi; Doyle, Winnie; Kirkpatrick, Helen

2006-01-01

St. Joseph's Healthcare Hamilton conceptualized a multi-step plan for implementing a recovery oriented service delivery approach within their Mental Health and Addictions Program. This brief report discusses the first phase of this plan which included building awareness of recovery utilizing Anthony's (2000) system standards to develop a needs assessment for managers and senior team members. The survey had three purposes: to increase managers' awareness about recovery; to allow managers to express concerns that they had with this paradigm; and to afford managers an opportunity to explore the ways in which their service was and was not operating in a recovery oriented way. Initiatives designed to build awareness throughout the program are discussed.

Harvard Community Health Plan's Mental Health Redesign Project: a managerial and clinical partnership.

PubMed

Abrams, H S

1993-01-01

Harvard Community Health Plan, founded in 1969 as a staff model HMO, is currently a staff and group model HMO with 521,000 members, 19 health centers and 12 independently owned group practices with 26 locations. In 1987, the Plan initiated a review of its mental health benefit and program because its costs were rising, member and clinician dissatisfaction was increasing and many believed the problem was the nature and scope of the benefit. After two years of study, surveys, interviews, cost and utilization analysis, the Plan identified its professional staff as its key asset but recognized many problem areas, including problems with access, variation from site to site, inconsistent service delivery, lack of consistent utilization management and the need for greater diversity along the spectrum of care available to members. From 1989 to 1990, more than 200 clinicians and support staff were engaged in the process of developing a variety of components to the "mental health redesign program." Three simultaneous efforts included developing a method of categorizing patients, restructuring the delivery system and redesigning the benefit. A Mental Health Patient Assessment Tool was created which assists clinicians in performing comprehensive evaluations, administers the benefit, measures progress and supports outcomes research. Delivery system changes included the implementation of self-referral, access standards, intake triage functions by non-clinical staff, program development and an outpatient utilization management function.

Health plan approach to operationalizing a specialty drug management program.

PubMed

Tegenu, Mesfin

2008-05-01

Expenditures related to specialty drugs consume a significant percentage of available health care resources. Explain the process of transitioning the management of specialty drugs from medical services to pharmacy services in 2 managed care plans and provide insight into the issues encountered and solutions implemented based on 6 years of experience using traditional and innovative pharmacy utilization management tools to insure appropriate specialty drug use and reimbursement. The level of involvement in a specialty management program varies from managing only products dispensed by the retail, mail, and specialty pharmacy vendor to encompassing a broad list of specialty drugs distributed through a variety of channels. Efficient administrative, operational, and clinical processes are critical to the success of the program. Additionally, an accurate and timely claims processing procedure is also essential for success as is the ability to mine data and effectively report on the use of specialty products. A clinically sound, cost-effective, and patient-friendly program requires input from health plan members, pharmacy service leaders, and physician providers, and must overcome challenges associated with disrupting current relationships and removing competing incentives. A well-constructed and properly funded specialty drug management program results in clinical and financial benefits for the plan.

Space transportation system payload status and reimbursement policy

NASA Technical Reports Server (NTRS)

Yardley, J. F.

1977-01-01

The status of the Space Transportation System (STS) is reviewed. The management structure and project planning status are discussed, including considerations of STS utilization, payloads, cost assessments, and pricing policy.

4 CFR 2.1 - Purpose, scope, and applicability.

Code of Federal Regulations, 2011 CFR

2011-01-01

... all who plan, direct, or supervise the work of employees. The objective of personnel management is to... treatment, motivation, compensation and productive utilization f employees. (b) Nothing in this regulation...

4 CFR 2.1 - Purpose, scope, and applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... treatment, motivation, compensation and productive utilization f employees. (b) Nothing in this regulation... all who plan, direct, or supervise the work of employees. The objective of personnel management is to...

A computerized model for integrating the physical environmental factors into metropolitan landscape planning

Treesearch

Julius Gy Fabos; Kimball H. Ferris

1977-01-01

This paper justifies and illustrates (in simplified form) a landscape planning approach to the environmental management of the metropolitan landscape. The model utilizes a computerized assessment and mapping system, which exhibits a recent advancement in computer technology that allows for greater accuracy and the weighting of different values when mapping at the...

Major Events Leading to Establishment of The National Task Bank.

ERIC Educational Resources Information Center

Upjohn (W.E.) Inst. for Employment Research, Washington, DC.

This document describes how the plan for a National Task Bank evolved as part of an effort to encourage State and local public welfare agencies to adopt new approaches to staff planning and utilization. The task bank is an outgrowth of the application of systems approach and functional job analysis to agency management. Individualized data banks…

Effect of TV and radio family planning messages on the probability of modern contraception utilization in post-Soviet Central Asia.

PubMed

Habibov, Nazim; Zainiddinov, Hakim

2017-01-01

This study evaluates the effects of family planning message broadcast on radio and TV on the probability of modern contraception utilization in post-Soviet Central Asia. Viewing family planning messages on TV improves the chances of using modern contraception for a woman who actually saw the messages by about 11 and 8 per cent in Kyrgyzstan and Tajikistan, respectively. If every woman in Kyrgyzstan and Tajikistan had an opportunity to watch a family planning message on TV, then the likelihood of using modern contraception would have improved by 10 and 7 per cent in Kyrgyzstan and Tajikistan, respectively. By contrast, the effect of hearing family planning messages on radio is not significant in both countries. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd. Viewing family planning messages on TV improves the chances of using modern contraception for a woman who actually saw the messages by about 11 and 8 per cent in Kyrgyzstan and Tajikistan, respectively. If every woman in Kyrgyzstan and Tajikistan had an opportunity to watch a family planning message on TV, then the probability of using modern contraception would have improved by 10 and 7 per cent in Kyrgyzstan and Tajikistan, respectively. Consequently, using TV family planning messages in both countries should be encouraged. In comparison, the effect of hearing family planning messages on radio is not significant in both countries. © 2015 The Authors. International Journal of Health Planning and Management published by John Wiley & Sons, Ltd.

Phase II -- Photovoltaics for Utility Scale Applications (PVUSA): Safety and health action plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berg, K.

1994-09-01

To establish guidelines for the implementation and administration of an injury and illness prevention program for PVUSA and to assign specific responsibilities for the execution of the program. To provide a basic Safety and Health Action Plan (hereinafter referred to as Plan) that assists management, supervision, and project personnel in the recognition, evaluation, and control of hazardous activities and/or conditions within their respective areas of responsibility.

Personalised Care Plan Management Utilizing Guideline-Driven Clinical Decision Support Systems.

PubMed

Laleci Erturkmen, Gokce Banu; Yuksel, Mustafa; Sarigul, Bunyamin; Lilja, Mikael; Chen, Rong; Arvanitis, Theodoros N

2018-01-01

Older age is associated with an increased accumulation of multiple chronic conditions. The clinical management of patients suffering from multiple chronic conditions is very complex, disconnected and time-consuming with the traditional care settings. Integrated care is a means to address the growing demand for improved patient experience and health outcomes of multimorbid and long-term care patients. Care planning is a prevalent approach of integrated care, where the aim is to deliver more personalized and targeted care creating shared care plans by clearly articulating the role of each provider and patient in the care process. In this paper, we present a method and corresponding implementation of a semi-automatic care plan management tool, integrated with clinical decision support services which can seamlessly access and assess the electronic health records (EHRs) of the patient in comparison with evidence based clinical guidelines to suggest personalized recommendations for goals and interventions to be added to the individualized care plans.

Resource utilization after introduction of a standardized clinical assessment and management plan.

PubMed

Friedman, Kevin G; Rathod, Rahul H; Farias, Michael; Graham, Dionne; Powell, Andrew J; Fulton, David R; Newburger, Jane W; Colan, Steven D; Jenkins, Kathy J; Lock, James E

2010-01-01

A Standardized Clinical Assessment and Management Plan (SCAMP) is a novel quality improvement initiative that standardizes the assessment and management of all patients who carry a predefined diagnosis. Based on periodic review of systemically collected data the SCAMP is designed to be modified to improve its own algorithm. One of the objectives of a SCAMP is to identify and reduce resource utilization and patient care costs. We retrospectively reviewed resource utilization in the first 93 arterial switch operation (ASO) SCAMP patients and 186 age-matched control ASO patients. We compared diagnostic and laboratory testing obtained at the initial SCAMP clinic visit and control patient visits. To evaluate the effect of the SCAMP over time, the number of clinic visits per patient year and echocardiograms per patient year in historical control ASO patients were compared to the projected rates for ASO SCAMP participants. Cardiac magnetic resonance imaging (MRI), stress echocardiogram, and lipid profile utilization were higher in the initial SCAMP clinic visit group than in age-matched control patients. Total echocardiogram and lung scan usage were similar. Chest X-ray and exercise stress testing were obtained less in SCAMP patients. ASO SCAMP patients are projected to have 0.5 clinic visits and 0.5 echocardiograms per year. Historical control patients had more clinic visits (1.2 vs. 0.5 visits/patient year, P<.01) and a higher echocardiogram rate (0.92 vs. 0.5 echocardiograms/patient year, P<.01) Implementation of a SCAMP may initially lead to increased resource utilization, but over time resource utilization is projected to decrease.

Strategic plan to optimize the management of right-of-way parcel and utility information at FDOT : [research summary].

DOT National Transportation Integrated Search

2013-05-01

The Florida Department of Transportation (FDOT) manages more than 12,000 centerline-miles of highway that run through hundreds of jurisdictions. The right-of-way (ROW) that these roads are built on is a massive and complex resource in its own right a...

Salient Beliefs in Majoring in Management Information Systems: An Elicitation Study

ERIC Educational Resources Information Center

Chipidza, Wallace; Green, Gina; Riemenschneider, Cindy

2016-01-01

Research utilizing the Theory of Planned Behavior to understand behavior should first elicit beliefs about the phenomenon from the target population. In order to understand the reasons why students choose to major or not major in Management Information Systems (MIS), we elicited beliefs from 136 students attending university in the United States…

Program Impact Evaluations: An Introduction for Managers of Title VII Projects. A Draft Guidebook.

ERIC Educational Resources Information Center

Bissell, Joan S.

Intended to assist administrators in the planning, management, and utilization of evaluation, this guidebook is designed as an introduction and supplement to other evaluation materials for bilingual education programs being developed under federal sponsorship, including evaluation models for Title VII projects. General information is provided on…

School-Based Management: Promise and Process. CPRE Finance Briefs.

ERIC Educational Resources Information Center

Wohlstetter, Priscilla; Mohrman, Susan Albers

This publication summarizes research that investigated how school-based management (SBM) can be implemented for long-term school improvement. It is argued that a successful SBM plan must be part of a quest for improvement and utilize a "high involvement" model. In addition to having more power, schools need knowledge of the organization,…

Air Force Aerospace Medicine Enterprise Ambulatory Medical Care Survey

DTIC Science & Technology

2014-03-01

aerospace medicine • utilization • health care • Air Force Introduction The planning and management of health care delivery is becoming increasingly...preferences and to adhere to the prescribed regimen. In the broader context of heath care systems, managers and policy makers influence budget and...providers, managers , policy makers, and researchers on the effectiveness of health care organization, patterns of service use, quality of care, health

Manage Toward Success - Utilization of Analytics in Acquisition Decision Making

DTIC Science & Technology

2015-04-01

on the concept of knowledge- based acquisition described by the GAO. In the GAO (2005) report for National Aeronautics and Space Administration ( NASA ...acquisition programs, GAO recommended to NASA , and NASA subsequently con- curred, that transition to a knowledge-based acquisition framework will...Certification and Accreditation Process; ERAM = Enterprise Risk Assessment Manager; EVMS = Earned Value Management System; GOV = Government; POA&M = Plan of

Virtual 3-dimensional preoperative planning with the dextroscope for excision of a 4th ventricular ependymoma.

PubMed

Anil, S M; Kato, Y; Hayakawa, M; Yoshida, K; Nagahisha, S; Kanno, T

2007-04-01

Advances in computer imaging and technology have facilitated enhancement in surgical planning with a 3-dimensional model of the surgical plan of action utilizing advanced visualization tools in order to plan individual interactive operations with the aid of the dextroscope. This provides a proper 3-dimensional imaging insight to the pathological anatomy and sets a new dimension in collaboration for training and education. The case of a seventeen-year-old female, being operated with the aid of a preoperative 3-dimensional virtual reality planning and the practical application of the neurosurgical operation, is presented. This young lady presented with a two-year history of recurrent episodes of severe, global, throbbing headache with episodes of projectile vomiting associated with shoulder pain which progressively worsened. She had no obvious neurological deficits on clinical examination. CT and MRI showed a contrast-enhancing midline posterior fossa space-occupying lesion. Utilizing virtual imaging technology with the aid of a dextroscope which generates stereoscopic images, a 3-dimensional image was produced with the CT and MRI images. A preoperative planning for excision of the lesion was made and a real-time 3-dimensional volume was produced and surgical planning with the dextroscope was made and the lesion excised. Virtual reality has brought new proportions in 3-dimensional planning and management of various complex neuroanatomical problems that are faced during various operations. Integration of 3-dimensional imaging with stereoscopic vision makes understanding the complex anatomy easier and helps improve decision making in patient management.

Update on security plans to prevent bioterrorism attacks during agricultural bacilli programs

Treesearch

Robert A. Fusco

2003-01-01

In the aftermath of September 11, security in aerial application suppression programs utilizing Bacillus thuringiensis has become a critical concern for State pest control managers and aerial applicators.

Implementation and outcomes of commercial disease management programs in the United States: the disease management outcomes consolidation survey.

PubMed

Fitzner, Karen; Fox, Kathe; Schmidt, Joseph; Roberts, Mark; Rindress, Donna; Hay, Joel

2005-08-01

Despite widespread adoption of disease management (DM) programs by US health plans, gaps remain in the evidence for their benefit. The Disease Management Outcomes Consolidation Survey was designed to gather data on DM programs for commercial health plans, to assess program success and DM effectiveness. The questionnaire was mailed to 292 appropriate health plan contacts; 26 plans covering more than 14 million commercial members completed and returned the survey. Respondents reported that DM plays a significant and increasing role in their organizations. Key reasons for adopting DM were improving clinical outcomes, reducing medical costs and utilization, and improving member satisfaction. More respondents were highly satisfied with clinical results than with utilization or cost outcomes of their programs (46%, 17%, and 13%, respectively). Detailed results were analyzed for 57 DM programs with over 230,000 enrollees. Most responding plans offered DM programs for diabetes and asthma, with return on investment (ROI) ranging from 0.16:1 to 4:1. Weighted by number of enrollees per DM program, average ROI was 2.56:1 for asthma (n = 1,136 enrollees) and 1.98:1 for diabetes (n = 25,364). Most (but not all) respondents reported reduced hospital admissions, increasing rates of preventive care, and improved clinical measures. Few respondents provided detailed information about DM programs for other medical conditions, but most that did reported positive outcomes. Lack of standardized methodology was identified as a major barrier to in-house program evaluation. Although low response rate precluded drawing many general conclusions, a clear need emerged for more rigorous evaluation methods and greater standardization of outcomes measurement.

Application of system dynamics for developing financially self-sustaining management policies for water and wastewater systems.

PubMed

Rehan, R; Knight, M A; Haas, C T; Unger, A J A

2011-10-15

Recently enacted regulations in Canada and elsewhere require water utilities to be financially self-sustaining over the long-term. This implies full cost recovery for providing water and wastewater services to users. This study proposes a new approach to help water utilities plan to meet the requirements of the new regulations. A causal loop diagram is developed for a financially self-sustaining water utility which frames water and wastewater network management as a complex system with multiple interconnections and feedback loops. The novel System Dynamics approach is used to develop a demonstration model for water and wastewater network management. This is the first known application of System Dynamics to water and wastewater network management. The network simulated is that of a typical Canadian water utility that has under invested in maintenance. Model results show that with no proactive rehabilitation strategy the utility will need to substantially increase its user fees to achieve financial sustainability. This increase is further exacerbated when price elasticity of water demand is considered. When the utility pursues proactive rehabilitation, financial sustainability is achieved with lower user fees. Having demonstrated the significance of feedback loops for financial management of water and wastewater networks, the paper makes the case for a more complete utility model that considers the complexity of the system by incorporating all feedback loops. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

Integrated water resources management using engineering measures

NASA Astrophysics Data System (ADS)

Huang, Y.

2015-04-01

The management process of Integrated Water Resources Management (IWRM) consists of aspects of policies/strategies, measures (engineering measures and non-engineering measures) and organizational management structures, etc., among which engineering measures such as reservoirs, dikes, canals, etc., play the backbone that enables IWRM through redistribution and reallocation of water in time and space. Engineering measures are usually adopted for different objectives of water utilization and water disaster prevention, such as flood control and drought relief. The paper discusses the planning and implementation of engineering measures in IWRM of the Changjiang River, China. Planning and implementation practices of engineering measures for flood control and water utilization, etc., are presented. Operation practices of the Three Gorges Reservoir, particularly the development and application of regulation rules for flood management, power generation, water supply, ecosystem needs and sediment issues (e.g. erosion and siltation), are also presented. The experience obtained in the implementation of engineering measures in Changjiang River show that engineering measures are vital for IWRM. However, efforts should be made to deal with changes of the river system affected by the operation of engineering measures, in addition to escalatory development of new demands associated with socio-economic development.

Rethinking Funding Strategies: Integrated Planning and Resource Development for the Small Two-Year College of 1990.

ERIC Educational Resources Information Center

Bender, Louis; Daniel, David

1986-01-01

Presents management models showing the evolution of public expectancy as reflected in legislated policy: the petty cash model, the public utility model, and the business model. Discusses the John A. Walker Community Center at Wilkes Community College (North Carolina) as an example of the integrated planning/resource development (i.e., business)…

A senior manager with a knowledge management portfolio: the Santa Clara County experience.

PubMed

Lindberg, Arley

2012-01-01

The agency director sought to create a systematically coordinated department that utilizes knowledge management strategies to promote evidence-informed practice. In his view, the organization was not providing needed information or organizational supports for practitioners to use knowledge effectively. To address this issue, he created a Director of Development and Operational Planning (DDOP) position with the responsibility to build structures and facilitate processes that support knowledge management. The DDOP oversees research and planning, government relations, legislative development and support, Board of Supervisors communications, staff development and training, community contracts, public information and in-house communication. The DDOP is reorganizing units under her supervision to create a knowledge management matrix that will implement new knowledge sharing strategies related to evaluation, contracts, legislation, organizational development, policy and planning, and staff development. The case study describes challenges and strategies related to: government regulations, size and complexity of the agency, staff resistance, and the developmental nature of the process. Copyright © Taylor & Francis Group, LLC

Pharmacy Benefit Management Companies: Do They Create Value in the US Healthcare System?

PubMed

Lyles, Alan

2017-05-01

Pharmacy benefit management companies (PBMs) perform functions in the US market-based healthcare system that may be performed by public agencies or quasi-public institutions in other nations. By aggregating lives covered under their many individual contracts with payers, PBMs have formidable negotiating power. They influence pharmaceutical insurance coverage, design the terms of coverage in a plan's drug benefit, and create competition among providers for inclusion in a plan's network. PBMs have, through intermediation, the potential to secure lower drug prices and to improve rational prescribing. Whether these potential outcomes are realized within the relevant budget is a function of the healthcare system and the interaction of benefit design and clinical processes-not just individually vetted components. Efficiencies and values achieved in price discounts and cost sharing can be nullified if there is irrational prescribing (over-utilization, under-utilization and mis-utilization), variable patient adherence to medication regimens, ineffective formulary processes, or fraud, waste and abuse. Rising prescription drug costs and the increasing prevalence of 'high deductible health plans', which require much greater patient out-of-pocket costs, is creating a crisis for PBM efforts towards an affordable pharmacy benefit. Since PBM rebate and incentive contracts are opaque to the public, whether they add value by restraining higher drug prices or benefit from them is debatable.

Evaluation readiness: improved evaluation planning using a data inventory framework.

PubMed

Cohen, A B; Hall, K C; Cohodes, D R

1985-01-01

Factors intrinsic to many programs, such as ambiguously stated objectives, inadequately defined performance measures, and incomplete or unreliable databases, often conspire to limit the evaluability of these programs. Current evaluation planning approaches are somewhat constrained in their ability to overcome these obstacles and to achieve full preparedness for evaluation. In this paper, the concept of evaluation readiness is introduced as a complement to other evaluation planning approaches, most notably that of evaluability assessment. The basic products of evaluation readiness--the formal program definition and the data inventory framework--are described, along with a guide for assuring more timely and appropriate evaluation response capability to support the decision making needs of program managers. The utility of evaluation readiness for program planning, as well as for effective management, is also discussed.

Bluetooth data collection system for planning and arterial management.

DOT National Transportation Integrated Search

2014-08-01

This report presents the results of a research and development project of an implementable portable wireless traffic data collection system. Utilizing Bluetooth wireless technology as a platform, portable battery powered data collection units housed ...

Perspectives on the use of green infrastructure for stormwater management in Cleveland and Milwaukee.

PubMed

Keeley, Melissa; Koburger, Althea; Dolowitz, David P; Medearis, Dale; Nickel, Darla; Shuster, William

2013-06-01

Green infrastructure is a general term referring to the management of landscapes in ways that generate human and ecosystem benefits. Many municipalities have begun to utilize green infrastructure in efforts to meet stormwater management goals. This study examines challenges to integrating gray and green infrastructure for stormwater management, informed by interviews with practitioners in Cleveland, OH and Milwaukee WI. Green infrastructure in these cities is utilized under conditions of extreme fiscal austerity and its use presents opportunities to connect stormwater management with urban revitalization and economic recovery while planning for the effects of negative- or zero-population growth. In this context, specific challenges in capturing the multiple benefits of green infrastructure exist because the projects required to meet federally mandated stormwater management targets and the needs of urban redevelopment frequently differ in scale and location.

Perspectives on the Use of Green Infrastructure for Stormwater Management in Cleveland and Milwaukee

NASA Astrophysics Data System (ADS)

Keeley, Melissa; Koburger, Althea; Dolowitz, David P.; Medearis, Dale; Nickel, Darla; Shuster, William

2013-06-01

Green infrastructure is a general term referring to the management of landscapes in ways that generate human and ecosystem benefits. Many municipalities have begun to utilize green infrastructure in efforts to meet stormwater management goals. This study examines challenges to integrating gray and green infrastructure for stormwater management, informed by interviews with practitioners in Cleveland, OH and Milwaukee WI. Green infrastructure in these cities is utilized under conditions of extreme fiscal austerity and its use presents opportunities to connect stormwater management with urban revitalization and economic recovery while planning for the effects of negative- or zero-population growth. In this context, specific challenges in capturing the multiple benefits of green infrastructure exist because the projects required to meet federally mandated stormwater management targets and the needs of urban redevelopment frequently differ in scale and location.

Study on workshop layout of a motorcycle company based on systematic layout planning (SLP)

NASA Astrophysics Data System (ADS)

Zhou, Kang-Qu; Zhang, Rui-Juan; Wang, Ying-Dong; Wang, Bing-Jie

2010-08-01

The method of SLP has been applied in a motorcycle company's layout planning. In this layout design, the related graphics have been used to illuminate the logistics and non-logistics relationships of every workshop to get the integrated relationships of workshops and preliminary plans. Comparing the two preliminary plans including logistics efficiency, space utilization, management conveniences, etc, an improvement solution is proposed. Through the improvement solution, the productivity has been increased by 18% and the production capacity is able to make 1600 engines each day.

The Mental Health Parity and Addiction Equity Act Evaluation Study: Impact on Specialty Behavioral Health Care Utilization and Spending Among Carve-In Enrollees.

PubMed

Harwood, Jessica M; Azocar, Francisca; Thalmayer, Amber; Xu, Haiyong; Ong, Michael K; Tseng, Chi-Hong; Wells, Kenneth B; Friedman, Sarah; Ettner, Susan L

2017-02-01

The federal Mental Health Parity and Addiction Equity Act (MHPAEA) sought to eliminate historical disparities between insurance coverage for behavioral health (BH) treatment and coverage for medical treatment. Our objective was to evaluate MHPAEA's impact on BH expenditures and utilization among "carve-in" enrollees. We received specialty BH insurance claims and eligibility data from Optum, sampling 5,987,776 adults enrolled in self-insured plans from large employers. An interrupted time series study design with segmented regression analysis estimated monthly time trends of per-member spending and use before (2008-2009), during (2010), and after (2011-2013) MHPAEA compliance (N=179,506,951 member-month observations). Outcomes included: total, plan, patient out-of-pocket spending; outpatient utilization (assessment/diagnostic evaluation visits, medication management, individual and family psychotherapy); intermediate care utilization (structured outpatient, day treatment, residential); and inpatient utilization. MHPAEA was associated with increases in monthly per-member total spending, plan spending, assessment/diagnostic evaluation visits [respective immediate increases of: $1.05 (P=0.02); $0.88 (P=0.04); 0.00045 visits (P=0.00)], and individual psychotherapy visits [immediate increase of 0.00578 visits (P=0.00) and additional increases of 0.00017 visits/mo (P=0.03)]. MHPAEA was associated with modest increases in total and plan spending and outpatient utilization; for example, in July 2012 predicted per-enrollee plan spending was $4.92 without MHPAEA and $6.14 with MHPAEA. Efforts should focus on understanding how other barriers to BH care unaddressed by MHPAEA may affect access/utilization. Future research should evaluate effects produced by the Affordable Care Act's inclusion of BH care as an essential health benefit and expansion of MHPAEA protections to the individual and small group markets.

Bridging Scientific Model Outputs with Emergency Response Needs in Catastrophic Earthquake Responses

ERIC Educational Resources Information Center

Johannes, Tay W.

2010-01-01

In emergency management, scientific models are widely used for running hazard simulations and estimating losses often in support of planning and mitigation efforts. This work expands utility of the scientific model into the response phase of emergency management. The focus is on the common operating picture as it gives context to emergency…

Hands-on Precision Agriculture Data Management Workshops for Producers and Industry Professionals: Development and Assessment

ERIC Educational Resources Information Center

Luck, Joe D.; Fulton, John P.; Rees, Jennifer

2015-01-01

Three Precision Agriculture Data Management workshops regarding yield monitor data were conducted in 2014, reaching 62 participants. Post-workshop surveys (n = 58) indicated 73% of respondents experienced a moderate to significant increase in knowledge related to yield monitor data usage. Another 72% reported that they planned to utilize best…

Moving forward: Responding to and mitigating effects of the MPB epidemic [Chapter 8

Treesearch

Claudia Regan; Barry Bollenbacher; Rob Gump; Mike Hillis

2014-01-01

The final webinar in the Future Forest Webinar Series provided an example of how managers utilized available science to address questions about post-epidemic forest conditions. Assessments of current conditions and projected trends, and how these compare with historical patterns, provide important information for land management planning. Large-scale disturbance events...

Scenario-based water resources planning for utilities in the Lake Victoria region

NASA Astrophysics Data System (ADS)

Mehta, Vishal K.; Aslam, Omar; Dale, Larry; Miller, Norman; Purkey, David R.

Urban areas in the Lake Victoria (LV) region are experiencing the highest growth rates in Africa. As efforts to meet increasing demand accelerate, integrated water resources management (IWRM) tools provide opportunities for utilities and other stakeholders to develop a planning framework comprehensive enough to include short term (e.g. landuse change), as well as longer term (e.g. climate change) scenarios. This paper presents IWRM models built using the Water Evaluation And Planning (WEAP) decision support system, for three towns in the LV region - Bukoba (Tanzania), Masaka (Uganda), and Kisii (Kenya). Each model was calibrated under current system performance based on site visits, utility reporting and interviews. Projected water supply, demand, revenues and costs were then evaluated against a combination of climate, demographic and infrastructure scenarios up to 2050. Our results show that water supply in all three towns is currently infrastructure limited; achieving existing design capacity could meet most projected demand until 2020s in Masaka beyond which new supply and conservation strategies would be needed. In Bukoba, reducing leakages would provide little performance improvement in the short-term, but doubling capacity would meet all demands until 2050. In Kisii, major infrastructure investment is urgently needed. In Masaka, streamflow simulations show that wetland sources could satisfy all demand until 2050, but at the cost of almost no water downstream of the intake. These models demonstrate the value of IWRM tools for developing water management plans that integrate hydroclimatology-driven supply to demand projections on a single platform.

Impact of HMO ownership on management processes and utilization outcomes.

PubMed

Ahern, M; Molinari, C

2001-05-01

To examine the effects of health maintenance organization (HMO) ownership characteristics on selected utilization outcomes and management processes affecting utilization. We used 1995 HMO data from the American Association of Health Plans. Using regression analysis, we examined the relation between HMO utilization (hospital discharges, days, and average length of stay; cardiac catheterization procedures; and average cost of outpatient prescriptions) and the structural characteristics of HMOs: ownership type (insurance company, hospital, physician, independent, and national managed care company), HMO size, for-profit status, model type, geographic region, and payer mix. HMO ownership type is significantly associated with medical management processes, including risk sharing by providers, risk sharing by consumers, and other management strategies. Relative to hospital-owned HMOs, insurance company-owned HMOs have fewer hospital discharges, fewer hospital days, and longer lengths of stay. National managed care organization-owned HMOs have fewer cardiac catheterizations and lower average outpatient prescription costs. Independently owned HMOs have more cardiac catheterizations. For-profit HMOs have lower prescription costs. Relative to hospital-owned HMOs, insurance company-owned HMOs are more likely to use hospital risk sharing and provider capitation and less likely to use out-of-pocket payments for hospital use and a closed formulary. National managed care organization-owned HMOs are less likely to use provider capitation, out-of-pocket payments for hospital use, catastrophic case management, and hospital risk sharing. Physician-hospital-owned HMOs are less likely to use catastrophic case management. For-profit HMOs are more likely to use hospital risk sharing and catastrophic case management. HMO ownership type affects utilization outcomes and management strategies.

Understanding Climate Adaptation on Public Lands in the Upper Midwest: Implications for Monitoring and Tracking Progress

NASA Astrophysics Data System (ADS)

Anhalt-Depies, Christine M.; Knoot, Tricia Gorby; Rissman, Adena R.; Sharp, Anthony K.; Martin, Karl J.

2016-05-01

There are limited examples of efforts to systematically monitor and track climate change adaptation progress in the context of natural resource management, despite substantial investments in adaptation initiatives. To better understand the status of adaptation within state natural resource agencies, we utilized and problematized a rational decision-making framework to characterize adaptation at the level of public land managers in the Upper Midwest. We conducted in-depth interviews with 29 biologists and foresters to provide an understanding of managers' experiences with, and perceptions of, climate change impacts, efforts towards planning for climate change, and a full range of actions implemented to address climate change. While the majority of managers identified climate change impacts affecting their region, they expressed significant uncertainty in interpreting those signals. Just under half of managers indicated planning efforts are underway, although most planning is remote from local management. Actions already implemented include both forward-looking measures and those aimed at coping with current impacts. In addition, cross-scale dynamics emerged as an important theme related to the overall adaptation process. The results hold implications for tracking future progress on climate change adaptation. Common definitions or measures of adaptation (e.g., presence of planning documents) may need to be reassessed for applicability at the level of public land managers.

Understanding Climate Adaptation on Public Lands in the Upper Midwest: Implications for Monitoring and Tracking Progress.

PubMed

Anhalt-Depies, Christine M; Knoot, Tricia Gorby; Rissman, Adena R; Sharp, Anthony K; Martin, Karl J

2016-05-01

There are limited examples of efforts to systematically monitor and track climate change adaptation progress in the context of natural resource management, despite substantial investments in adaptation initiatives. To better understand the status of adaptation within state natural resource agencies, we utilized and problematized a rational decision-making framework to characterize adaptation at the level of public land managers in the Upper Midwest. We conducted in-depth interviews with 29 biologists and foresters to provide an understanding of managers' experiences with, and perceptions of, climate change impacts, efforts towards planning for climate change, and a full range of actions implemented to address climate change. While the majority of managers identified climate change impacts affecting their region, they expressed significant uncertainty in interpreting those signals. Just under half of managers indicated planning efforts are underway, although most planning is remote from local management. Actions already implemented include both forward-looking measures and those aimed at coping with current impacts. In addition, cross-scale dynamics emerged as an important theme related to the overall adaptation process. The results hold implications for tracking future progress on climate change adaptation. Common definitions or measures of adaptation (e.g., presence of planning documents) may need to be reassessed for applicability at the level of public land managers.

Multi-Criteria GIS Analyses with the Use of Uavs for the Needs of Spatial Planning

NASA Astrophysics Data System (ADS)

Zawieska, D.; Markiewicz, J.; Turek, A.; Bakuła, K.; Kowalczyk, M.; Kurczyński, Z.; Ostrowski, W.; Podlasiak, P.

2016-06-01

Utilization of Unmanned Aerial Systems (UAVs) in agriculture, forestry, or other environmental contexts has recently become common. However, in the case of spatial planning, the role of UAVs still seems to be underestimated. At present, sections of municipal development use UAVs mainly for promotional purposes (films, folders, brochures, etc.). The use of UAVs for spatial management provides results, first of all, in the form of savings in human resources and time; however, more frequently, it is also connected with financial savings (given the decreasing cost of UAVs and photogrammetric software). The performed research presented here relates to the possibilities of using UAVs to update planning documents, and, in particular, to update the study of conditions and directions of spatial management and preparation of local plans for physical management. Based on acquired photographs with a resolution of 3 cm, a cloud of points is generated, as well as 3D models and the true orthophotomap. These data allow multi-criteria spatial analyses. Additionally, directions of development and changes in physical management are analysed for the given area.

Habitat Evaluation Procedures (HEP) Report; Tacoma/Trimble Area Management Plan, Technical Report 2001-2003.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Entz, Ray; Lockwood, Jr., Neil; Holmes, Darren

2003-10-01

In 2000 and 2001, the Kalispel Natural Resource Department (KNRD) continued to mitigate the wildlife habitat losses as part of the Albeni Falls Wildlife Mitigation Project. Utilizing Bonneville Power Administration (BPA) funds, the Kalispel Tribe of Indians (Tribe) purchased three projects totaling nearly 1,200 acres. The Tacoma/Trimble Wildlife Management Area is a conglomeration of properties now estimated at 1,700 acres. It is the Tribe's intent to manage these properties in cooperation and collaboration with the Pend Oreille County Public Utility District (PUD) No. 1 and the U.S. Fish and Wildlife Service (USFWS) to benefit wildlife habitats and associated species, populations,more » and guilds.« less

Glaucoma and cataract surgery: two roads merging into one.

PubMed

Shah, Manjool; Law, Geoffrey; Ahmed, Iqbal Ike K

2016-01-01

To discuss the increasing utilization of cataract extraction in the management of glaucoma and to highlight advances in surgical care that can promote synergistic treatment of these comorbid conditions. Recent years have demonstrated significant advances in the management of glaucoma through the use of novel microinvasive glaucoma devices. Furthermore, an increased understanding of the role of cataract surgery in the treatment of various glaucomas warrants review. Nevertheless, cataract surgery in the glaucoma patient warrants specific preoperative, intraoperative, and postoperative planning to optimize visual function and quality of life while mitigating potential risk factors for adverse events. Although the challenges of performing cataract extraction on glaucoma patients exist, the potential benefit to these patients is substantial. With attention to pre- and perioperative surgical planning and intraoperative technique, as well as with awareness and potential utilization of novel devices and treatment strategies, cataract extraction offers a unique platform for anatomical and functional improvement in this increasingly common cohort of patients.

Demand-side management glossary

DOE Office of Scientific and Technical Information (OSTI.GOV)

Isaksen, L.; Ignelzi, P.C.

1992-10-01

Demand-side management (DSM) plays an increasingly important role in helping utilities meet capacity needs while addressing important customer service issues. In implementing utility-specific programs, however, DSM professionals have created an entire vocabulary of words and phrases that are often used and interpreted in very different ways by people with similar utility planning backgrounds. Such inconsistent terminology can hamper the very communication DSM seeks to support. Thus, this report-the first of its kind-presents a glossary of DSM terms, grouped under five major categories: (1) utility systems, (2) programs and techniques, (3) costs, revenues, and rates, (4) modeling and analysis, and (5)more » marketing. An index facilitates the rapid search for key words. This glossary together with a complimentary report entitled, Electric Utility DSM Programs: Terminology and Reporting Formats attempts to define some of the most common terms used in DSM today.« less

Demand-side management glossary. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Isaksen, L.; Ignelzi, P.C.

1992-10-01

Demand-side management (DSM) plays an increasingly important role in helping utilities meet capacity needs while addressing important customer service issues. In implementing utility-specific programs, however, DSM professionals have created an entire vocabulary of words and phrases that are often used and interpreted in very different ways by people with similar utility planning backgrounds. Such inconsistent terminology can hamper the very communication DSM seeks to support. Thus, this report-the first of its kind-presents a glossary of DSM terms, grouped under five major categories: (1) utility systems, (2) programs and techniques, (3) costs, revenues, and rates, (4) modeling and analysis, and (5)more » marketing. An index facilitates the rapid search for key words. This glossary together with a complimentary report entitled, Electric Utility DSM Programs: Terminology and Reporting Formats attempts to define some of the most common terms used in DSM today.« less

Electric utility of the year for 1984: Potomac Electric Power

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1984-11-01

High performance, efficiency improvements, a modest construction program, a clear balance sheet, and an effort to expend power plant life were among the qualities that earned Potomac Electric Power (PEPCO) the title of 1984 Utility of the Year. Other key elements in the utility's selection were its strategy for purchasing power, a load management plan, diversified investments into subsidiary businesses, community concern that considers the aesthetics of transmission facilities, and its interest in personnel development, especially among minorities. 3 figures.

Patient-reported denials, appeals, and complaints: associations with overall plan ratings.

PubMed

Quigley, Denise D; Haviland, Amelia M; Dembosky, Jacob W; Klein, David J; Elliott, Marc N

2018-03-01

To assess whether Medicare patients' reports of denied care, appeals/complaints, and satisfactory resolution were associated with ratings of their health plan or care. Retrospective analysis of 2010 Medicare Advantage Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey data. Multivariate linear regression of data from 154,766 respondents (61.1% response rate) tested the association of beneficiary ratings of plan and care with beneficiary reports of denied care, appeals, complaints, and complaint resolution, adjusting for beneficiary demographics. Beneficiaries who reported being denied needed care rated their plans and care significantly less positively, by 17.2 points (on a 100-point scale) and 9.1 points, respectively. Filing an appeal was not statistically significantly associated with further lower ratings. Beneficiaries who filed a complaint that was satisfactorily resolved gave slightly lower ratings of plans (-3.4 points) and care (-2.5 points) than those not filing a complaint (P <.001 for all results). Lower ratings from patients reporting complaints and denied care may notably affect the overall 0-10 CAHPS ratings of Medicare Advantage plans. Our results suggest that beneficiaries may attribute the actions that lead to complaints or denials to plans more than to the care they received. Successful complaint resolution and utilization management review might eliminate most deficits associated with complaints and denied care, consistent with the service recovery paradox. High rates of complaints and denied care might identify areas that need improved utilization management review, customer service, and quality improvement. Among those reporting being denied care, filing an appeal was not associated with lower patient ratings of plan or care.

The structure and content of telephonic scripts found useful in a Medicaid Chronic Disease Management Program.

PubMed

Roth, Alexis M; Ackermann, Ronald T; Downs, Stephen M; Downs, Anne M; Zillich, Alan J; Holmes, Ann M; Katz, Barry P; Murray, Michael D; Inui, Thomas S

2010-06-01

In 2003, the Indiana Office of Medicaid Policy and Planning launched the Indiana Chronic Disease Management Program (ICDMP), a programme intended to improve the health and healthcare utilization of 15,000 Aged, Blind and Disabled Medicaid members living with diabetes and/or congestive heart failure in Indiana. Within ICDMP, programme components derived from the Chronic Care Model and education based on an integrated theoretical framework were utilized to create a telephonic care management intervention that was delivered by trained, non-clinical Care Managers (CMs) working under the supervision of a Registered Nurse. CMs utilized computer-assisted health education scripts to address clinically important topics, including medication adherence, diet, exercise and prevention of disease-specific complications. Employing reflective listening techniques, barriers to optimal self-management were assessed and members were encouraged to engage in health-improving actions. ICDMP evaluation results suggest that this low-intensity telephonic intervention shifted utilization and lowered costs. We discuss this patient-centred method for motivating behaviour change, the theoretical constructs underlying the scripts and the branched-logic format that makes them suitable to use as a computer-based application. Our aim is to share these public-domain materials with other programmes.

Mission management, planning, and cost: PULSE Attitude And Control Systems (AACS)

NASA Technical Reports Server (NTRS)

1990-01-01

The Pluto unmanned long-range scientific explorer (PULSE) is a probe that will do a flyby of Pluto. It is a low weight, relatively low costing vehicle which utilizes mostly off-the-shelf hardware, but not materials or techniques that will be available after 1999. A design, fabrication, and cost analysis is presented. PULSE will be launched within the first decade of the twenty-first century. The topics include: (1) scientific instrumentation; (2) mission management, planning, and costing; (3) power and propulsion systems; (4) structural subsystem; (5) command, control, and communication; and (6) attitude and articulation control.

Resource analysis applications in Michigan. [NASA remote sensing

NASA Technical Reports Server (NTRS)

Schar, S. W.; Enslin, W. R.; Sattinger, I. J.; Robinson, J. G.; Hosford, K. R.; Fellows, R. S.; Raad, J. H.

1974-01-01

During the past two years, available NASA imagery has been applied to a broad spectrum of problems of concern to Michigan-based agencies. These demonstrations include the testing of remote sensing for the purposes of (1) highway corridor planning and impact assessments, (2) game management-area information bases, (3) multi-agency river basin planning, (4) timber resource management information systems, (5) agricultural land reservation policies, and (6) shoreline flooding damage assessment. In addition, cost accounting procedures have been developed for evaluating the relative costs of utilizing remote sensing in land cover and land use analysis data collection procedures.

Considerations and techniques for incorporating remotely sensed imagery into the land resource management process.

NASA Technical Reports Server (NTRS)

Brooner, W. G.; Nichols, D. A.

1972-01-01

Development of a scheme for utilizing remote sensing technology in an operational program for regional land use planning and land resource management program applications. The scheme utilizes remote sensing imagery as one of several potential inputs to derive desired and necessary data, and considers several alternative approaches to the expansion and/or reduction and analysis of data, using automated data handling techniques. Within this scheme is a five-stage program development which includes: (1) preliminary coordination, (2) interpretation and encoding, (3) creation of data base files, (4) data analysis and generation of desired products, and (5) applications.

Distribution automation and control support; Analysis and interpretation of DAC working group results for use in project planning

NASA Technical Reports Server (NTRS)

Klock, P.; Evans, D.

1979-01-01

The Executive Summary and Proceedings of the Working Group Meeting was analyzed to identify specific projects appropriate for Distribution Automation and Control DAC RD&D. Specific projects that should be undertaken in the DAC RD&D program were recommended. The projects are presented under broad categories of work selected based on ESC's interpretation of the results of the Working Group Meeting. Some of the projects are noted as utility industry projects. The ESC recommendations regarding program management are presented. Utility versus Government management responsibilities are noted.

The utility strategic surveys for rare and little-known species under the Northwest Forest Plan.

Treesearch

Deanna H. Olson; Kelli J. Van Norman; Robert D. Huff

2007-01-01

Management of over 400 rare species thought to be associated with late successional and old-growth forest conditions on U.S. federal lands within the range of the northern spotted owl (Strix occidentalis caurina) included a four-pronged "survey-and-manage" approach in 1994–2004 and 2006-2007, which included predisturbance surveys,...

Conjoint analysis: a pragmatic approach for the accounting of multiple benefits in southern forest management

Treesearch

F. Christian Zinkhan; Thomas P. Holmes; D. Evan Mercer

1994-01-01

With conjoint analysis as its foundation, a practical approach for measuring the utility and dollar value of non-market outputs from southern forests is described and analyzed. The approach can be used in the process of evaluating alternative silvicultural and broader natural resource management plans when non-market as well as market outputs are recognized. When...

A regional, market oriented governance for disaster management: A new planning approach.

PubMed

Blackstone, Erwin A; Hakim, Simon; Meehan, Brian

2017-10-01

This paper proposes a regional competitive governance and management of response and recovery from disasters. It presents problems experienced in major disasters, analyzes the failures, and suggests how a competitive system that relies on private and volunteer regional leaders, personnel, and capital can improve preparation, response and recovery efforts over the existing government system. A Public Choice approach is adopted to explain why government often fails, and how regional governance may be socially more efficient than the existing federal- state-local funded and managed disaster system. The paper suggests that the federal role might change from both funding and supplying aid in disasters to merely funding disaster recovery efforts. When a disaster occurs, available businesses and government resources in the region can be utilized under a competitive system. These resources could replace existing federal and state inventories and emergency personnel. An independent regionally controlled and managed council, which also develops its own financial resources, and local volunteer leaders are key for success. The paper suggests a new planning method that utilizes the statistical Factor Analysis methodology to derive an efficient organizational and functional model to confront disasters. Copyright © 2017 Elsevier Ltd. All rights reserved.

Construction in Occupied Spaces

NASA Astrophysics Data System (ADS)

Ward, Andrew E.; Azhar, Salman; Khalfan, Malik

2017-06-01

Conducting construction activities in occupied environments presents a great challenge due to the additional logistical requirements and the presence of the building occupants. The aim of this research is to gather and evaluate the means and methods to successfully plan, manage, and execute construction activities in occupied spaces in an effort to provide consolidated industry tools and strategies for maintaining a schedule and minimizing the impact on the occupants. The methodology of the research utilizes an exploratory approach to gather qualitative data. The data was collected through interviews with industry professionals to identify industry best practices. The semi-structured interviews provided a platform for the documents, lessons learned, and the techniques and strategies used for occupied construction by the construction industry. The information obtained in the interview process identified six themes that are critical to achieving and maintaining quality in occupied construction. These themes of the schedule, cost, customer satisfaction, planning, fire/life safety and utilities, and contractor management are reviewed in detail, and the paper discusses how to manage each element. The analysis and extracted management techniques, procedures and strategies can be used by the construction industry for future projects by focusing on the critical aspects of occupied construction and the manner in which to succeed with it.

The Affordable Care Act and the Burden of High Cost Sharing and Utilization Management Restrictions on Access to HIV Medications for People Living with HIV/AIDS.

PubMed

Zamani-Hank, Yasamean

2016-08-01

The HIV/AIDS epidemic continues to be a critical public health issue in the United States, where an estimated 1.2 million individuals live with HIV infection. Viral suppression is one of the primary public health goals for People Living with HIV/AIDS (PLWHA). A crucial component of this goal involves adequate access to health care, specifically anti-retroviral HIV medications. The enactment of the Affordable Care Act (ACA) in 2010 raised hopes for millions of PLWHA without access to health care coverage. High cost-sharing requirements enacted by health plans place a financial burden on PLWHA who need ongoing access to these life-saving medications. Plighted with poverty, Detroit, Michigan, is a center of attention for examining the financial burden of HIV medications on PLWHA under the new health plans. From November 2014 to January 2015, monthly out-of-pocket costs and medication utilization requirements for 31 HIV medications were examined for the top 12 insurance carriers offering Qualified Health Plans on Michigan's Health Insurance Marketplace Exchange. The percentage of medications requiring quantity limits and prior authorization were calculated. The average monthly out-of-pocket cost per person ranged from $12 to $667 per medication. Three insurance carriers placed all 31 HIV medications on the highest cost-sharing tier, charging 50% coinsurance. High out-of-pocket costs and medication utilization restrictions discourage PLWHA from enrolling in health plans and threaten interrupted medication adherence, drug resistance, and increased risk of viral transmission. Health plans inflicting high costs and medication restrictions violate provisions of the ACA and undermine health care quality for PLWHA. (Population Health Management 2016;19:272-278).

Planning factors for developing an enterprise-wide picture archiving and communication system maintenance program.

PubMed

Staley, S; Romlein, J; Chacko, A K; Wider, R

2000-05-01

Picture archiving and communication system (PACS) maintenance on an individual site basis has historically been a complex and costly challenge. With the advent of enterprise-wide PACS projects such as the Virtual Radiology Environment (VRE) project, the challenge of a maintenance program with even more complexities has presented itself. The approach of the project management team for the VRE project is not one of reactive maintenance, but one of highly proactive planning and negotiations, in hopes of capitalizing on the economies of scale of an enterprise-wide PACS maintenance program. A proactive maintenance program is one aspect of life-cycle management. As with any capital acquisition, life-cycle management may be used to manage the specific project aspects related to PACS. The purpose of an enterprise-wide warranty and maintenance life-cycle management approach is to maintain PACS at its maximum operational efficiency and utilization levels through a flexible, shared, yet symbiotic relationship between local, regional, and vendor resources. These goals include providing maximum operational performance levels on a local, regional, and enterprise basis, while maintaining acceptable costs and resource utilization levels. This goal must be achieved without negatively impacting point of care activities, regardless of changes to the clinical business environment.

The Future of Electricity Resource Planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kahrl, Fredrich; Mills, Andrew; Lavin, Luke

Electricity resource planning is the process of identifying longer-term investments to meet electricity reliability requirements and public policy goals at a reasonable cost. Resource planning processes provide a forum for regulators, electric utilities, and electricity industry stakeholders to evaluate the economic, environmental, and social benefits and costs of different investment options. By facilitating a discussion on future goals, challenges and strategies, resource planning processes often play an important role in shaping utility business decisions. Resource planning emerged more than three decades ago in an era of transition, where declining electricity demand and rising costs spurred fundamental changes in electricity industrymore » regulation and structure. Despite significant changes in the industry, resource planning continues to play an important role in supporting investment decision making. Over the next two decades, the electricity industry will again undergo a period of transition, driven by technological change, shifting customer preferences and public policy goals. This transition will bring about a gradual paradigm shift in resource planning, requiring changes in scope, approaches and methods. Even as it changes, resource planning will continue to be a central feature of the electricity industry. Its functions — ensuring the reliability of high voltage (“bulk”) power systems, enabling oversight of regulated utilities and facilitating low-cost compliance with public policy goals — are likely to grow in importance as the electricity industry enters a new period of technological, economic and regulatory change. This report examines the future of electricity resource planning in the context of a changing electricity industry. The report examines emerging issues and evolving practices in five key areas that will shape the future of resource planning: (1) central-scale generation, (2) distributed generation, (3) demand-side resources, (4) transmission and (5) uncertainty and risk management. The analysis draws on a review of recent resource plans for 10 utilities that reflect some of the U.S. electricity industry’s extensive diversity.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Trujillo, Angelina Michelle

Strategy, Planning, Acquiring- very large scale computing platforms come and go and planning for immensely scalable machines often precedes actual procurement by 3 years. Procurement can be another year or more. Integration- After Acquisition, machines must be integrated into the computing environments at LANL. Connection to scalable storage via large scale storage networking, assuring correct and secure operations. Management and Utilization – Ongoing operations, maintenance, and trouble shooting of the hardware and systems software at massive scale is required.

An examination of the relationship between care management with coaching for activation and patient outcomes.

PubMed

Reistroffer, Cindy; Hearld, Larry R; Szychowski, Jeff M

2017-02-01

A growing body of research has established the benefits of patient activation, which is defined as the knowledge, skills, confidence, and motivation to make effective decisions and take action to maintain or improve one's health. Consequently, healthcare stakeholders of all types continue to seek ways to improve patient activation. The purpose of this study was to empirically examine whether enrollment in a health plan-sponsored care management (CM) program that included coaching for activation (CFA) was associated with utilization, medication adherence, and clinical outcomes. Cross-sectional, quantitative study of commercially insured enrollees in a Midwest-based health plan. Poisson, logistic, and ordinary least squares regression models were used to test the relationships between CM programs and outcomes. The benefit of measuring patient activation and offering CFA was associated with reduced healthcare utilization and better clinical outcomes. Relative to respondents in the CFA CM group (ie, intervention), respondents in the usual CM group experienced 18.29% more emergency department visits, 97.78% more hospital admissions, a higher glycated hemoglobin level (β = 0.48; P <.001), and higher systolic blood pressure (β = 1.19; P <.01). These findings suggest that coaching interventions based on activation level may help care managers engage in more effective interactions that strengthen a patient's role in managing his or her healthcare. Programs that are more targeted in their application, rather than uniformly developed and implemented, may be an important factor in reducing utilization and improving clinical outcomes.

Developing and applying uncertain global climate change projections for regional water management planning

NASA Astrophysics Data System (ADS)

Groves, David G.; Yates, David; Tebaldi, Claudia

2008-12-01

Climate change may impact water resources management conditions in difficult-to-predict ways. A key challenge for water managers is how to incorporate highly uncertain information about potential climate change from global models into local- and regional-scale water management models and tools to support local planning. This paper presents a new method for developing large ensembles of local daily weather that reflect a wide range of plausible future climate change scenarios while preserving many statistical properties of local historical weather patterns. This method is demonstrated by evaluating the possible impact of climate change on the Inland Empire Utilities Agency service area in southern California. The analysis shows that climate change could impact the region, increasing outdoor water demand by up to 10% by 2040, decreasing local water supply by up to 40% by 2040, and decreasing sustainable groundwater yields by up to 15% by 2040. The range of plausible climate projections suggests the need for the region to augment its long-range water management plans to reduce its vulnerability to climate change.

18 CFR 801.0 - Introduction.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Commission. The Commission is a regional governmental agency whose purpose is to effect comprehensive multiple purpose planning for the conservation, utilization, development, management, and control of the... fulfill its statutory regional governmental role. (c) The objectives of the Commission are to: (1) Develop...

5 CFR 370.109 - Agency plans.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS INFORMATION TECHNOLOGY EXCHANGE... organization or self-nomination, to include endorsement by their respective supervisor; (3) Forward nominations... extent to which the employee's current competencies and skills are being utilized in the agency; (ii) The...

Connected vehicle pilot deployment program phase 2, data management plan - Wyoming

DOT National Transportation Integrated Search

2017-04-10

The Wyoming Department of Transportations (WYDOT) Connected Vehicle (CV) Pilot Deployment Program is intended to develop a suite of applications that utilize vehicle to infrastructure (V2I) and vehicle to vehicle (V2V) communication technology to ...

The relationship between budget allocated and budget utilized of faculties in an academic institution

NASA Astrophysics Data System (ADS)

Aziz, Wan Noor Hayatie Wan Abdul; Aziz, Rossidah Wan Abdul; Shuib, Adibah; Razi, Nor Faezah Mohamad

2014-06-01

Budget planning enables an organization to set priorities towards achieving certain goals and to identify the highest priorities to be accomplished with the available funds, thus allowing allocation of resources according to the set priorities and constraints. On the other hand, budget execution and monitoring enables allocated funds or resources to be utilized as planned. Our study concerns with investigating the relationship between budget allocation and budget utilization of faculties in a public university in Malaysia. The focus is on the university's operations management financial allocation and utilization based on five categories which are emolument expenditure, academic or services and supplies expenditure, maintenance expenditure, student expenditure and others expenditure. The analysis on financial allocation and utilization is performed based on yearly quarters. Data collected include three years faculties' budget allocation and budget utilization performance involving a sample of ten selected faculties of a public university in Malaysia. Results show that there are positive correlation and significant relationship between quarterly budget allocation and quarterly budget utilization. This study found that emolument give the highest contribution to the total allocation and total utilization for all quarters. This paper presents some findings based on statistical analysis conducted which include descriptive statistics and correlation analysis.

Project Management Meets Change Management - A Success Story. Focus Area: Tech Perspectives TI012SN

NASA Technical Reports Server (NTRS)

Hall, Wayne

2011-01-01

Utilizing the concepts and terminology from Project Management, the process of planning and executing a Change Management (CM) Infrastructure improvement project is described. The primary audience for this presentation includes both experienced and relatively new CM administrators and their managers. It also includes anyone with an interest in the application of project management knowledge to CM administration. There are several benefits: the complexity of the CM tool technology is more manageable, CM administrators get to use project management knowledge to complete a project (not "firefighting"), improve relations with your customers (that means developers and managers), and get the opportunity to do it again.

Planning Tool for Strategic Evaluation of Facility Plans - 13570

DOE Office of Scientific and Technical Information (OSTI.GOV)

Magoulas, Virginia; Cercy, Michael; Hall, Irin

2013-07-01

Savannah River National Laboratory (SRNL) has developed a strategic planning tool for the evaluation of the utilization of its unique resources for processing and research and development of nuclear materials. The Planning Tool is a strategic level tool for assessing multiple missions that could be conducted utilizing the SRNL facilities and showcasing the plan. Traditional approaches using standard scheduling tools and laying out a strategy on paper tended to be labor intensive and offered either a limited or cluttered view for visualizing and communicating results. A tool that can assess the process throughput, duration, and utilization of the facility wasmore » needed. SRNL teamed with Newport News Shipbuilding (NNS), a division of Huntington Ingalls Industries, to create the next generation Planning Tool. The goal of this collaboration was to create a simulation based tool that allows for quick evaluation of strategies with respect to new or changing missions, and clearly communicates results to the decision makers. This tool has been built upon a mature modeling and simulation software previously developed by NNS. The Planning Tool provides a forum for capturing dependencies, constraints, activity flows, and variable factors. It is also a platform for quickly evaluating multiple mission scenarios, dynamically adding/updating scenarios, generating multiple views for evaluating/communicating results, and understanding where there are areas of risks and opportunities with respect to capacity. The Planning Tool that has been developed is useful in that it presents a clear visual plan for the missions at the Savannah River Site (SRS). It not only assists in communicating the plans to SRS corporate management, but also allows the area stakeholders a visual look at the future plans for SRS. The design of this tool makes it easily deployable to other facility and mission planning endeavors. (authors)« less

A narrative method for analyzing transitions in urban water management: The case of the Miami-Dade Water and Sewer Department

NASA Astrophysics Data System (ADS)

Treuer, Galen; Koebele, Elizabeth; Deslatte, Aaron; Ernst, Kathleen; Garcia, Margaret; Manago, Kim

2017-01-01

Although the water management sector is often characterized as resistant to risk and change, urban areas across the United States are increasingly interested in creating opportunities to transition toward more sustainable water management practices. These transitions are complex and difficult to predict - the product of water managers acting in response to numerous biophysical, regulatory, political, and financial factors within institutional constraints. Gaining a better understanding of how these transitions occur is crucial for continuing to improve water management. This paper presents a replicable methodology for analyzing how urban water utilities transition toward sustainability. The method combines standardized quantitative measures of variables that influence transitions with contextual qualitative information about a utility's unique decision making context to produce structured, data-driven narratives. Data-narratives document the broader context, the utility's pretransition history, key events during an accelerated period of change, and the consequences of transition. Eventually, these narratives should be compared across cases to develop empirically-testable hypotheses about the drivers of and barriers to utility-level urban water management transition. The methodology is illustrated through the case of the Miami-Dade Water and Sewer Department (WASD) in Miami-Dade County, Florida, and its transition toward more sustainable water management in the 2000s, during which per capita water use declined, conservation measures were enacted, water rates increased, and climate adaptive planning became the new norm.

Managed care and inpatient mortality in adults: effect of primary payer.

PubMed

Hines, Anika L; Raetzman, Susan O; Barrett, Marguerite L; Moy, Ernest; Andrews, Roxanne M

2017-02-08

Because managed care is increasingly prevalent in health care finance and delivery, it is important to ascertain its effects on health care quality relative to that of fee-for-service plans. Some stakeholders are concerned that basing gatekeeping, provider selection, and utilization management on cost may lower quality of care. To date, research on this topic has been inconclusive, largely because of variation in research methods and covariates. Patient age has been the only consistently evaluated outcome predictor. This study provides a comprehensive assessment of the association between managed care and inpatient mortality for Medicare and privately insured patients. A cross-sectional design was used to examine the association between managed care and inpatient mortality for four common inpatient conditions. Data from the 2009 Healthcare Cost and Utilization Project State Inpatient Databases for 11 states were linked to data from the American Hospital Association Annual Survey Database. Hospital discharges were categorized as managed care or fee for service. A phased approach to multivariate logistic modeling examined the likelihood of inpatient mortality when adjusting for individual patient and hospital characteristics and for county fixed effects. Results showed different effects of managed care for Medicare and privately insured patients. Privately insured patients in managed care had an advantage over their fee-for-service counterparts in inpatient mortality for acute myocardial infarction, stroke, pneumonia, and congestive heart failure; no such advantage was found for the Medicare managed care population. To the extent that the study showed a protective effect of privately insured managed care, it was driven by individuals aged 65 years and older, who had consistently better outcomes than their non-managed care counterparts. Privately insured patients in managed care plans, especially older adults, had better outcomes than those in fee-for-service plans. Patients in Medicare managed care had outcomes similar to those in Medicare FFS. Additional research is needed to understand the role of patient selection, hospital quality, and differences among county populations in the decreased odds of inpatient mortality among patients in private managed care and to determine why this result does not hold for Medicare.

Quality control and quality assurance plan for bridge channel-stability assessments in Massachusetts

USGS Publications Warehouse

Parker, Gene W.; Pinson, Harlow

1993-01-01

A quality control and quality assurance plan has been implemented as part of the Massachusetts bridge scour and channel-stability assessment program. This program is being conducted by the U.S. Geological Survey, Massachusetts-Rhode Island District, in cooperation with the Massachusetts Highway Department. Project personnel training, data-integrity verification, and new data-management technologies are being utilized in the channel-stability assessment process to improve current data-collection and management techniques. An automated data-collection procedure has been implemented to standardize channel-stability assessments on a regular basis within the State. An object-oriented data structure and new image management tools are used to produce a data base enabling management of multiple data object classes. Data will be reviewed by assessors and data base managers before being merged into a master bridge-scour data base, which includes automated data-verification routines.

Time evolving multi-city dependencies and robustness tradeoffs for risk-based portfolios of conservation, transfers, and cooperative water supply infrastructure development pathways

NASA Astrophysics Data System (ADS)

Trindade, B. C.; Reed, P. M.; Zeff, H. B.; Characklis, G. W.

2016-12-01

Water scarcity in historically water-rich regions such as the southeastern United States is becoming a more prevalent concern. It has been shown that cooperative short-term planning that relies on conservation and transfers of existing supplies amongst communities can be used by water utilities to mitigate the effects of water scarcity in the near future. However, in the longer term, infrastructure expansion is likely to be necessary to address imbalances between growing water demands and the available supply capacity. This study seeks to better diagnose and avoid candidate modes for system failure. Although it is becoming more common for water utilities to evaluate the robustness of their water supply, defined as the insensitivity of their systems to errors in deeply uncertain projections or assumptions, defining robustness is particularly challenging in multi-stakeholder regional contexts for decisions that encompass short management actions and long-term infrastructure planning. Planning and management decisions are highly interdependent and strongly shape how a region's infrastructure itself evolves. This research advances the concept of system robustness by making it evolve over time rather than static, so that it is applicable to an adaptive system and therefore more suited for use for combined short and long-term planning efforts. The test case for this research is the Research Triangle area of North Carolina, where the cities of Raleigh, Durham, Cary and Chapel Hill are experiencing rapid population growth and increasing concerns over drought. This study is facilitating their engagement in cooperative and robust regional water portfolio planning. The insights from this work have general merit for regions where adjacent municipalities can benefit from improving cooperative infrastructure investments and more efficient resource management strategies.

The relationship between activity specialization and preferences for setting and route attributes of selected rock climbers

Treesearch

Kurt Merrill; Alan Graefe

1998-01-01

Many natural areas are now in the process of developing climbing management plans in order to control management factors associated with the growth of rock climbing. These factors may include limiting areas of use and limiting the type of climber utilizing the resource. The purpose of this study was to further develop and operationalize the concept of recreation...

Pedestrian Levels of Service (LOS) at Muir Woods National Monument (California): An introduction to multi-modal LOS for parks and protected areas

Treesearch

Peter R. Pettengill; Robert E. Manning; William Valliere; Laura E. Anderson

2010-01-01

Historically, transportation planning and management have been guided largely by principles of efficiency. Specifically, the Transportation Research Board has utilized a levels of service (LOS) framework to assess quality of service in terms of traffic congestion, speed and travel time, and maximum road capacity. In the field of park and outdoor recreation management,...

Federal Emergency Management Information System (FEMIS) system administration guide. Version 1.3

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burford, M.J.; Burnett, R.A.; Downing, T.R.

The Federal Emergency Management Information System (FEMIS) is an emergency management planning and analysis tool that was developed by the (Pacific Northwest National Laboratory) (PNNL) under the direction of the U.S. Army Chemical Biological Defense Command. The FEMIS System Administration Guide defines FEMIS hardware and software requirements and gives instructions for installing the FEMIS software package. 91 This document also contains information on the following: software installation for the FEMIS data servers, communication server, mail server, and the emergency management workstations; distribution media loading and FEMIS installation validation and troubleshooting; and system management of FEMIS users, login, privileges, and usage.more » The system administration utilities (tools), available in the FEMIS client software, are described for user accounts and site profile. This document also describes the installation and use of system and database administration utilities that will assist in keeping the FEMIS system running in an operational environment.« less

Impact of standardized clinical assessment and management plans on resource utilization and costs in children after the arterial switch operation.

PubMed

Rathod, Rahul H; Jurgen, Brittney; Hamershock, Rose A; Friedman, Kevin G; Marshall, Audrey C; Samnaliev, Mihail; Graham, Dionne A; Jenkins, Kathy; Lock, James E; Powell, Andrew J

2017-12-01

Standardized Clinical Assessment and Management Plans (SCAMPs) are a quality improvement initiative designed to reduce unnecessary utilization, decrease practice variation, and improve patient outcomes. We created a novel methodology, the SCAMP managed episode of care (SMEOC), which encompasses multiple encounters to assess the impact of the arterial switch operation (ASO) SCAMP on total costs. All ASO SCAMP patients (dates March 2009 to July 2015) were compared to a control group of ASO patients (January 2001 to February 2009). Patients were divided into "younger" (<2 years) and "older" (2-18 years) subgroups. Utilization included all cardiology visits, tests, and procedures. Standardized costs were applied to each unit of utilization. There were 100 historical and 63 SCAMP patients in the younger subgroup, and 163 historical and 165 SCAMP patients in the older subgroup. In the younger subgroup, the SCAMP had a 28% reduction in outpatient clinic visits (P < .001), a 52% reduction in chest radiographs (P < .001), a 21% reduction in electrocardiograms (P < .001), and a 30% total reduction in costs. In the older subgroup, the SCAMP had a 21% reduction in outpatient clinic visits (P < .001), a 20% reduction in chest radiographs (P = .05), a 10% reduction in echocardiograms (P = .05), a 25% reduction in exercise stress tests (P = .01), and a 14% total reduction in costs. The total cost savings of the ASO SCAMP was $216 649 in the first 6 years of the SCAMP. There was no difference in clinical outcomes between the historical and SCAMP cohorts. SCAMPs can improve resource utilization and reduce costs after the ASO operation while maintaining quality of care. © 2017 Wiley Periodicals, Inc.

Reducing regional drought vulnerabilities and multi-city robustness conflicts using many-objective optimization under deep uncertainty

NASA Astrophysics Data System (ADS)

Trindade, B. C.; Reed, P. M.; Herman, J. D.; Zeff, H. B.; Characklis, G. W.

2017-06-01

Emerging water scarcity concerns in many urban regions are associated with several deeply uncertain factors, including rapid population growth, limited coordination across adjacent municipalities and the increasing risks for sustained regional droughts. Managing these uncertainties will require that regional water utilities identify coordinated, scarcity-mitigating strategies that trigger the appropriate actions needed to avoid water shortages and financial instabilities. This research focuses on the Research Triangle area of North Carolina, seeking to engage the water utilities within Raleigh, Durham, Cary and Chapel Hill in cooperative and robust regional water portfolio planning. Prior analysis of this region through the year 2025 has identified significant regional vulnerabilities to volumetric shortfalls and financial losses. Moreover, efforts to maximize the individual robustness of any of the mentioned utilities also have the potential to strongly degrade the robustness of the others. This research advances a multi-stakeholder Many-Objective Robust Decision Making (MORDM) framework to better account for deeply uncertain factors when identifying cooperative drought management strategies. Our results show that appropriately designing adaptive risk-of-failure action triggers required stressing them with a comprehensive sample of deeply uncertain factors in the computational search phase of MORDM. Search under the new ensemble of states-of-the-world is shown to fundamentally change perceived performance tradeoffs and substantially improve the robustness of individual utilities as well as the overall region to water scarcity. Search under deep uncertainty enhanced the discovery of how cooperative water transfers, financial risk mitigation tools, and coordinated regional demand management must be employed jointly to improve regional robustness and decrease robustness conflicts between the utilities. Insights from this work have general merit for regions where adjacent municipalities can benefit from cooperative regional water portfolio planning.

Remote sensing for urban planning

NASA Technical Reports Server (NTRS)

Davis, Bruce A.; Schmidt, Nicholas; Jensen, John R.; Cowen, Dave J.; Halls, Joanne; Narumalani, Sunil; Burgess, Bryan

1994-01-01

Utility companies are challenged to provide services to a highly dynamic customer base. With factory closures and shifts in employment becoming a routine occurrence, the utility industry must develop new techniques to maintain records and plan for expected growth. BellSouth Telecommunications, the largest of the Bell telephone companies, currently serves over 13 million residences and 2 million commercial customers. Tracking the movement of customers and scheduling the delivery of service are major tasks for BellSouth that require intensive manpower and sophisticated information management techniques. Through NASA's Commercial Remote Sensing Program Office, BellSouth is investigating the utility of remote sensing and geographic information system techniques to forecast residential development. This paper highlights the initial results of this project, which indicate a high correlation between the U.S. Bureau of Census block group statistics and statistics derived from remote sensing data.

Connected vehicle pilot deployment program phase 2 : data management plan - Tampa (THEA).

DOT National Transportation Integrated Search

2017-10-01

The Tampa Hillsborough Expressway Authority (THEA) Connected Vehicle (CV) Pilot Deployment Program is intended to develop a suite of applications that utilize vehicle-to-infrastructure (V2I) and vehicle-to-vehicle (V2V) communication technology to re...

Connected vehicle pilot deployment program phase 1, safety management plan – ICF/Wyoming.

DOT National Transportation Integrated Search

2016-03-14

The Wyoming Department of Transportations (WYDOT) Connected Vehicle (CV) Pilot Deployment Program is intended to develop a suite of applications that utilize vehicle to infrastructure (V2I) and vehicle to vehicle (V2V) communication technology to ...

Utilization of a multimedia PACS workstation for surgical planning of epilepsy

NASA Astrophysics Data System (ADS)

Soo Hoo, Kent; Wong, Stephen T.; Hawkins, Randall A.; Knowlton, Robert C.; Laxer, Kenneth D.; Rowley, Howard A.

1997-05-01

Surgical treatment of temporal lobe epilepsy requires the localization of the epileptogenic zone for surgical resection. Currently, clinicians utilize electroencephalography, various neuroimaging modalities, and psychological tests together to determine the location of this zone. We investigate how a multimedia neuroimaging workstation built on top of the UCSF Picture Archiving and Communication System can be used to aid surgical planning of epilepsy and related brain diseases. This usage demonstrates the ability of the workstation to retrieve image and textural data from PACS and other image sources, register multimodality images, visualize and render 3D data sets, analyze images, generate new image and text data from the analysis, and organize all data in a relational database management system.

Application of JLab 12GeV helium refrigeration system for the FRIB accelerator at MSU

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ganni, Venkatarao; Knudsen, Peter N.; Arenius, Dana M.

The planned approach to have a turnkey helium refrigeration system for the MSU-FRIB accelerator system, encompassing the design, fabrication, installation and commissioning of the 4.5-K refrigerator cold box(es), cold compression system, warm compression system, gas management, oil removal and utility/ancillary systems, was found to be cost prohibitive. Following JLab’s suggestion, MSU-FRIB accelerator management made a formal request to evaluate the applicability of the recently designed 12GeV JLab cryogenic system for this application. The following paper will outline the findings and the planned approach for the FRIB helium refrigeration system.

Application of a forest-simulation model to assess the energy yield and ecological impact of forest utilization for energy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Doyle, T W; Shugart, H H; West, D C

1981-01-01

This study examines the utilization and management of natural forest lands to meet growing wood-energy demands. An application of a forest simulation model is described for assessing energy returns and long-term ecological impacts of wood-energy harvesting under four general silvicultural practices. Results indicate that moderate energy yields could be expected from mild cutting operations which would significantly effect neither the commercial timber market nor the composition, structure, or diversity of these forests. Forest models can provide an effective tool for determining optimal management strategies that maximize energy returns, minimize environmental detriment, and complement existing land-use plans.

What Ambulatory Care Managers Need to Know About Examination Room Utilization Measurement and Analysis.

PubMed

Klarich, Mark J; Rea, Ronald W; Lal, Tarun Mohan; Garcia, Angel L; Steffens, Fay L

2016-01-01

Demand for ambulatory care visits is projected to increase 22% between 2008 and 2025. Given this growth, ambulatory care managers need to proactively plan for efficient use of scarce resources (ie, space, equipment, and staff). One important component of ambulatory care space (the number of examination rooms) is dependent on multiple factors, including variation in demand, hours of operation, scheduling, and staff. The authors (1) outline common data collection methods, (2) highlight analysis and reporting considerations for examination room utilization, and (3) provide a strategic framework for short- and long-term decision making for facility design or renovation.

Self-Management Plan, Perceived Quality of Life and Medical Resource Utilization of Asthmatic Children.

DTIC Science & Technology

1997-05-07

quality of life , however, has not been addressed. This descriptive, correlational study compared the perceived quality of life and number of...not adhere to a plan. Quality of life was measured using the Childhood Asthma Questionnaire, a valid and reliable quality of life measurement tool for...children of different ages. There were no significant differences between the Adherence and Non-adherence groups relative to quality of life

Mega-Project Construction Management: The Corps of Engineers and Bechtel Group in Saudi Arabia

DTIC Science & Technology

1991-02-01

collaborative efforts of government and private firms; utilizing state-of-the-art technology; and, having economic , sociocultural, and environmental impacts...pushing out their traditional managerial corps of stodgy engineers and aristocrats."LA Although I don’t focus on individual personalities in this...help from Western economists the Central Planning Organization created Saudi Arabia’s first five year economic plan, which covered the years 1970 to

Healthcare cost differences with participation in a community-based group physical activity benefit for medicare managed care health plan members.

PubMed

Ackermann, Ronald T; Williams, Barbara; Nguyen, Huong Q; Berke, Ethan M; Maciejewski, Matthew L; LoGerfo, James P

2008-08-01

To determine whether participation in a physical activity benefit by Medicare managed care enrollees is associated with lower healthcare utilization and costs. Retrospective cohort study. Medicare managed care. A cohort of 1,188 older adult health maintenance organization enrollees who participated at least once in the EnhanceFitness (EF) physical activity benefit and a matched group of enrollees who never used the program. Healthcare costs and utilization were estimated. Ordinary least squares regression was used, adjusting for demographics, comorbidity, indicators of preventive service use, and baseline utilization or cost. Robustness of findings was tested in sensitivity analyses involving continuous propensity score adjustment and generalized linear models with nonconstant variance assumptions. EF participants had similar total healthcare costs during Year 1 of the program, but during Year 2, adjusted total costs were $1,186 lower (P=.005) than for non-EF users. Differences were partially attributable to lower inpatient costs (-$3,384; P=.02), which did not result from high-cost outliers. Enrollees who attended EF an average of one visit or more per week had lower adjusted total healthcare costs in Year 1 (-$1,929; P<.001) and Year 2 (-$1,784; P<.001) than nonusers. Health plan coverage of a preventive physical activity benefit for seniors is a promising strategy to avoid significant healthcare costs in the short term.

The Mental Health Parity and Addiction Equity Act Evaluation Study: Impact on Specialty Behavioral Healthcare Utilization and Spending Among Carve-In Enrollees

PubMed Central

Harwood, Jessica M.; Azocar, Francisca; Thalmayer, Amber; Xu, Haiyong; Ong, Michael K.; Tseng, Chi-Hong; Wells, Kenneth B.; Friedman, Sarah; Ettner, Susan L.

2016-01-01

Objective The federal Mental Health Parity and Addiction Equity Act (MHPAEA) sought to eliminate historical disparities between insurance coverage for behavioral health (BH) treatment and coverage for medical treatment. Our objective was to evaluate MHPAEA’s impact on BH expenditures and utilization among “carve-in” enrollees. Method We received specialty BH insurance claims and eligibility data from Optum, sampling 5,987,776 adults enrolled in self-insured plans from large employers. An interrupted time series study design with segmented regression analysis estimated monthly time trends of per-member spending and use before (2008–2009), during (2010), and after (2011–2013) MHPAEA compliance (N=179,506,951 member-month observations). Outcomes included: total, plan, patient out-of-pocket spending; outpatient utilization (assessment/diagnostic evaluation visits; medication management; individual and family psychotherapy); intermediate care utilization (structured outpatient; day treatment; residential); and inpatient utilization. Results MHPAEA was associated with increases in monthly per-member total spending, plan spending, assessment/diagnostic evaluation visits (respective immediate increases of: $1.05 [p=0.02]; $0.88 [p=0.04]; 0.00045 visits [p=0.00]), and individual psychotherapy visits (immediate increase of 0.00578 visits [p=0.00] and additional increases of 0.00017 visits/month [p=0.03]). Conclusions MHPAEA was associated with modest increases in total and plan spending and outpatient utilization; e.g., in July 2012 predicted per-enrollee plan spending was $4.92 without MHPAEA and $6.14 with MHPAEA. Efforts should focus on understanding how other barriers to BH care unaddressed by MHPAEA may affect access/utilization. Future research should evaluate effects produced by the Affordable Care Act’s inclusion of BH care as an essential health benefit and expansion of MHPAEA protections to the individual and small group markets. PMID:27632769

Marsh management plans in practice: Do they work in coastal Louisiana, USA?

NASA Astrophysics Data System (ADS)

Cowan, James H.; Turner, R. Eugene; Cahoon, Donald R.

1988-01-01

Louisiana's coastal wetlands represent about 41% of the nation's total and are extensively managed for fish, fur, and waterfowl. Marsh management plans (MMPs) are currently used to avoid potential user conflicts and are believed to be a best management practice for specific management goals. In this article, we define MMPs and examine their variety, history, impacts, and future. A MMP is an organized written plan submitted to state and federal permitting agencies for approval and whose purpose is to regulate wetland habitat quantity and quality (control land loss and enhance productivity). MMPs are usually implemented by making structural modifications in the marsh, primarily by using a variety of water control structures in levees to impound or semi-impound managed areas. It appears that MMPs using impoundments are only marginally successful in achieving and often contradict management goals. Although 20% of coastal Louisiana may be in MMPs by the year 2000, conflict resolution of public and private goals is compromised by a surfeit of opinion and dearth of data and experience. Based on interpretation of these results, we believe the next phase of management should include scientific studies of actual impacts, utilization of post-construction monitoring data, inventory of existing MMPs, development of new techniques, and determination of cumulative impacts.

Healthcare utilization and costs in persons with insomnia in a managed care population.

PubMed

Anderson, Louise H; Whitebird, Robin R; Schultz, Jennifer; McEvoy, Charlene E; Kreitzer, Mary Jo; Gross, Cynthia R

2014-05-01

To better understand the direct costs of insomnia. Our study aimed to compare healthcare costs and utilization of patients diagnosed with insomnia who received care in a managed care organization with a set of matched controls. Our observational, retrospective cohort study compared 7647 adults with an insomnia diagnosis with an equally sized matched cohort of health plan members without an insomnia diagnosis between 2003 and 2006. We also compared a subset of patients diagnosed with and treated for insomnia with those diagnosed with insomnia but not treated. A large Midwestern health plan with more than 600,000 members. Multivariate analysis was used to estimate the association between insomnia diagnosis and costs, controlling for covariates, in the baseline and follow-up periods. Although we cannot conclude a causal relationship between insomnia and healthcare costs, our analysis found that insomnia diagnosis was associated with 26% higher costs in the baseline and 46% in the 12 months after diagnosis. When comorbidities were recognized, the insomnia cohort had 80% higher costs, on average, than the matched control cohort. These outcomes suggest the need to look beyond the direct cost of insomnia to how its interaction with comorbid conditions drives healthcare cost and utilization.

A strategic approach for Water Safety Plans implementation in Portugal.

PubMed

Vieira, Jose M P

2011-03-01

Effective risk assessment and risk management approaches in public drinking water systems can benefit from a systematic process for hazards identification and effective management control based on the Water Safety Plan (WSP) concept. Good results from WSP development and implementation in a small number of Portuguese water utilities have shown that a more ambitious nationwide strategic approach to disseminate this methodology is needed. However, the establishment of strategic frameworks for systematic and organic scaling-up of WSP implementation at a national level requires major constraints to be overcome: lack of legislation and policies and the need for appropriate monitoring tools. This study presents a framework to inform future policy making by understanding the key constraints and needs related to institutional, organizational and research issues for WSP development and implementation in Portugal. This methodological contribution for WSP implementation can be replicated at a global scale. National health authorities and the Regulator may promote changes in legislation and policies. Independent global monitoring and benchmarking are adequate tools for measuring the progress over time and for comparing the performance of water utilities. Water utilities self-assessment must include performance improvement, operational monitoring and verification. Research and education and resources dissemination ensure knowledge acquisition and transfer.

Strategic rehabilitation planning of piped water networks using multi-criteria decision analysis.

PubMed

Scholten, Lisa; Scheidegger, Andreas; Reichert, Peter; Maurer, Max; Mauer, Max; Lienert, Judit

2014-02-01

To overcome the difficulties of strategic asset management of water distribution networks, a pipe failure and a rehabilitation model are combined to predict the long-term performance of rehabilitation strategies. Bayesian parameter estimation is performed to calibrate the failure and replacement model based on a prior distribution inferred from three large water utilities in Switzerland. Multi-criteria decision analysis (MCDA) and scenario planning build the framework for evaluating 18 strategic rehabilitation alternatives under future uncertainty. Outcomes for three fundamental objectives (low costs, high reliability, and high intergenerational equity) are assessed. Exploitation of stochastic dominance concepts helps to identify twelve non-dominated alternatives and local sensitivity analysis of stakeholder preferences is used to rank them under four scenarios. Strategies with annual replacement of 1.5-2% of the network perform reasonably well under all scenarios. In contrast, the commonly used reactive replacement is not recommendable unless cost is the only relevant objective. Exemplified for a small Swiss water utility, this approach can readily be adapted to support strategic asset management for any utility size and based on objectives and preferences that matter to the respective decision makers. Copyright © 2013 Elsevier Ltd. All rights reserved.

Coverage and prior authorization of psychotropic drugs under Medicare Part D.

PubMed

Huskamp, Haiden A; Stevenson, David G; Donohue, Julie M; Newhouse, Joseph P; Keating, Nancy L

2007-03-01

This study examined formulary coverage and use of utilization management tools for three classes of psychotropic medications (antidepressants, antipsychotics, and anticonvulsants) among Medicare Part D prescription drug plans serving individuals dually eligible for the Medicare and Medicaid programs. Plans must cover "all or substantially all" molecules (distinct drugs) in these classes. Plans serving "dual eligibles" generally covered at least one formulation of all molecules in the three classes. However, certain product formulations were not covered by a number of plans, and use of prior authorization was common for a minority of plans. The effect of Part D will depend on the restrictiveness of the prior authorization and appeals processes, which is currently unknown.

Overutilization and underutilization of operating rooms - insights from behavioral health care operations management.

PubMed

Fügener, Andreas; Schiffels, Sebastian; Kolisch, Rainer

2017-03-01

The planning of surgery durations is crucial for efficient usage of operating theaters. Both planning too long and too short durations for surgeries lead to undesirable consequences, e.g. idle time, overtime, or rescheduling of surgeries. We define these consequences as operating room inefficiency. The overall objective of planning surgery durations is to minimize expected operating room inefficiency, since surgery durations are stochastic. While most health care studies assume economically rational behavior of decision makers, experimental studies have shown that decision makers often do not act according to economic incentives. Based on insights from health care operations management, medical decision making, behavioral operations management, as well as empirical observations, we derive hypotheses that surgeons' behavior deviates from economically rational behavior. To investigate this, we undertake an experimental study where experienced surgeons are asked to plan surgeries with uncertain durations. We discover systematic deviations from optimal decision making and offer behavioral explanations for the observed biases. Our research provides new insights to tackle a major problem in hospitals, i.e. low operating room utilization going along with staff overtime.

Overview of Hydrometeorologic Forecasting Procedures at BC Hydro

NASA Astrophysics Data System (ADS)

McCollor, D.

2004-12-01

Energy utility companies must balance production from limited sources with increasing demand from industrial, business, and residential consumers. The utility planning process requires a balanced, efficient, and effective distribution of energy from source to consumer. Therefore utility planners must consider the impact of weather on energy production and consumption. Hydro-electric companies should be particularly tuned to weather because their source of energy is water, and water supply depends on precipitation. BC Hydro operates as the largest hydro-electric company in western Canada, managing over 30 reservoirs within the province of British Columbia, and generating electricity for 1.6 million people. BC Hydro relies on weather forecasts of watershed precipitation and temperature to drive hydrologic reservoir inflow models and of urban temperatures to meet energy demand requirements. Operations and planning specialists in the company rely on current, value-added weather forecasts for extreme high-inflow events, daily reservoir operations planning, and long-term water resource management. Weather plays a dominant role for BC Hydro financial planners in terms of sensitive economic responses. For example, a two percent change in hydropower generation, due in large part to annual precipitation patterns, results in an annual net change of \\50 million in earnings. A five percent change in temperature produces a \\5 million change in yearly earnings. On a daily basis, significant precipitation events or temperature extremes involve potential profit/loss decisions in the tens of thousands of dollars worth of power generation. These factors are in addition to environmental and societal costs that must be considered equally as part of a triple bottom line reporting structure. BC Hydro water resource managers require improved meteorological information from recent advancements in numerical weather prediction. At BC Hydro, methods of providing meteorological forecast data are changing as new downscaling and ensemble techniques evolve to improve environmental information supplied to water managers.

Employer health care plan design and its effect on plan costs.

PubMed

Custer, W S

1991-01-01

This study uses claims data from employers in the Houston Area Health Care Coalition (HAHCC) for 1985 through the first half of 1987 to examine the effect of health care plan attributes on health care costs. Plan attributes affect the site of care and the costs of care. Utilization review clearly was effective in reducing the demand for inpatient services, but that reduction was in large measure matched by increases in care in the outpatient setting. Restrictions on mental health benefits also shifted the site of care. In contrast, neither premium sharing nor the plan's deductible had a significant impact on total plan charges. The study results demonstrate the need to have a comprehensive cost management strategy.

Create your own science planning tool in 3 days with SOA

NASA Technical Reports Server (NTRS)

Streiffert, Barbara A.; Polanskey, Carol A.; O'Reilly, Taifun

2003-01-01

Scientific discovery and advancement of knowledge has been, and continues to be, the goal for space missions at Jet Propulsion Laboratory. Scientist must plan their observation/experiments to get the maximum data return in order to make those discoveries. However, each mission has different science objectives, a different spacecraft and different instrument payloads, as well as, different routes to different destinations with different spacecraft restrictions and characteristics. In the current reduced cost environment, manageable cost for mission planning software is a must. Science Opportunity Analyzer (SOA), a planning tool for scientists and mission planners, utilizes a simple approach to reduce cost and promote reusability.

How Do Land-Use and Climate Change Affect Watershed Health? A Scenario-Based Analysis

EPA Science Inventory

With the growing emphasis on biofuel crops and potential impacts of climate variability and change, there is a need to quantify their effects on hydrological processes for developing watershed management plans. Environmental consequences are currently estimated by utilizing comp...

Applying Utility Functions to Adaptation Planning for Home Automation Applications

NASA Astrophysics Data System (ADS)

Bratskas, Pyrros; Paspallis, Nearchos; Kakousis, Konstantinos; Papadopoulos, George A.

A pervasive computing environment typically comprises multiple embedded devices that may interact together and with mobile users. These users are part of the environment, and they experience it through a variety of devices embedded in the environment. This perception involves technologies which may be heterogeneous, pervasive, and dynamic. Due to the highly dynamic properties of such environments, the software systems running on them have to face problems such as user mobility, service failures, or resource and goal changes which may happen in an unpredictable manner. To cope with these problems, such systems must be autonomous and self-managed. In this chapter we deal with a special kind of a ubiquitous environment, a smart home environment, and introduce a user-preference-based model for adaptation planning. The model, which dynamically forms a set of configuration plans for resources, reasons automatically and autonomously, based on utility functions, on which plan is likely to best achieve the user's goals with respect to resource availability and user needs.

Measuring and Enhancing Organizational Productivity: An Annotated Bibliography.

DTIC Science & Technology

1981-07-01

Repor for Peritod April 1 9811 - Jur. 19841 U R E S LABORATORY AIR FORCE SYSTEMS COMMAND BROOKS AIR FORCE BASETEXAS 78235 81 8 06060 NOTICE When U.S...personnel utilization, retention and productivity. To develop an effective force management system , research is needed to provide Air Force managers with...2) formal production incentive systems , (3) manpower planning, and (4) behavioral science and organizational design. He argues for developing

Final Environmental Assessment for Munitions Storage Area at Langley Air Force Base, Virginia

DTIC Science & Technology

2004-08-01

Existing Conditions LAND USE Land uses on Langley AFB are grouped by function in distinct geographic areas. For example, aircraft operations and...1998a) is used to coordinate natural resource management. Langley’s Urban Forest Inventory Review and Management Plan (Davey Resource Group 1997...following data to develop noise contours: aircraft types, runway utilization patterns, engine power settings, airspeeds, altitude profiles , flight track

Lean Manufacturing Improves Emergency Department Throughput and Patient Satisfaction.

PubMed

Kane, Marlena; Chui, Kristen; Rimicci, Janet; Callagy, Patrice; Hereford, James; Shen, Sam; Norris, Robert; Pickham, David

2015-09-01

A multidisciplinary team led by nursing leadership and physicians developed a plan to meet increasing demand and improve the patient experience in the ED without expanding the department's current resources. The approach included Lean tools and engaged frontline staff and physicians. Applying Lean management principles resulted in quicker service, improved patient satisfaction, increased capacity, and reduced resource utilization. Incorporating continuous daily management is necessary for sustainment of continuous improvement activities.

Managing coal combustion residues in mines

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

2006-07-01

Burning coal in electric utility plants produces, in addition to power, residues that contain constituents which may be harmful to the environment. The management of large volumes of coal combustion residues (CCRs) is a challenge for utilities, because they must either place the CCRs in landfills, surface impoundments, or mines, or find alternative uses for the material. This study focuses on the placement of CCRs in active and abandoned coal mines. The Committee on Mine Placement of Coal Combustion Wastes of the National Research Council believes that placement of CCRs in mines as part of the reclamation process may bemore » a viable option for the disposal of this material as long as the placement is properly planned and carried out in a manner that avoids significant adverse environmental and health impacts. This report discusses a variety of steps that are involved in planning and managing the use of CCRs as minefills, including an integrated process of CCR characterization and site characterization, management and engineering design of placement activities, and design and implementation of monitoring to reduce the risk of contamination moving from the mine site to the ambient environment. Enforceable federal standards are needed for the disposal of CCRs in minefills to ensure that states have adequate, explicit authority and that they implement minimum safeguards. 267 refs., 6 apps.« less

Improving equity in the provision of primary health care: lessons from decentralized planning and management in Namibia.

PubMed Central

Bell, Ruth; Ithindi, Taathi; Low, Anne

2002-01-01

This paper draws lessons from a review of primary health care services in Windhoek, the capital of Namibia, undertaken by a regional health management team. The review was carried out because of perceived increases in workload and inadequate staffing levels, arising from the rapid expansion of the city associated with inward migration. A survey of the utilization of government clinics was used to develop a more equitable allocation of primary health care services between localities. The survey revealed disparities between patterns of utilization of the services and the allocation of staff: the poorer localities were relatively underprovided. Decisions made centrally on resource allocation had reinforced the inequities. On the basis of the results of the review, the regional health management team redistributed nursing and medical staff and argued for a shift in the allocation of capital expenditure towards the poorer communities. The review demonstrates the potential for regional and provincial health management teams to make effective assessments of the needs of their populations and to promote the equitable delivery of primary health care services. In order to achieve this they need not only to become effective managers, but also to develop population-based planning skills and the confidence and authority to influence the allocation of resources between and within their regions and provinces. PMID:12219160

Crawler Acquisition and Testing Demonstration Project Management Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

DEFIGH-PRICE, C.

2000-10-23

If the crawler based retrieval system is selected, this project management plan identifies the path forward for acquiring a crawler/track pump waste retrieval system, and completing sufficient testing to support deploying the crawler for as part of a retrieval technology demonstration for Tank 241-C-104. In the balance of the document, these activities will be referred to as the Crawler Acquisition and Testing Demonstration. During recent Tri-Party Agreement negotiations, TPA milestones were proposed for a sludge/hard heel waste retrieval demonstration in tank C-104. Specifically one of the proposed milestones requires completion of a cold demonstration of sufficient scale to support finalmore » design and testing of the equipment (M-45-03G) by 6/30/2004. A crawler-based retrieval system was one of the two options evaluated during the pre-conceptual engineering for C-104 retrieval (RPP-6843 Rev. 0). The alternative technology procurement initiated by the Hanford Tanks Initiative (HTI) project, combined with the pre-conceptual engineering for C-104 retrieval provide an opportunity to achieve compliance with the proposed TPA milestone M-45-03H. This Crawler Acquisition and Testing Demonstration project management plan identifies the plans, organizational interfaces and responsibilities, management control systems, reporting systems, timeline and requirements for the acquisition and testing of the crawler based retrieval system. This project management plan is complimentary to and supportive of the Project Management Plan for Retrieval of C-104 (RPP-6557). This project management plan focuses on utilizing and completing the efforts initiated under the Hanford Tanks Initiative (HTI) to acquire and cold test a commercial crawler based retrieval system. The crawler-based retrieval system will be purchased on a schedule to support design of the waste retrieval from tank C-104 (project W-523) and to meet the requirement of proposed TPA milestone M-45-03H. This Crawler Acquisition and Testing Demonstration project management plan includes the following: (1) Identification of acquisition strategy and plan to obtain a crawler based retrieval system; (2) Plan for sufficient cold testing to make a decision for W-523 and to comply with TPA Milestone M-45-03H; (3) Cost and schedule for path forward; (4) Responsibilities of the participants; and (5) The plan is supported by updated Level 1 logics, a Relative Order of Magnitude cost estimate and preliminary project schedule.« less

Why are You Late?: Investigating the Role of Time Management in Time-Based Prospective Memory

PubMed Central

Waldum, Emily R; McDaniel, Mark A.

2016-01-01

Time-based prospective memory tasks (TBPM) are those that are to be performed at a specific future time. Contrary to typical laboratory TBPM tasks (e.g., “hit the “z” key every 5 minutes”), many real-world TBPM tasks require more complex time-management processes. For instance to attend an appointment on time, one must estimate the duration of the drive to the appointment and then utilize this estimate to create and execute a secondary TBPM intention (e.g., “I need to start driving by 1:30 to make my 2:00 appointment on time”). Future under- and overestimates of drive time can lead to inefficient TBPM performance with the former lending to missed appointments and the latter to long stints in the waiting room. Despite the common occurrence of complex TBPM tasks in everyday life, to date, no studies have investigated how components of time management, including time estimation, affect behavior in such complex TBPM tasks. Therefore, the current study aimed to investigate timing biases in both older and younger adults and further to determine how such biases along with additional time management components including planning and plan fidelity influence complex TBPM performance. Results suggest for the first time that younger and older adults do not always utilize similar timing strategies, and as a result, can produce differential timing biases under the exact same environmental conditions. These timing biases, in turn, play a vital role in how efficiently both younger and older adults perform a later TBPM task that requires them to utilize their earlier time estimate. PMID:27336325

Scandinavian systems monitoring the oral health in children and adolescents; an evaluation of their quality and utility in the light of modern perspectives of caries management.

PubMed

Skeie, Marit S; Klock, Kristin S

2014-04-30

Recording reliable oral health data is a challenge. The aims were a) to outline different Scandinavian systems of oral health monitoring, b) to evaluate the quality and utility of the collected data in the light of modern concepts of disease management and to suggest improvements. The information for in this study was related to (a) children and adolescents, (b) oral health data and (c) routines for monitoring such data. This meant information available in the official web sites of the "KOSTRA-data" (Municipality-State-Report) in Norway, the Swedish National Board of Health and Welfare ("Socialstyrelsen") and Oral Health Register (the SCOR system, National Board of Health) in Denmark. A potential for increasing the reliability and validity of the data existed. Routines for monitoring other oral diseases than caries were limited. Compared with the other Scandinavian countries, the data collection system in Denmark appeared more functional and had adopted more modern concepts of disease management than other systems. In the light of modern concepts of caries management, data collected elsewhere had limited utility. The Scandinavian systems of health reporting had much in common, but some essential differences existed. If the quality of epidemiological data were enhanced, it would be possible to use the data for planning oral health care. Routines and procedures should be improved and updated in accordance with the modern ideas about caries prevention and therapy. For appropriate oral health planning in an organised dental service, reporting of enamel caries is essential.

Using multiobjective tradeoff sets and Multivariate Regression Trees to identify critical and robust decisions for long term water utility planning

NASA Astrophysics Data System (ADS)

Smith, R.; Kasprzyk, J. R.; Balaji, R.

2017-12-01

In light of deeply uncertain factors like future climate change and population shifts, responsible resource management will require new types of information and strategies. For water utilities, this entails potential expansion and efficient management of water supply infrastructure systems for changes in overall supply; changes in frequency and severity of climate extremes such as droughts and floods; and variable demands, all while accounting for conflicting long and short term performance objectives. Multiobjective Evolutionary Algorithms (MOEAs) are emerging decision support tools that have been used by researchers and, more recently, water utilities to efficiently generate and evaluate thousands of planning portfolios. The tradeoffs between conflicting objectives are explored in an automated way to produce (often large) suites of portfolios that strike different balances of performance. Once generated, the sets of optimized portfolios are used to support relatively subjective assertions of priorities and human reasoning, leading to adoption of a plan. These large tradeoff sets contain information about complex relationships between decisions and between groups of decisions and performance that, until now, has not been quantitatively described. We present a novel use of Multivariate Regression Trees (MRTs) to analyze tradeoff sets to reveal these relationships and critical decisions. Additionally, when MRTs are applied to tradeoff sets developed for different realizations of an uncertain future, they can identify decisions that are robust across a wide range of conditions and produce fundamental insights about the system being optimized.

Implementing Natural Resources Cadastral Plan in Pasargadae District of Iran by Using Quick Bird Images

NASA Astrophysics Data System (ADS)

Azhdari, G. H.; Deilami, K.; Firooznia, E.

2015-12-01

Natural Resources are essential for security and sustainable development of each country. Therefore, in order to reach sustainable development, conservation as well as optimum utilization of natural resources, executing of natural resources cadastral plan is necessary and essential. Governments conduct lands management in Iran, so there is a need for comprehensive plan with arranged program for best evaluation. In this research as a pilot, Pasargadae city is opted. Pasargadae region is located in north-east of Shiraz in Fars province with Latitude and longitude of 30° 15 ´ 53 ° N and 53° 13 ´ 29 ° E respectively. In order to generate the cadastral maps, Firstly, images from QuickBird satellite with 50-60 centimeters resolution were georeferenced by utilizing ground control points with accurate GPS coordinates. In addition to satellite images, old paper maps with 1:10000 scale in local coordinate system from agriculture ministry in 1963 were digitized according to 1:25000 scale map from army geographical organization with AutoCad software. Beside, paper maps with 1:50000 scale and Google Earth were used to find the changes during time. All the above maps were added to QuickBird images as new layers by using ArcMap software. These maps also were utilized to determine the different land-uses. Thus, by employing ArcMap software lands divide into 2 groups: firstly, lands with official document, which is owned by either natural or legal persons, and secondly national lands under different uses such as forestry, range management and desertification plans. Consequently, the generation of cadastral maps leads to better difference between private and national lands. In addition, producing cadastral maps prevent the destruction and illegal possession of natural lands by individuals.

The anti-hepatitis drug use effect and inventory management optimization from the perspective of hospital drug supply chain.

PubMed

Liu, Zhanyu

2017-09-01

By analyzing the current hospital anti hepatitis drug use, dosage, indications and drug resistance, this article studied the drug inventory management and cost optimization. The author used drug utilization evaluation method, analyzed the amount and kind distribution of anti hepatitis drugs and made dynamic monitoring of inventory. At the same time, the author puts forward an effective scheme of drug classification management, uses the ABC classification method to classify the drugs according to the average daily dose of drugs, and implements the automatic replenishment plan. The design of pharmaceutical services supply chain includes drug procurement platform, warehouse management system and connect to the hospital system through data exchange. Through the statistical analysis of drug inventory, we put forward the countermeasures of drug logistics optimization. The results showed that drug replenishment plan can effectively improve drugs inventory efficiency.

Increasing Epilepsy Awareness in Schools: A Seizure Smart Schools Project.

PubMed

Brook, Heather A; Hiltz, Cynthia M; Kopplin, Vicki L; Lindeke, Linda L

2015-08-01

A high prevalence of epilepsy diagnoses and seizure events among students was identified at a large Midwestern school district. In partnership with the Epilepsy Foundation of Minnesota (EFMN), a quality improvement project was conducted to provide education and resources to staff caring for school children with seizures. School nurses (N = 26) were trained as seizure management educators and instructed staff in 21 schools on seizure awareness and response. School nurses utilized new seizure management resources, a procedural guideline, and care plan updates. The majority of school nurses rated the resources and training interventions as "very helpful." School nurse confidence in managing students with seizures increased, seizure action plan use increased, and 88% of children's records with new seizure diagnoses had completed documentation. School nurses played vital roles in increasing seizure awareness as educators and care managers. EFMN is using this project as an exemplar for expanding its Seizure Smart Schools program. © The Author(s) 2015.

Energy management of a university campus utilizing short-term load forecasting with an artificial neural network

NASA Astrophysics Data System (ADS)

Palchak, David

Electrical load forecasting is a tool that has been utilized by distribution designers and operators as a means for resource planning and generation dispatch. The techniques employed in these predictions are proving useful in the growing market of consumer, or end-user, participation in electrical energy consumption. These predictions are based on exogenous variables, such as weather, and time variables, such as day of week and time of day as well as prior energy consumption patterns. The participation of the end-user is a cornerstone of the Smart Grid initiative presented in the Energy Independence and Security Act of 2007, and is being made possible by the emergence of enabling technologies such as advanced metering infrastructure. The optimal application of the data provided by an advanced metering infrastructure is the primary motivation for the work done in this thesis. The methodology for using this data in an energy management scheme that utilizes a short-term load forecast is presented. The objective of this research is to quantify opportunities for a range of energy management and operation cost savings of a university campus through the use of a forecasted daily electrical load profile. The proposed algorithm for short-term load forecasting is optimized for Colorado State University's main campus, and utilizes an artificial neural network that accepts weather and time variables as inputs. The performance of the predicted daily electrical load is evaluated using a number of error measurements that seek to quantify the best application of the forecast. The energy management presented utilizes historical electrical load data from the local service provider to optimize the time of day that electrical loads are being managed. Finally, the utilization of forecasts in the presented energy management scenario is evaluated based on cost and energy savings.

American power conference: Proceedings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1994-01-01

The first volume of this conference contains papers on the following topics: (1) Controls, monitoring, and expert systems (Harnessing microprocessor revolution for a more competitive power industry; Plant control--Upgrades; Neural network applications); (2) Diversification and globalization (Electric utility diversification/globalization--Panel; Private power in developing countries); (3) Environment and clean air (Clean Air compliance costs; Site selection for power stations and related facilities; Electric utility trace substance emissions; Solid waste disposal and commercial use; Precipitators/fabric filters; and Effect of flow modifications on fisheries and water quality); (4) Generation--Fuel options equipment (Alternate fuels; Advances in fuel cells for electric power applications; Secondary containmentmore » and seismic requirements for petrochemical facilities; Clean coal technology demonstration; Advanced energy systems; Hydropower); (5) Nuclear operations options (Radioactive waste management and disposal; Off normal conditions; Advanced light water reactors--15 years after TMI; Structural dynamic analyses for nuclear power plants); (6) Retrofit, betterment, repowering maintenance (Project management; Improving competitiveness through process re-engineering; Central stations; Water and wastewater treatment); (7) System planning, operation demand maintenance (Transmission system access; Stability; Systems planning); (8) Transmission and distribution (Transformers; Relaying for system protection; Managing EMF effects); and (9) Education (Power engineering). 155 papers have been processed separately for inclusion on the data base.« less

Reduced mortality: the unexpected impact of a telephone-based care management intervention for older adults in managed care.

PubMed

Alkema, Gretchen E; Wilber, Kathleen H; Shannon, George R; Allen, Douglas

2007-08-01

This analysis evaluated mortality over 24 months for Medicare managed care members who participated in the Care Advocate Program (CA Program) designed to link those with high health care utilization to home- and community-based services. Secondary data from the CA Program, part of the California HealthCare Foundation's Elders in Managed Care Initiative. Randomized-control trial in which participants (N=781) were randomly assigned to intent-to-treat (ITT) and control groups. ITT group received telephonic social care management and 12 months of follow-up. Various multivariate analyses were used to evaluate mortality risk throughout multiple study periods controlling for sociodemographic characteristics, health status, and health care utilization. Older adults (65+) enrolled in a Medicare managed care plan who had high health care utilization in the previous year. ITT group had a significantly lower odds of mortality throughout the study (OR=0.55; p=.005) and during the care management intervention (OR=0.45; p=.006), whereas differential risk in the postintervention period was not statistically significant. Other significant predictors of mortality were age, gender, three chronic conditions (cancer, heart disease, and kidney disease), and emergency room utilization. Findings suggest that the care advocate model of social care management affected mortality while the program was in progress, but not after completion of the intervention phase. Key model elements accounted for the findings, which include individualized targeting, assessment, and monitoring; consumer choice, control, and participant self-management; and bridging medical and social service delivery systems through direct linkages and communication.

Draft project management update to the Iowa DOT Project Development Manual : tech transfer summary.

DOT National Transportation Integrated Search

2016-08-01

The Iowa DOT applied and was selected to receive User Incentive : funding from the U.S. DOT Federal Highway Administration (FHWA) : for the SHRP 2 R10 Implementation Assistance Program. Through the : program, the Iowa DOT plans to utilize the results...

Dorm Renovations: To Increase Enrollment or Maintain Status Quo?

ERIC Educational Resources Information Center

Stauff, William

2001-01-01

Explores South Carolina's Erskine College's planning and decision making process to renovate all seven of its dormitories over three summers. Discusses how the organization built a strong relationship with the contractor, successfully utilized outside architectural and consulting services, applied facilities management techniques in the process,…

Guidelines for Selecting a Construction Approach for Education Building Programs.

ERIC Educational Resources Information Center

Barton Malow Co., Southfield, MI.

This book discusses the advantages and disadvantages of the two most common construction planning methods utilized for educational facilities: general contracting and construction management. Diagrams are provided that illustrate the chain of command and communication within each approach, and highlight considerations that every school district…

Power Buying: Planning For Your Deregulated Future.

ERIC Educational Resources Information Center

Robertson, Wayne K.

1997-01-01

Colleges and universities can benefit from the coming deregulation of utilities. Deregulation creates opportunity for facility managers to aggressively negotiate agreements, implement changes to the physical plant to make the institution a more attractive customer, and explore new, less expensive energy supply options and alternatives. Some action…

Planning and Managing School Facilities for Agriculture

ERIC Educational Resources Information Center

Staller, Bernie

1976-01-01

The Agribusiness Department at Janesville Parker Senior High in Wisconsin involves 360 students and three instructors in three different buildings. Facilities were provided through a variety of methods with major emphasis on utilizing the urban setting. Future Farmers of America students operate projects in orchards, greenhouse, gardens, and…

Towards Knowledge Management for Smart Manufacturing.

PubMed

Feng, Shaw C; Bernstein, William Z; Hedberg, Thomas; Feeney, Allison Barnard

2017-09-01

The need for capturing knowledge in the digital form in design, process planning, production, and inspection has increasingly become an issue in manufacturing industries as the variety and complexity of product lifecycle applications increase. Both knowledge and data need to be well managed for quality assurance, lifecycle-impact assessment, and design improvement. Some technical barriers exist today that inhibit industry from fully utilizing design, planning, processing, and inspection knowledge. The primary barrier is a lack of a well-accepted mechanism that enables users to integrate data and knowledge. This paper prescribes knowledge management to address a lack of mechanisms for integrating, sharing, and updating domain-specific knowledge in smart manufacturing. Aspects of the knowledge constructs include conceptual design, detailed design, process planning, material property, production, and inspection. The main contribution of this paper is to provide a methodology on what knowledge manufacturing organizations access, update, and archive in the context of smart manufacturing. The case study in this paper provides some example knowledge objects to enable smart manufacturing.

Data warehousing: toward knowledge management.

PubMed

Shams, K; Farishta, M

2001-02-01

With rapid changes taking place in the practice and delivery of health care, decision support systems have assumed an increasingly important role. More and more health care institutions are deploying data warehouse applications as decision support tools for strategic decision making. By making the right information available at the right time to the right decision makers in the right manner, data warehouses empower employees to become knowledge workers with the ability to make the right decisions and solve problems, creating strategic leverage for the organization. Health care management must plan and implement data warehousing strategy using a best practice approach. Through the power of data warehousing, health care management can negotiate bettermanaged care contracts based on the ability to provide accurate data on case mix and resource utilization. Management can also save millions of dollars through the implementation of clinical pathways in better resource utilization and changing physician behavior to best practices based on evidence-based medicine.

Managed Behavioral Health Care: An Instrument to Characterize Critical Elements of Public Sector Programs

PubMed Central

Ridgely, M Susan; Giard, Julienne; Shern, David; Mulkern, Virginia; Burnam, M Audrey

2002-01-01

Objective To develop an instrument to characterize public sector managed behavioral health care arrangements to capture key differences between managed and “unmanaged” care and among managed care arrangements. Study Design The instrument was developed by a multi-institutional group of collaborators with participation of an expert panel. Included are six domains predicted to have an impact on access, service utilization, costs, and quality. The domains are: characteristics of the managed care plan, enrolled population, benefit design, payment and risk arrangements, composition of provider networks, and accountability. Data are collected at three levels: managed care organization, subcontractor, and network of service providers. Data Collection Methods Data are collected through contract abstraction and key informant interviews. A multilevel coding scheme is used to organize the data into a matrix along key domains, which is then reviewed and verified by the key informants. Principal Findings This instrument can usefully differentiate between and among Medicaid fee-for-service programs and Medicaid managed care plans along key domains of interest. Beyond documenting basic features of the plans and providing contextual information, these data will support the refinement and testing of hypotheses about the impact of public sector managed care on access, quality, costs, and outcomes of care. Conclusions If managed behavioral health care research is to advance beyond simple case study comparisons, a well-conceptualized set of instruments is necessary. PMID:12236386

Opportunities and Strategies to Incorporate Ecosystem Services Knowledge and Decision Support Tools into Planning and Decision Making in Hawai`i

NASA Astrophysics Data System (ADS)

Bremer, Leah L.; Delevaux, Jade M. S.; Leary, James J. K.; J. Cox, Linda; Oleson, Kirsten L. L.

2015-04-01

Incorporating ecosystem services into management decisions is a promising means to link conservation and human well-being. Nonetheless, planning and management in Hawai`i, a state with highly valued natural capital, has yet to broadly utilize an ecosystem service approach. We conducted a stakeholder assessment, based on semi-structured interviews, with terrestrial ( n = 26) and marine ( n = 27) natural resource managers across the State of Hawai`i to understand the current use of ecosystem services (ES) knowledge and decision support tools and whether, how, and under what contexts, further development would potentially be useful. We found that ES knowledge and tools customized to Hawai`i could be useful for communication and outreach, justifying management decisions, and spatial planning. Greater incorporation of this approach is clearly desired and has a strong potential to contribute to more sustainable decision making and planning in Hawai`i and other oceanic island systems. However, the unique biophysical, socio-economic, and cultural context of Hawai`i, and other island systems, will require substantial adaptation of existing ES tools. Based on our findings, we identified four key opportunities for the use of ES knowledge and tools in Hawai`i: (1) linking native forest protection to watershed health; (2) supporting sustainable agriculture; (3) facilitating ridge-to-reef management; and (4) supporting statewide terrestrial and marine spatial planning. Given the interest expressed by natural resource managers, we envision broad adoption of ES knowledge and decision support tools if knowledge and tools are tailored to the Hawaiian context and coupled with adequate outreach and training.

Evaluating the Effectiveness of Science for Decision-Making: Water Managers and Tree- Ring Data in the Western United States

NASA Astrophysics Data System (ADS)

Rice, J. L.; Woodhouse, C.; Lukas, J.

2008-12-01

Current climate variability, potential impacts of climate change, and limited resources in the face of growing demand are increasingly prompting water managers in the western United States to consider and use data from climate-related research in water resource planning. Much of these data are produced by stakeholder- driven science programs, such as NOAA's Regional Integrated Science Assessments (RISAs), but there have been few efforts to evaluate the effectiveness of these science-to-application efforts. Over the past several years, researchers with the Western Water Assessment (WWA) RISA have been providing tree-ring reconstructions of streamflow to water managers in Colorado and other western states, and presenting technical workshops explaining the applications of these tree-ring data for water management and planning. Using in-depth interviews and a survey questionnaire, we have assessed the effectiveness and outcomes of these engagements, addressing (1) the factors that have prompted water managers to seek out tree-ring data, (2) how paleoclimate data has been made relevant and accessible for water resource planning, and (3) how tree-ring data and information have been utilized by water managers and other workshop participants. We also provide an assessment of challenges and opportunities that exist in the translation of climate science for decision-making, including how tree-ring data are interpreted in the context of water planning paradigms, issues of credibility and acceptance of tree ring data, and what data needs exist in different planning environments. These findings have broader application in improving and evaluating science-policy interactions related to climate and climate change.

Opportunities and strategies to incorporate ecosystem services knowledge and decision support tools into planning and decision making in Hawai'i.

PubMed

Bremer, Leah L; Delevaux, Jade M S; Leary, James J K; J Cox, Linda; Oleson, Kirsten L L

2015-04-01

Incorporating ecosystem services into management decisions is a promising means to link conservation and human well-being. Nonetheless, planning and management in Hawai'i, a state with highly valued natural capital, has yet to broadly utilize an ecosystem service approach. We conducted a stakeholder assessment, based on semi-structured interviews, with terrestrial (n = 26) and marine (n = 27) natural resource managers across the State of Hawai'i to understand the current use of ecosystem services (ES) knowledge and decision support tools and whether, how, and under what contexts, further development would potentially be useful. We found that ES knowledge and tools customized to Hawai'i could be useful for communication and outreach, justifying management decisions, and spatial planning. Greater incorporation of this approach is clearly desired and has a strong potential to contribute to more sustainable decision making and planning in Hawai'i and other oceanic island systems. However, the unique biophysical, socio-economic, and cultural context of Hawai'i, and other island systems, will require substantial adaptation of existing ES tools. Based on our findings, we identified four key opportunities for the use of ES knowledge and tools in Hawai'i: (1) linking native forest protection to watershed health; (2) supporting sustainable agriculture; (3) facilitating ridge-to-reef management; and (4) supporting statewide terrestrial and marine spatial planning. Given the interest expressed by natural resource managers, we envision broad adoption of ES knowledge and decision support tools if knowledge and tools are tailored to the Hawaiian context and coupled with adequate outreach and training.

Matching physician compensation plans to capitation levels.

PubMed

Kennedy, K M; Buckley, M P

1997-09-01

As managed care penetration increases, physician compensation plans need to reflect the current transition from fee-for-service to capitated payment. In choosing the compensation structure that will be most beneficial to the success of the group practice and secure physician buy-in, practices need to assess their mission, goals, and corporate culture. They also need to assess their percentage of capitation to total revenues and develop, when necessary, new compensation pools that reward physicians for a variety of behaviors, such as increased productivity and utilization control. Compensation plans should be fair, flexible, and simple to understand and administer.

Continual planning and scheduling for managing patient tests in hospital laboratories.

PubMed

Marinagi, C C; Spyropoulos, C D; Papatheodorou, C; Kokkotos, S

2000-10-01

Hospital laboratories perform examination tests upon patients, in order to assist medical diagnosis or therapy progress. Planning and scheduling patient requests for examination tests is a complicated problem because it concerns both minimization of patient stay in hospital and maximization of laboratory resources utilization. In the present paper, we propose an integrated patient-wise planning and scheduling system which supports the dynamic and continual nature of the problem. The proposed combination of multiagent and blackboard architecture allows the dynamic creation of agents that share a set of knowledge sources and a knowledge base to service patient test requests.

Soil Management Plan for the Oak Ridge Y-12 National Security Complex Oak Ridge, Tennessee

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

2005-03-02

This Soil Management Plan applies to all activities conducted under the auspices of the National Nuclear Security Administration (NNSA) Oak Ridge Y-12 National Security Complex (Y-12) that involve soil disturbance and potential management of waste soil. The plan was prepared under the direction of the Y-12 Environmental Compliance Department of the Environment, Safety, and Health Division. Soil disturbances related to maintenance activities, utility and building construction projects, or demolition projects fall within the purview of the plan. This Soil Management Plan represents an integrated, visually oriented, planning and information resource tool for decision making involving excavation or disturbance of soilmore » at Y-12. This Soil Management Plan addresses three primary elements. (1) Regulatory and programmatic requirements for management of soil based on the location of a soil disturbance project and/or the regulatory classification of any contaminants that may be present (Chap. 2). Five general regulatory or programmatic classifications of soil are recognized to be potentially present at Y-12; soil may fall under one or more these classifications: (a) Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) pursuant to the Oak Ridge Reservation (ORR) Federal Facilities Agreement; (b) Resource Conservation and Recovery Act (RCRA); (c) RCRA 3004(u) solid waste managements units pursuant to the RCRA Hazardous and Solid Waste Amendments Act of 1984 permit for the ORR; (d) Toxic Substances and Control Act-regulated soil containing polychlorinated biphenyls; and (e) Radiologically contaminated soil regulated under the Atomic Energy Act review process. (2) Information for project planners on current and future planned remedial actions (RAs), as prescribed by CERCLA decision documents (including the scope of the actions and remedial goals), land use controls implemented to support or maintain RAs, RCRA post-closure regulatory requirements for former waste management units, legacy contamination source areas and distribution of contamination in soils, and environmental infrastructure (e.g., caps, monitoring systems, etc.) that is in place or planned in association with RAs. (3) Regulatory considerations and processes for management and disposition of waste soil upon generation, including regulatory drivers, best management practices (BMPs), waste determination protocols, waste acceptance criteria, and existing waste management procedures and BMPs for Y-12. This Soil Management Plan provides information to project planners to better coordinate their activities with other organizations and programs with a vested interest in soil disturbance activities at Y-12. The information allows project managers and maintenance personnel to evaluate and anticipate potential contaminant levels that may be present at a proposed soil disturbance site prior to commencement of activities and allows a more accurate assessment of potential waste management requirements.« less

Telerobotic management system: coordinating multiple human operators with multiple robots

NASA Astrophysics Data System (ADS)

King, Jamie W.; Pretty, Raymond; Brothers, Brendan; Gosine, Raymond G.

2003-09-01

This paper describes an application called the Tele-robotic management system (TMS) for coordinating multiple operators with multiple robots for applications such as underground mining. TMS utilizes several graphical interfaces to allow the user to define a partially ordered plan for multiple robots. This plan is then converted to a Petri net for execution and monitoring. TMS uses a distributed framework to allow robots and operators to easily integrate with the applications. This framework allows robots and operators to join the network and advertise their capabilities through services. TMS then decides whether tasks should be dispatched to a robot or a remote operator based on the services offered by the robots and operators.

Adapting to Rising Sea Level: A Florida Perspective

NASA Astrophysics Data System (ADS)

Parkinson, Randall W.

2009-07-01

Global climate change and concomitant rising sea level will have a profound impact on Florida's coastal and marine systems. Sea-level rise will increase erosion of beaches, cause saltwater intrusion into water supplies, inundate coastal marshes and other important habitats, and make coastal property more vulnerable to erosion and flooding. Yet most coastal areas are currently managed under the premise that sea-level rise is not significant and the shorelines are static or can be fixed in place by engineering structures. The new reality of sea-level rise and extreme weather due to climate change requires a new style of planning and management to protect resources and reduce risk to humans. Scientists must: (1) assess existing coastal vulnerability to address short term management issues and (2) model future landscape change and develop sustainable plans to address long term planning and management issues. Furthermore, this information must be effectively transferred to planners, managers, and elected officials to ensure their decisions are based upon the best available information. While there is still some uncertainty regarding the details of rising sea level and climate change, development decisions are being made today which commit public and private investment in real estate and associated infrastructure. With a design life of 30 yrs to 75 yrs or more, many of these investments are on a collision course with rising sea level and the resulting impacts will be significant. In the near term, the utilization of engineering structures may be required, but these are not sustainable and must ultimately yield to "managed withdrawal" programs if higher sea-level elevations or rates of rise are forthcoming. As an initial step towards successful adaptation, coastal management and planning documents (i.e., comprehensive plans) must be revised to include reference to climate change and rising sea-level.

The Mental Health Parity and Addiction Equity Act evaluation study: Impact on specialty behavioral healthcare utilization and spending among enrollees with substance use disorders.

PubMed

Friedman, Sarah; Xu, Haiyong; Harwood, Jessica M; Azocar, Francisca; Hurley, Brian; Ettner, Susan L

2017-09-01

The federal Mental Health Parity and Addiction Equity Act (MHPAEA) sought to eliminate historical disparities between behavioral health and medical health insurance benefits among the commercially insured. This study determines whether MHPAEA was associated with increased BH expenditures and utilization among a population with substance use disorder (SUD) diagnoses. Claims and eligibility data from 5,987,776 enrollees, 2008-2013, were obtained from a national, commercial, managed behavioral health organization. An interrupted time series study design with segmented regression analysis estimated time trends of per-member-per-month (PMPM) spending and use before (2008-2009), during (2010), and after (2011-2013) MHPAEA compliance. The study sample contained individuals with drug or alcohol use disorder diagnosis during study period (N=2,716,473 member-month observations). Outcomes included: total, plan, patient out-of-pocket spending; outpatient utilization (assessment/diagnostic evaluation visits; medication management; individual, group and family psychotherapy, and structured outpatient care); intermediate care utilization (day treatment; recovery home and residential); and inpatient utilization. Starting at the beginning of the post-parity period, MHPAEA was associated with increased levels of PMPM total and plan spending ($25.80 [p=0.01]; $28.33 [p=0.00], respectively), as well as the number of PMPM assessment/evaluation, individual psychotherapy, and group psychotherapy visits, and inpatient days (0.01 visits [p=0.01]; 0.02 visits [p=0.01]; 0.01 visits [p=0.03]; 0.01days [p=0.01], respectively). Following these initial level changes, MHPAEA was also associated with monthly increases in PMPM total, plan, and patent out-of-pocket spending ($2.56/month [p=0.00]; $2.25/month [p=0.00]; $0.27 [p=0.03], respectively), as well as structured outpatient visits and inpatient days (0.0012 visits/month [p=0.01]; 0.0012days/month [p=0.00]). MHPAEA was associated with modest increases in total, plan, and patient out-of-pocket spending and outpatient and inpatient utilization. These increases, while modest in magnitude, are larger in magnitude than increases detected among a sample of all enrollees (i.e. not only those with SUD diagnoses). Published by Elsevier Inc.

Green stormwater infrastructure eco-planning and development on the regional scale: a case study of Shanghai Lingang New City, East China

NASA Astrophysics Data System (ADS)

Xu, Haishun; Chen, Liang; Zhao, Bing; Zhang, Qiuzhuo; Cai, Yongli

2016-06-01

Urban underlying surface has been greatly changed with rapid urbanization, considered to be one of the major causes for the destruction of urban natural hydrological processes. This has imposed a huge challenge for stormwater management in cities. There has been a shift from gray water management to green stormwater management thinking. The green stormwater infrastructure (GSI) is regarded as an effective and cost-efficient stormwater management eco-landscape approach. China's GSI practice and the development of its theoretical framework are still in the initial stage. This paper presents an innovative framework for stormwater management, integrating green stormwater infrastructure and landscape security patterns on a regional scale based on an urban master plan. The core concept of green stormwater infrastructure eco-planning is to form an interconnected GSI network (i.e., stormwater management landscape security pattern) which consists of the location, portion, size, layout, and structure of GSI so as to efficiently safeguard natural hydrological processes. Shanghai Lingang New City, a satellite new town of Shanghai, China was selected as a case study for GSI studies. Simulation analyses of hydrological processes were carried out to identify the critical significant landscape nodes in the highpriority watersheds for stormwater management. GSI should be planned and implemented in these identified landscape nodes. The comprehensive stormwater management landscape security pattern of Shanghai Lingang New City is designed with consideration of flood control, stormwater control, runoff reduction, water quality protection, and rainwater utilization objectives which could provide guidelines for smart growth and sustainable development of this city.

76 FR 42590 - Retrospective Review Under E.O. 13563; Improving Common Acreage Reporting Processes

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-19

... solutions to preserve and strengthen the economic stability of America's agricultural producers. RMA..., commodity, credit, conservation, disaster, and emergency assistance programs that help improve the stability... management system. To implement ACRSI in an economical manner, we plan to the extent possible to utilize CIMS...

75 FR 26702 - Fisheries off West Coast States; Pacific Coast Groundfish Fishery Management Plan; Amendments 20...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-12

... increase net economic benefits, create individual economic stability, provide full utilization of the trawl... (Amendments 20 and 21) is intended to increase net economic benefits, create individual economic stability... licenses, quota share accounts, vessel accounts, further tracking and monitoring components, and economic...

101 Ways to Save Money in Small Schools.

ERIC Educational Resources Information Center

Bratlie, Ron

This paper is a checklist on ways to save money targeted to administrators of small rural schools but appropriate to schools of any size. Tips concerning staff include salary issues, early retirement, time management techniques, involving staff in budget and facilities planning, and utilizing limited-experience teachers, teacher-administrators,…

36 CFR 223.30 - Consistency with plans, environmental standards, and other management requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE SALE AND DISPOSAL OF NATIONAL FOREST SYSTEM TIMBER...) Providing favorable conditions of water flow and quality; (f) Utilization of the timber resource to provide... characteristics; (g) Reduction of the likelihood of loss to destructive agencies; and (h) Minimizing adverse...

Efficiency in Resource Utilization in Education. Education and Development Technical Reports.

ERIC Educational Resources Information Center

Organisation for Economic Cooperation and Development, Paris (France). Directorate for Scientific Affairs.

This volume consists of papers presented at a meeting of scientific and technical personnel who examined and evaluated applications of systems analysis and operational research, and who related techniques to practical educational planning. Topics represent a variety of new management techniques available to educational administrators including…

Development of a queue warning system utilizing ATM infrastructure system development and field-testing : final report.

DOT National Transportation Integrated Search

2017-06-13

MnDOT has already deployed an extensive infrastructure for Active Traffic Management (ATM) on I-35W and I-94 with plans to expand on other segments of the Twin Cities freeway network. The ATM system includes intelligent lane control signals (ILCS) sp...

Utilizing Job Camera Technology in Construction Education

ERIC Educational Resources Information Center

Bruce, Richard D.; McCandless, David W.; Berryman, Chuck W.; Strong, Shawn D.

2008-01-01

One of the toughest hurdles to overcome in construction education is the varying levels of construction field experience among undergraduate students. Although an internship is a common construction management requirement, it is often completed after students complete classes in planning and scheduling. This poses a challenge for the modern…

Electric Restructuring and Utilities Deregulation: A Facility Manager's Guide.

ERIC Educational Resources Information Center

Glazner, Steve, Ed.

This volume presents 12 papers offering guidelines to higher education institutions on planning for the deregulation of the electric power industry. Following an introduction (by Dorsey D. Jacobs), the papers are organized into three parts which address: the changing market, identifying opportunities and challenges, and taking advantage of…

7 CFR 1717.1204 - Policies and conditions applicable to settlements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... and action plans by the members to change their operations, management, and organizational structure... to meet its financial obligations will be based on analyses and documentation by RUS of the borrower... based on comparisons with benchmark electric utilities; and (H) The accuracy and completeness of the...

50 CFR 270.11 - Responsibilities of NMFS.

Code of Federal Regulations, 2010 CFR

2010-10-01

... disapproval of a marketing and promotion plan or budget, together with reasons for such disapproval; (3) Issue orders and amendments to such orders that are necessary to implement quality standards under § 270.15; (4... management resources NMFS determines can be utilized. (b) NMFS may provide, on a reimbursable or other basis...

75 FR 54857 - Meeting of the Chief of Naval Operations Executive Panel

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-09

... Operations (CNO) Executive Panel will deliberate on the findings and proposed recommendations of the... Navy strategy, plans, and policies regarding the utilization of technically diverse systems, primarily associated with information management systems. DATES: The meeting will be held on September 30, 2010, from 9...

MODIA: Vol. 4. The Resource Utilization Model. A Project AIR FORCE Report.

ERIC Educational Resources Information Center

Gallegos, Margaret

MODIA (Method of Designing Instructional Alternatives) was developed to help the Air Force manage resources for formal training by systematically and explicitly relating quantitative requirements for training resources to the details of course design and course operation during the planning stage. This report describes the Resource Utilization…

76 FR 28060 - Regional Habitat Conservation Plan, Hays County, TX

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-13

... alternative features the acquisition of a modestly sized, pre-determined preserve system and limits the amount... under Alternative B, this alternative involves a conservation program that utilizes a pre-determined..., adaptive management, and other strategies designed to avoid and minimize harm to the covered species and...

A Save-Energy, Save-Money Program That Pays Off

ERIC Educational Resources Information Center

Embersits, John F.

1976-01-01

Suggested guidelines for energy saving on campus include a 3-phase plan: (1) Quick Fix--effective management of what you already have; (2) Refitting--modification of existing systems and installation of simple controls; (3) Systems Convert--installation of computerized controls, waste-heat recovery, solid-waste recovery utilization and other…

The central equipment pool, an opportunity for improved technology management.

PubMed

Gentles, W M

2000-01-01

A model for a central equipment pool managed by a clinical engineering department has been presented. The advantages to patient care and to the clinical engineering department are many. The distribution of portable technology that has been traditionally managed by the materials management function is a logical match to the expanding role of clinical engineering departments in technology management. Accurate asset management tools have allowed us to provide reliable measures of infusion pump utilization, permitting us to predict future needs as programs expand. Thus we are more actively involved in strategic technology planning. The central equipment pool is an excellent opportunity for the clinical engineering department to increase its technology management activities.

Earned Value Management (EVM) Implementation Handbook

NASA Technical Reports Server (NTRS)

2013-01-01

The purpose of this handbook is to provide Earned Value Management (EVM) guidance for the effective application, implementation, and utilization of EVM on NASA programs, projects, major contracts and subcontracts in a consolidated reference document. EVM is a project management process that effectively integrates a project s scope of work with schedule and cost elements for optimum project planning and control. The goal is to achieve timely and accurate quantification of progress that will facilitate management by exception and enable early visibility into the nature and the magnitude of technical problems as well as the intended course and success of corrective actions.

Analysis of eighty-four commercial aviation incidents - Implications for a resource management approach to crew training

NASA Technical Reports Server (NTRS)

Murphy, M. R.

1980-01-01

A resource management approach to aircrew performance is defined and utilized in structuring an analysis of 84 exemplary incidents from the NASA Aviation Safety Reporting System. The distribution of enabling and associated (evolutionary) and recovery factors between and within five analytic categories suggests that resource management training be concentrated on: (1) interpersonal communications, with air traffic control information of major concern; (2) task management, mainly setting priorities and appropriately allocating tasks under varying workload levels; and (3) planning, coordination, and decisionmaking concerned with preventing and recovering from potentially unsafe situations in certain aircraft maneuvers.

Earned Value Management (EVM) Implementation Handbook

NASA Technical Reports Server (NTRS)

Terrell, Stefanie M.; Richards, Brad W.

2018-01-01

The purpose of this handbook is to provide Earned Value Management (EVM) guidance for the effective application, implementation, and utilization of EVM on NASA programs, projects, major contracts and subcontracts in a consolidated reference document. EVM is a project management process that effectively integrates a project?s scope of work with schedule and cost elements for optimum project planning and control. The goal is to achieve timely and accurate quantification of progress that will facilitate management by exception and enable early visibility into the nature and the magnitude of technical problems as well as the intended course and success of corrective actions.

Multiple methods for multiple futures: Integrating qualitative scenario planning and quantitative simulation modeling for natural resource decision making

USGS Publications Warehouse

Symstad, Amy J.; Fisichelli, Nicholas A.; Miller, Brian W.; Rowland, Erika; Schuurman, Gregor W.

2017-01-01

Scenario planning helps managers incorporate climate change into their natural resource decision making through a structured “what-if” process of identifying key uncertainties and potential impacts and responses. Although qualitative scenarios, in which ecosystem responses to climate change are derived via expert opinion, often suffice for managers to begin addressing climate change in their planning, this approach may face limits in resolving the responses of complex systems to altered climate conditions. In addition, this approach may fall short of the scientific credibility managers often require to take actions that differ from current practice. Quantitative simulation modeling of ecosystem response to climate conditions and management actions can provide this credibility, but its utility is limited unless the modeling addresses the most impactful and management-relevant uncertainties and incorporates realistic management actions. We use a case study to compare and contrast management implications derived from qualitative scenario narratives and from scenarios supported by quantitative simulations. We then describe an analytical framework that refines the case study’s integrated approach in order to improve applicability of results to management decisions. The case study illustrates the value of an integrated approach for identifying counterintuitive system dynamics, refining understanding of complex relationships, clarifying the magnitude and timing of changes, identifying and checking the validity of assumptions about resource responses to climate, and refining management directions. Our proposed analytical framework retains qualitative scenario planning as a core element because its participatory approach builds understanding for both managers and scientists, lays the groundwork to focus quantitative simulations on key system dynamics, and clarifies the challenges that subsequent decision making must address.

Plan characteristics and SSI enrollees' access to and quality of care in four TennCare MCOs.

PubMed

Hill, Steven C; Wooldridge, Judith

2002-10-01

To assess hypotheses about which managed care organization (MCO) characteristics affect access to care and quality of care--including access to specialists, providers' knowledge about disability, and coordination of care--for people with disabilities. Survey of blind/disabled Supplemental Security Income (SSI) enrollees in four MCOs serving TennCare, Tennessee's Medicaid managed care program, in Memphis, conducted from 1998 through spring 1999. We compared enrollee reports of access and quality across the four MCOs using regression methods, and we use case study methods to assess whether patterns both within and across MCOs are consistent with the hypotheses. We conducted computer-assisted telephone surveys and used regression analysis to compare access and quality controlling for enrollee characteristics. Although the four MCOs' characteristics varied, access to providers, coordination of care, and access to some services were generally similar across MCOs. Enrollees in one plan, the only MCO with a larger provider network and that paid physicians on a fee-for-service basis, reported their providers were more knowledgeable, and they had more secondary preventive care visits. Differences found in access to specialists and delays in approving care appear to be unrelated to characteristics reported by the MCOs, but instead may be related to how tightly utilization is reviewed. Plan networks, financial incentives, utilization management methods, and state requirements are important areas for further study, and, in the meantime, ongoing monitoring of SSI enrollees in each MCO may be important for detecting problems and successes.

An exploratory analysis of behavioral health care use within families.

PubMed

Lave, Judith R; Peele, Pamela B; Xu, Ying; Scholle, Sarah H; Pincus, Harold Alan

2002-06-01

The authors studied enrollees in employer-sponsored managed health plans to determine the extent of multiple behavioral health consumers within families, use of behavioral health services by employees who have another family member using such services, congruence of diagnoses between two family members using behavioral health services, and the effect on covered charge per behavioral health consumer when other family members use behavioral health services. Claims data from 911 plans sold or managed by a single managed behavioral health care company were examined. The plans provided coverage for 724,789 employees and covered about 1.7 million lives. Family members of employees were identified by the relationship codes on the claims. Service utilization rates were calculated for employees overall and for employees who had spouses or children who used behavioral health services. Mean and median covered charges were determined and were examined by number and type of consumers in the family. The use of behavioral health services was greater among employees whose children or spouses used behavioral health services. Utilization rates varied by the child's or spouse's diagnoses. More than 50 percent of male employees whose children received treatment for a depressive disorder also received such treatment. Congruence of diagnoses within families was noted. Covered charges per person generally increased with the number of family members who used behavioral health services. Greater knowledge about patterns of use of behavioral health services within families may help in improving access to care and developing more effective family interventions.

Knowledge-based computer systems for radiotherapy planning.

PubMed

Kalet, I J; Paluszynski, W

1990-08-01

Radiation therapy is one of the first areas of clinical medicine to utilize computers in support of routine clinical decision making. The role of the computer has evolved from simple dose calculations to elaborate interactive graphic three-dimensional simulations. These simulations can combine external irradiation from megavoltage photons, electrons, and particle beams with interstitial and intracavitary sources. With the flexibility and power of modern radiotherapy equipment and the ability of computer programs that simulate anything the machinery can do, we now face a challenge to utilize this capability to design more effective radiation treatments. How can we manage the increased complexity of sophisticated treatment planning? A promising approach will be to use artificial intelligence techniques to systematize our present knowledge about design of treatment plans, and to provide a framework for developing new treatment strategies. Far from replacing the physician, physicist, or dosimetrist, artificial intelligence-based software tools can assist the treatment planning team in producing more powerful and effective treatment plans. Research in progress using knowledge-based (AI) programming in treatment planning already has indicated the usefulness of such concepts as rule-based reasoning, hierarchical organization of knowledge, and reasoning from prototypes. Problems to be solved include how to handle continuously varying parameters and how to evaluate plans in order to direct improvements.

NASA Earth Observations Informing Energy Management Decision Making

NASA Technical Reports Server (NTRS)

Eckman, Richard; Stackhouse, Paul

2017-01-01

The Energy Sector is experiencing increasing impacts from severe weather and shifting climatic trends, as well as facing a changing political climate, adding uncertainty for stakeholders as they make short- and long-term planning investments. Climate changes such as prolonged extreme heat and drought (leading to wildfire spread, for example), sea level rise, and extreme storms are changing the ways that utilities operate. Energy infrastructure located in coastal or flood-prone areas faces inundation risks, such as damage to energy facilities. The use of renewable energy resources is increasing, requiring more information about their intermittency and spatial patterns. In light of these challenges, public and private stakeholders have collaborated to identify potential data sources, tools, and programmatic ideas. For example, utilities across the country are using cutting-edge technology and data to plan for and adapt to these changes. In the Federal Government, NASA has invested in preliminary work to identify needs and opportunities for satellite data in energy sector application, and the Department of Energy has similarly brought together stakeholders to understand the landscape of climate vulnerability and resilience for utilities and others. However, have these efforts improved community-scale resilience and adaptation efforts? Further, some communities are more vulnerable to climate change and infrastructure impacts than others. This session has two goals. First, panelists seek to share existing and ongoing efforts related to energy management. Second, the session seeks to engage with attendees via group knowledge exchange to connect national energy management efforts to local practice for increased community resilience.

Formal strategy in public hospitals.

PubMed

Denis, J; Langley, A; Lozeau, D

1991-02-01

This paper suggests that the difficulties associated with the application of formal strategic planning in public professional service organizations may have been underestimated in much of the literature. A survey of written strategic plans produced by Canadian hospitals showed that these plans were often heavily oriented towards expansion, ambiguous and rather loosely integrated, leading to questions concerning their realism and utility as a basis for strategic decisions. This phenomenon seems symptomatic of the complex (and often highly political) decision making environment faced by hospital administrators (and by managers of other professional service organizations such as universities and social service agencies). It is concluded that the benefits of formal planning may be different and less tangible for these organizations than for private business.

Avionics test bed development plan

NASA Technical Reports Server (NTRS)

Harris, L. H.; Parks, J. M.; Murdock, C. R.

1981-01-01

A development plan for a proposed avionics test bed facility for the early investigation and evaluation of new concepts for the control of large space structures, orbiter attached flex body experiments, and orbiter enhancements is presented. A distributed data processing facility that utilizes the current laboratory resources for the test bed development is outlined. Future studies required for implementation, the management system for project control, and the baseline system configuration are defined. A background analysis of the specific hardware system for the preliminary baseline avionics test bed system is included.

The Need for a Comprehensive Mental Health Information System. 1. Data Requirements of Local Clinicians and Administrators in Navy Psychiatry.

DTIC Science & Technology

1980-07-01

management, e.g., treatment plans and goals, current objectives of treatment, patient progress, and the results of any medical consultations. A planned... medical care utilization fol-low mental health interventions. Add to this fact the estimate that 50%o of patients entering the Navy health care delivery...Captain Sears is Chief, Psychiatric Services, Naval Regional Medical Center, San Diego, CA 92134. Report No. 80-19, supported by Naval Medical Research

Foundational Report Series: Advanced Distribution Management Systems for Grid Modernization, Implementation Strategy for a Distribution Management System

DOE Office of Scientific and Technical Information (OSTI.GOV)

Singh, Ravindra; Reilly, James T.; Wang, Jianhui

Electric distribution utilities encounter many challenges to successful deployment of Distribution Management Systems (DMSs). The key challenges are documented in this report, along with suggestions for overcoming them. This report offers a recommended list of activities for implementing a DMS. It takes a strategic approach to implementing DMS from a project management perspective. The project management strategy covers DMS planning, procurement, design, building, testing, Installation, commissioning, and system integration issues and solutions. It identifies the risks that are associated with implementation and suggests strategies for utilities to use to mitigate them or avoid them altogether. Attention is given to commonmore » barriers to successful DMS implementation. This report begins with an overview of the implementation strategy for a DMS and proceeds to put forward a basic approach for procuring hardware and software for a DMS; designing the interfaces with external corporate computing systems such as EMS, GIS, OMS, and AMI; and implementing a complete solution.« less

An Early Survey of Best Practices for the Use of Small Unmanned Aerial Systems by the Electric Utility Industry

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lusk, Rick M.; Monday, William

This technical manual is about doing things safely. It isn’t so much a how-to guide as it is a collection of best practices from unmanned aerial system (UAS) operators from all over the world. The desired end state is to provide a touchstone for utility businesses, directors, managers, and operators that will inform them as they begin to strategize, plan, and incorporate this technology into day-to-day operations.

Forest management applications of Landsat data in a geographic information system

NASA Technical Reports Server (NTRS)

Maw, K. D.; Brass, J. A.

1982-01-01

The utility of land-cover data resulting from Landsat MSS classification can be greatly enhanced by use in combination with ancillary data. A demonstration forest management applications data base was constructed for Santa Cruz County, California, to demonstrate geographic information system applications of classified Landsat data. The data base contained detailed soils, digital terrain, land ownership, jurisdictional boundaries, fire events, and generalized land-use data, all registered to a UTM grid base. Applications models were developed from problems typical of fire management and reforestation planning.

Towards Ubiquitous Peer Review Strategies to Sustain and Enhance a Clinical Knowledge Management Framework

PubMed Central

Rocha, Roberto A.; Bradshaw, Richard L.; Bigelow, Sharon M.; Hanna, Timothy P.; Fiol, Guilherme Del; Hulse, Nathan C.; Roemer, Lorrie K.; Wilkinson, Steven G.

2006-01-01

Widespread cooperation between domain experts and front-line clinicians is a key component of any successful clinical knowledge management framework. Peer review is an established form of cooperation that promotes the dissemination of new knowledge. The authors describe three peer collaboration scenarios that have been implemented using the knowledge management infrastructure available at Intermountain Healthcare. Utilization results illustrating the early adoption patterns of the proposed scenarios are presented and discussed, along with succinct descriptions of planned enhancements and future implementation efforts. PMID:17238422

Proceedings: 1989 electric utility franchise conference

DOE Office of Scientific and Technical Information (OSTI.GOV)

Romo, R.G.

The primary purpose of the Conference was to present and discuss strategic issues related to franchising electric service. The theme for the conference was to both improve the management of existing franchises and the negotiation of new franchises. To promote a better understanding of the planning issues related to this theme, the following sessions were designed: (1) public utility franchising, (2) investor owned utility and community perspectives on franchising, (3) franchise case study presentations, (4) alternatives to franchise renewal: the public acquisition option, and (5) special franchise issues. The Conference combined results from research coupled with actual franchise negotiating experiences,more » and concepts and ideas considered or implemented by utilities, government agencies, consultants and others.« less

Orofacial pain: a guide for the headache physician.

PubMed

Shephard, Martina K; Macgregor, E Anne; Zakrzewska, Joanna M

2014-01-01

Orofacial pain represents a significant burden in terms of morbidity and health service utilization. It includes very common disorders such as toothache and temporomandibular disorders, as well as rare orofacial pain syndromes. Many orofacial pain conditions have overlapping presentations, and diagnostic uncertainty is frequently encountered in clinical practice. This review provides a clinically orientated overview of common and uncommon orofacial pain presentations and diagnoses, with an emphasis on conditions that may be unfamiliar to the headache physician. A holistic approach to orofacial pain management is important, and the social, cultural, psychological and cognitive context of each patient needs to be considered in the process of diagnostic formulation, as well as in the development of a pain management plan according to the biopsychosocial model. Recognition of psychological comorbidities will assist in diagnosis and management planning. © 2013 American Headache Society.

Impact of 2 employer-sponsored population health management programs on medical care cost and utilization.

PubMed

Mattke, Soeren; Serxner, Seth A; Zakowski, Sarah L; Jain, Arvind K; Gold, Daniel B

2009-02-01

Integrated health management programs combining disease prevention and disease management services, although popular with employers, have been insufficiently researched with respect to their effect on costs. To estimate the overall impact of a population health management program and its components on cost and utilization. STUDY DESIGN, SETTING, AND PARTICIPANTS: Observational study of 2 employer-sponsored health management programs involving more than 200,000 health plan members. We used claims data for the first program year and the 2 preceding years to calculate cost and utilization metrics, and program activity data to determine program uptake. Using an intent-to-treat approach and regression-based risk adjustment, we estimated whether the program was associated with changes in cost and utilization. Data on program fees were unavailable. Overall, the program was associated with a nonsignificant cost increase of $13.75 per member per month (PMPM). The wellness component alone was associated with a significant increase of $20.14 PMPM. Case and disease management were associated with a significant decrease in hospital admissions of 4 and 1 per 1000 patient-years, respectively. Our results suggest that the programs did not reduce medical cost in their first year, despite a beneficial effect on hospital admissions. If we had been able to include program fees, it is likely that the overall cost would have increased significantly. Although this study had important limitations, the results suggest that a belief that these programs will save money may be too optimistic and better evaluation is needed.

Load Forecasting in Electric Utility Integrated Resource Planning

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carvallo, Juan Pablo; Larsen, Peter H.; Sanstad, Alan H

Integrated resource planning (IRP) is a process used by many vertically-integrated U.S. electric utilities to determine least-cost/risk supply and demand-side resources that meet government policy objectives and future obligations to customers and, in many cases, shareholders. Forecasts of energy and peak demand are a critical component of the IRP process. There have been few, if any, quantitative studies of IRP long-run (planning horizons of two decades) load forecast performance and its relationship to resource planning and actual procurement decisions. In this paper, we evaluate load forecasting methods, assumptions, and outcomes for 12 Western U.S. utilities by examining and comparing plansmore » filed in the early 2000s against recent plans, up to year 2014. We find a convergence in the methods and data sources used. We also find that forecasts in more recent IRPs generally took account of new information, but that there continued to be a systematic over-estimation of load growth rates during the period studied. We compare planned and procured resource expansion against customer load and year-to-year load growth rates, but do not find a direct relationship. Load sensitivities performed in resource plans do not appear to be related to later procurement strategies even in the presence of large forecast errors. These findings suggest that resource procurement decisions may be driven by other factors than customer load growth. Our results have important implications for the integrated resource planning process, namely that load forecast accuracy may not be as important for resource procurement as is generally believed, that load forecast sensitivities could be used to improve the procurement process, and that management of load uncertainty should be prioritized over more complex forecasting techniques.« less

Achieving Effective Risk Management Reduction Throughout Decommissioning at the Columbus Closure Project

DOE Office of Scientific and Technical Information (OSTI.GOV)

Anderson, K.D.

2006-07-01

Nuclear facility decontamination, dismantlement, and demolition activities provide a myriad of challenges along the path to reaching a safe, effective, and compliant decommissioning. Among the challenges faced during decommissioning, is the constant management and technical effort to eliminate, mitigate, or minimize the potential of risks of radiation exposures and other hazards to the worker, the surrounding community, and the environment. Management strategies to eliminate, mitigate, or minimize risks include incorporating strong safety and As Low As Reasonably Achievable (ALARA) principles into an integrated work planning process. Technical and operational strategies may include utilizing predictive risk analysis tools to establish contaminationmore » limits for demolition and using remote handling equipment to reduce occupational and radiation exposures to workers. ECC and E2 Closure Services, LLC (Closure Services) have effectively utilized these management and technical tools to eliminate, mitigate, and reduce radiation exposures under contract to the U.S. Department of Energy (DOE) for the decontamination and decommissioning Columbus Closure Project (CCP). In particular, Closure Services achieved significant dose reduction during the dismantling, decontamination, and demolition activities for Building JN-1. Management strategies during the interior dismantlement, decontamination, and demolition of the facility demanded an integrated work planning processes that involved project disciplines. Integrated planning processes identified multiple opportunities to incorporate the use of remote handling equipment during the interior dismantling and demolition activities within areas of high radiation. Technical strategies employed predictive risk analysis tools to set upper bounding contamination limits, allowed for the radiological demolition of the building without exceeding administrative dose limits to the worker, general public, and the environment. Adhering to management and technical strategies during the dismantlement, decontamination, and demolition of Building JN-1 enabled Closure Services to achieve strong ALARA performance, maintain absolute compliance under the regulatory requirements and meeting licensing conditions for decommissioning. (authors)« less

The LiveWire Project final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brown, C.D.; Nelson, T.T.; Kelly, J.C.

Utilities across the US have begun pilot testing a variety of hardware and software products to develop a two-way communications system between themselves and their customers. Their purpose is to reduce utility operating costs and to provide new and improved services for customers in light of pending changes in the electric industry being brought about by deregulation. A consortium including utilities, national labs, consultants, and contractors, with the support of the Department of Energy (DOE) and the Electric Power Research Institute (EPRI), initiated a project that utilized a hybrid fiber-coax (HFC) wide-area network integrated with a CEBus based local areamore » network within the customers home. The system combined energy consumption data taken within the home, and home automation features to provide a suite of energy management services for residential customers. The information was transferred via the Internet through the HFC network, and presented to the customer on their personal computer. This final project report discusses the design, prototype testing, and system deployment planning of the energy management system.« less

Needs analysis of a flexible computerized management infrastructure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Usman, S.; Hajek, B. K.; Ali, S. F.

2006-07-01

The United States' Energy Policy Act of 2005 is expected to facilitate construction of new commercial nuclear power plants. In the meanwhile, current plants are in the process of obtaining licenses for extended operation beyond their predetermined design life. In this beneficial yet challenging situation, it seems desirable to develop a strategic plan for smooth and seamless transition from paper based procedure systems to computer based procedure systems for improved performance and safety of the existing nuclear power plants. Many utilities already maintain procedures using word processing software, but it is common to print paper copies for daily use. Atmore » this time it is highly desirable to better understand the collective as well as individual document management needs of a commercial nuclear power plant as they migrate to a computer based system. As a contributory role in initiating a strategic plan, this paper offers a comprehensive questionnaire that is suitable for conducting a survey to determine the related needs of the utilities. The questionnaire covers three major areas: Formatting and User Friendly Features; Technical and Environmental Considerations; and Safety, System Integrity and Regulatory Considerations. A plan to conduct the proposed survey is also outlined in the future work section of this paper. (authors)« less

Marketing: Today's imperative. Marketing must be seen as the process by which a company creates, satisfies, and keeps customers. at a profit

DOE Office of Scientific and Technical Information (OSTI.GOV)

Murray, W.R.

While utilities are now much more market-oriented than in the past, marketing and sales budgets are still under attack at many gas and electric companies. Moreover, the marketing process is not being organized or managed for optimal effectiveness. To make the changes necessary to improve their competitive position, most utilities still need to address a variety of issues, such as: (1) Taking a more integrated, holistic approach to managing the various elements of the marketing process and achieving a position of competitive advantage; (2) Understanding customer/segment and product/service profitability; (3) Linking marketing plans and budgets with the utility's financial andmore » strategic plans, and using this to drive appropriate resource allocation decisions based on fact rather than guess; (4) Making the Marketing Department accountable for profit, not just sales; (5) Developing information-gathering capabilities and databases on customers, markets, and competitors that can be used to shape marketing strategies and tactics; and (6) Developing the analytical skill needed to understand differences in customer needs, buying economics, and ways a utility can effectively, efficiently, and profitably serve its customers. In the past, changes of this type would have been seen as unnecessary, perhaps even dangerous. However, until these actions are taken it will be difficult, if not impossible, for utilities to implement the new marketing imperative. Companies in other industries that have experienced similar regulatory changes have had to adapt in these ways to compete successfully, In general, the companies that took the lead have fared better than those that found themselves playing catch-up. It will be no different for utilities.« less

Financial risk management of pharmacy benefits.

PubMed

Saikami, D

1997-10-01

Financial risk management of pharmacy benefits in integrated health systems is explained. A managed care organization should assume financial risk for pharmacy benefits only if it can manage the risk. Horizontally integrated organizations often do not have much control over the management of drug utilization and costs. Vertically integrated organizations have the greatest ability to manage pharmacy financial risk; virtual integration may also be compatible. Contracts can be established in which the provider is incentivized or placed at partial or full risk. The main concerns that health plans have with respect to pharmacy capitation are formulary management and the question of who should receive rebates from manufacturers. The components needed to managed pharmacy financial risk depend on the type of contract negotiated. Health-system pharmacists are uniquely positioned to take advantage of opportunities opening up through pharmacy risk contracting. Functions most organizations must provide when assuming pharmacy financial risk can be divided into internal and external categories. Internally performed functions include formulary management, clinical pharmacy services and utilization management, and utilization reports for physicians. Functions that can be outsourced include claims processing and administration, provider- and customer support services, and rebates. Organizations that integrate the pharmacy benefit across the health care continuum will be more effective in controlling costs and improving outcomes than organizations that handle this benefit as separate from others. Patient care should not focus on payment mechanisms and unit costs but on developing superior processes and systems that improve health care.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barr, Jonathan L.; Tuffner, Francis K.; Hadley, Mark D.

This document contains the Integrated Assessment Plan (IAP) for the Phase 2 Operational Demonstration (OD) of the Smart Power Infrastructure Demonstration for Energy Reliability (SPIDERS) Joint Capability Technology Demonstration (JCTD) project. SPIDERS will be conducted over a three year period with Phase 2 being conducted at Fort Carson, Colorado. This document includes the Operational Demonstration Execution Plan (ODEP) and the Operational Assessment Execution Plan (OAEP), as approved by the Operational Manager (OM) and the Integrated Management Team (IMT). The ODEP describes the process by which the OD is conducted and the OAEP describes the process by which the data collectedmore » from the OD is processed. The execution of the OD, in accordance with the ODEP and the subsequent execution of the OAEP, will generate the necessary data for the Quick Look Report (QLR) and the Utility Assessment Report (UAR). These reports will assess the ability of the SPIDERS JCTD to meet the four critical requirements listed in the Implementation Directive (ID).« less

Geographic information system-based healthcare waste management planning for treatment site location and optimal transportation routeing.

PubMed

Shanmugasundaram, Jothiganesh; Soulalay, Vongdeuane; Chettiyappan, Visvanathan

2012-06-01

In Lao People's Democratic Republic (Lao PDR), a growth of healthcare centres, and the environmental hazards and public health risks typically accompanying them, increased the need for healthcare waste (HCW) management planning. An effective planning of an HCW management system including components such as the treatment plant siting and an optimized routeing system for collection and transportation of waste is deemed important. National government offices at developing countries often lack the proper tools and methodologies because of the high costs usually associated with them. However, this study attempts to demonstrate the use of an inexpensive GIS modelling tool for healthcare waste management in the country. Two areas were designed for this study on HCW management, including: (a) locating centralized treatment plants and designing optimum travel routes for waste collection from nearby healthcare facilities; and (b) utilizing existing hospital incinerators and designing optimum routes for collecting waste from nearby healthcare facilities. Spatial analysis paved the way to understand the spatial distribution of healthcare wastes and to identify hotspots of higher waste generating locations. Optimal route models were designed for collecting and transporting HCW to treatment plants, which also highlights constraints in collecting and transporting waste for treatment and disposal. The proposed model can be used as a decision support tool for the efficient management of hospital wastes by government healthcare waste management authorities and hospitals.

Scandinavian systems monitoring the oral health in children and adolescents; an evaluation of their quality and utility in the light of modern perspectives of caries management

PubMed Central

2014-01-01

Background Recording reliable oral health data is a challenge. The aims were a) to outline different Scandinavian systems of oral health monitoring, b) to evaluate the quality and utility of the collected data in the light of modern concepts of disease management and to suggest improvements. Material and methods The information for in this study was related to (a) children and adolescents, (b) oral health data and (c) routines for monitoring such data. This meant information available in the official web sites of the “KOSTRA-data” (Municipality-State-Report) in Norway, the Swedish National Board of Health and Welfare (“Socialstyrelsen”) and Oral Health Register (the SCOR system, National Board of Health) in Denmark. Results A potential for increasing the reliability and validity of the data existed. Routines for monitoring other oral diseases than caries were limited. Compared with the other Scandinavian countries, the data collection system in Denmark appeared more functional and had adopted more modern concepts of disease management than other systems. In the light of modern concepts of caries management, data collected elsewhere had limited utility. Conclusions The Scandinavian systems of health reporting had much in common, but some essential differences existed. If the quality of epidemiological data were enhanced, it would be possible to use the data for planning oral health care. Routines and procedures should be improved and updated in accordance with the modern ideas about caries prevention and therapy. For appropriate oral health planning in an organised dental service, reporting of enamel caries is essential. PMID:24885243

Seaweeds: an opportunity for wealth and sustainable livelihood for coastal communities.

PubMed

Rebours, Céline; Marinho-Soriano, Eliane; Zertuche-González, José A; Hayashi, Leila; Vásquez, Julio A; Kradolfer, Paul; Soriano, Gonzalo; Ugarte, Raul; Abreu, Maria Helena; Bay-Larsen, Ingrid; Hovelsrud, Grete; Rødven, Rolf; Robledo, Daniel

2014-01-01

The European, Canadian, and Latin American seaweed industries rely on the sustainable harvesting of natural resources. As several countries wish to increase their activity, the harvest should be managed according to integrated and participatory governance regimes to ensure production within a long-term perspective. Development of regulations and directives enabling the sustainable exploitation of natural resources must therefore be brought to the national and international political agenda in order to ensure environmental, social, and economic values in the coastal areas around the world. In Europe, Portugal requires an appraisal of seaweed management plans while Norway and Canada have developed and implemented coastal management plans including well-established and sustainable exploitation of their natural seaweed resources. Whereas, in Latin America, different scenarios of seaweed exploitation can be observed; each country is however in need of long-term and ecosystem-based management plans to ensure that exploitation is sustainable. These plans are required particularly in Peru and Brazil, while Chile has succeeded in establishing a sustainable seaweed-harvesting plan for most of the economically important seaweeds. Furthermore, in both Europe and Latin America, seaweed aquaculture is at its infancy and development will have to overcome numerous challenges at different levels (i.e., technology, biology, policy). Thus, there is a need for regulations and establishment of "best practices" for seaweed harvesting, management, and cultivation. Trained human resources will also be required to provide information and education to the communities involved, to enable seaweed utilization to become a profitable business and provide better income opportunities to coastal communities.

A tale of integrated regional water supply planning: Meshing socio-economic, policy, governance, and sustainability desires together

NASA Astrophysics Data System (ADS)

Asefa, Tirusew; Adams, Alison; Kajtezovic-Blankenship, Ivana

2014-11-01

In 1998, Tampa Bay Water, the largest wholesale water provider in South East USA with over 2.3 million customers, assumed the role of planning, developing, and operating water supply sources from six local water supply utilities through an Interlocal Agreement. Under the agreement, cities and counties served by the agency would have their water supply demands met unequivocally and share the cost of delivery and/or development of new supplies based on their consumption, allowing a more holistic approach to manage resources in the region. Consequently, the agency was able to plan and execute several components of its Long-Term Master Water Plan to meet the region's demand, as well as diversify its sources of water supply. Today, the agency manages a diverse and regionally interconnected water supply system that includes 13 wellfields, two surface water supply sources, off-site reservoir storage, a sea water desalination plant, a surface water treatment plant, and 14 pumping/booster stations. It delivers water through 390 km of large diameter pipe to 19 potable water connections. It uses state-of-the-practice computer tools to manage short and long-term operations and planning. As a result, after the agency's inception, groundwater pumpage was reduced by more than half in less than a decade-by far one of the largest cutback and smaller groundwater utilization rate compared to other utilities in Florida or elsewhere. The region was able to witness a remarkable recovery in lake and wetland water levels through the agency's use of this diverse mix of supply sources. For example, in the last three years, 45-65% of water supply came from groundwater sources, 35-45% from surface water sources and 1-9% from desalinated seawater-very different from 100% groundwater only supply just few years ago. As an "on demand" wholesale water provider, the agency forecasts water supply availability and expected water demands from seasonal to decadal time frames using a suite of forecasting tools and a structured decision-making process. This paper presents a case study of the approach taken by Tampa Bay Water to meet the region's growing water demands while satisfying other competing objectives in a sustainable fashion and documents the remarkable environmental improvement observed in the area.

Centralized mission planning and scheduling system for the Landsat Data Continuity Mission

USGS Publications Warehouse

Kavelaars, Alicia; Barnoy, Assaf M.; Gregory, Shawna; Garcia, Gonzalo; Talon, Cesar; Greer, Gregory; Williams, Jason; Dulski, Vicki

2014-01-01

Satellites in Low Earth Orbit provide missions with closer range for studying aspects such as geography and topography, but often require efficient utilization of space and ground assets. Optimizing schedules for these satellites amounts to a complex planning puzzle since it requires operators to face issues such as discontinuous ground contacts, limited onboard memory storage, constrained downlink margin, and shared ground antenna resources. To solve this issue for the Landsat Data Continuity Mission (LDCM, Landsat 8), all the scheduling exchanges for science data request, ground/space station contact, and spacecraft maintenance and control will be coordinated through a centralized Mission Planning and Scheduling (MPS) engine, based upon GMV’s scheduling system flexplan9 . The synchronization between all operational functions must be strictly maintained to ensure efficient mission utilization of ground and spacecraft activities while working within the bounds of the space and ground resources, such as Solid State Recorder (SSR) and available antennas. This paper outlines the functionalities that the centralized planning and scheduling system has in its operational control and management of the Landsat 8 spacecraft.

78 FR 74046 - Gray's Reef National Marine Sanctuary Regulations and Management Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-10

... or viewed on the internet at www.regulations.gov (search for docket NOAA-NOS-2013-0160) or at http... operators occasionally taking people out to the sanctuary. A 2008 survey (Ehler 2010) identified 15 charter boats that utilize GRNMS as one of their fishing locations. The survey found that approximately 40...

Computational Modeling and Analysis of Networked Organizational Planning in a Coalition Maritime Strike Environment

DTIC Science & Technology

2006-06-01

KMO ) for the CFMCC staff. That officer had a daily meeting with all of the CFMCC’s collateral duty knowledge managers (KM) to discuss information...analyses of process steps) and mentored by the KMO , could enhance knowledge creation and utilization while not jeopardizing work flows. Clearly in

National remote computational flight research facility

NASA Technical Reports Server (NTRS)

Rediess, Herman A.

1989-01-01

The extension of the NASA Ames-Dryden remotely augmented vehicle (RAV) facility to accommodate flight testing of a hypersonic aircraft utilizing the continental United States as a test range is investigated. The development and demonstration of an automated flight test management system (ATMS) that uses expert system technology for flight test planning, scheduling, and execution is documented.

SWREGAP DATA TO ESTIMATE CHANGE IN WATERSHED CONDITION FOR SELECTED NEVADA WATERSHEDS USING A GIS-BASED HYDROLOGIC MODELING APPROACH

EPA Science Inventory

Planning and assessment in land and water resource management are an important contemporary requisite for almost all natural resource agencies. An overview of the utility of SWReGAP data for watershed assessment and conservation will be presented using specific examples in Nevad...

Development of state and transition model assumptions used in National Forest Plan revision

Treesearch

Eric B. Henderson

2008-01-01

State and transition models are being utilized in forest management analysis processes to evaluate assumptions about disturbances and succession. These models assume valid information about seral class successional pathways and timing. The Forest Vegetation Simulator (FVS) was used to evaluate seral class succession assumptions for the Hiawatha National Forest in...

Using Eucalypts in manufacturing

Treesearch

William A. Dost

1983-01-01

Eucalypts have a number of characteristics affecting processing and utilization that distinguish them from other woods. The major current interest in the eucalypts is as a fuel. Possible demand as a chemical feedstock, for pulp-wood, panel products, lumber or round timbers should be considered in initial planning and management as a hedge against changes resulting from...

Comparing the Effects of Home versus Clinic-Based Parent Training for Children with Autism

ERIC Educational Resources Information Center

Crone, Regina M.

2010-01-01

Research with parents on managing child problem behavior typically measures either child or parent behavior. This study was designed to evaluate the effectiveness of training parents to implement a function-based behavior intervention plan (BIP) in a non-trained natural environment utilizing a Multiple Probe Design across Participants.…

48 CFR 519.7009 - Application process.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS GSA Mentor-Protégé Program 519.7009 Application process. (a... 3695 to the GSA Mentor-Protégé Program Manager, at GSA Office of Small Business Utilization (E... active approved subcontracting plan (small business exempted) and the firm is eligible, as of the date of...

48 CFR 519.7009 - Application process.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS GSA Mentor-Protégé Program 519.7009 Application process. (a... 3695 to the GSA Mentor-Protégé Program Manager, at GSA Office of Small Business Utilization (E... active approved subcontracting plan (small business exempted) and the firm is eligible, as of the date of...

48 CFR 519.7009 - Application process.

Code of Federal Regulations, 2012 CFR

2012-10-01

... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS GSA Mentor-Protégé Program 519.7009 Application process. (a... 3695 to the GSA Mentor-Protégé Program Manager, at GSA Office of Small Business Utilization (E... active approved subcontracting plan (small business exempted) and the firm is eligible, as of the date of...

48 CFR 519.7009 - Application process.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS GSA Mentor-Protégé Program 519.7009 Application process. (a... 3695 to the GSA Mentor-Protégé Program Manager, at GSA Office of Small Business Utilization (E... active approved subcontracting plan (small business exempted) and the firm is eligible, as of the date of...

Research utilization in the building industry: decision model and preliminary assessment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Watts, R.L.; Johnson, D.R.; Smith, S.A.

1985-10-01

The Research Utilization Program was conceived as a far-reaching means for managing the interactions of the private sector and the federal research sector as they deal with energy conservation in buildings. The program emphasizes a private-public partnership in planning a research agenda and in applying the results of ongoing and completed research. The results of this task support the hypothesis that the transfer of R and D results to the buildings industry can be accomplished more efficiently and quickly by a systematic approach to technology transfer. This systematic approach involves targeting decision makers, assessing research and information needs, properly formatingmore » information, and then transmitting the information through trusted channels. The purpose of this report is to introduce elements of a market-oriented knowledge base, which would be useful to the Building Systems Division, the Office of Buildings and Community Systems and their associated laboratories in managing a private-public research partnership on a rational systematic basis. This report presents conceptual models and data bases that can be used in formulating a technology transfer strategy and in planning technology transfer programs.« less

National Transonic Facility: A review of the operational plan

NASA Technical Reports Server (NTRS)

Liepmann, H. W.; Black, R. E.; Dietz, R. O.; Kirchner, M. E.; Sears, W. R.

1980-01-01

The proposed National Transonic Facility (NTF) operational plan is reviewed. The NTF will provide an aerodynamic test capability significantly exceeding that of other transonic regime wind tunnels now available. A limited number of academic research program that might use the NTF are suggested. It is concluded that the NTF operational plan is useful for management, technical, instrumentation, and model building techniques available in the specialized field of aerodynamic analysis and simulation. It is also suggested that NASA hold an annual conference to discuss wind tunnel research results and to report on developments that will further improve the utilization and cost effectiveness of the NTF and other wind tunnels.

Commonwealth of the Northern Mariana Islands Energy Action Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Conrad, M. D.; Ness, J. E.

2013-07-01

This document describes the three near-term energy strategies selected by the CNMI Energy Task Force during action planning workshops conducted in March 2013, and outlines the steps being taken to implement those strategies. The three energy strategies selected by the task force are (1) designing a demand-side management program focusing on utility, residential and commercial sectors, (2) developing an outreach and education plan focused on energy conservation in government agencies and businesses, including workplace rules, and (3) exploring waste-to-energy options. The task force also discussed several other medium- and long-term energy strategies that could be explored at a future date.

Medical talent management: a model for physician deployment.

PubMed

Brightman, Baird

2007-01-01

This article aims to provide a focused cost-effective method for triaging physicians into appropriate non-clinical roles to benefit both doctors and healthcare organizations. Reviews a validated career-planning process and customize it for medical talent management. A structured career assessment can differentiate between different physician work styles and direct medical talent into best-fit positions. This allows healthcare organizations to create a more finely tuned career ladder than the familiar "in or out" binary choice. PRACTICAL IMPLICATIONS--Healthcare organizations can invest in cost-effective processes for the optimal utilization of their medical talent. Provides a new use for a well-validated career assessment and planning system. The actual value of this approach should be studied using best-practices in ROI research.

Environmental impact assessment using a utility-based recursive evidential reasoning approach for structural flood mitigation measures in Metro Manila, Philippines.

PubMed

Gilbuena, Romeo; Kawamura, Akira; Medina, Reynaldo; Nakagawa, Naoko; Amaguchi, Hideo

2013-12-15

In recent years, the practice of environmental impact assessment (EIA) has created significant awareness on the role of environmentally sound projects in sustainable development. In view of the recent studies on the effects of climate change, the Philippine government has given high priority to the construction of flood control structures to alleviate the destructive effects of unmitigated floods, especially in highly urbanized areas like Metro Manila. EIA thus, should be carefully and effectively carried out to maximize or optimize the potential benefits that can be derived from structural flood mitigation measures (SFMMs). A utility-based environmental assessment approach may significantly aid flood managers and decision-makers in planning for effective and environmentally sound SFMM projects. This study proposes a utility-based assessment approach using the rapid impact assessment matrix (RIAM) technique, coupled with the evidential reasoning approach, to rationally and systematically evaluate the ecological and socio-economic impacts of 4 planned SFMM projects (i.e. 2 river channel improvements and 2 new open channels) in Metro Manila. Results show that the overall environmental effects of each of the planned SFMM projects are positive, which indicate that the utility of the positive impacts would generally outweigh the negative impacts. The results also imply that the planned river channel improvements will yield higher environmental benefits over the planned open channels. This study was able to present a clear and rational approach in the examination of overall environmental effects of SFMMs, which provides valuable insights that can be used by decision-makers and policy makers to improve the EIA practice and evaluation of projects in the Philippines. Copyright © 2013 Elsevier Ltd. All rights reserved.

[The effectiveness of continuing care models in patients with chronic diseases: a systematic review].

PubMed

Chen, Hsiao-Mei; Han, Tung-Chen; Chen, Ching-Min

2014-04-01

Population aging has caused significant rises in the prevalence of chronic diseases and the utilization of healthcare services in Taiwan. The current healthcare delivery system is fragmented. Integrating medical services may increase the quality of healthcare, enhance patient and patient family satisfaction with healthcare services, and better contain healthcare costs. This article introduces two continuing care models: discharge planning and case management. Further, the effectiveness and essential components of these two models are analyzed using a systematic review method. Articles included in this systematic review were all original articles on discharge-planning or case-management interventions published between February 1999 and March 2013 in any of 6 electronic databases (Medline, PubMed, Cinahl Plus with full Text, ProQuest, Cochrane Library, CEPS and Center for Chinese Studies electronic databases). Of the 70 articles retrieved, only 7 were randomized controlled trial studies. Three types of continuity-of-care models were identified: discharge planning, case management, and a hybrid of these two. All three models used logical and systematic processes to conduct assessment, planning, implementation, coordination, follow-up, and evaluation activities. Both the discharge planning model and the case management model were positively associated with improved self-care knowledge, reduced length of stay, decreased medical costs, and better quality of life. This study cross-referenced all reviewed articles in terms of target clients, content, intervention schedules, measurements, and outcome indicators. Study results may be referenced in future implementations of continuity-care models and may provide a reference for future research.

[Disease management programs: Difficulties in the analysis of benefit].

PubMed

Linder, Roland; Horenkamp-Sonntag, D; Bestmann, B; Battmer, U; Heilmann, T; Verheyen, F

2015-04-01

After an introduction to the theme with an overview of the implementation of the Disease Management Programs (DMP), accompanying documentation, present utilization and costs of the programs, the present article is primarily devoted to the issue of the analysis of the benefits of DMP. Following an assessment of the legally specified evaluation requirements, in the absence of a prospective, randomized, controlled trial (RCT), the results of three studies are first summarized, which, with the application of propensity score matching, utilize the routine data of the statutory health insurance schemes to form a control group. The overview concludes with a look at the planned changes in evaluation and the intended expansion of the DMP to programs for other chronic illnesses.

Better Quality of Care or Healthier Patients? Hospital Utilization by Medicare Advantage and Fee-for-Service Enrollees

PubMed Central

Nicholas, Lauren Hersch

2013-01-01

Do differences in rates of use among managed care and Fee-for-Service Medicare beneficiaries reflect selection bias or successful care management by insurers? I demonstrate a new method to estimate the treatment effect of insurance status on health care utilization. Using clinical information and risk-adjustment techniques on data on acute admission that are unrelated to recent medical care, I create a proxy measure of unobserved health status. I find that positive selection accounts for between one-quarter and one-third of the risk-adjusted differences in rates of hospitalization for ambulatory care sensitive conditions and elective procedures among Medicare managed care and Fee-for-Service enrollees in 7 years of Healthcare Cost and Utilization Project State Inpatient Databases from Arizona, Florida, New Jersey and New York matched to Medicare enrollment data. Beyond selection effects, I find that managed care plans reduce rates of potentially preventable hospitalizations by 12.5 per 1,000 enrollees (compared to mean of 46 per 1,000) and reduce annual rates of elective admissions by 4 per 1,000 enrollees (mean 18.6 per 1,000). PMID:24533012

A Probe into Key Points in the Planning and Design of Integrated Corridor at Large Civil Airports

NASA Astrophysics Data System (ADS)

Zhao, Qing

2018-05-01

If we compare an airport to our human body, all sorts of specialized pipelines and wires are to an airport as the vascular system and nervous system etc. to the human body, where each functional zone connecting the airport serves each major system of airport and provides “throughput like the function of driving out the processed for the new” and “central control and transmission function”. Guided by the master plan and the concept of progressive development of airports, it is critical to map out a plan to link near-term and long-term development of supporting utilities. The role and effect of integrated corridor is of significance to the construction of multi-runway large-sized new airports or to the expansion of an airport costing tens of billions. In view of the features of the fast growing civil aviation sector in China, this thesis argues for the necessity to plan for and build integrated corridor at large airports, suggests doing research on integrated corridor at the project consulting stage by drawing upon available airport design experiences and case studies and combining the plan for public utilities (or special plan), and analyzes and outlines key points in integrated corridor design based on special requirements and industrial standards for civil airport management.

TU-FG-201-10: Quality Management of Accelerated Partial Breast Irradiation (APBI) Plans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ji, H; Lorio, V; Cernica, G

2016-06-15

Purpose: Since 2008, over 700 patients received high dose rate (HDR) APBI treatment at Virginia Hospital Center. The complexity involved in the planning process demonstrated a broad variation between patient geometry across all applicators, in relation to anatomical regions of interest. A quality management program instituting various metrics was implemented in March 2013 with the goal of ensuring an optimal plan is achieved for each patient. Methods: For each plan, an in-house complexity index, geometric conformity index, and plan quality index were defined. These indices were obtained for all patients treated. For patients treated after the implementation, the conformity indexmore » and quality index were maximized while other dosimetric limits, such as maximum skin and rib doses, were strictly kept. Subsequently, all evaluation parameters and applicator information were placed in a database for cross-evaluation with similar complexity. Results: Both the conformity and quality indices show good correlation with the complexity index. They decrease as complexity increases for all applicators. Multi lumen type balloon applicators demonstrate a minimal advantage over single lumen applicators in increasingly complex patient geometries, as compared to SAVI applicators which showed considerably greater advantage in these circumstances. After the implementation of the in-house planning protocol, there is a direct improvement of quality for SAVI plans. Conclusion: Due to their interstitial nature, SAVI devices show a better conformity in comparison to balloon-based devices regardless of the number of lumens, especially in complex cases. The quality management program focuses on optimizing indices by utilizing prior planning knowledge based on complexity levels. The database of indices assists in decision making and has subsequently aided in balancing the experience level among planners. This approach has made APBI planning more robust for patient care, with a measurable improvement in the plan quality.« less

Optimal planning for the sustainable utilization of municipal solid waste.

PubMed

Santibañez-Aguilar, José Ezequiel; Ponce-Ortega, José María; Betzabe González-Campos, J; Serna-González, Medardo; El-Halwagi, Mahmoud M

2013-12-01

The increasing generation of municipal solid waste (MSW) is a major problem particularly for large urban areas with insufficient landfill capacities and inefficient waste management systems. Several options associated to the supply chain for implementing a MSW management system are available, however to determine the optimal solution several technical, economic, environmental and social aspects must be considered. Therefore, this paper proposes a mathematical programming model for the optimal planning of the supply chain associated to the MSW management system to maximize the economic benefit while accounting for technical and environmental issues. The optimization model simultaneously selects the processing technologies and their location, the distribution of wastes from cities as well as the distribution of products to markets. The problem was formulated as a multi-objective mixed-integer linear programing problem to maximize the profit of the supply chain and the amount of recycled wastes, where the results are showed through Pareto curves that tradeoff economic and environmental aspects. The proposed approach is applied to a case study for the west-central part of Mexico to consider the integration of MSW from several cities to yield useful products. The results show that an integrated utilization of MSW can provide economic, environmental and social benefits. Copyright © 2013 Elsevier Ltd. All rights reserved.

Geoscience research databases for coastal Alabama ecosystem management

USGS Publications Warehouse

Hummell, Richard L.

1995-01-01

Effective management of complex coastal ecosystems necessitates access to scientific knowledge that can be acquired through a multidisciplinary approach involving Federal and State scientists that take advantage of agency expertise and resources for the benefit of all participants working toward a set of common research and management goals. Cooperative geostatic investigations have led toward building databases of fundamental scientific knowledge that can be utilized to manage coastal Alabama's natural and future development. These databases have been used to assess the occurrence and economic potential of hard mineral resources in the Alabama EFZ, and to support oil spill contingency planning and environmental analysis for coastal Alabama.

Disease management as a performance improvement strategy.

PubMed

McClatchey, S

2001-11-01

Disease management is a strategy of organizing care and services for a patient population across the continuum. It is characterized by a population database, interdisciplinary and interagency collaboration, and evidence-based clinical information. The effectiveness of a disease management program has been measured by a combination of clinical, financial, and quality of life outcomes. In early 1997, driven by a strategic planning process that established three Centers of Excellence (COE), we implemented disease management as the foundation for a new approach to performance improvement utilizing five key strategies. The five implementation strategies are outlined, in addition to a review of the key elements in outcome achievement.

Knowledge enabled plan of care and documentation prototype.

PubMed

DaDamio, Rebecca; Gugerty, Brian; Kennedy, Rosemary

2006-01-01

There exist significant challenges in integrating the plan of care into documentation and point of care operational processes. A plan of care is often a static artifact that meets regulatory standards with limited influence on supporting goal-directed care delivery processes. Although this prototype is applicable to many clinical disciplines, we will highlight nursing processes in demonstrating a knowledge-driven computerized solution that fully integrates the plan of care within documentation. The knowledge-driven solution reflects evidenced-based practice; is an effective tool for managing problems, orders/interventions, and the patient's progress towards expected outcomes; meets regulatory standards; and drives quality and process improvement. The knowledge infrastructure consists of fully represented terminology, structured clinical expressions utilizing the controlled terminology and clinical knowledge representing evidence-based practice.

ISS Operations Cost Reductions Through Automation of Real-Time Planning Tasks

NASA Technical Reports Server (NTRS)

Hall, Timothy A.

2011-01-01

In 2008 the Johnson Space Center s Mission Operations Directorate (MOD) management team challenged their organization to find ways to reduce the costs of International Space station (ISS) console operations in the Mission Control Center (MCC). Each MOD organization was asked to identify projects that would help them attain a goal of a 30% reduction in operating costs by 2012. The MOD Operations and Planning organization responded to this challenge by launching several software automation projects that would allow them to greatly improve ISS console operations and reduce staffing and operating costs. These projects to date have allowed the MOD Operations organization to remove one full time (7 x 24 x 365) ISS console position in 2010; with the plan of eliminating two full time ISS console support positions by 2012. This will account for an overall 10 EP reduction in staffing for the Operations and Planning organization. These automation projects focused on utilizing software to automate many administrative and often repetitive tasks involved with processing ISS planning and daily operations information. This information was exchanged between the ground flight control teams in Houston and around the globe, as well as with the ISS astronaut crew. These tasks ranged from managing mission plan changes from around the globe, to uploading and downloading information to and from the ISS crew, to even more complex tasks that required multiple decision points to process the data, track approvals and deliver it to the correct recipient across network and security boundaries. The software solutions leveraged several different technologies including customized web applications and implementation of industry standard web services architecture between several planning tools; as well as a engaging a previously research level technology (TRL 2-3) developed by Ames Research Center (ARC) that utilized an intelligent agent based system to manage and automate file traffic flow, archiving f data, and generating console logs. This technology called OCAMS (OCA (Orbital Communication System) Management System), is now considered TRL level 9 and is in daily use in the Mission Control Center in support of ISS operations. These solutions have not only allowed for improved efficiency on console; but since many of the previously manual data transfers are now automated, many of the human error prone steps have been removed, and the quality of the planning products has improved tremendously. This has also allowed our Planning Flight Controllers more time to focus on the abstract areas of the job, (like the complexities of planning a mission for 6 international crew members with a global planning team), instead of being burdened with the administrative tasks that took significant time each console shift to process. The resulting automation solutions have allowed the Operations and Planning organization to realize significant cost savings for the ISS program through 2020 and many of these solutions could be a viable

24 CFR 599.507 - Tax incentives utilization plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 3 2010-04-01 2010-04-01 false Tax incentives utilization plan....507 Tax incentives utilization plan. (a) Preliminary plan. Within six months of designation, the CoRA must prepare and submit to HUD a preliminary tax incentives utilization plan for achieving the State...

Self-management for patients with inflammatory bowel disease in a gastroenterology ward in China: a best practice implementation project.

PubMed

Chen, Ruo-Bing

2016-11-01

Globally, there is an increasing incidence of inflammatory bowel disease. It is very important for patients to be involved with self-management that can optimize personal heath behavior to control the disease. The aim of this project was to increase nursing staff knowledge of inflammatory bowel disease discharge guidance, and to improve the quality of education for discharged patients, thereby improving their self-management. A baseline audit was conducted by interviewing 30 patients in the gastroenterology ward of Huadong Hospital, Fudan University. The project utilized the Joanna Briggs Institute's Practical Application of Clinical Evidence System and Getting Research Into Practice audit tools for promoting quality of education and self-management of patients with inflammatory bowel disease. Thirty patients were provided with written materials, which included disease education and information regarding self-management. A post-implementation audit was conducted. There was improvement of education prior to discharge and dietary consultancy in the gastroenterology ward. Self-management plans utilizing written materials only were not sufficient for ensuring sustainability of the project. Comprehensive self-management education can make a contribution to improving awareness of the importance of self-management for patients with inflammatory bowel disease.

Implementation of two new resource management information systems in Australia

NASA Astrophysics Data System (ADS)

Kessell, Stephen R.; Good, Roger B.; Hopkins, Angas J. M.

1984-05-01

This paper describes the development and implementation of PREPLAN, A Pristine Environment Planning Language and Simulator, for two conservation areas in Australia, Kosciusko National Park (New South Wales) and Tutanning Nature Reserve (Western Australia). PREPLAN was derived from the North American gradient modeling systems and the Forest Planning Language and Simulator (FORPLAN), but includes unique characteristics not previously available. PREPLAN includes an integrated resource management data base, modules for predicting site-specific vegetation, fuels, animals, fire behavior, and fire effects, and an English language instruction set. PREPLAN was developed specifically to provide available information and understanding of ecosystems to managers in a readily accessible and usable form, and to provide the motivation to conduct additional required research projects. An evaluation of the system's advantages and limitations is presented, and the way the utilization of such systems is improving natural area decision making throughout Australia is discussed.

ACHS Quality Awards 2000. Quality is the way we do business.

PubMed

Cruickshank, N; Bullock, J

2001-01-01

Hollywood Private Hospital recognized that the use of quality management processes can achieve numerous benefits; however, for this to occur quality must be regarded as normal business practice rather than a separate programme. Therefore, the means of ensuring a quality service must be embedded in the strategic plans of both the organization and individual departments. The Hollywood Private Hospital Executive committed the organization to this approach further building on the 'core values' of the hospital by: integrating quality into the Strategic Planning of the organization; integrating risk management into the existing quality system; further embedding of the core values into the culture of the organisation; introducing systems thinking into the organization; taking a process improvement approach to improving quality; involving staff in Quality Action Teams and utilizing the Evaluation and Quality Improvement Programme as the management framework to co-ordinate all the above.

Managing autonomy levels in the SSM/PMAD testbed. [Space Station Power Management and Distribution

NASA Technical Reports Server (NTRS)

Ashworth, Barry R.

1990-01-01

It is pointed out that when autonomous operations are mixed with those of a manual nature, concepts concerning the boundary of operations and responsibility become clouded. The space station module power management and distribution (SSM/PMAD) automation testbed has the need for such mixed-mode capabilities. The concept of managing the SSM/PMAD testbed in the presence of changing levels of autonomy is examined. A knowledge-based approach to implementing autonomy management in the distributed SSM/PMAD utilizing a centralized planning system is presented. Its knowledge relations and system-wide interactions are discussed, along with the operational nature of the currently functioning SSM/PMAD knowledge-based systems.

A regional approach to the Co-Production of climate information for water utilities- Managing Messages, Approaches, Benefits, and Lessons learned

NASA Astrophysics Data System (ADS)

Yates, D. N.; Kaatz, L.

2016-12-01

Over the past decade, water utility managers across Colorado have joined together to advance their understanding of the role of climate information in their planning process. In an unprecedented step, managers from 5 different organizations and agencies pooled their resources and worked collaboratively to better understand the ever evolving role of science in helping understand risks, uncertainties, and opportunities that climate uncertainty and change might bring to this semi-arid region. The group developed an ongoing educational process to better understand climate projections (Scale); cohesively communicate with customers and the media (Communication); provided institutional coverage to an often contentious topic (Safety); and helped coordinate with other investigations and participants to facilitate education and training (Collaboration); and pooled finances, staff, and expert resources (Resources). We will share this experience and give examples of concrete outcomes.

Longitudinal analysis on utilization of medical document management system in a hospital with EPR implementation.

PubMed

Kuwata, Shigeki; Yamada, Hitomi; Park, Keunsik

2011-01-01

Document management systems (DMS) have widespread in major hospitals in Japan as a platform to digitize the paper-based records being out of coverage by EPR. This study aimed to examine longitudinal trends of actual use of DMS in a hospital in which EPR had been in operation, which would be conducive to planning the further information management system in the hospital. Degrees of utilization of electronic documents and templates with DMS were analyzed based on data extracted from a university-affiliated hospital with EPR. As a result, it was found that the number of electronic documents as well as scanned documents circulating at the hospital tended to increase. The result indicated that replacement of paper-based documents with electronic documents did not occur. Therefore it was anticipated that the need for DMS would continue to increase in the hospital. The methods used this study to analyze the trend of DMS utilization would be applicable to other hospitals with with a variety of DMS implementation, such as electronic storage by scanning documents or paper preservation that is compatible with EPR.

Green utilities for research and eco-tourist communities, Rio Bravo, Belize, Central America

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jackson, O.

1997-12-31

Programme for Belize (PFB), a non-governmental organization which owns and manages the Rio Bravo Conservation and Management Area (RBCMA), a 229,000 acre section of subtropical rainforest in northwestern Belize, is developing a series of research and eco-tourism developments as sustainable development projects. Guided by a comprehensive Sustainable Infrastructure Plan completed by Caribbean Infra-Tech, Inc. (CIT) in 1995, PFB adopted an organizational goal of implementing 100% green renewable energy-based utilities for their two major development sites: La Milpa and Hill Bank stations. To date, PFB has constructed or installed over 20 kW of standalone PV power, sustainable water supply systems, recyclingmore » waste treatment systems, and a model sustainable Dormitory and Bath House facility in the RBCMA. In addition, a Resource Conservation and Management Program (RCMP), which is to guide ongoing visitor orientation, staff training, and sustainable systems operations and maintenance, is now being prepared for immediate implementation. In this paper, the design and technical performance of the solar (PV) electric power plants, PV water pumping, solar water heating and other green utility systems will be assessed.« less

A New Methodology for Modeling National Command Level Decisionmaking in War Games and Simulations.

DTIC Science & Technology

1986-07-01

Conclusions about Utility and Development Options, The Rand Corporation, R-2945-DNA, March 1983. Drucker , Peter F., Management : Tasks, Responsibilities...looks to the worst case can readily find himself paralyzed. Of course, it is also true ’The effort to affect an opponent’s image of oneself is part of...how to manage forces on a continuing basis. So long as the broad features of the NCL-specified plan continue to appear valid, it is the military com

The role of imaging in the management of patients with nonmelanoma skin cancer: When is imaging necessary?

PubMed

Humphreys, Tatyana R; Shah, Komal; Wysong, Ashley; Lexa, Frank; MacFarlane, Deborah

2017-04-01

When treating aggressive skin cancers, pre- and postoperative imaging provides important information for treatment planning and multidisciplinary cooperation of care. It is important for dermatologists to recognize the clinical scenarios where imaging is indicated in the management of skin cancer. We here address the most common indications for imaging in cutaneous oncology and how to best utilize the modalities available. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Strategic plan for infrastructure optimization

DOE Office of Scientific and Technical Information (OSTI.GOV)

Donley, C.D.

This document represents Fluor Daniel Hanford`s and DynCorp`s Tri-Cities Strategic Plan for Fiscal Years 1998--2002, the road map that will guide them into the next century and their sixth year of providing safe and cost effective infrastructure services and support to the Department of Energy (DOE) and the Hanford Site. The Plan responds directly to the issues raised in the FDH/DOE Critical Self Assessment specifically: (1) a strategy in place to give DOE the management (systems) and physical infrastructure for the future; (2) dealing with the barriers that exist to making change; and (3) a plan to right-size the infrastructuremore » and services, and reduce the cost of providing services. The Plan incorporates initiatives from several studies conducted in Fiscal Year 1997 to include: the Systems Functional Analysis, 200 Area Water Commercial Practices Plan, $ million Originated Cost Budget Achievement Plan, the 1OO Area Vacate Plan, the Railroad Shutdown Plan, as well as recommendations from the recently completed Review of Hanford Electrical Utility. These and other initiatives identified over the next five years will result in significant improvements in efficiency, allowing a greater portion of the infrastructure budget to be applied to Site cleanup. The Plan outlines a planning and management process that defines infrastructure services and structure by linking site technical base line data and customer requirements to work scope and resources. The Plan also provides a vision of where Site infrastructure is going and specific initiatives to get there.« less

Geographic Information Systems for Assessing Existing and Potential Bio-energy Resources: Their Use in Determining Land Use and Management Options which Minimize Ecological and Landscape Impacts in Rural Areas

NASA Technical Reports Server (NTRS)

Jackman, A. E.; Fabos, J. G.; Carlozzi, C. C.

1982-01-01

A management construct is described which forms part of an overall landscape ecological planning model which has as a principal objective the extension of the traditional descriptive land use mapping capabilities of geographic information systems into land management realms. It is noted that geographic information systems appear to be moving to more comprehensive methods of data handling and storage, such as relational and hierarchical data management systems, and a clear need has simultaneously arisen therefore for planning assessment techniques and methodologies which can actually use such complex levels of data in a systematic, yet flexible and scenario dependent way. The descriptive of mapping method proposed broaches such issues and utilizes a current New England bioenergy scenario, stimulated by the use of hardwoods for household heating purposes established in the post oil crisis era and the increased awareness of the possible landscape and ecological ramifications of the continued increasing use of the resource.

The role of organizational culture and leadership in water safety plan implementation for improved risk management.

PubMed

Summerill, Corinna; Pollard, Simon J T; Smith, Jennifer A

2010-09-15

Appropriate implementation of WSPs offers an important opportunity to engage in and promote preventative risk management within water utilities. To ensure success, the whole organization, especially executive management, need to be advocates. Illustrated by two case studies, we discuss the influence of organizational culture on buy-in and commitment to public health protection and WSPs. Despite an internal desire to undertake risk management, some aspects of organizational culture prevented these from reaching full potential. Enabling cultural features included: camaraderie; competition; proactive, involved leaders; community focus; customer service mentality; transparency; accountability; competent workforce; empowerment; appreciation of successes, and a continual improvement culture. Blocking features included: poor communication; inflexibility; complacency; lack of awareness, interest or reward and coercion. We urge water utilities to consider the influence of organizational culture on the success and sustainability of WSP adoption, and better understand how effective leadership can mould culture to support implementation. Copyright 2010 Elsevier B.V. All rights reserved.

MO-B-BRB-01: Optimize Treatment Planning Process in Clinical Environment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Feng, W.

The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

MO-B-BRB-00: Optimizing the Treatment Planning Process

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

MO-B-BRB-03: Systems Engineering Tools for Treatment Planning Process Optimization in Radiation Medicine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kapur, A.

The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

MO-B-BRB-02: Maintain the Quality of Treatment Planning for Time-Constraint Cases

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chang, J.

The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image-guided-radiation-therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequentialmore » events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality. In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include: Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS. Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment. Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi-automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality Learning Objectives: Gain familiarity with the workflow of modern treatment planning process. Understand the scope and challenges of managing modern treatment planning processes. Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.« less

An integrated decision support system for TRAC: A proposal

NASA Technical Reports Server (NTRS)

Mukkamala, Ravi

1991-01-01

Optimal allocation and usage of resources is a key to effective management. Resources of concern to TRAC are: Manpower (PSY), Money (Travel, contracts), Computing, Data, Models, etc. Management activities of TRAC include: Planning, Programming, Tasking, Monitoring, Updating, and Coordinating. Existing systems are insufficient, not completely automated, manpower intensive, and has the potential for data inconsistency exists. A system is proposed which suggests a means to integrate all project management activities of TRAC through the development of a sophisticated software and by utilizing the existing computing systems and network resources. The systems integration proposal is examined in detail.

SAGA: A project to automate the management of software production systems

NASA Technical Reports Server (NTRS)

Campbell, R. H.

1983-01-01

The current work in progress for the SAGA project are described. The highlights of this research are: a parser independent SAGA editor, design for the screen editing facilities of the editor, delivery to NASA of release 1 of Olorin, the SAGA parser generator, personal workstation environment research, release 1 of the SAGA symbol table manager, delta generation in SAGA, requirements for a proof management system, documentation for and testing of the cyber pascal make prototype, a prototype cyber-based slicing facility, a June 1984 demonstration plan, SAGA utility programs, summary of UNIX software engineering support, and theorem prover review.

[Should disease management be feared? (1): hospital care].

PubMed

Gaspoz, J M; Rutschmann, O

2005-11-23

The goals of disease management are: (1) an integrated health care delivery system; (2) knowledge-based care; (3) elaborate information systems; (4) continuous quality improvement. In-hospital disease management and, more specifically, critical pathways, establish standardized care plans, set goals and time actions to reach these goals. They can reduce variations in practice patterns and resource utilization without compromising quality of care. Such strategies participate to quality improvement programs in hospitals when they involve and empower all actors of a given process of care, are not imposed from outside, and use sound and rigorous development and evaluation methods.

77 FR 64300 - Fisheries of the Caribbean, Gulf of Mexico, and South Atlantic; Reef Fish Fishery of the Gulf of...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-19

...NMFS proposes to implement management measures described in Amendment 38 to the Fishery Management Plan for the Reef Fish Resources of the Gulf of Mexico (FMP) prepared by the Gulf of Mexico (Gulf) Fishery Management Council (Council). If implemented, this rule would modify post-season accountability measures (AMs) that affect shallow- water grouper species (SWG), change the trigger for AMs, and revise the Gulf reef fish framework procedure. The intent of this proposed rule is to achieve optimum yield (OY) while ensuring the fishery resources are utilized efficiently.

Knowledge Management Implementation and the Tools Utilized in Healthcare for Evidence-Based Decision Making: A Systematic Review.

PubMed

Shahmoradi, Leila; Safadari, Reza; Jimma, Worku

2017-09-01

Healthcare is a knowledge driven process and thus knowledge management and the tools to manage knowledge in healthcare sector are gaining attention. The aim of this systematic review is to investigate knowledge management implementation and knowledge management tools used in healthcare for informed decision making. Three databases, two journals websites and Google Scholar were used as sources for the review. The key terms used to search relevant articles include: "Healthcare and Knowledge Management"; "Knowledge Management Tools in Healthcare" and "Community of Practices in healthcare". It was found that utilization of knowledge management in healthcare is encouraging. There exist numbers of opportunities for knowledge management implementation, though there are some barriers as well. Some of the opportunities that can transform healthcare are advances in health information and communication technology, clinical decision support systems, electronic health record systems, communities of practice and advanced care planning. Providing the right knowledge at the right time, i.e., at the point of decision making by implementing knowledge management in healthcare is paramount. To do so, it is very important to use appropriate tools for knowledge management and user-friendly system because it can significantly improve the quality and safety of care provided for patients both at hospital and home settings.

24 CFR 599.507 - Tax incentives utilization plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... utilization plan for achieving the State and local commitments made at the time of application as required by... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true Tax incentives utilization plan. 599....507 Tax incentives utilization plan. (a) Preliminary plan. Within six months of designation, the CoRA...

Utilization of health services in a resource-limited rural area in Kenya: Prevalence and associated household-level factors.

PubMed

Ngugi, Anthony K; Agoi, Felix; Mahoney, Megan R; Lakhani, Amyn; Mang'ong'o, David; Nderitu, Esther; Armstrong, Robert; Macfarlane, Sarah

2017-01-01

Knowledge of utilization of health services and associated factors is important in planning and delivery of interventions to improve health services coverage. We determined the prevalence and factors associated with health services utilization in a rural area of Kenya. Our findings inform the local health management in development of appropriately targeted interventions. We used a cluster sample survey design and interviewed household key informants on history of illness for household members and health services utilization in the preceding month. We estimated prevalence and performed random effects logistic regression to determine the influence of individual and household level factors on decisions to utilize health services. 1230/6,440 (19.1%, 95% CI: 18.3%-20.2%) household members reported an illness. Of these, 76.7% (95% CI: 74.2%-79.0%) sought healthcare in a health facility. The majority (94%) of the respondents visited dispensary-level facilities and only 60.1% attended facilities within the study sub-counties. Of those that did not seek health services, 43% self-medicated by buying non-prescription drugs, 20% thought health services were too costly, and 10% indicated that the sickness was not serious enough to necessitate visiting a health facility. In the multivariate analyses, relationship to head of household was associated with utilization of health services. Relatives other than the nuclear family of the head of household were five times less likely to seek medical help (Odds Ratio 0.21 (95% CI: 0.05-0.87)). Dispensary level health facilities are the most commonly used by members of this community, and relations at the level of the household influence utilization of health services during an illness. These data enrich the perspective of the local health management to better plan the allocation of healthcare resources according to need and demand. The findings will also contribute in the development of community-level health coverage interventions that target the disadvantaged household groups.

78 FR 65675 - Proposed Collection; 60-Day Comment Request; Multidisciplinary Treatment Planning (MTP) Within...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-01

... summaries of proposed projects to be submitted to the Office of Management and Budget (OMB) for review and..., including the validity of the methodology and assumptions used; (3) Ways to enhance the quality, utility... on multidisciplinary care in cancer. A total of 21 hospitals participating in the NCCCP through June...

Does Medicaid managed care market penetration impact provider participation, costs, utilization, and access?

PubMed

Minott, Jenny

2010-09-01

Key findings. (1) An increase in commercial plan penetration increased the liklihood [sic] that a physician would accept new Medicaid patients, but this did not significantly impact enrollee costs. (2) An increase in Medicaid-dominant HMO market penetration increased the probability that individuals reported using the ED as their primary source of care.

78 FR 7391 - Motorized Travel Management Plan, Tonto National Forest; Gila, Maricopa, Pinal, and Counties, AZ

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-01

... Federal lands. The regulations provide ``for a system of National Forest System (NFS) roads, NFS trails, and areas of NFS lands that are designated for motor vehicle use. Motor vehicle use off designated... travel and for administration, utilization, and protection of NFS lands (36 CFR 212.5(b)). Based on...

Considerations in the Design of Follow-Up and Follow-Along Systems for Improving Transition Programs and Services.

ERIC Educational Resources Information Center

Johnson, David R.

1993-01-01

This paper examines the qualities and limitations of information utilization in special education program planning and improvement; discusses the results of a federally funded transition follow-along and follow-up research and demonstration project in Minnesota; and describes methods for organizing, managing, and reporting follow-along and…

77 FR 63299 - Notice of Intent To Prepare a Joint Environmental Impact Statement/Environmental Impact Report...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-16

... operation rules of Folsom Dam and Reservoir to reduce flood risk to the Sacramento area by utilizing the... the Dam's new flood operations plan, with the intention of meeting flood risk management objectives... direction to reduce Folsom Reservoir variable space allocation from the current operating range of 400,000...

Modular space station, phase B extension. Information management advanced development. Volume 5: Software assembly

NASA Technical Reports Server (NTRS)

Gerber, C. R.

1972-01-01

The development of uniform computer program standards and conventions for the modular space station is discussed. The accomplishments analyzed are: (1) development of computer program specification hierarchy, (2) definition of computer program development plan, and (3) recommendations for utilization of all operating on-board space station related data processing facilities.

Application of Sludges and Wastewaters on Agricultural Land: A Planning and Educational Guide, MCD-35. Research Bulletin 1090.

ERIC Educational Resources Information Center

Knezek, Bernard D., Ed.; Miller, Robert H., Ed.

This report addresses the application of agricultural processing wastes, industrial and municipal wastes on agricultural land as both a waste management and resource recovery and reuse practice. The document emphasizes the treatment and beneficial utilization of sludge and wastewater as opposed to waste disposal. These objectives are achieved…

Review of crisis resource management (CRM) principles in the setting of intraoperative malignant hyperthermia.

PubMed

Isaak, Robert Scott; Stiegler, Marjorie Podraza

2016-04-01

The practice of medicine is characterized by routine and typical cases whose management usually goes according to plan. However, the occasional case does arise which involves rare catastrophic emergencies, such as intraoperative malignant hyperthermia (MH), which require a comprehensive, coordinated, and resource-intensive treatment plan. Physicians are expected to provide expert quality care for routine, typical cases, but is it reasonable to expect the same standard of expertise and comprehensive management when the emergency involves a rare entity? Although physicians would like to say yes to this question, the reality is that no physician will ever amass the amount of experience in patient care needed to truly qualify as an expert in the management of a rare emergency entity, such as MH. However, physicians can become expert in the global process of managing emergencies by using the principles of crisis resource management (CRM). In this article, we review the key concepts of CRM, using a real life example of a team who utilized CRM principles to successfully manage an intraoperative MH crisis, despite there being no one on the team who had ever previously encountered a true MH crisis.

Final Technical Report for Contract No. DE-EE0006332, "Integrated Simulation Development and Decision Support Tool-Set for Utility Market and Distributed Solar Power Generation"

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cormier, Dallas; Edra, Sherwin; Espinoza, Michael

This project will enable utilities to develop long-term strategic plans that integrate high levels of renewable energy generation, and to better plan power system operations under high renewable penetration. The program developed forecast data streams for decision support and effective integration of centralized and distributed solar power generation in utility operations. This toolset focused on real time simulation of distributed power generation within utility grids with the emphasis on potential applications in day ahead (market) and real time (reliability) utility operations. The project team developed and demonstrated methodologies for quantifying the impact of distributed solar generation on core utility operations,more » identified protocols for internal data communication requirements, and worked with utility personnel to adapt the new distributed generation (DG) forecasts seamlessly within existing Load and Generation procedures through a sophisticated DMS. This project supported the objectives of the SunShot Initiative and SUNRISE by enabling core utility operations to enhance their simulation capability to analyze and prepare for the impacts of high penetrations of solar on the power grid. The impact of high penetration solar PV on utility operations is not only limited to control centers, but across many core operations. Benefits of an enhanced DMS using state-of-the-art solar forecast data were demonstrated within this project and have had an immediate direct operational cost savings for Energy Marketing for Day Ahead generation commitments, Real Time Operations, Load Forecasting (at an aggregate system level for Day Ahead), Demand Response, Long term Planning (asset management), Distribution Operations, and core ancillary services as required for balancing and reliability. This provided power system operators with the necessary tools and processes to operate the grid in a reliable manner under high renewable penetration.« less

Developing a GIS based integrated approach to flood management in Trinidad, West Indies.

PubMed

Ramlal, Bheshem; Baban, Serwan M J

2008-09-01

Trinidad and Tobago is plagued with a perennial flooding problem. The higher levels of rainfall in the wet season often lead to extensive flooding in the low-lying areas of the country. This has lead to significant damage to livestock, agricultural produce, homes and businesses particularly in the Caparo River Basin. Clearly, there is a need for developing flood mitigation and management strategies to manage flooding in the areas most affected. This paper utilizes geographic information systems to map the extent of the flooding, estimate soil loss due to erosion and estimate sediment loading in the rivers in the Caparo River Basin. In addition, the project required the development of a watershed management plan and a flood control plan. The results indicate that flooding was caused by several factors including clear cutting of vegetative cover, especially in areas of steep slopes that lead to sediment filled rivers and narrow waterways. Other factors include poor agricultural practices, and uncontrolled development in floodplains. Recommendations to manage floods in the Caparo River Basin have been provided.

Psychiatric Inpatient Discharge Planning Practices and Attendance at Aftercare Appointments.

PubMed

Smith, Thomas E; Abraham, Maria; Bolotnikova, Natalia V; Donahue, Sheila A; Essock, Susan M; Olfson, Mark; Shao, Wenjun S; Wall, Melanie M; Radigan, Marleen

2017-01-01

This study examined discharge planning practices by hospital providers for 17,053 psychiatric discharges in New York's statewide Medicaid program. Claims data were linked to information reported to New York State by managed behavioral health care organizations (MBHOs) conducting inpatient utilization reviews. MBHOs documented hospital providers' reports of the presence of three discharge planning practices for each discharge: communicating with an outpatient provider prior to discharge, scheduling an aftercare appointment, and forwarding a discharge summary. Hospital providers reported completing at least one of the three discharge planning practices for 85% of discharges. Individuals who received all three discharge planning practices had a higher likelihood of follow-up and kept their first outpatient follow-up visit at almost twice the speed compared with individuals who received none of the practices (hazard ratio=1.96, p<.001). This study provided baseline information concerning routine discharge planning practices and their relationship to timeliness of care transitions.

EBMUD Drought Planning Put to the Test in 2014

NASA Astrophysics Data System (ADS)

Bray, B. S.

2014-12-01

The East Bay Municipal Utility District faced challenges in the unprecedented 2014 drought managing limited supplies to reliably serve its customers. The District's successful drought planning required a multi-faceted plan to preserve a reliable water supply, now and into the future. Planning has included investments in recycled water projects, passive and active customer conservation programs, and pursuit of alternative water supply options. EBMUD's drought planning efforts have been tested in 2014 when California experienced one of the driest years on record and the 2nd driest year in the Mokelumne Watershed, the source of 90% of the District's water supply. This presentation will highlight the effectiveness of drought planning in three areas: (1) implementing 10% water conservation as of July 2014, (2) the securing of nearly 20TAF of supplemental water supply conveyed through the Freeport Regional Water Project, and (3) operating EBMUD's Mokelumne River Project to meet fishery flow and water quality objectives.

Incorporating Social Determinants into a Groundwater Risk Framework

NASA Astrophysics Data System (ADS)

Simpson, M.; Allen, D. M.; Journeay, M.; Korteling, B.

2009-12-01

The remediation of polluted groundwater is often very costly, therefore water managers utilize various proactive measures, such as wellhead protection planning, to prevent contamination events. With limited available resources, it is essential to prioritize where these measures are introduced; systematic and integrated methodologies of assessing risk to groundwater can be utilized for this prioritization. To quantify the resistance of the physical system to pollution, Aquifer Vulnerability is commonly mapped for the area of interest. This information is useful for focusing monitoring efforts and identifying data gaps, but is a relative measure of contaminant risk. To more accurately assess the probability of contamination, an inventory of hazards can be integrated with intrinsic vulnerability of the physical system. This Threat indicator links land-use with chemicals and quantifies the risk based on the toxicity and environmental fate of these substances. Local knowledge of the quantity stored and likelihood of release can be utilized to further assess these threats. Both of these steps form part of an existing frameworks for assessing risk to groundwater. In this study, a groundwater risk framework is developed and tested in two study areas; Pender Island and the Lower Fraser Valley in British Columbia, Canada. Enhancements of a basic groundwater risk framework include not only incorporating points sources such as septic systems, landfills and fuel storage, but also various social determinants of risk. These social determinants include the Resistance of a community, which represents the planning and protection initiatives designed to safeguard the resource. These include items such as land-use planning that consider groundwater vulnerability and best management practices enforced by local governments. The ability to recover following an event is the Capacity of a community; indicators include the presence or absence of spill response plans, treatment systems or an alternative supply of water. The determinant of Loss quantifies the financial impact of this work. This indicator may be altered in future applications to include loss associated with human health and/or that stemming from a reduction in ecosystem health.

Employing Earned Value Management in Government Research and Design - Lessons Learned from the Trenches

NASA Technical Reports Server (NTRS)

Simon, Tom

2009-01-01

To effectively manage a project, the project manager must have a plan, understand the current conditions, and be able to take action to correct the course when challenges arise. Research and design projects face technical, schedule, and budget challenges that make it difficult to utilize project management tools developed for projects based on previously demonstrated technologies. Projects developing new technologies by their inherent nature are trying something new and thus have little to no data to support estimates for schedule and cost, let alone the technical outcome. Projects with a vision for the outcome but little confidence in the exact tasks to accomplish in order to achieve the vision incur cost and schedule penalties when conceptual solutions require unexpected iterations or even a reinvention of the plan. This presentation will share the project management methodology and tools developed through trial and error for a NASA research and design project combining industry, academia, and NASA inhouse work in which Earned Value Management principles were employed but adapted for the reality of the government financial system and the reality of challenging technology development. The priorities of the presented methodology are flexibility, accountability, and simplicity to give the manager tools to help deliver to the customer while not using up valuable time and resources on extensive planning and analysis. This presentation will share the methodology, tools, and work through failed and successful examples from the three years of process evolution.

The growing need for resources to help older adults manage their financial and healthcare choices.

PubMed

MacLeod, Stephanie; Musich, Shirley; Hawkins, Kevin; Armstrong, Douglas G

2017-04-11

Both financial literacy (managing personal finances) and health literacy (managing personal health) become increasingly important for older adults, potentially impacting their quality of life. Resources in these constructs of literacy tend to be distinct, although the skills and decision-making involved overlap as financial issues impact healthcare choices. Thus the primary purpose of this commentary is to propose a new area of research focus that defines the intersection of financial and health literacy (i.e., financial health literacy). We conducted a limited literature review related to financial, health, and health insurance literacy to demonstrate gaps in the literature and support our position. Online search engines were utilized to identify research in our primary areas of interest. We define the intersection of financial and health literacy as an area of need labeled financial health literacy, with a focus on four domains. These include: 1) the ability to manage healthcare expenses; 2) pay medical bills; 3) determine health needs and understand treatment options; and 4) make sound healthcare decisions with financial resources available. Despite some overlap with health insurance literacy, financial health literacy would define an area of need encompassing health management choices and health plan selections integrated with other financial management issues including living arrangements, financial planning, and retirement planning. Potential initiatives should be considered to help at-risk older adults find resources to improve their financial health literacy, which in turn will enhance their abilities to manage medical choices in the environment of an increasingly complex healthcare system.

Hiawatha National Forest Riparian Inventory: A Case Study

NASA Astrophysics Data System (ADS)

Abood, S. A.

2014-12-01

Riparian areas are dynamic, transitional ecotones between aquatic and terrestrial ecosystems with well-defined vegetation and soil characteristics. Riparian areas offers wildlife habitat and stream water quality, offers bank stability and protects against erosions, provides aesthetics and recreational value, and other numerous valuable ecosystem functions. Quantifying and delineating riparian areas is an essential step in riparian monitoring, riparian management/planning and policy decisions, and in preserving its valuable ecological functions. Previous approaches to riparian areas mapping have primarily utilized fixed width buffers. However, these methodologies only take the watercourse into consideration and ignore critical geomorphology, associated vegetation and soil characteristics. Other approaches utilize remote sensing technologies such as aerial photos interpretation or satellite imagery riparian vegetation classification. Such techniques requires expert knowledge, high spatial resolution data, and expensive when mapping riparian areas on a landscape scale. The goal of this study is to develop a cost effective robust workflow to consistently map the geographic extent and composition of riparian areas within the Hiawatha National Forest boundary utilizing the Riparian Buffer Delineation Model (RBDM) v3.0 and open source geospatial data. This approach recognizes the dynamic and transitional natures of riparian areas by accounting for hydrologic, geomorphic and vegetation data as inputs into the delineation process and the results would suggests incorporating functional variable width riparian mapping within watershed management planning to improve protection and restoration of valuable riparian functionality and biodiversity.

Impact of the residential conservation service program on natural gas and electric utilities. Appendix B

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

An assessment of the RCS program is provided from the perspective of eleven case study utilities. First, an introduction to the role and value of conservation in utility strategic planning is presented. The interplay of various utility system characteristics is shown to be the primary determinant of the value of conservation efforts from the utility's point of view. Simplified typologies of utilities are developed to aid in the identification of those combinations of the utility characteristics that will favor the adoption of the utility sponsored strategic conservation efforts. The integration of the RCS program with other utility conservation and loadmore » management programs is explored for the eleven case study utilities. Reference is made to the simplified typologies in order to show, through actual program experience, how the strategic position of the utility company affects its adoption of this federal program. Evaluative studies done by the eleven case study utilities of the RCS program are reviewed. Results are presented and the methodologies are critiqued. Conclusions regarding the RCS program from the utility perspective are presented.« less

Pathologic Analysis of Control Plans for Air Pollution Management in Tehran Metropolis: A Cross-Sectional Study

PubMed Central

Salehi Shahrabi, Narges; Pourezzat, Aliasghar; Mobaraki, Hossein; Mafimoradi, Shiva

2013-01-01

Abstract Background The centralization of human activities is associated with different pollutants which enter into environment easily and cause the urban environment more vulnerable. Regarding the importance of air pollution issue for Tehran metropolis, many plans and regulations have been developed. However, most of them failed to decline the pollution. The purpose of this study was to pathologically analyze air-pollution control plans to offer effective solutions for Tehran metropolis. Methods A Qualitative content analysis in addition to a semi-structured interview with 14 practicing professional were used to identify 1) key sources of Tehran’s air pollution, 2) recognize challenges towards effective performance of pertinent plans and 3), offer effective solutions. Results Related challenges to air-pollution control plans can be divided into two major categories including lack of integrated and organized stewardship and PEST challenges. Conclusion For controlling the air pollution of Tehran effectively, various controlling alternatives were identified as systematization of plan preparation process, standardization and utilization of new technologies & experts, infrastructural development, realization of social justice, developing coordination mechanisms, improving citizens’ participatory capacity and focusing on effective management of fuel and energy. Controlling air pollution in Tehran needs a serious attention of policymakers to make enforcements through applying a systemic cycle of preparation comprehensive plans. Further, implement the enforcements and evaluate the environmental impact of the plans through involving all stakeholders. PMID:26171340

Integrated concurrent utilization quality review, Part one.

PubMed

Caterinicchio, R P

1987-01-01

This article is the first of a two-part series which argues for the concurrent management of the appropriateness, necessity, and quality of patient care. Intensifying scrutiny by the credentialing groups, the PROs and all third-party payors underscores the vital need to implement cost-effective information systems which integrate the departmentalized functions of patient-physician profiling, DRG case-mix analyses, length of stay monitoring, pre-admission/admission and continued stay review, discharge planning, risk management, incident reporting and quality review. In the domain of physician performance regarding admitting and practice patterns, the ability to exercise concurrent utilization-quality review means early detection and prevention of events which would otherwise result in denials of payment and/or compromised patient care. Concurrent utilization-quality review must, by definition, be managerially invasive and focused; hence, it is integral to maintaining the integrity of the services and product lines offered by the provider. In fact, if PPO status is a marketing agenda, then the institutional objectives of cost-effectiveness, productivity, value, and competitiveness can only be achieved through concurrent utilization-quality review.

Sacramento Municipal Utility District PV and Smart Grid Pilot at Anatolia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rawson, Mark; Sanchez, Eddie Paul

2013-12-30

Under DE-FOA-0000085 High Penetration Solar Deployment, the U. S. Department of Energy funded agreements with SMUD and Navigant Consulting, SunPower, GridPoint, the National Renewable Energy Laboratory, and the California Energy Commission for this pilot demonstration project. Funding was $5,962,409.00. Cost share of $500,000 was also provided by the California Energy Commission. The project has strategic implications for SMUD, other utilities and the PV and energy-storage industries in business and resource planning, technology deployment and asset management. These implications include: -At this point, no dominant business models have emerged and the industry is open for new ideas. -Demonstrated two business modelsmore » for using distributed PV and energy storage, and brainstormed several dozen more, each with different pros and cons for SMUD, its customers and the industry. -Energy storage can be used to manage high penetrations of PV and mitigate potential issues such as reverse power flow, voltage control violations, power quality issues, increased wear and tear on utility equipment, and system wide power supply issues. - Smart meters are another tool utilities can use to manage high penetrations of PV. The necessary equipment and protocols exist, and the next step is to determine how to integrate the functionality with utility programs and what level of utility control is required. - Time-of-use rates for the residential customers who hosted energy storage systems did not cause a significant change in energy usage patterns. However, the rates we used were not optimized for PV and energy storage. Opportunities exist for utilities to develop new structures.« less

Strategic enterprise resource planning in a health-care system using a multicriteria decision-making model.

PubMed

Lee, Chang Won; Kwak, N K

2011-04-01

This paper deals with strategic enterprise resource planning (ERP) in a health-care system using a multicriteria decision-making (MCDM) model. The model is developed and analyzed on the basis of the data obtained from a leading patient-oriented provider of health-care services in Korea. Goal criteria and priorities are identified and established via the analytic hierarchy process (AHP). Goal programming (GP) is utilized to derive satisfying solutions for designing, evaluating, and implementing an ERP. The model results are evaluated and sensitivity analyses are conducted in an effort to enhance the model applicability. The case study provides management with valuable insights for planning and controlling health-care activities and services.

American BRCA Outcomes and Utilization of Testing (ABOUT) study: a pragmatic research model that incorporates personalized medicine/patient-centered outcomes in a real world setting.

PubMed

Armstrong, Joanne; Toscano, Michele; Kotchko, Nancy; Friedman, Sue; Schwartz, Marc D; Virgo, Katherine S; Lynch, Kristian; Andrews, James E; Aguado Loi, Claudia X; Bauer, Joseph E; Casares, Carolina; Teten, Rachel Threet; Kondoff, Matthew R; Molina, Ashley D; Abdollahian, Mehrnaz; Brand, Lana; Walker, Gregory S; Sutphen, Rebecca

2015-02-01

Research to date regarding identification and management of hereditary breast and ovarian cancer syndrome (HBOC) in the U.S. has been confined primarily to academic center-based studies with limited patient engagement. To begin to understand and address the current gaps and disparities in delivery of services for the appropriate identification and optimal risk management of individuals with HBOC, we designed and have initiated the American BRCA Outcomes and Utilization of Testing (ABOUT) Study. ABOUT relies on a collaborative patient advocacy, academic and industry partnership to recruit and engage U.S. individuals who are at increased risk for HBOC and investigate their experiences, decisions and outcomes. It utilizes an extensive research infrastructure, including an interactive web-based data system and electronic interfaces for secure online participation and automated data exchange. We describe the novel recruitment approach that was designed for collaboration with a national commercial health plan partner to identify all individuals for whom a healthcare provider orders a BRCA test and mail to each individual an invitation to participate and study packet. The study packet contains detailed information about the study, a baseline questionnaire and informed consent for participation in the study, for release of relevant medical and health plan records and for ongoing research engagement. This approach employs patient-reported, laboratory-reported and health plan-reported outcomes and facilitates longitudinal engagement. We believe that the type of innovative methodology and collaborative framework we have developed for ABOUT is an ideal foundation for a patient-powered research network. This approach can make substantial contributions to identifying current and best practices in HBOC, leading to improved strategies for clinical care and optimal health outcomes among individuals with high inherited risk for cancer.

Effects of cancer comorbidity on disease management: making the case for diabetes education (a report from the SOAR program).

PubMed

Irizarry, Lauren; Li, Qijuan E; Duncan, Ian; Thurston, Andrew L; Fitzner, Karen A; Edwards, Beatrice J; McKoy-Bent, Judith M; Tulas, Katrina M; McKoy, June M

2013-02-01

Individuals with type II diabetes have an increased risk of cancer diagnosis (relative risk [RR]=1.12-2.50) and mortality (RR=1.4) compared to normoglycemic individuals. Biologic mechanisms, including mitogenic effects of insulin, hyperglycemia, and increased oxidative stress, as well as behavioral factors (eg, difficulty managing the comorbidity) may explain the elevated risk. To investigate the effects of the comorbidity on disease management, the authors compared diabetes education utilization in individuals with diabetes-cancer co-morbidity to utilization by individuals with diabetes in the absence of cancer. The effect of diabetes education on outcomes was further assessed in the subset of individuals with diabetes-cancer comorbidity. Administrative claims data were used for this analysis. The study population included individuals >60 years of age and members of both commercial and Medicare Advantage health plans from a private national database of payer data, but excluded Medicare fee for service and Medicaid patients. Most of these individuals were eligible to receive reimbursement for diabetes education. Diabetes education utilization was identified using procedure codes. Outcomes were assessed for a 3-year time period. There was little difference in diabetes education utilization between individuals with diabetes in the absence of cancer (3.8% utilization) and those with diabetes-cancer comorbidity (3.5% utilization). Individuals who receive diabetes education are more likely to have multiple HbA1c tests per year, fewer emergency department visits, fewer hospital admissions, and lower care-associated costs (except for outpatient and pharmacy averages). When diabetes coexists with cancer, management of diabetes often lags, making diabetes education an imperative.

Breast Imaging Second Opinions Impact Surgical Management.

PubMed

Spivey, Tara Lynn; Carlson, Kjirsten Ayn; Janssen, Imke; Witt, Thomas R; Jokich, Peter; Madrigrano, Andrea

2015-07-01

Breast surgeons often see women for second opinions for abnormalities found on breast imaging. For second opinions, these images are submitted for review and interpretation by dedicated breast imagers. This study evaluated the conformity of results among interpretation of imaging submitted from outside hospitals both from tertiary care centers, as well as community programs, in an attempt to evaluate the utility of this practice for the sake of clinical management and resource utilization. A retrospective chart review was conducted on all breast patients that submitted outside imaging films for the years 2011 to 2013 at Rush University Medical Center (RUMC). The radiologic diagnosis and each patient's proposed management plan was collected and evaluated for concordance between the outside institutions and RUMC. A total of 380 patients who presented for second opinions with an interpretation of outside exams were evaluated. In 47.4 % [95 % confidence interval (CI) 42.4-52.4] of cases there was distinct variance in radiologic impression. For 53.5 % (95 % CI 48.4-58.5) of patients, there was a change in recommended management plan, which included recommendations for either additional imaging or need for additional biopsy. In total, this changed the overall surgical management in 27.1 % (95 % CI 22.8-31.9) of cases. In six patients, the reinterpretation of outside imaging detected new malignancies not previously identified. Overall, 83.7 % (95 % CI 79.7-87.1) of patients who submitted imaging from outside institutions chose to complete the remainder of their treatment at RUMC. The practice of second opinion review changed overall definitive management at our specialty center in more than one in four cases. In addition, the review identified six previously unrecognized malignancies. Given this data, the practice of second opinions and interpretation of outside exams should continue despite the additional resources required.

Scoping study of integrated resource planning needs in the public utility sector

DOE Office of Scientific and Technical Information (OSTI.GOV)

Garrick, C J; Garrick, J M; Rue, D R

Integrated resource planning (IRP) is an approach to utility resource planning that integrates the evaluation of supply- and demand-site options for providing energy services at the least cost. Many utilities practice IRP; however, most studies about IRP focus on investor-owned utilities (IOUs). This scoping study investigates the IRP activities and needs of public utilities (not-for-profit utilities, including federal, state, municipal, and cooperative utilities). This study (1) profiles IRP-related characteristics of the public utility sector, (2) articulates the needs of public utilities in understanding and implementing IRP, and (3) identifies strategies to advance IRP principles in public utility planning.

Risk-based water resources planning: Incorporating probabilistic nonstationary climate uncertainties

NASA Astrophysics Data System (ADS)

Borgomeo, Edoardo; Hall, Jim W.; Fung, Fai; Watts, Glenn; Colquhoun, Keith; Lambert, Chris

2014-08-01

We present a risk-based approach for incorporating nonstationary probabilistic climate projections into long-term water resources planning. The proposed methodology uses nonstationary synthetic time series of future climates obtained via a stochastic weather generator based on the UK Climate Projections (UKCP09) to construct a probability distribution of the frequency of water shortages in the future. The UKCP09 projections extend well beyond the range of current hydrological variability, providing the basis for testing the robustness of water resources management plans to future climate-related uncertainties. The nonstationary nature of the projections combined with the stochastic simulation approach allows for extensive sampling of climatic variability conditioned on climate model outputs. The probability of exceeding planned frequencies of water shortages of varying severity (defined as Levels of Service for the water supply utility company) is used as a risk metric for water resources planning. Different sources of uncertainty, including demand-side uncertainties, are considered simultaneously and their impact on the risk metric is evaluated. Supply-side and demand-side management strategies can be compared based on how cost-effective they are at reducing risks to acceptable levels. A case study based on a water supply system in London (UK) is presented to illustrate the methodology. Results indicate an increase in the probability of exceeding the planned Levels of Service across the planning horizon. Under a 1% per annum population growth scenario, the probability of exceeding the planned Levels of Service is as high as 0.5 by 2040. The case study also illustrates how a combination of supply and demand management options may be required to reduce the risk of water shortages.

Is it time to abandon care planning in mental health services? A qualitative study exploring the views of professionals, service users and carers.

PubMed

Brooks, Helen L; Lovell, Karina; Bee, Penny; Sanders, Caroline; Rogers, Anne

2018-06-01

It has been established that mental health-care planning does not adequately respond to the needs of those accessing services. Understanding the reasons for this and identifying whose needs care plans serve requires an exploration of the perspectives of service users, carers and professionals within the wider organizational context. To explore the current operationalization of care planning and perceptions of its function within mental health services from the perspectives of multiple stakeholders. Participants included 21 mental health professionals, 29 service users and 4 carers from seven Mental Health Trusts in England. All participants had experience of care planning processes within secondary mental health-care services. Fifty-four semi-structured interviews were conducted with participants and analysed utilizing a qualitative framework approach. Care plans and care planning were characterized by a failure to meet the complexity of mental health needs, and care planning processes were seen to prioritize organizational agendas and risk prevention which distanced care planning from the everyday lives of service users. Care planning is recognized, embedded and well established in the practices of mental health professionals and service users. However, it is considered too superficial and mainly irrelevant to users for managing mental health in their everyday lives. Those responsible for the planning and delivery of mental health services should consider ways to increase the relevance of care planning to the everyday lives of service users including separating risk from holistic needs assessment, using support aids and utilizing a peer workforce in this regard. © 2017 The Authors Health Expectations published by John Wiley & Sons Ltd.

A health plan report card for dentistry.

PubMed

Bader, J D; Shugars, D A; Hayden, W J; White, B A

1996-01-01

Employers are demanding information about the performance of the health care plans they purchase for their employees. As a result, "report cards" are now beginning to appear that provide standardized, population-based comparison data for managed medical care plans' quality of care, access and member satisfaction, utilization, and financial status. Although report cards for dental care plans have not yet been developed, it is likely that purchasers will soon expect such performance information. A prototype report card for dental managed care plans is proposed in an effort to facilitate the development of a consensus standard for dentistry. The thirty-eight measures proposed for the report card are designed to be obtainable with a realistic level of additional effort in most dental practices. They were selected to provide data on questions of importance to purchasers and to assess processes and outcomes important because there is strong evidence for their effectiveness. The rationale for the measures is discussed, as are the steps required to develop more sophisticated measures. While the responsibility for the procurement of the information needed for dental report cards will die initially with administrators of dental care plans, it is likely in the near future that individual practitioners will be expected to supply this information to both individual patients and potential contractors.

Hesitant Fuzzy Linguistic Preference Utility Set and Its Application in Selection of Fire Rescue Plans

PubMed Central

Si, Guangsen; Xu, Zeshui

2018-01-01

Hesitant fuzzy linguistic term set provides an effective tool to represent uncertain decision information. However, the semantics corresponding to the linguistic terms in it cannot accurately reflect the decision-makers’ subjective cognition. In general, different decision-makers’ sensitivities towards the semantics are different. Such sensitivities can be represented by the cumulative prospect theory value function. Inspired by this, we propose a linguistic scale function to transform the semantics corresponding to linguistic terms into the linguistic preference values. Furthermore, we propose the hesitant fuzzy linguistic preference utility set, based on which, the decision-makers can flexibly express their distinct semantics and obtain the decision results that are consistent with their cognition. For calculations and comparisons over the hesitant fuzzy linguistic preference utility sets, we introduce some distance measures and comparison laws. Afterwards, to apply the hesitant fuzzy linguistic preference utility sets in emergency management, we develop a method to obtain objective weights of attributes and then propose a hesitant fuzzy linguistic preference utility-TOPSIS method to select the best fire rescue plan. Finally, the validity of the proposed method is verified by some comparisons of the method with other two representative methods including the hesitant fuzzy linguistic-TOPSIS method and the hesitant fuzzy linguistic-VIKOR method. PMID:29614019

Hesitant Fuzzy Linguistic Preference Utility Set and Its Application in Selection of Fire Rescue Plans.

PubMed

Liao, Huchang; Si, Guangsen; Xu, Zeshui; Fujita, Hamido

2018-04-03

Hesitant fuzzy linguistic term set provides an effective tool to represent uncertain decision information. However, the semantics corresponding to the linguistic terms in it cannot accurately reflect the decision-makers' subjective cognition. In general, different decision-makers' sensitivities towards the semantics are different. Such sensitivities can be represented by the cumulative prospect theory value function. Inspired by this, we propose a linguistic scale function to transform the semantics corresponding to linguistic terms into the linguistic preference values. Furthermore, we propose the hesitant fuzzy linguistic preference utility set, based on which, the decision-makers can flexibly express their distinct semantics and obtain the decision results that are consistent with their cognition. For calculations and comparisons over the hesitant fuzzy linguistic preference utility sets, we introduce some distance measures and comparison laws. Afterwards, to apply the hesitant fuzzy linguistic preference utility sets in emergency management, we develop a method to obtain objective weights of attributes and then propose a hesitant fuzzy linguistic preference utility-TOPSIS method to select the best fire rescue plan. Finally, the validity of the proposed method is verified by some comparisons of the method with other two representative methods including the hesitant fuzzy linguistic-TOPSIS method and the hesitant fuzzy linguistic-VIKOR method.

Assessing quality of care for migraineurs: a model health plan measurement set.

PubMed

Leas, Brian F; Gagne, Joshua J; Goldfarb, Neil I; Rupnow, Marcia F T; Silberstein, Stephen

2008-08-01

Quality of care measures are increasingly important to health plans, purchasers, physicians, and patients. Appropriate measures can be used to assess quality and evaluate improvement and are necessary components of pay-for-performance programs. Despite the broad scope of activity in the development of quality measures, migraine headache has received little attention. Given the enormous costs associated with migraine, especially in terms of lost productivity and preventable health care utilization, health plans could gain from a structured approach to measuring the quality of migraine care their beneficiaries receive. A potential migraine quality measurement set was developed through a review of migraine care literature and guidelines, interviews with leaders in migraine care, health care purchasing, and managed care, and the assembly of an advisory board. The board discussed candidate measures and established consensus on a testable measurement set. Twenty measures were developed, focused primarily on diagnosis and utilization. Areas of utilization include physician visits, emergency department visits, hospitalizations, and imaging. Use of both acute and preventive medications is included. More complex aspects of migraine care are also addressed, including triptan overuse, the relationship between acute and preventive medications, and follow-up after emergency department visits. The measures are currently being tested in health plans to assess their feasibility and value. A compelling case can be made for the development of migraine-specific quality measures for health plans. This effort to develop and test a starter set of measures should lead to new and innovative efforts to assess and improve quality of care for migraineurs.

Power control and management of the grid containing largescale wind power systems

NASA Astrophysics Data System (ADS)

Aula, Fadhil Toufick

The ever increasing demand for electricity has driven many countries toward the installation of new generation facilities. However, concerns such as environmental pollution and global warming issues, clean energy sources, high costs associated with installation of new conventional power plants, and fossil fuels depletion have created many interests in finding alternatives to conventional fossil fuels for generating electricity. Wind energy is one of the most rapidly growing renewable power sources and wind power generations have been increasingly demanded as an alternative to the conventional fossil fuels. However, wind power fluctuates due to variation of wind speed. Therefore, large-scale integration of wind energy conversion systems is a threat to the stability and reliability of utility grids containing these systems. They disturb the balance between power generation and consumption, affect the quality of the electricity, and complicate load sharing and load distribution managing and planning. Overall, wind power systems do not help in providing any services such as operating and regulating reserves to the power grid. In order to resolve these issues, research has been conducted in utilizing weather forecasting data to improve the performance of the wind power system, reduce the influence of the fluctuations, and plan power management of the grid containing large-scale wind power systems which consist of doubly-fed induction generator based energy conversion system. The aims of this research, my dissertation, are to provide new methods for: smoothing the output power of the wind power systems and reducing the influence of their fluctuations, power managing and planning of a grid containing these systems and other conventional power plants, and providing a new structure of implementing of latest microprocessor technology for controlling and managing the operation of the wind power system. In this research, in order to reduce and smooth the fluctuations, two methods are presented. The first method is based on a de-loaded technique while the other method is based on utilizing multiple storage facilities. The de-loaded technique is based on characteristics of the power of a wind turbine and estimation of the generated power according to weather forecasting data. The technique provides a reference power by which the wind power system will operate and generate a smooth power. In contrast, utilizing storage facilities will allow the wind power system to operate at its maximum tracking power points' strategy. Two types of energy storages are considered in this research, battery energy storage system (BESS) and pumped-hydropower storage system (PHSS), to suppress the output fluctuations and to support the wind power system to follow the system load demands. Furthermore, this method provides the ability to store energy when there is a surplus of the generated power and to reuse it when there is a shortage of power generation from wind power systems. Both methods are new in terms of utilizing of the techniques and wind speed data. A microprocessor embedded system using an IntelRTM Atom(TM) processor is presented for controlling the wind power system and for providing the remote communication for enhancing the operation of the individual wind power system in a wind farm. The embedded system helps the wind power system to respond and to follow the commands of the central control of the power system. Moreover, it enhances the performance of the wind power system through self-managing, self-functioning, and self-correcting. Finally, a method of system power management and planning is modeled and studied for a grid containing large-scale wind power systems. The method is based on a new technique through constructing a new load demand curve (NLDC) from merging the estimation of generated power from wind power systems and forecasting of the load. To summarize, the methods and their results presented in this dissertation, enhance the operation of the large-scale wind power systems and reduce their drawbacks on the operation of the power grid.

Vegetation and terrain mapping in Alaska using Landsat MSS and digital terrain data

USGS Publications Warehouse

Shasby, Mark; Carneggie, David M.

1986-01-01

During the past 5 years, the U.S. Geological Survey's (USGS) Earth Resources Observation Systems (EROS) Data Center Field Office in Anchorage, Alaska has worked cooperatively with Federal and State resource management agencies to produce land-cover and terrain maps for 245 million acres of Alaska. The need for current land-cover information in Alaska comes principally from the mandates of the Alaska National Interest Lands Conservation Act (ANILCA), December 1980, which requires major land management agencies to prepare comprehensive management plans. The land-cover mapping projects integrate digital Landsat data, terrain data, aerial photographs, and field data. The resultant land-cover and terrain maps and associated data bases are used for resource assessment, management, and planning by many Alaskan agencies including the U.S. Fish and Wildlife Service, U.S. Forest Service, Bureau of Land Management, and Alaska Department of Natural Resources. Applications addressed through use of the digital land-cover and terrain data bases range from comprehensive refuge planning to multiphased sampling procedures designed to inventory vegetation statewide. The land-cover mapping programs in Alaska demonstrate the operational utility of digital Landsat data and have resulted in a new land-cover mapping program by the USGS National Mapping Division to compile 1:250,000-scale land-cover maps in Alaska using a common statewide land-cover map legend.

The Business Change Initiative: A Novel Approach to Improved Cost and Schedule Management

NASA Technical Reports Server (NTRS)

Shinn, Stephen A.; Bryson, Jonathan; Klein, Gerald; Lunz-Ruark, Val; Majerowicz, Walt; McKeever, J.; Nair, Param

2016-01-01

Goddard Space Flight Center's Flight Projects Directorate employed a Business Change Initiative (BCI) to infuse a series of activities coordinated to drive improved cost and schedule performance across Goddard's missions. This sustaining change framework provides a platform to manage and implement cost and schedule control techniques throughout the project portfolio. The BCI concluded in December 2014, deploying over 100 cost and schedule management changes including best practices, tools, methods, training, and knowledge sharing. The new business approach has driven the portfolio to improved programmatic performance. The last eight launched GSFC missions have optimized cost, schedule, and technical performance on a sustained basis to deliver on time and within budget, returning funds in many cases. While not every future mission will boast such strong performance, improved cost and schedule tools, management practices, and ongoing comprehensive evaluations of program planning and control methods to refine and implement best practices will continue to provide a framework for sustained performance. This paper will describe the tools, techniques, and processes developed during the BCI and the utilization of collaborative content management tools to disseminate project planning and control techniques to ensure continuous collaboration and optimization of cost and schedule management in the future.

Assessment of cost sharing in the Pima County Marketplace.

PubMed

Jennings, Nicholas B; Eng, Howard J

2017-01-01

The Patient Protection and Affordable Care Act established health insurance marketplaces to allow consumers to make educated decisions about their health care coverage. During the first open enrollment period in 2013, the federally facilitated marketplace in Pima County, Arizona listed 119 plans, making it one of the most competitive markets in the country. This study compares these plans based on differences in consumer cost sharing, including deductibles, co-pays and premiums. Consumer costs were reviewed using specific cases including a normal delivery pregnancy, the management of Type II Diabetes, and the utilization of specialty drugs to treat Hepatitis C. Total cost of care was calculated as the cost of managing the condition or event plus the cost of monthly premiums, evaluated as a single individual age 27. Evaluating a plan on premium alone is not sufficient as cost sharing can dramatically raise the cost of care. A rating system and better cost transparency tools could provider easier access to pertinent information for consumers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

DBMS UTILIZATION: A Corporate Information System (CIS) development approach

NASA Technical Reports Server (NTRS)

Rozett, P.

1983-01-01

The Corporate Information System (CIS), an integrated information system intended to tie the corporation together as a functioning entity, is described. In addition to being a major upgraded automated data processing system, the CIS is a management philosophy which recognizes data as a valuable corporate resource and which distinguishes between data and selected data, or information. It further recognizes that different users need different kinds of information. Plans for CIS development are discussed. It will offer its users not just after-the-fact data, but timely information in a format that is meaningful and useful to the particular user, so that the information can be applied in planning, controlling, and decision making by all levels of management. In effect, CIS will help the corporation itself to function as a total, integrated system by typing together administrative activities through information exchange. The CIS supports the operational, tactical control, and strategic planning functions of the corporation. Operational functions are the day-to-day processing necessary to support the corporation's work, such as purchasing and payroll.

Unmanned Aircraft Systems (UAS) Integration in the National Airspace System (NAS) Project: KDP-A for Phase 2 Minimum Operational Performance Standards

NASA Technical Reports Server (NTRS)

Grindle, Laurie; Hackenberg, Davis L.

2016-01-01

UAS Integration in the NAS Project has: a) Developed Technical Challenges that are crucial to UAS integration, aligned with NASA's Strategic Plan and Thrusts, and support FAA standards development. b) Demonstrated rigorous project management processes through the execution of previous phases. c) Defined Partnership Plans. d) Established path to KDP-C. Request approval of Technical Challenges, execution of partnerships and plans, and execution of near-term FY17 activities. There is an increasing need to fly UAS in the NAS to perform missions of vital importance to National Security and Defense, Emergency Management, and Science. There is also an emerging need to enable commercial applications such as cargo transport (e.g. FedEx). Unencumbered NAS Access for Civil/Commercial UAS. Provide research findings, utilizing simulation and flight tests, to support the development and validation of DAA and C2 technologies necessary for integrating Unmanned Aircraft Systems into the National Airspace System.

View from the top: CEO perspectives on executive development and succession planning practices in healthcare organizations.

PubMed

Groves, Kevin S

2006-01-01

Many healthcare professionals question whether the industry's hospitals and multi-site systems are implementing the necessary executive development and succession planning systems to ensure that high potential managers are prepared and aptly selected to assume key executive roles. Survey data, case studies, and cross-industry comparisons suggest that healthcare organizations may face a leadership crisis as the current generation of chief executive officers (CEOs) nears retirement while traditional means of developing the leadership pipeline, including middle-management positions and graduate programs requiring formal residencies, continue to dissipate. Given the daunting challenges that accompany the healthcare industry's quest to identify, develop, and retain leadership talent, this article provides best practice findings from a qualitative study of 13 healthcare organizations with a record of exemplary executive development and succession planning practices. CEOs from six single-site hospitals, six healthcare systems, and one medical group were interviewed to identify industry best practices so that healthcare practitioners and educators may utilize the findings to enhance the industry's leadership capacity.

Cost-utility of cognitive behavioral therapy for low back pain from the commercial payer perspective.

PubMed

Norton, Giulia; McDonough, Christine M; Cabral, Howard; Shwartz, Michael; Burgess, James F

2015-05-15

Markov cost-utility model. To evaluate the cost-utility of cognitive behavioral therapy (CBT) for the treatment of persistent nonspecific low back pain (LBP) from the perspective of US commercial payers. CBT is widely deemed clinically effective for LBP treatment. The evidence is suggestive of cost-effectiveness. We constructed and validated a Markov intention-to-treat model to estimate the cost-utility of CBT, with 1-year and 10-year time horizons. We applied likelihood of improvement and utilities from a randomized controlled trial assessing CBT to treat LBP. The trial randomized subjects to treatment but subjects freely sought health care services. We derived the cost of equivalent rates and types of services from US commercial claims for LBP for a similar population. For the 10-year estimates, we derived recurrence rates from the literature. The base case included medical and pharmaceutical services and assumed gradual loss of skill in applying CBT techniques. Sensitivity analyses assessed the distribution of service utilization, utility values, and rate of LBP recurrence. We compared health plan designs. Results are based on 5000 iterations of each model and expressed as an incremental cost per quality-adjusted life-year. The incremental cost-utility of CBT was $7197 per quality-adjusted life-year in the first year and $5855 per quality-adjusted life-year over 10 years. The results are robust across numerous sensitivity analyses. No change of parameter estimate resulted in a difference of more than 7% from the base case for either time horizon. Including chiropractic and/or acupuncture care did not substantively affect cost-effectiveness. The model with medical but no pharmaceutical costs was more cost-effective ($5238 for 1 yr and $3849 for 10 yr). CBT is a cost-effective approach to manage chronic LBP among commercial health plans members. Cost-effectiveness is demonstrated for multiple plan designs. 2.

Do Global Indicators of Protected Area Management Effectiveness Make Sense? A Case Study from Siberia

NASA Astrophysics Data System (ADS)

Anthony, Brandon P.; Shestackova, Elena

2015-07-01

Driven by the underperformance of many protected areas (PAs), protected area management effectiveness (PAME) evaluations are increasingly being conducted to assess PAs in meeting specified objectives. A number of PAME tools have been developed, many of which are based on the IUCN-WCPA framework constituting six evaluative elements (context, planning, input, process, output, and outcomes). In a quest for a more universal tool and using this framework, Leverington et al. (Environ Manag 46(5):685-698, 2010) developed a common scale and list of 33 headline indicators, purported to be representative across a wide range of management effectiveness evaluation tools. The usefulness of such composite tools and the relative weighting of indicators are still being debated. Here, we utilize these headline indicators as a benchmark to assess PAME in 37 PAs of four types in Krasnoyarsk Kray, Russia, and compare these with global results. Moreover, we review the usefulness of these indicators in the Krasnoyarsk context based on the opinions of local PA management teams. Overall, uncorrected management scores for studied PAs were slightly better (mean = 5.66 ± 0.875) than the global average, with output and outcome elements being strongest, and planning and process scores lower. Score variability is influenced by PA size, location, and type. When scores were corrected based on indicator importance, the mean score significantly increased to 5.75 ± 0.858. We emphasize idiosyncrasies of Russian PA management, including the relative absence of formal management plans and limited efforts toward local community beneficiation, and how such contextual differences may confound PAME scores when indicator weights are treated equal.

Integrated Baseline System (IBS). Version 1.03, System Management Guide

DOE Office of Scientific and Technical Information (OSTI.GOV)

Williams, J.R.; Bailey, S.; Bower, J.C.

This IBS System Management Guide explains how to install or upgrade the Integrated Baseline System (IBS) software package. The IBS is an emergency management planning and analysis tool that was developed under the direction of the Federal Emergency Management Agency (FEMA). This guide includes detailed instructions for installing the IBS software package on a Digital Equipment Corporation (DEC) VAX computer from the IBS distribution tapes. The installation instructions include procedures for both first-time installations and upgrades to existing IBS installations. To ensure that the system manager has the background necessary for successful installation of the IBS package, this guide alsomore » includes information on IBS computer requirements, software organization, and the generation of IBS distribution tapes. When special utility programs are used during IBS installation and setups, this guide refers you to the IBS Utilities Guide for specific instructions. This guide also refers you to the IBS Data Management Guide for detailed descriptions of some IBS data files and structures. Any special requirements for installation are not documented here but should be included in a set of installation notes that come with the distribution tapes.« less

Developing Spatial Management Options for the Protection of Vulnerable Marine Ecosystems in the South Pacific Ocean Region.

NASA Astrophysics Data System (ADS)

Rowden, A. A.; Lundquist, C. J.; Clark, M. R.; Anderson, O. F.; Guinotte, J. M.; Baird, S. J.; Roux, M. J.; Wadhwa, S.

2016-02-01

The South Pacific Regional Fisheries Management Organisation (SPRFMO) Convention includes specific provisions to protect vulnerable marine ecosystems (VMEs). The SPRFMO Commission has determined that the interim measures put in place to protect VMEs would be replaced by an improved system of fishable and closed areas. These closures would effectively represent a preliminary spatial management plan, whereby conservation and management measures are implemented that will result in sustainable fisheries and benthic protection. We used the conservation planning tool Zonation to develop spatial management options that balance the protection of VMEs with utilisation of high value areas for fishing. Input data included habitat suitability maps, and uncertainties associated with these model predictions, for eleven VME indicator taxa (4 Scleractinian coral species; 3 other cnidarian groups (Family Stylasteridae, Order Antipatharia, Order Pennatulacea; 2 classes of sponges (Demospongiae, Hexactinellidae), and 2 echninoderm groups (Crinoidea and Brisingida)) at bathyal depths across the entire SPRFMO area (divided into 1 km2 grid cells); New Zealand fishing catch data (for two different time periods and trawl types); naturalness (represented by proxy variable using the number of trawl tows); and a bioregionalisation scheme. Running various scenario models for spatial planning allowed for the cost to fishing to be determined, in terms of the amount of the trawl catch footprint lost if high priority areas for VME indicator taxa are protected. Generally, the cost to fishing was low given the relatively high proportion of suitable habitat for VME indicator taxa protected. The main outcome of the present study is a demonstration of the practical utility of using available data, including modelled data, and the Zonation conservation planning software tool to develop options for the spatial management of the SPRFMO area.

K-12 education sector desk reference. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1998-01-01

K-12 schools are a major energy customer. To help utility managers better analyze their business relationships with this important market segment, this reference provides background information, statistics, and other useful information. This is a reference. It is a compilation of figures, charts, and tables taken from many existing sources representing some of the best information available about K-12 schools. Analysts reviews over 2,500 pages of government and private sector documents (listed in Appendix A) to select the 100 pages included here. They made every effort to select documents likely to be useful to utility planning staff and program managers. Wherevermore » possible, specific state data have been included to help utility staff compute impacts within a service territory. Both a phone number and e-mail address have been included wherever available for each document listed in Appendix A. The report includes data on the following: energy use; federal mandates; deferred maintenance; indoor air quality; and technology in education. 21 figs., 49 tabs.« less

Community energy self-reliance

NASA Astrophysics Data System (ADS)

1980-07-01

Goals of a workshop/conference on community renewable energy systems are: (1) to encourage decentralization in attacking energy problems, (2) to show how renewable energy can meet community goals, (3) to present examples of successful projects, (4) to discuss the planning and management of renewable energy systems, (5) to identify sources of financial support, (6) to share legal strategies, and (7) to examine utility roles.

Profitable Hog Production. An Instructional Unit for Teachers of Adult Vocational Education in Agriculture.

ERIC Educational Resources Information Center

Vincent, Gary; Iverson, Maynard J.

Developed as a guide for teachers in planning and conducting classes in young or adult farmer education, the 10-lesson unit covers the basic areas of hog production; selection, breeding, feeding, managing, and marketing. The format used is designed to assist teachers in utilizing problem-solving and the discussion method of teaching. The appendix…

Utilizing the Multidisciplinary Team for Planning and Monitoring Care and Quality Improvement

PubMed Central

Patel, A.; Franko, Edward R.; Fleshman, James W.

2015-01-01

Multidisciplinary team management of patients with rectal cancer requires a dedicated group of surgeons, medical and radiation oncologists, pathologists, radiologists, and mid-level providers who meet to discuss every patient with rectal cancer. The data from that meeting is collected prospectively, recommendations made for case, follow-up obtained, and quality issues monitored. Improved case is the result. PMID:25733969

75 FR 37883 - Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-30

... Planning and Cost Allocation by Transmission Owning and Operating Public Utilities; Proposed Rule #0;#0...] Transmission Planning and Cost Allocation by Transmission Owning and Operating Public Utilities Issued June 17... Transmission Services by Public Utilities; Recovery of Stranded Costs by Public Utilities and Transmitting...

Autonomously managed electrical power systems

NASA Technical Reports Server (NTRS)

Callis, Charles P.

1986-01-01

The electric power systems for future spacecraft such as the Space Station will necessarily be more sophisticated and will exhibit more nearly autonomous operation than earlier spacecraft. These new power systems will be more reliable and flexible than their predecessors offering greater utility to the users. Automation approaches implemented on various power system breadboards are investigated. These breadboards include the Hubble Space Telescope power system test bed, the Common Module Power Management and Distribution system breadboard, the Autonomusly Managed Power System (AMPS) breadboard, and the 20 kilohertz power system breadboard. Particular attention is given to the AMPS breadboard. Future plans for these breadboards including the employment of artificial intelligence techniques are addressed.

Forestry applications project/timber resource. Sam Houston National forest inventory and development of a survey planning model

NASA Technical Reports Server (NTRS)

Colwell, R. N.

1976-01-01

The Forestry Applications Project has been directed towards solving the problem of meeting informational needs of the resource managers utilizing remote sensing data sources including satellite data, conventional aerial photography, and direct measurement on the ground in such combinations as needed to best achieve these goals. It is recognized that sampling plays an important role in generating relevant information for managing large geographic populations. The central problem, therefore, is to define the kind and amount of sampling and the place of remote sensing data sources in that sampling system to do the best possible job of meeting the manager's informational needs.

One-Year Outcomes of an Integrated Multiple Sclerosis Disease Management Program.

PubMed

Groeneweg, Marti; Forrester, Sara H; Arnold, Beth; Palazzo, Lorella; Zhu, Weiwei; Yoon, Paul; Scearce, Tim

2018-05-01

Multiple sclerosis (MS) is associated with high total health care cost, the majority of which is attributable to medications. Patients with MS are less likely to experience relapses, emergency department (ED) visits, and hospitalizations when they are adherent to disease-modifying treatments. Disease management programs are hypothesized to improve medication adherence thereby improving clinical and economic outcomes. To evaluate the clinical and economic effects of a specialty pharmacy and chronic disease management program for patients with MS from a health plan perspective. This study was a retrospective analysis using prescription drug claims, medical claims, and electronic medical record information (2013-2015) 1 year before and after enrollment in the disease management program for members with 24 months of continuous health plan coverage. Medication adherence was calculated using proportion of days covered (PDC). Relapse rate was defined as an MS outpatient visit associated with a corticosteroid dispense within 7 days of the visit or an MS hospitalization. Disease progression was assessed using the Modified Expanded Disability Status Scale (mEDSS). Resource use included outpatient visits, ED visits, and hospitalizations. Cost information was collected as health plan-paid amount and was reported in 2013 U.S. dollars. The analysis included 377 patients (mean age 55 years, 76.4% female). After enrollment in the program, 78.7% of the study group had a PDC of ≥ 0.80 compared with 70.0% before enrollment (P < 0.001). There was no difference in MS relapse rate (0.25 after vs. 0.45 before, P = 0.11) or mEDSS score (3.77 after vs. 3.76 before, P = 0.19). Health care resource utilization was minimal and did not change significantly throughout the study period: mean outpatient visits (13.09 after vs. 13.78 before, P = 0.69); mean ED visits (0.18 after vs. 0.16 before, P = 0.60); and mean hospitalizations (0.12 after vs. 0.12 before, P = 1.00). This nonsignificant finding remained when the analysis was limited to MS-related visits only. Average annual health plan spend per patient on MS medications significantly increased ($55,835 after vs. $40,883 before, P < 0.001). Specialty pharmacy and chronic disease management for patients with MS can increase the proportion of patients adherent to medication. The increase in health plan spend on MS medications is not offset by savings in health care resource utilization. This study was funded by Kaiser Permanente Washington Health Research Institute and Kaiser Permanente Washington Pharmacy Administration. The authors have no disclosures to report.

[Professional's expectations to improve quality of care and social services utilization in geriatric oncology].

PubMed

Antoine, Valéry; de Wazières, Benoît; Houédé, Nadine

2015-02-01

Coordination of a multidisciplinary and multi-professional intervention is a key issue in the management of elderly cancer patients to improve health status and quality of life. Optimizing the links between professionals is needed to improve care planning, health and social services utilization. Descriptive study in a French University Hospital. A 6-item structured questionnaire was addressed to professionals involved in global and supportive cares of elderly cancer patients (name, location, effective health care and services offered, needs to improve the quality of their intervention). After the analysis of answers, definition of propositions to improve cares and services utilization. The 37 respondents identified a total of 166 needs to improve quality of care in geriatric oncology. Major expectations were concerning improvement of global/supportive cares and health care services utilization, a better coordination between geriatric teams and oncologists. Ten propositions, including a model of in-hospital health care planning, were defined to answer to professional's needs with the aim of optimizing cancer treatment and global cares. Identification of effective services and needs can represent a first step in a continuous program to improve quality of cares, according to the French national cancer plan 2014-2019. It allows federating professionals for a coordination effort, a better organization of the clinical activity in geriatric oncology, to optimize clinical practice and global cares. Copyright © 2014 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Design research about coastal zone planning and management information system based on GIS and database technologies

NASA Astrophysics Data System (ADS)

Huang, Pei; Wu, Sangyun; Feng, Aiping; Guo, Yacheng

2008-10-01

As littoral areas in possession of concentrated population, abundant resources, developed industry and active economy, the coastal areas are bound to become the forward positions and supported regions for marine exploitation. In the 21st century, the pressure that coastal zones are faced with is as follows: growth of population and urbanization, rise of sea level and coastal erosion, shortage of freshwater resource and deterioration of water resource, and degradation of fishery resource and so on. So the resources of coastal zones should be programmed and used reasonably for the sustainable development of economy and environment. This paper proposes a design research on the construction of coastal zone planning and management information system based on GIS and database technologies. According to this system, the planning results of coastal zones could be queried and displayed expediently through the system interface. It is concluded that the integrated application of GIS and database technologies provides a new modern method for the management of coastal zone resources, and makes it possible to ensure the rational development and utilization of the coastal zone resources, along with the sustainable development of economy and environment.

Emergency Preparedness in the 10-Mile Emergency Planning Zone Surrounding Nuclear Power Plants

PubMed Central

Adalja, Amesh A.; Sell, Tara Kirk; Ravi, Sanjana J.; Minton, Katie; Morhard, Ryan

2015-01-01

Objectives Each of the nuclear power plants in the US is encircled by an Emergency Planning Zone (EPZ). Within each EPZ, government officials, utility professionals, emergency managers, and public health practitioners collectively conduct extensive planning, exercises, and outreach to better protect their communities in the event of a nuclear accident. Our objective was to conduct a cross-sectional study of off-site public health preparedness within EPZs to better understand the dynamics of nuclear preparedness and uncover lessons for all-hazards preparedness. Methods Using a qualitative, interview-based method, we consulted 120 county emergency managers, state health preparedness officers, state radiation health officials, and industry officials from 17 EPZs in ten different states. Results Interviewees reflected that EPZ emergency preparedness is generally robust, results from strong public-private partnership between nuclear plants and emergency management agencies, and enhances all-hazard preparedness. However, there exist a few areas which merit further study and improvement. These areas include cross-state coordination, digital public communication, and optimizing the level of public education within EPZs. Conclusions This first-of-its-kind study provides a cross-sectional snapshot of emergency preparedness in the 10-mile EPZ surrounding nuclear power plants. PMID:26692825

Emergency Preparedness in the 10-Mile Emergency Planning Zone Surrounding Nuclear Power Plants.

PubMed

Adalja, Amesh A; Sell, Tara Kirk; Ravi, Sanjana J; Minton, Katie; Morhard, Ryan

2014-12-01

Each of the nuclear power plants in the US is encircled by an Emergency Planning Zone (EPZ). Within each EPZ, government officials, utility professionals, emergency managers, and public health practitioners collectively conduct extensive planning, exercises, and outreach to better protect their communities in the event of a nuclear accident. Our objective was to conduct a cross-sectional study of off-site public health preparedness within EPZs to better understand the dynamics of nuclear preparedness and uncover lessons for all-hazards preparedness. Using a qualitative, interview-based method, we consulted 120 county emergency managers, state health preparedness officers, state radiation health officials, and industry officials from 17 EPZs in ten different states. Interviewees reflected that EPZ emergency preparedness is generally robust, results from strong public-private partnership between nuclear plants and emergency management agencies, and enhances all-hazard preparedness. However, there exist a few areas which merit further study and improvement. These areas include cross-state coordination, digital public communication, and optimizing the level of public education within EPZs. This first-of-its-kind study provides a cross-sectional snapshot of emergency preparedness in the 10-mile EPZ surrounding nuclear power plants.

"Engendering" Agenda 21: gender equality and water resource management: five years after Rio.

PubMed

Hannan-andersson, C

1997-01-01

Agenda 21 acknowledges women's role in natural resources management at the local level and emphasizes the need for more women in senior positions to contribute positively to the implementation of environmental policy. This article assesses Agenda 21's approach to gender equality and its achievements. A few explicit references to women and water resource management (WRM) without consideration on the gender implications of the WRM policies and strategies were noted. The macro-oriented, technology-focused and supply-oriented approach of Agenda 21 on WRM hinders the inclusion of a gender perspective. There are two levels of implications of gender-blind intervention in relation to WRM: the issue of social justice and rights, and the negative impact of the neglect of gender inequality on overall planning and success of interventions. The inclusion of a gender perspective at policy and planning levels to facilitate the resolution of inconsistencies, as well as the importance of water sources and patterns of use knowledge for adequate policy development and planning was suggested. It is important that the WRM principle application utilize a sociocultural and gender perspective at both community and household levels before decisions are made on WRM interventions.

An integrative health information systems approach for facilitating strategic planning in hospitals.

PubMed

Killingsworth, Brenda; Newkirk, Henry E; Seeman, Elaine

2006-01-01

This article presents a framework for developing strategic information systems (SISs) for hospitals. It proposes a SIS formulation process which incorporates complexity theory, strategic/organizational analysis theory, and conventional MIS development concepts. Within the formulation process, four dimensions of SIS are proposed as well as an implementation plan. A major contribution of this article is the development of a hospital SIS framework which permits an organization to fluidly respond to external, interorganizational, and intraorganizational influences. In addition, this article offers a checklist which managers can utilize in developing an SIS in health care.

Consumerism and wellness: rising tide, falling cost.

PubMed

Domaszewicz, Alexander

2008-01-01

Annual employer-sponsored health plan cost increases have been slowing incrementally due to slowing health care utilization--a phenomenon very likely tied to the proliferation of health management activities, wellness programs and other consumerism strategies. This article describes the sharp rise in recent years of consumer-directed health plans (CDHPs) and explains what developments must happen for genuine consumer-directed health care to realize its full potential. These developments include gathering transparent health care information, increasing consumer demand for that information and creating truly intuitive data solutions that allow consumers to easily access information in order to make better health care decisions.

Satellite Application for Disaster Management Information Systems

NASA Astrophysics Data System (ADS)

Okpanachi, George

Abstract Satellites are becoming increasingly vital to modern day disaster management activities. Earth observation (EO) satellites provide images at various wavelengths that assist rapid-mapping in all phases of the disaster management cycle: mitigation of potential risks in a given area, preparedness for eventual disasters, immediate response to a disaster event, and the recovery/reconstruction efforts follo wing it. Global navigation satellite systems (GNSS) such as the Global Positioning System (GPS) assist all the phases by providing precise location and navigation data, helping manage land and infrastructures, and aiding rescue crews coordinate their search efforts. Effective disaster management is a complex problem, because it involves many parameters, which are usually not easy to measure and even identify: Analysis of current situation, planning, optimum resource management, coordination, controlling and monitoring current activities and making quick and correct decisions are only some of these parameters, whose complete list is very long. Disaster management information systems (DMIS) assist disaster management to analyse the situation better, make decisions and suggest further actions following the emergency plans. This requires not only fast and thorough processing and optimization abilities, but also real-time data provided to the DMIS. The need of DMIS for disaster’s real-time data can be satisfied by small satellites data utilization. Small satellites can provide up-to-data, plus a better media to transfer data. This paper suggests a rationale and a framework for utilization of small Satellite data by DMIS. DMIS should be used ‘’before’’, ‘’during’’ and ‘’after’’ the disasters. Data provided by the Small Satellites are almost crucial in any period of the disasters, because early warning can save lives, and satellite data may help to identify disasters before they occur. The paper also presents’ ‘when’’, ‘’where’’ and ‘’how’’ small satellite data should be used by DMIS.

Pharmacy Utilization and the Medicare Modernization Act

PubMed Central

Maio, Vittorio; Pizzi, Laura; Roumm, Adam R; Clarke, Janice; Goldfarb, Neil I; Nash, David B; Chess, David

2005-01-01

To control expenditures and use medications appropriately, the Medicare drug coverage program has established pharmacy utilization management (PUM) measures. This article assesses the effects of these strategies on the care of seniors. The literature suggests that although caps on drug benefits lower pharmaceutical costs, they may also increase the use of other health care services and hurt health outcomes. Our review raises concerns regarding the potential unintended effects of the Medicare drug program's PUM policies for beneficiaries. Therefore, the economic and clinical impact of PUM measures on seniors should be studied further to help policymakers design better drug benefit plans. PMID:15787955

Enhancing Cassini Operations & Science Planning Tools

NASA Technical Reports Server (NTRS)

Castello, Jonathan

2012-01-01

The Cassini team uses a variety of software utilities as they manage and coordinate their mission to Saturn. Most of these tools have been unchanged for many years, and although stability is a virtue for long-lived space missions, there are some less-fragile tools that could greatly benefit from modern improvements. This report shall describe three such upgrades, including their architectural differences and their overall impact. Emphasis is placed on the motivation and rationale behind architectural choices rather than the final product, so as to illuminate the lessons learned and discoveries made.These three enhancements included developing a strategy for migrating Science Planning utilities to a new execution model, rewriting the team's internal portal for ease of use and maintenance, and developing a web-based agenda application for tracking the sequence of files being transmitted to the Cassini spacecraft. Of this set, the first two have been fully completed, while the agenda application is currently in the early prototype stage.

42 CFR 456.181 - Reports of evaluations and plans of care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals... and plan of care must be entered in the applicant's or recipient's record— (a) At the time of... evaluation or plan. Utilization Review (UR) Plan: General Requirements ...

42 CFR 456.381 - Reports of evaluations and plans of care.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... evaluation and plan of care must be entered in the applicant's or recipient's record— (a) At the time of... plan. Utilization Review (UR) Plan: General Requirement ...

42 CFR 456.381 - Reports of evaluations and plans of care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care... evaluation and plan of care must be entered in the applicant's or recipient's record— (a) At the time of... plan. Utilization Review (UR) Plan: General Requirement ...

Statistical analysis plan for the Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART). A randomized controlled trial

PubMed Central

Damiani, Lucas Petri; Berwanger, Otavio; Paisani, Denise; Laranjeira, Ligia Nasi; Suzumura, Erica Aranha; Amato, Marcelo Britto Passos; Carvalho, Carlos Roberto Ribeiro; Cavalcanti, Alexandre Biasi

2017-01-01

Background The Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART) is an international multicenter randomized pragmatic controlled trial with allocation concealment involving 120 intensive care units in Brazil, Argentina, Colombia, Italy, Poland, Portugal, Malaysia, Spain, and Uruguay. The primary objective of ART is to determine whether maximum stepwise alveolar recruitment associated with PEEP titration, adjusted according to the static compliance of the respiratory system (ART strategy), is able to increase 28-day survival in patients with acute respiratory distress syndrome compared to conventional treatment (ARDSNet strategy). Objective To describe the data management process and statistical analysis plan. Methods The statistical analysis plan was designed by the trial executive committee and reviewed and approved by the trial steering committee. We provide an overview of the trial design with a special focus on describing the primary (28-day survival) and secondary outcomes. We describe our data management process, data monitoring committee, interim analyses, and sample size calculation. We describe our planned statistical analyses for primary and secondary outcomes as well as pre-specified subgroup analyses. We also provide details for presenting results, including mock tables for baseline characteristics, adherence to the protocol and effect on clinical outcomes. Conclusion According to best trial practice, we report our statistical analysis plan and data management plan prior to locking the database and beginning analyses. We anticipate that this document will prevent analysis bias and enhance the utility of the reported results. Trial registration ClinicalTrials.gov number, NCT01374022. PMID:28977255

Integrating telemedicine and telehealth: putting it all together.

PubMed

Weinstein, Ronald S; Lopez, Ana Maria; Krupinski, Elizabeth A; Beinar, Sandra J; Holcomb, Michael; McNeely, Richard A; Latifi, Rifat; Barker, Gail

2008-01-01

Telemedicine and telehealth programs are inherently complex compared with their traditional on-site health care delivery counterparts. Relatively few organizations have developed sustainable, multi-specialty telemedicine programs, although single service programs, such as teleradiology and telepsychiatry programs, are common. A number of factors are barriers to the development of sustainable telemedicine and telehealth programs. First, starting programs is often challenging since relatively few organizations have, in house, a critical mass of individuals with the skill sets required to organize and manage a telemedicine program. Therefore, it is necessary to "boot strap" many of the start-up activities using available personnel. Another challenge is to assemble a management team that has time to champion telemedicine and telehealth while dealing with the broad range of issues that often confront telemedicine programs. Telemedicine programs housed within a single health care delivery system have advantages over programs that serve as umbrella telehealth organizations for multiple health care systems. Planning a telemedicine program can involve developing a shared vision among the participants, including the parent organizations, management, customers and the public. Developing shared visions can be a time-consuming, iterative process. Part of planning includes having the partnering organizations and their management teams reach a consensus on the initial program goals, priorities, strategies, and implementation plans. Staffing requirements of telemedicine and telehealth programs may be met by sharing existent resources, hiring additional personnel, or outsourcing activities. Business models, such as the Application Service Provider (ASP) model used by the Arizona Telemedicine Program, are designed to provide staffing flexibility by offering a combination of in-house and out-sourced services, depending on the needs of the individual participating health care organizations. Telemedicine programs should perform ongoing assessments of activities, ranging from service usage to quality of service assessments, to ongoing analyses of financial performance. The financial assessments should include evaluations of costs and benefits, coding issues, reimbursement, account receivables, bad debt and network utilization. Long-range strategic planning for a telemedicine and telehealth program should be carried out on an on-going basis and should include the program's governing board. This planning process should include goal setting and the periodic updating of the program's vision and mission statements. There can be additional special issues for multi-organization telemedicine and telehealth programs. For example, authority management can require the use of innovative approaches tailored to the realities of the organizational structures of the participating members. Inter-institutional relations may introduce additional issues when competing health care organizations are utilizing shared resources. Branding issues are preferably addressed during the initial planning of a multi-organizational telemedicine and telehealth program. Ideally, public policy regarding telemedicine and telehealth within a service region will complement the objectives of telemedicine and telehealth programs within that service area.

The complete "how to" guide for selecting a disease management vendor.

PubMed

Linden, Ariel; Roberts, Nancy; Keck, Kevin

2003-01-01

Decision-makers in health plans, large medical groups, and self-insured employers face many challenges in selecting and implementing disease management programs. One strategy is the "buy" approach, utilizing one or more of the many vendors to provide disease management services for the purchasing organization. As a relatively new field, the disease management vendor landscape is continually changing, uncovering the many uncertainties about demonstrating outcomes, corporate stability, or successful business models. Given the large investment an organization may make in each disease management program (many cost 1 million dollars or more in annual fees for a moderately sized population), careful consideration must be given in selecting a disease management partner. This paper describes, in detail, the specific steps necessary and the issues to consider in achieving a successful contract with a vendor for full-service disease management.

Diabetes disease management results in Hispanic Medicaid patients.

PubMed

Berg, Gregory D; Wadhwa, Sandeep

2009-05-01

To investigate outcomes of a telephonic nursing disease management program for Medicaid patients with diabetes residing in Puerto Rico. A 12-month, matched-cohort study. Four hundred and ninety (490) intervention group members matched to 490 controls. Disease management diabetes program. For those in the intervention group, the disease management program customized a self-management intervention plan. Medical service utilization, including hospitalizations, emergency department visits, physician evaluation and management visits, selected clinical indicators, and financial impact. The intervention group showed significant effects compared with the control group, including a 48% reduction in inpatient bed days, and a 23% increase in ACE inhibitor use, resulting in a return on investment estimate of 3.8:1. The study demonstrates that a nursing disease management program for diabetes can significantly improve hospitalizations, drug compliance, and vaccinations in a Hispanic Medicaid population.

Maximizing Energy Savings Reliability in BC Hydro Industrial Demand-side Management Programs: An Assessment of Performance Incentive Models

NASA Astrophysics Data System (ADS)

Gosman, Nathaniel

For energy utilities faced with expanded jurisdictional energy efficiency requirements and pursuing demand-side management (DSM) incentive programs in the large industrial sector, performance incentive programs can be an effective means to maximize the reliability of planned energy savings. Performance incentive programs balance the objectives of high participation rates with persistent energy savings by: (1) providing financial incentives and resources to minimize constraints to investment in energy efficiency, and (2) requiring that incentive payments be dependent on measured energy savings over time. As BC Hydro increases its DSM initiatives to meet the Clean Energy Act objective to reduce at least 66 per cent of new electricity demand with DSM by 2020, the utility is faced with a higher level of DSM risk, or uncertainties that impact the costeffective acquisition of planned energy savings. For industrial DSM incentive programs, DSM risk can be broken down into project development and project performance risks. Development risk represents the project ramp-up phase and is the risk that planned energy savings do not materialize due to low customer response to program incentives. Performance risk represents the operational phase and is the risk that planned energy savings do not persist over the effective measure life. DSM project development and performance risks are, in turn, a result of industrial economic, technological and organizational conditions, or DSM risk factors. In the BC large industrial sector, and characteristic of large industrial sectors in general, these DSM risk factors include: (1) capital constraints to investment in energy efficiency, (2) commodity price volatility, (3) limited internal staffing resources to deploy towards energy efficiency, (4) variable load, process-based energy saving potential, and (5) a lack of organizational awareness of an operation's energy efficiency over time (energy performance). This research assessed the capacity of alternative performance incentive program models to manage DSM risk in BC. Three performance incentive program models were assessed and compared to BC Hydro's current large industrial DSM incentive program, Power Smart Partners -- Transmission Project Incentives, itself a performance incentive-based program. Together, the selected program models represent a continuum of program design and implementation in terms of the schedule and level of incentives provided, the duration and rigour of measurement and verification (M&V), energy efficiency measures targeted and involvement of the private sector. A multi criteria assessment framework was developed to rank the capacity of each program model to manage BC large industrial DSM risk factors. DSM risk management rankings were then compared to program costeffectiveness, targeted energy savings potential in BC and survey results from BC industrial firms on the program models. The findings indicate that the reliability of DSM energy savings in the BC large industrial sector can be maximized through performance incentive program models that: (1) offer incentives jointly for capital and low-cost operations and maintenance (O&M) measures, (2) allow flexible lead times for project development, (3) utilize rigorous M&V methods capable of measuring variable load, process-based energy savings, (4) use moderate contract lengths that align with effective measure life, and (5) integrate energy management software tools capable of providing energy performance feedback to customers to maximize the persistence of energy savings. While this study focuses exclusively on the BC large industrial sector, the findings of this research have applicability to all energy utilities serving large, energy intensive industrial sectors.

Service-Based Learning for Residents: A Success for Communities and Medical Education.

PubMed

Gefter, Liana; Merrell, Sylvia Bereknyei; Rosas, Lisa G; Morioka-Douglas, Nancy; Rodriguez, Eunice

2015-01-01

Community-based service-learning opportunities could support residents' acquisition of Accreditation Council for Graduate Medical Education (ACGME) competencies, but this concept has not been tested, and such programs are difficult to find. The objective of this work was to assess the value and the ACGME competency relevance of a service-learning program for residents that could be easily replicated nationally. Forty-one family medicine residents from three training programs participated in the Stanford Youth Diabetes Coaches Program at six high schools in California and Georgia serving minority students of low socioeconomic status. Residents completed online surveys to provide qualitative feedback and assess the program's impact on their acquisition of residency program competencies and self-management support proficiencies, including prior use and planned use of action plans-a key self-management support strategy. Ninety-five percent of residents indicated that the program was a valuable experience that contributed to acquisition of residency program competencies, including interpersonal and communication skills and communication with teens. Compared with baseline, significantly more residents reported intention to use action plans with patients following participation. Themes from qualitative feedback included: valuing the overall experience, increasing opportunities to practice teaching, enhancing their ability to communicate with adolescents, contributing to the health of the community, recognizing the potential of action plans, and increasing intent to use action plans. This pilot demonstrated that a brief service-learning program can enhance standard residency curriculum by encouraging acquisition of ACGME competencies and promoting utilization of self-management support in clinical practice.

Physician need. An alternative projection from a study of large, prepaid group practices.

PubMed

Mulhausen, R; McGee, J

1989-04-07

To model a base level of physician demand in a managed health care system, we examined in 1983 the ratios by specialty of full-time equivalent physicians to health maintenance organization members in seven large, closed-panel health maintenance organizations, each with more than 100,000 members. The medical director of each plan was surveyed by mailed questionnaire and telephone interview to determine the plan's number of full-time equivalent physicians by specialty and members served. Out-of-plan physicians contracted by the group were included within the specialty distribution wherever possible. We compared our findings (4779.4 full-time equivalent physicians serving 4,297,790 members) with Graduate Medical Education National Advisory Committee and others' projections of physician need and supply. Based on this model and unknowns that might affect utilization, our study suggests that at least 111 physicians per 100,000 population would be necessary in a system that emphasized reduced utilization of services and that more primary care physicians would be needed than the Graduate Medical Education National Advisory Committee predicted would be available.

The effect of an active implementation of a disease management programme for chronic obstructive pulmonary disease on healthcare utilization - a cluster-randomised controlled trial

PubMed Central

2013-01-01

Background The growing population living with chronic conditions calls for efficient healthcare-planning and effective care. Implementing disease-management-programmes is one option for responding to this demand. Knowledge is scarce about the effect of implementation processes and their effect on patients; only few studies have reported the effectiveness of disease-management-programmes targeting patients with chronic obstructive pulmonary disease (COPD). The objective of this paper was to determine the effect on healthcare-utilization of an active implementation model for a disease-management-programme for patients with one of the major multimorbidity diseases, COPD. Methods The standard implementation of a new disease-management-programme for COPD was ongoing during the study-period from November 2008 to November 2010 in the Central Denmark Region. We wanted to test a strategy using Breakthrough Series, academic detailing and lists of patients with COPD. It targeted GPs and three hospitals serving approx. 60,000 inhabitants aged 35 or older and included interventions directed at professionals, organisations and patients. The study was a non-blinded block- and cluster-randomised controlled trial with GP-practices as the unit of randomisation. In Ringkoebing-Skjern Municipality, Denmark, 16 GP-practices involving 38 GPs were randomised to either the intervention-group or the control-group. A comparable neighbouring municipality acted as an external-control-group which included nine GP-practices with 25 GPs. An algorithm based on health-registry-data on lung-related contacts to the healthcare-system identified 2,736 patients who were alive at the end of the study-period. The population included in this study counted 1,372 (69.2%) patients who responded to the baseline questionnaire and confirmed their COPD diagnosis; 458 (33.4%) patients were from the intervention-group, 376 (27.4%) from the control-group and 538(39.2%) from the external-control-group. The primary outcome was adherence to the disease-management-programme measured at patient-level by use of specific services from general practice. Secondary outcomes were use of out-of-hours-services, outpatient-clinic, and emergency-department and hospital-admissions. Results The intervention practices provided more planned preventive consultations, additional preventive consultations and spirometries than non-intervention practices. A comparison of the development in the intervention practices with the development in the control-practices showed that the intervention resulted in more planned preventive-consultations, fewer conventional consultations and fewer patients admitted without a lung-related-diagnosis. Conclusions Use of the active implementation model for the disease-management-programme for COPD changed the healthcare utilization in accordance with the programme. Trial registration Clinicaltrials.gov identifier: NCT01228708. PMID:24090189

The effect of an active implementation of a disease management programme for chronic obstructive pulmonary disease on healthcare utilization--a cluster-randomised controlled trial.

PubMed

Smidth, Margrethe; Christensen, Morten Bondo; Fenger-Grøn, Morten; Olesen, Frede; Vedsted, Peter

2013-10-03

The growing population living with chronic conditions calls for efficient healthcare-planning and effective care. Implementing disease-management-programmes is one option for responding to this demand. Knowledge is scarce about the effect of implementation processes and their effect on patients; only few studies have reported the effectiveness of disease-management-programmes targeting patients with chronic obstructive pulmonary disease (COPD). The objective of this paper was to determine the effect on healthcare-utilization of an active implementation model for a disease-management-programme for patients with one of the major multimorbidity diseases, COPD. The standard implementation of a new disease-management-programme for COPD was ongoing during the study-period from November 2008 to November 2010 in the Central Denmark Region. We wanted to test a strategy using Breakthrough Series, academic detailing and lists of patients with COPD. It targeted GPs and three hospitals serving approx. 60,000 inhabitants aged 35 or older and included interventions directed at professionals, organisations and patients. The study was a non-blinded block- and cluster-randomised controlled trial with GP-practices as the unit of randomisation. In Ringkoebing-Skjern Municipality, Denmark, 16 GP-practices involving 38 GPs were randomised to either the intervention-group or the control-group. A comparable neighbouring municipality acted as an external-control-group which included nine GP-practices with 25 GPs. An algorithm based on health-registry-data on lung-related contacts to the healthcare-system identified 2,736 patients who were alive at the end of the study-period. The population included in this study counted 1,372 (69.2%) patients who responded to the baseline questionnaire and confirmed their COPD diagnosis; 458 (33.4%) patients were from the intervention-group, 376 (27.4%) from the control-group and 538(39.2%) from the external-control-group. The primary outcome was adherence to the disease-management-programme measured at patient-level by use of specific services from general practice. Secondary outcomes were use of out-of-hours-services, outpatient-clinic, and emergency-department and hospital-admissions. The intervention practices provided more planned preventive consultations, additional preventive consultations and spirometries than non-intervention practices. A comparison of the development in the intervention practices with the development in the control-practices showed that the intervention resulted in more planned preventive-consultations, fewer conventional consultations and fewer patients admitted without a lung-related-diagnosis. Use of the active implementation model for the disease-management-programme for COPD changed the healthcare utilization in accordance with the programme. Clinicaltrials.gov identifier: NCT01228708.

NSF-Sponsored Biological and Chemical Oceanography Data Management Office

NASA Astrophysics Data System (ADS)

Allison, M. D.; Chandler, C. L.; Copley, N.; Galvarino, C.; Gegg, S. R.; Glover, D. M.; Groman, R. C.; Wiebe, P. H.; Work, T. T.; Biological; Chemical Oceanography Data Management Office

2010-12-01

Ocean biogeochemistry and marine ecosystem research projects are inherently interdisciplinary and benefit from improved access to well-documented data. Improved data sharing practices are important to the continued exploration of research themes that are a central focus of the ocean science community and are essential to interdisciplinary and international collaborations that address complex, global research themes. In 2006, the National Science Foundation Division of Ocean Sciences (NSF OCE) funded the Biological and Chemical Oceanography Data Management Office (BCO-DMO) to serve the data management requirements of scientific investigators funded by the National Science Foundation’s Biological and Chemical Oceanography Sections. BCO-DMO staff members work with investigators to manage marine biogeochemical, ecological, and oceanographic data and information developed in the course of scientific research. These valuable data sets are documented, stored, disseminated, and protected over short and intermediate time frames. One of the goals of the BCO-DMO is to facilitate regional, national, and international data and information exchange through improved data discovery, access, display, downloading, and interoperability. In May 2010, NSF released a statement to the effect that in October 2010, it is planning to require that all proposals include a data management plan in the form of a two-page supplementary document. The data management plan would be an element of the merit review process. NSF has long been committed to making data from NSF-funded research publicly available and the new policy will strengthen this commitment. BCO-DMO is poised to assist in creating the data management plans and in ultimately serving the data and information resulting from NSF OCE funded research. We will present an overview of the data management system capabilities including: geospatial and text-based data discovery and access systems; recent enhancements to data search tools; data export and download utilities; and strategic use of controlled vocabularies to facilitate data integration and improve interoperability.

Public health agendas addressing violence against rural women - an analysis of local level health services in the State of Rio Grande do Sul, Brazil.

PubMed

da Costa, Marta Cocco; Lopes, Marta Julia Marques; Soares, Joannie dos Santos Fachinelli

2015-05-01

This study analyses health managers' perceptions of local public health agendas addressing violence against rural women in municipalities in the southern part of the State Rio Grande do Sul in Brazil. It consists of an exploratory descriptive study utilizing a qualitative approach. Municipal health managers responsible for planning actions directed at women's health and primary health care were interviewed. The analysis sought to explore elements of programmatic vulnerability related to violence in the interviewees' narratives based on the following dimensions of programmatic vulnerability: expression of commitment, transformation of commitment into action, and planning and coordination. It was found that local health agendas directed at violence against rural women do not exist. Health managers are therefore faced with the challenge of defining lines of action in accordance with the guidelines and principles of the SUS. The repercussions of this situation are expressed in fragile comprehensive services for these women and programmatic vulnerability.

Coming of age: pharmacy practice in the 21st century.

PubMed

Downing, Donald F

2015-01-01

Individuals, families, health plans and governments are struggling with the growing importance of managing chronic, non-communicable diseases. People in many countries are living longer and thus are facing many years of managing hypertension, diabetes and hyperlipidemia - often complicated by obesity, declining physical activity and changing diets. The financial burden this places on governments, employers, and individuals purchasing health care services is growing and solutions are being sought on how to both finance this care and deliver the best care possible. New ideas are emerging that look to newfound resources, and one untapped resource increasingly being utilized is the clinical pharmacist. After many years being primarily involved in medication supply-chain management, the assistance that highly skilled pharmacists can provide medical providers and their patients is now being recognized. In order to realize fully the benefits of clinical pharmacists, governments, health plans and medical providers are taking a second look at the wisdom of maintaining the long-standing policy of compensating pharmacists only for filling prescriptions.

Climate Change and Water Working Group - User Needs to Manage Hydrclimatic Risk from Days to Decades

NASA Astrophysics Data System (ADS)

Raff, D. A.; Brekke, L. D.; Werner, K.; Wood, A.; White, K. D.

2012-12-01

The Federal Climate Change Water Working Group (CCAWWG) provides engineering and scientific collaborations in support of water management. CCAWWG objectives include building working relationships across federal science and water management agencies, provide a forum to share expertise and leverage resources, develop education and training forums, to work with water managers to understand scientific needs and to foster collaborative efforts across the Federal and non-Federal water management and science communities to address those needs. Identifying and addressing water management needs has been categorized across two major time scales: days to a decade and multi-decadal, respectively. These two time periods are termed "Short-Term" and "Long-Term" in terms of the types of water management decisions they support where Short-Term roughly correlates to water management operations and Long-Term roughly correlates to planning activities. This presentation will focus on portraying the identified water management user needs across these two time periods. User Needs for Long-Term planning were identified in the 2011 Reclamation and USACE "Addressing Climate Change in Long-Term Water Resources Planning and Management: User Needs for Improving Tools and Information." User needs for Long-Term planning are identified across eight major categories: Summarize Relevant Literature, Obtain Climate Change Information, Make Decisions About How to Use the Climate Change Information, Assess Natural Systems Response, Assess Socioeconomic and Institutional Response, Assess System Risks and Evaluate Alternatives, Assess and Characterize Uncertainties, and Communicating Results and Uncertainties to Decisionmakers. User Needs for Short-Term operations are focused on needs relative to available or desired monitoring and forecast products from the hydroclimatic community. These needs are presenting in the 2012 USACE, Reclamation, and NOAA - NWS "Short-Term Water Management Decisions: User Needs for Improved Climate, Weather, and Hydrologic Information." Identified needs are presented in four categories: Monitoring, Forecasting, Understanding on Product Relationships and Utilization in Water Management, and Information Services Enterprise. These needs represent everything from continuation and enhancement of in situ monitoring products such as USGS water gages and precipitation networks to supporting product maintenance and evolution to accommodate newly developed technologies.

Patterns of Service Use in Two Types of Managed Behavioral Health Care Plan

PubMed Central

Merrick, Elizabeth Levy; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M.; Azzone, Vanessa; McCann, Bernard; Ritter, Grant; Zolotusky, Galina; McGuire, Thomas G.; Reif, Sharon

2009-01-01

Objective To describe service use patterns by level of care in two managed care products: employee assistance program (EAP) combined with behavioral health benefits, and standard behavioral health benefits. Methods This is a cross-sectional analysis of administrative data for 2004 from a national managed behavioral health care organization (MBHO). Utilization of 11 specific service categories was compared across products. The weighted sample reflected exact matching on sociodemographics (N= 710,014 unweighted; 286,750 weighted). Results In the EAP/behavioral health product,, the proportion of enrollees with outpatient mental health and substance abuse office visits (including EAP) was higher (p<.01), as was substance abuse day treatment/intensive outpatient care (p<.05). Use of residential substance abuse rehabilitation was lower (p<.05). Other differences were also found. Conclusion EAP/behavioral health and standard behavioral health care products had distinct utilization patterns in this large MBHO. In particular, greater use of certain outpatient services was observed within the EAP/behavioral health product. PMID:20044425

Food management behaviours in food-insecure, lone mother-led families.

PubMed

Sim, S Meaghan; Glanville, N Theresa; McIntyre, Lynn

2011-01-01

Little is known about how food is managed in households where food resources are scarce. In this study, the household food management behaviours utilized by food-insecure, lone mother-led families from Atlantic Canada were characterized, and relationships among these behaviours and diet quality were examined. Thematic analysis of 24 in-depth interviews from a larger study of mother-led, low-income families was integrated with sociodemographic characteristics, food-insecurity status, and four weekly 24-hour dietary recalls for all household members to yield a family behaviour score (FBS) as a summative measure of food management behaviours, and a healthy plate score (HPS) as a measure of diet quality. Five distinct food management behaviours were identified: authoritative, healthism, sharing, structured, and planning behaviours. An increase in the FBS was associated with a proportional increase in the HPS. Authoritative, healthism, and planning food management behaviours were the strongest predictors of the HPS for all household members (p<0.05). The structured management behaviour was related to the degree of food insecurity. The FBS and HPS tools hold promise as a way to identify food-insecure families at risk of low diet quality. The next phase of this research will validate the use of these tools in the practice setting.

Population-based worksite obesity management interventions: a qualitative case study.

PubMed

Romney, Martha C; Thomson, Erin; Kash, Kathryn

2011-06-01

Due to the increased prevalence of obesity and associated direct and indirect costs to employers, weight management programs have become an integral component of employer and insurer benefits plans. The programs vary in foci, scope, breadth, and implementation. The aim of this study was to explore promising employer-sponsored population-based obesity management programs. A case study that utilized a telephonic semi-structured questionnaire was conducted with small and large organizations located in different regions of the United States that had been recruited to participate. Eight employers and 1 health care advocacy coalition who met the inclusion criteria were interviewed about features of their weight management programs. The case study revealed a number of themes consistent with reports in the literature and reflecting cited best practices. Key findings include confirmation that weight management is a significant component of the wellness strategy in all participating organizations because employers are invested in population health programs and cost savings. Based upon their experience and knowledge, occupational health specialists are responsible for designing, implementing, managing, and evaluating employee health programs. Almost all employers utilize electronic media as a prominent component of wellness and disease management initiatives. Experience has shown that incentives-both financial and nonmonetary-are effective motivators for employee engagement and outcomes. However, while employers report success, favorable outcomes have been difficult to quantify.

Quasi-experimental trial of diabetes Self-Management Automated and Real-Time Telephonic Support (SMARTSteps) in a Medicaid managed care plan: study protocol.

PubMed

Ratanawongsa, Neda; Handley, Margaret A; Quan, Judy; Sarkar, Urmimala; Pfeifer, Kelly; Soria, Catalina; Schillinger, Dean

2012-01-26

Health information technology can enhance self-management and quality of life for patients with chronic disease and overcome healthcare barriers for patients with limited English proficiency. After a randomized controlled trial of a multilingual automated telephone self-management support program (ATSM) improved patient-centered dimensions of diabetes care in safety net clinics, we collaborated with a nonprofit Medicaid managed care plan to translate research into practice, offering ATSM as a covered benefit and augmenting ATSM to promote medication activation. This paper describes the protocol of the Self-Management Automated and Real-Time Telephonic Support Project (SMARTSteps). This controlled quasi-experimental trial used a wait-list variant of a stepped wedge design to enroll 362 adult health plan members with diabetes who speak English, Cantonese, or Spanish and receive care at 4 publicly-funded clinics. Through language-stratified randomization, participants were assigned to four intervention statuses: SMARTSteps-ONLY, SMARTSteps-PLUS, or wait-list for either intervention. In addition to usual primary care, intervention participants received 27 weekly calls in their preferred language with rotating queries and response-triggered education about self-care, medication adherence, safety concerns, psychological issues, and preventive services. Health coaches from the health plan called patients with out-of-range responses for collaborative goal setting and action planning. SMARTSteps-PLUS also included health coach calls to promote medication activation, adherence and intensification, if triggered by ATSM-reported non-adherence, refill non-adherence from pharmacy claims, or suboptimal cardiometabolic indicators. Wait-list patients crossed-over to SMARTSteps-ONLY or -PLUS at 6 months. For participants who agreed to structured telephone interviews at baseline and 6 months (n = 252), primary outcomes will be changes in quality of life and functional status with secondary outcomes of 6-month changes in self-management behaviors/efficacy and patient-centered processes of care. We will also evaluate 6-month changes in cardiometabolic (HbA1c, blood pressure, and LDL) and utilization indicators for all participants. Outcomes will provide evidence regarding real-world implementation of ATSM within a Medicaid managed care plan serving safety net settings. The evaluation trial will provide insight into translating and scaling up health information technology interventions for linguistically and culturally diverse vulnerable populations with chronic disease. ClinicalTrials.gov: NCT00683020.

Quasi-experimental trial of diabetes Self-Management Automated and Real-Time Telephonic Support (SMARTSteps) in a Medicaid managed care plan: study protocol

PubMed Central

2012-01-01

Background Health information technology can enhance self-management and quality of life for patients with chronic disease and overcome healthcare barriers for patients with limited English proficiency. After a randomized controlled trial of a multilingual automated telephone self-management support program (ATSM) improved patient-centered dimensions of diabetes care in safety net clinics, we collaborated with a nonprofit Medicaid managed care plan to translate research into practice, offering ATSM as a covered benefit and augmenting ATSM to promote medication activation. This paper describes the protocol of the Self-Management Automated and Real-Time Telephonic Support Project (SMARTSteps). Methods/Design This controlled quasi-experimental trial used a wait-list variant of a stepped wedge design to enroll 362 adult health plan members with diabetes who speak English, Cantonese, or Spanish and receive care at 4 publicly-funded clinics. Through language-stratified randomization, participants were assigned to four intervention statuses: SMARTSteps-ONLY, SMARTSteps-PLUS, or wait-list for either intervention. In addition to usual primary care, intervention participants received 27 weekly calls in their preferred language with rotating queries and response-triggered education about self-care, medication adherence, safety concerns, psychological issues, and preventive services. Health coaches from the health plan called patients with out-of-range responses for collaborative goal setting and action planning. SMARTSteps-PLUS also included health coach calls to promote medication activation, adherence and intensification, if triggered by ATSM-reported non-adherence, refill non-adherence from pharmacy claims, or suboptimal cardiometabolic indicators. Wait-list patients crossed-over to SMARTSteps-ONLY or -PLUS at 6 months. For participants who agreed to structured telephone interviews at baseline and 6 months (n = 252), primary outcomes will be changes in quality of life and functional status with secondary outcomes of 6-month changes in self-management behaviors/efficacy and patient-centered processes of care. We will also evaluate 6-month changes in cardiometabolic (HbA1c, blood pressure, and LDL) and utilization indicators for all participants. Discussion Outcomes will provide evidence regarding real-world implementation of ATSM within a Medicaid managed care plan serving safety net settings. The evaluation trial will provide insight into translating and scaling up health information technology interventions for linguistically and culturally diverse vulnerable populations with chronic disease. Trial Registration ClinicalTrials.gov: NCT00683020 PMID:22280514

PLAN: a web platform for automating high-throughput BLAST searches and for managing and mining results.

PubMed

He, Ji; Dai, Xinbin; Zhao, Xuechun

2007-02-09

BLAST searches are widely used for sequence alignment. The search results are commonly adopted for various functional and comparative genomics tasks such as annotating unknown sequences, investigating gene models and comparing two sequence sets. Advances in sequencing technologies pose challenges for high-throughput analysis of large-scale sequence data. A number of programs and hardware solutions exist for efficient BLAST searching, but there is a lack of generic software solutions for mining and personalized management of the results. Systematically reviewing the results and identifying information of interest remains tedious and time-consuming. Personal BLAST Navigator (PLAN) is a versatile web platform that helps users to carry out various personalized pre- and post-BLAST tasks, including: (1) query and target sequence database management, (2) automated high-throughput BLAST searching, (3) indexing and searching of results, (4) filtering results online, (5) managing results of personal interest in favorite categories, (6) automated sequence annotation (such as NCBI NR and ontology-based annotation). PLAN integrates, by default, the Decypher hardware-based BLAST solution provided by Active Motif Inc. with a greatly improved efficiency over conventional BLAST software. BLAST results are visualized by spreadsheets and graphs and are full-text searchable. BLAST results and sequence annotations can be exported, in part or in full, in various formats including Microsoft Excel and FASTA. Sequences and BLAST results are organized in projects, the data publication levels of which are controlled by the registered project owners. In addition, all analytical functions are provided to public users without registration. PLAN has proved a valuable addition to the community for automated high-throughput BLAST searches, and, more importantly, for knowledge discovery, management and sharing based on sequence alignment results. The PLAN web interface is platform-independent, easily configurable and capable of comprehensive expansion, and user-intuitive. PLAN is freely available to academic users at http://bioinfo.noble.org/plan/. The source code for local deployment is provided under free license. Full support on system utilization, installation, configuration and customization are provided to academic users.

POLARIS: Agent-based modeling framework development and implementation for integrated travel demand and network and operations simulations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Auld, Joshua; Hope, Michael; Ley, Hubert

This paper discusses the development of an agent-based modelling software development kit, and the implementation and validation of a model using it that integrates dynamic simulation of travel demand, network supply and network operations. A description is given of the core utilities in the kit: a parallel discrete event engine, interprocess exchange engine, and memory allocator, as well as a number of ancillary utilities: visualization library, database IO library, and scenario manager. The overall framework emphasizes the design goals of: generality, code agility, and high performance. This framework allows the modeling of several aspects of transportation system that are typicallymore » done with separate stand-alone software applications, in a high-performance and extensible manner. The issue of integrating such models as dynamic traffic assignment and disaggregate demand models has been a long standing issue for transportation modelers. The integrated approach shows a possible way to resolve this difficulty. The simulation model built from the POLARIS framework is a single, shared-memory process for handling all aspects of the integrated urban simulation. The resulting gains in computational efficiency and performance allow planning models to be extended to include previously separate aspects of the urban system, enhancing the utility of such models from the planning perspective. Initial tests with case studies involving traffic management center impacts on various network events such as accidents, congestion and weather events, show the potential of the system.« less

Improving sand and gravel utilization and land-use planning. - 3D-modelling gravel resources with geospatial data.

NASA Astrophysics Data System (ADS)

Rolstad Libach, Lars; Wolden, Knut; Dagestad, Atle; Eskil Larsen, Bjørn

2017-04-01

The Norwegian aggregate industry produces approximately 14 million tons of sand and gravel aggregates annually to a value of approximately 100 million Euros. Utilization of aggregates are often linked to land-use conflicts and complex environmental impacts at the extraction site. These topics are managed on a local municipal level in Norway. The Geological Survey of Norway has a database and a web map service with information about sand and gravel deposits with considerable volumes and an importance evaluation. Some of the deposits covers large areas where the land-use conflicts are high. To ease and improve land-use planning, safeguard other important resources like groundwater and sustainable utilization of sand and gravel resources - there is a need for more detailed information of already mapped important resources. Detailed 3D-models of gravel deposits is a tool for a better land-use- and resource management. By combining seismic, GPR and resistivity geophysical profile data, borehole data, quaternary maps and lidar surface data, it has been possible to make 3D-models of deposits and to further research the possibilities for distinguishing different qualities and volumes. Good datasets and a detailed resource map is a prerequisite to assess geological resources for planners, extractors and neighbours. Future challenges lies in use of, often old, geophysical data, and combining these. What kind of information is it possible to grasp from depth-data that actually argues for a more detailed delineation of resources?

Developing a PPO: challenges and benefits.

PubMed

Range, R P

1984-12-01

When deciding upon which kind of alternative delivery system to develop, Saint Vincent Charity Hospital and Health Center, Cleveland, selected the preferred provider organization (PPO) mode because of four basic advantages: (1) the health care consumer's freedom to choose providers; (2) effective cost containment; (3) coordination of services among allied providers; and (4) health promotion programs. More specifically, the Ohio Health Choice Plan (OHCP) benefits hospitals by assisting to maintain or increase market share, facilitating prompt claims payments, and improving financial mix. Physicians benefit not only because they receive prompt payment and are not a risk but also because the fee-for-service system is retained and their market shares can also be preserved or enhanced. Employers' advantages include savings through controlled utilization, positive employee relations, and improved management information. Employees' benefits include lower out-of-pocket costs and freedom of choice. As a full-service PPO, the organization provides benefits plans designed to meet each employer's needs as well as actuary services, claims screening and processing, benefits coordination, utilization control, management reporting, health promotion activities, and networking capabilities. Four major challenges do confront PPOs: 1. Start-up and operating costs can be significant; 2. The administrative skills required are different from those used in traditional health care systems; 3. The commitment in implementing and operating a PPO; and 4. All participating providers must genuinely accept the PPO. A PPO's success also can be measured in three ways: the development of a strong network; size of enrollment; and effectiveness in utilization control.(ABSTRACT TRUNCATED AT 250 WORDS)

GIS based solid waste management information system for Nagpur, India.

PubMed

Vijay, Ritesh; Jain, Preeti; Sharma, N; Bhattacharyya, J K; Vaidya, A N; Sohony, R A

2013-01-01

Solid waste management is one of the major problems of today's world and needs to be addressed by proper utilization of technologies and design of effective, flexible and structured information system. Therefore, the objective of this paper was to design and develop a GIS based solid waste management information system as a decision making and planning tool for regularities and municipal authorities. The system integrates geo-spatial features of the city and database of existing solid waste management. GIS based information system facilitates modules of visualization, query interface, statistical analysis, report generation and database modification. It also provides modules like solid waste estimation, collection, transportation and disposal details. The information system is user-friendly, standalone and platform independent.

Strategies for positioning in the managed health care marketplace.

PubMed

Cohn, R

1994-01-01

Managed health care is becoming increasingly common as the demands of cost containment are placed on providers of care. This article defines managed health care, illustrates its continued growth, demonstrates its effect on clinical decision making and reimbursement issues, and suggests strategies for optimal positioning in the managed care marketplace. The hand therapy specialist, whether based in a hospital, an institution-based ambulatory care setting, or a private practice, must be aware of a managed plan's contractual limitations. Parameters discussed are patient length of stay, documentation, reimbursement, patient responsibility, alternatives to conventional treatment protocols, and the potential effects of utilization review on patient treatment. A heightened awareness of managed health care is critical for the manager and practitioner, especially because national health care reform is on the horizon. A provider must be well prepared to ensure delivery of quality care within the myriad restrictions imposed by managed care regulations.

Mapping fire regimes from data you may already have: assessing LANDFIRE fire regime maps using local products

Treesearch

Melissa A. Thomas-Van Gundy

2014-01-01

LANDFIRE maps of fire regime groups are frequently used by land managers to help plan and execute prescribed burns for ecosystem restoration. Since LANDFIRE maps are generally applicable at coarse scales, questions often arise regarding their utility and accuracy. Here, the two recently published products from West Virginia, a rule-based and a witness tree-based model...

A Study of Placing Army Requirements on Contract

DTIC Science & Technology

2016-04-01

perhaps being unable to control the external environment, has management authority over business and technical aspects of a specific program. The PM...research is the last element of the planning phase addressing both business and technical considerations. The acquisition team equips themselves with...report is the final product utilizing documented findings and supports the business strategy (DoD, Guidebook for the Acquisition of Services, 2011

LOGMIS Programmed Texts, Tests and Answers.

DTIC Science & Technology

1979-04-01

This publication contains the programmed text and related test and answer booklets produced to teach field users correct procedures for utilization of the Army’s Logistics Management Information System (LOGMIS). It was prepared by ARINC Research Corporation under Contract DAEA18-77-C-0184 for the Logistics Evaluation Branch, Plans and Programs Division of the Assistant Chief of Staff for Logistics, U.S. Army Communications Command. (Author)

PUREX/UO{sub 3} deactivation project management plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

Washenfelder, D.J.

1993-12-01

From 1955 through 1990, the Plutonium-Uranium Extraction Plant (PUREX) provided the United States Department of Energy Hanford Site with nuclear fuel reprocessing capability. It operated in sequence with the Uranium Trioxide (UO{sub 3}) Plant, which converted the PUREX liquid uranium nitrate product to solid UO{sub 3} powder. Final UO{sub 3} Plant operation ended in 1993. In December 1992, planning was initiated for the deactivation of PUREX and UO{sub 3} Plant. The objective of deactivation planning was to identify the activities needed to establish a passively safe, environmentally secure configuration at both plants, and ensure that the configuration could be retainedmore » during the post-deactivation period. The PUREX/UO{sub 3} Deactivation Project management plan represents completion of the planning efforts. It presents the deactivation approach to be used for the two plants, and the supporting technical, cost, and schedule baselines. Deactivation activities concentrate on removal, reduction, and stabilization of the radioactive and chemical materials remaining at the plants, and the shutdown of the utilities and effluents. When deactivation is completed, the two plants will be left unoccupied and locked, pending eventual decontamination and decommissioning. Deactivation is expected to cost $233.8 million, require 5 years to complete, and yield $36 million in annual surveillance and maintenance cost savings.« less

Developing team leadership to facilitate guideline utilization: planning and evaluating a 3-month intervention strategy.

PubMed

Gifford, Wendy; Davies, Barbara; Tourangeau, Ann; Lefebre, Nancy

2011-01-01

Research describes leadership as important to guideline use. Yet interventions to develop current and future leaders for this purpose are not well understood. To describe the planning and evaluation of a leadership intervention to facilitate nurses' use of guideline recommendations for diabetic foot ulcers in home health care. Planning the intervention involved a synthesis of theory and research (qualitative interviews and chart audits). One workshop and three follow-up teleconferences were delivered at two sites to nurse managers and clinical leaders (n=15) responsible for 180 staff nurses. Evaluation involved workshop surveys and interviews. Highest rated intervention components (four-point scale) were: identification of target indicators (mean 3.7), and development of a team leadership action plan (mean 3.5). Pre-workshop barriers assessment rated lowest (mean 2.9). Three months later participants indicated their leadership performance had changed as a result of the intervention, being more engaged with staff and clear about implementation goals. Creating a team leadership action plan to operationalize leadership behaviours can help in delivery of evidence-informed care. Access to clinical data and understanding team leadership knowledge and skills prior to formal training will assist nursing management in tailoring intervention strategies to identify needs and gaps. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

Stochastic optimal generation bid to electricity markets with emissions risk constraints.

PubMed

Heredia, F-Javier; Cifuentes-Rubiano, Julián; Corchero, Cristina

2018-02-01

There are many factors that influence the day-ahead market bidding strategies of a generation company (GenCo) within the framework of the current energy market. Environmental policy issues are giving rise to emission limitation that are becoming more and more important for fossil-fueled power plants, and these must be considered in their management. This work investigates the influence of the emissions reduction plan and the incorporation of the medium-term derivative commitments in the optimal generation bidding strategy for the day-ahead electricity market. Two different technologies have been considered: the high-emission technology of thermal coal units and the low-emission technology of combined cycle gas turbine units. The Iberian Electricity Market (MIBEL) and the Spanish National Emissions Reduction Plan (NERP) defines the environmental framework for dealing with the day-ahead market bidding strategies. To address emission limitations, we have extended some of the standard risk management methodologies developed for financial markets, such as Value-at-Risk (VaR) and Conditional Value-at-Risk (CVaR), thus leading to the new concept of Conditional Emission at Risk (CEaR). This study offers electricity generation utilities a mathematical model for determining the unit's optimal generation bid to the wholesale electricity market such that it maximizes the long-term profits of the utility while allowing it to abide by the Iberian Electricity Market rules as well as the environmental restrictions set by the Spanish National Emissions Reduction Plan. We analyze the economic implications for a GenCo that includes the environmental restrictions of this National Plan as well as the NERP's effects on the expected profits and the optimal generation bid. Copyright © 2017 Elsevier Ltd. All rights reserved.

Survivorship care planning in skin cancer: An unbiased statistical approach to identifying patterns of care-plan use.

PubMed

Benci, Joseph L; Minn, Andy J; Vachani, Carolyn C; Bach, Christina; Arnold-Korzeniowski, Karen; Hampshire, Margaret K; Metz, James M; Hill-Kayser, Christine E

2018-01-01

Nearly 1 in 5 Americans will develop skin cancer, and as a result, survivors of skin cancer compose one of the largest groups of cancer survivors. Survivorship care plans (SCPs) are an important tool for improving patient outcomes and provide critical information to both survivors and health care professionals. Recent efforts have been made to expand SCP utilization; however, which patients currently receive SCPs is poorly understood. This study used 596 individuals with a diagnosis of melanoma (n = 391) or nonmelanoma skin cancer (n = 205) who had used an Internet-based SCP tool from May 2010 to December 2016 to model the patient and provider characteristics that determine SCP utilization. Survivors were predominantly white (95.3%) and female (56.5%). Survivors who received a treatment summary were more likely to also receive an SCP. University and nonuniversity cancer centers used SCPs at a higher rate than other care settings. Survivors whose care was managed by a team rather than just an individual physician were also more likely to receive an SCP. Survivors older than 70 years at diagnosis were almost twice as likely to receive a plan as survivors who were diagnosed at a younger age. With a convenience sample of skin cancer survivors, it is possible to model factors that predict the receipt of SCPs. Important variables include the diagnosis age, treatment setting, physician type, and treatment-summary utilization. A closer examination of these variables identified several disparities in care-plan use and, therefore, opportunities to improve the distribution of SCPs. Further validation in additional cohorts of survivors is necessary to confirm these conclusions. Cancer 2018;124:183-91. © 2017 American Cancer Society. © 2017 American Cancer Society.

Tube Maps for Effective Geoscience Career Planning and Development

NASA Astrophysics Data System (ADS)

Keane, C. M.; Wilson, C. E.; Houlton, H. R.

2013-12-01

One of the greatest challenges faced by students and new graduates is the advice that they must take charge of their own career planning. This is ironic as new graduates are least prepared to understand the full spectrum of options and the potential pathways to meeting their personal goals. We will examine the rationale, tools, and utility of an approach aimed at assisting individuals in career planning nicknamed a "tube map." In particular, this approach has been used in support of geoscientist recruitment and career planning in major European energy companies. By utilizing information on the occupational sequences of geoscience professionals within an organization or a community, a student or new hire can quickly understand the proven pathways towards their eventual career goals. The tube map visualizes the career pathways of individuals in the form of a subway map, with specific occupations represented as "stations" and pathway interconnections represented as "transfers." The major application of this approach in the energy sector was to demonstrate both the logical career pathways to either senior management or senior technical positions, as well as present the reality that time must be invested in "lower level" jobs, thereby nullifying a persistent overinflated sense of the speed of upward mobility. To this end, we have run a similar occupational analysis on several geoscience employers, including one with somewhat non-traditional geoscience positions and another that would be considered a very traditional employer. We will examine the similarities and differences between the resulting 'tube maps,' critique the tools used to create the maps, and assess the utility of the product in career development planning for geoscience students and new hires.

Risk Management and Adaptation Transition Mechanisms and Pathways in New York City

NASA Astrophysics Data System (ADS)

Link, H. D.

2016-12-01

Understanding the values that drive current decision-making is essential to effective management of critical urban infrastructure. As urban infrastructure becomes increasingly interconnected, risks in one sector can translate to citywide risk in the flash of a photon or the blink of an eye. Approaches and goals of risk management vary across geographies. Administrators and residents attempt to reduce vulnerability to hazards and limit the scope of disasters in different ways in different contexts. Public and personal risk management decision making regimes are complex and often shifting. While the overarching goal is to try to reduce the level of risk faced by stakeholders in a particular locale, the conditions and changing character of local risk management decisions are affected by physical, economic and social factors. Opportunities for meaningful action are found at this nexus. To illuminate this nexus, this paper provides a detailed discussion and analysis of the New York City risk management regime and its trajectory as defined by local experts. The risk focus of the analysis is storm surge and flooding, and heat stress. The analysis examines the factors that enable movement and transition between different adaptive regimes, and on factors that support lock-in of current regime status The research utilizes a risk management framework based on four policy states developed for the Transformation and Resilience in the Urban Coast (TRUC) project (Solecki et al. 2016). "Collapse"; a state where there is no strategic risk planning; "Resistance"; risk planning that is directed at stability and aims at protecting current development pathways; "Resilience"; flexible planning that aims at introducing some changes to maintain current development, and "Transformation"; planning for fundamental changes in risk management including changing development choices and paths to accommodate uncertainty and future risk scenarios. (Solecki et al. 2016). To examine the risk management approach in New York City and the conditions for transition researchers gathered primary data - the results of an interactive risk management pathways workshop held in New York City and follow on, face-to-face interviews with local risk managers and stakeholders.

Patient population management: taking the leap from variance analysis to outcomes measurement.

PubMed

Allen, K M

1998-01-01

Case managers today at BCHS have a somewhat different role than at the onset of the Collaborative Practice Model. They are seen throughout the organization as: Leaders/participants on cross-functional teams. Systems change agents. Integrating/merging with quality services and utilization management. Outcomes managers. One of the major cross-functional teams is in the process of designing a Care Coordinator role. These individuals will, as one of their functions, assume responsibility for daily patient care management activities. A variance tracking program has come into the Utilization Management (UM) department as part of a software package purchased to automate UM work activities. This variance program could potentially be used by the new care coordinators as the role develops. The case managers are beginning to use a Decision Support software, (Transition Systems Inc.) in the collection of data that is based on a cost accounting system and linked to clinical events. Other clinical outcomes data bases are now being used by the case manager to help with the collection and measurement of outcomes information. Hoshin planning will continue to be a framework for defining and setting the targets for clinical and financial improvements throughout the organization. Case managers will continue to be involved in many of these system-wide initiatives. In the words of Galileo, 1579, "You need to count what's countable, measure what's measurable, and what's not measurable, make measurable."

Health and Safety Plan for Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee. Environmental Restoration Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Van Hoesen, S.D.; Clark, C. Jr.; Burman, S.N.

1993-12-01

The Martin Marietta Energy Systems, Inc. (Energy Systems), policy is to provide a safe and healthful workplace for all employees and subcontractors. The accomplishment of this policy requires that operations at Waste Area Grouping (WAG) 6 at the Department of Energy (DOE) Oak Ridge National Laboratory are guided by an overall plan and consistent proactive approach to safety and health (S&H) issues. The plan is written to utilize past experience and best management practices to minimize hazards to human health or the environment from events such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactivemore » materials to air, soil, or surface water This plan explains additional site-specific health and safety requirements such as Site Specific Hazards Evaluation Addendums (SSHEAs) to the Site Safety and Health Plan which should be used in concert with this plan and existing established procedures.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

The report is an overview of electric energy efficiency programs. It takes a concise look at what states are doing to encourage energy efficiency and how it impacts electric utilities. Energy efficiency programs began to be offered by utilities as a response to the energy crises of the 1970s. These regulatory-driven programs peaked in the early-1990s and then tapered off as deregulation took hold. Today, rising electricity prices, environmental concerns, and national security issues have renewed interest in increasing energy efficiency as an alternative to additional supply. In response, new methods for administering, managing, and delivering energy efficiency programs aremore » being implemented. Topics covered in the report include: Analysis of the benefits of energy efficiency and key methods for achieving energy efficiency; evaluation of the business drivers spurring increased energy efficiency; Discussion of the major barriers to expanding energy efficiency programs; evaluation of the economic impacts of energy efficiency; discussion of the history of electric utility energy efficiency efforts; analysis of the impact of energy efficiency on utility profits and methods for protecting profitability; Discussion of non-utility management of energy efficiency programs; evaluation of major methods to spur energy efficiency - systems benefit charges, resource planning, and resource standards; and, analysis of the alternatives for encouraging customer participation in energy efficiency programs.« less

42 CFR 456.201 - UR plan required for inpatient mental hospital services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false UR plan required for inpatient mental hospital... HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Utilization Review (ur) Plan: General Requirements § 456.201 UR plan required for...

Human resource development for nuclear generation - from the perspective of a utility company

NASA Astrophysics Data System (ADS)

Kahar, Wan Shakirah Wan Abdul; Mostafa, Nor Azlan; Salim, Mohd Faiz

2017-01-01

Malaysia is currently in the planning phase of its nuclear power program, with the first unit targeted to be operational in 2030. Training of nuclear power plant (NPP) staffs are usually long and rigorous due to the complexity and safety aspects of nuclear power. As the sole electricity utility in the country, it is therefore essential that Tenaga Nasional Berhad (TNB) prepares early in developing its human resource and nuclear expertise as a potential NPP owner-operator. A utility also has to be prudent in managing its work force efficiently and effectively, while ensuring that adequate preparations are being made to acquire the necessary nuclear knowledge with sufficient training lead time. There are several approaches to training that can be taken by a utility company with no experience in nuclear power. These include conducting feasibility studies and benchmarking exercises, preparing long term human resource development, increasing the exposure on nuclear power technology to both the top management and general staff, and employing the assistance of relevant agencies locally and abroad. This paper discusses the activities done and steps taken by TNB in its human resource development for Malaysia's nuclear power program.

Wind Tunnel Management and Resource Optimization: A Systems Modeling Approach

NASA Technical Reports Server (NTRS)

Jacobs, Derya, A.; Aasen, Curtis A.

2000-01-01

Time, money, and, personnel are becoming increasingly scarce resources within government agencies due to a reduction in funding and the desire to demonstrate responsible economic efficiency. The ability of an organization to plan and schedule resources effectively can provide the necessary leverage to improve productivity, provide continuous support to all projects, and insure flexibility in a rapidly changing environment. Without adequate internal controls the organization is forced to rely on external support, waste precious resources, and risk an inefficient response to change. Management systems must be developed and applied that strive to maximize the utility of existing resources in order to achieve the goal of "faster, cheaper, better". An area of concern within NASA Langley Research Center was the scheduling, planning, and resource management of the Wind Tunnel Enterprise operations. Nine wind tunnels make up the Enterprise. Prior to this research, these wind tunnel groups did not employ a rigorous or standardized management planning system. In addition, each wind tunnel unit operated from a position of autonomy, with little coordination of clients, resources, or project control. For operating and planning purposes, each wind tunnel operating unit must balance inputs from a variety of sources. Although each unit is managed by individual Facility Operations groups, other stakeholders influence wind tunnel operations. These groups include, for example, the various researchers and clients who use the facility, the Facility System Engineering Division (FSED) tasked with wind tunnel repair and upgrade, the Langley Research Center (LaRC) Fabrication (FAB) group which fabricates repair parts and provides test model upkeep, the NASA and LARC Strategic Plans, and unscheduled use of the facilities by important clients. Expanding these influences horizontally through nine wind tunnel operations and vertically along the NASA management structure greatly increases the complexity of developing a model that can be used for successfully implementing a standardized management planning tool. The objective of this study was to implement an Integrated Wind Tunnel Planning System to improve the operations within the aeronautics testing and research group, in particular Wind Tunnel Enterprise. The study included following steps: Conducted literature search and expert discussions (NASA and Old Dominion University faculty), Performed environmental scan of NASA Langley wind tunnel operations as foundation for problem definition. Established operation requirements and evaluation methodologies. Examined windtunnel operations to map out the common characteristics, critical components, and system structure. Reviewed and evaluated various project scheduling and management systems for implementation, Evaluated and implemented "Theory of Constraints (TOC)" project scheduling methodology at NASA Langley wind tunnel operations together with NASA staff.

Strategies to reduce nonurgent emergency department use: experience of a Northern Virginia Employer Group.

PubMed

DeVries, Andrea; Li, Chia-Hsuan; Oza, Manish

2013-03-01

This administrative claims analysis evaluated the impact of a health plan-sponsored Emergency Room Utilization Management Initiative (ERUMI), which combined increased patient copays for ED visits with educational outreach to reduce inappropriate ED use and encourage use of retail health clinics (RHCs) and other alternative treatment sites among a commercially insured population. Emergency department (ED) utilization rates for select acute but nonurgent conditions that could be treated appropriately in an RHC were compared for members of an employer group with (intervention group) and without (comparators) ERUMI. Utilization was compared for baseline period (January-June 2009) and ERUMI implementation period (January-June 2010). A total of 56,896 members (14,224 intervention, 42,672 matched comparators) were included. ED utilization for conditions that could be treated appropriately by RHCs decreased by 10.39 visits/1000 members in the intervention group versus 6.29 visits in comparators. RHC visits rose for both the groups, with a greater increase in the intervention group (22.61 visits/1000 members, P<0.001) versus comparison (1.64/1000, P=0.064). After ERUMI implementation, intervention group members were nearly 5 times more likely than comparators to choose RHCs over ED for nonurgent care. The health plan-sponsored ERUMI program, consisting of both financial and educational components, decreased nonurgent ED utilization while increasing the use of alternative treatment sites.

Aggregate modeling of fast-acting demand response and control under real-time pricing

DOE PAGES

Chassin, David P.; Rondeau, Daniel

2016-08-24

This paper develops and assesses the performance of a short-term demand response (DR) model for utility load control with applications to resource planning and control design. Long term response models tend to underestimate short-term demand response when induced by prices. This has two important consequences. First, planning studies tend to undervalue DR and often overlook its benefits in utility demand management program development. Second, when DR is not overlooked, the open-loop DR control gain estimate may be too low. This can result in overuse of load resources, control instability and excessive price volatility. Our objective is therefore to develop amore » more accurate and better performing short-term demand response model. We construct the model from first principles about the nature of thermostatic load control and show that the resulting formulation corresponds exactly to the Random Utility Model employed in economics to study consumer choice. The model is tested against empirical data collected from field demonstration projects and is shown to perform better than alternative models commonly used to forecast demand in normal operating conditions. Finally, the results suggest that (1) existing utility tariffs appear to be inadequate to incentivize demand response, particularly in the presence of high renewables, and (2) existing load control systems run the risk of becoming unstable if utilities close the loop on real-time prices.« less

Aggregate modeling of fast-acting demand response and control under real-time pricing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chassin, David P.; Rondeau, Daniel

This paper develops and assesses the performance of a short-term demand response (DR) model for utility load control with applications to resource planning and control design. Long term response models tend to underestimate short-term demand response when induced by prices. This has two important consequences. First, planning studies tend to undervalue DR and often overlook its benefits in utility demand management program development. Second, when DR is not overlooked, the open-loop DR control gain estimate may be too low. This can result in overuse of load resources, control instability and excessive price volatility. Our objective is therefore to develop amore » more accurate and better performing short-term demand response model. We construct the model from first principles about the nature of thermostatic load control and show that the resulting formulation corresponds exactly to the Random Utility Model employed in economics to study consumer choice. The model is tested against empirical data collected from field demonstration projects and is shown to perform better than alternative models commonly used to forecast demand in normal operating conditions. Finally, the results suggest that (1) existing utility tariffs appear to be inadequate to incentivize demand response, particularly in the presence of high renewables, and (2) existing load control systems run the risk of becoming unstable if utilities close the loop on real-time prices.« less

Aggregate modeling of fast-acting demand response and control under real-time pricing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chassin, David P.; Rondeau, Daniel

This paper develops and assesses the performance of a short-term demand response (DR) model for utility load control with applications to resource planning and control design. Long term response models tend to underestimate short-term demand response when induced by prices. This has two important consequences. First, planning studies tend to undervalue DR and often overlook its benefits in utility demand management program development. Second, when DR is not overlooked, the open-loop DR control gain estimate may be too low. This can result in overuse of load resources, control instability and excessive price volatility. Our objective is therefore to develop amore » more accurate and better performing short-term demand response model. We construct the model from first principles about the nature of thermostatic load control and show that the resulting formulation corresponds exactly to the Random Utility Model employed in economics to study consumer choice. The model is tested against empirical data collected from field demonstration projects and is shown to perform better than alternative models commonly used to forecast demand in normal operating conditions. The results suggest that (1) existing utility tariffs appear to be inadequate to incentivize demand response, particularly in the presence of high renewables, and (2) existing load control systems run the risk of becoming unstable if utilities close the loop on real-time prices.« less

42 CFR 456.200 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Mental Hospitals Utilization Review (ur) Plan... requirements for a written utilization review (UR) plan for each mental hospital providing Medicaid services...

Assessment of disaster preparedness among emergency departments in Italian hospitals: a cautious warning for disaster risk reduction and management capacity.

PubMed

Paganini, Matteo; Borrelli, Francesco; Cattani, Jonathan; Ragazzoni, Luca; Djalali, Ahmadreza; Carenzo, Luca; Della Corte, Francesco; Burkle, Frederick M Jr; Ingrassia, Pier Luigi

2016-08-15

Since the 1990s, Italian hospitals are required to comply with emergency disaster plans known as Emergency Plan for Massive Influx of Casualties. While various studies reveal that hospitals overall suffer from an insufficient preparedness level, the aim of this study was to better determine the preparedness level of Emergency Departments of Italian hospitals by assessing the knowledge-base of emergency physicians regarding basic disaster planning and procedures. A prospective observational study utilized a convenience sample of Italian Emergency Departments identified from the Italian Ministry of Health website. Anonymous telephone interviews were conducted of medical consultants in charge at the time in the respective Emergency Departments, and were structured in 3 parts: (1) general data and demographics, (2) the current disaster plan and (3) protocols and actions of the disaster plan. Eighty-five Emergency Departments met inclusion criteria, and 69 (81 %) agreed to undergo the interview. Only 45 % of participants declared to know what an Emergency Plan for Massive Influx of Casualties is, 41 % believed to know who has the authority to activate the plan, 38 % knew who is in charge of intra-hospital operations. In Part 3 physicians revealed a worrisome inconsistency in critical content knowledge of their answers. Results demonstrate a poor knowledge-base of basic hospital disaster planning concepts by Italian Emergency Department physicians-on-duty. These findings should alert authorities to enhance staff disaster preparedness education, training and follow-up to ensure that these plans are known to all who have responsibility for disaster risk reduction and management capacity.

Health and safety plan for the Environmental Restoration Program at Oak Ridge National Laboratory

DOE Office of Scientific and Technical Information (OSTI.GOV)

Clark, C. Jr.; Burman, S.N.; Cipriano, D.J. Jr.

1994-08-01

This Programmatic Health and Safety plan (PHASP) is prepared for the U.S. Department of Energy (DOE) Oak Ridge National Laboratory (ORNL) Environmental Restoration (ER) Program. This plan follows the format recommended by the U.S. Environmental Protection Agency (EPA) for remedial investigations and feasibility studies and that recommended by the EM40 Health and Safety Plan (HASP) Guidelines (DOE February 1994). This plan complies with the Occupational Safety and Health Administration (OSHA) requirements found in 29 CFR 1910.120 and EM-40 guidelines for any activities dealing with hazardous waste operations and emergency response efforts and with OSHA requirements found in 29 CFR 1926.65.more » The policies and procedures in this plan apply to all Environmental Restoration sites and activities including employees of Energy Systems, subcontractors, and prime contractors performing work for the DOE ORNL ER Program. The provisions of this plan are to be carried out whenever activities are initiated that could be a threat to human health or the environment. This plan implements a policy and establishes criteria for the development of procedures for day-to-day operations to prevent or minimize any adverse impact to the environment and personnel safety and health and to meet standards that define acceptable management of hazardous and radioactive materials and wastes. The plan is written to utilize past experience and best management practices to minimize hazards to human health and safety and to the environment from event such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactive materials to air, soil, or surface water.« less

Implementing a voluntary, nonregulatory approach to nitrogen management in Tampa Bay, FL: a public/private partnership.

PubMed

Greening, H; DeGrove, B D

2001-11-14

Participants in the Tampa Bay Estuary Program have agreed to adopt nitrogen-loading targets for Tampa Bay based on the water-quality and related light requirements of underwater seagrasses. Based on modeling results, it appears that light levels can be maintained at necessary levels by "holding the line" at existing nitrogen loadings; however, this goal may be difficult to achieve given the 20% increase in the watershed"s human population and associated 7% increase in nitrogen loading that are projected to occur over the next 20 years. To address the long-term management of nitrogen sources, a nitrogen management consortium of local electric utilities, industries, and agricultural interests, as well as local governments and regulatory agency representatives, has developed a consortium action plan to address the target load reduction needed to "hold the line" at 1992 to 1994 levels. To date, implemented and planned projects collated in the Consortium Action Plan meet and exceed the agreed-upon nitrogen-loading reduction goal. An example of the success of the private partnership aspect of this program can be seen in three phosphate fertilizer mining and manufacturing companies with facilities located on Tampa Bay. These companies are participants in the Estuary Program and the Nitrogen Management Consortium to provide support and input for a program that advocates voluntary, nonregulatory cooperation to reach environmental goals.