Final year projects (Baccalaureus Theses) (Industrial Engineering)

Permanent URI for this collection

https://scholar.sun.ac.za/handle/10019.1/17402

Browse

Browsing Final year projects (Baccalaureus Theses) (Industrial Engineering) by browse.metadata.advisor "Van Dyk, L."

Now showing 1 - 6 of 6
  • Thumbnail Image
    Item
    An assessment of the implementation of teleradiology in the Eastern Cape towards the enhanced utilisation of the system
    (Stellenbosch : Stellenbosch University, 2010-12) Hauman, Charlotte; Van Dyk, L.; Stellenbosch University. Faculty of Engineering. Dept. of Industrial Engineering.
    ENGLISH ABSTRACT: Telemedicine is the use of communication and information technology (ICT) to enable the delivery of specialised health care services. In a developing country like South Africa where there is a shortage of medical specialists, telemedicine is an innovative tool that can contribute to the equitable distribution of resources such as specialist knowledge. The problem is that the past decade has seen numerous telemedicine initiatives being introduced in the country, with little sustainability and low utilisation rates. The initiatives being introduced need to be monitored and evaluated to ensure the sustained implementation and complete adoption of the telemedicine systems in the country. This project focuses on a specific South African telemedicine initiative, the teleradiology system in the Eastern Cape province, with the purpose to provide an assessment of the implementation of the system and a framework towards the enhanced utilisation of the system. Literature is studied comprehensively to find a broad perspective on the factors involved when teleradiology is implemented. Four barriers to the sustained implementation of teleradiology are identified, namely technological, organisational, behavioural and economical barriers. These barriers are discussed with regard to the literature and then the broad perspective is narrowed by applying the literature to various aspects of the Eastern Cape system. This application follows a visit as part of a project team from the Medical Research Council of South Africa and the University of Stellenbosch in June 2010 to monitor and evaluate telemedicine in the Eastern Cape. Research was done using surveys, interviews and observations and valuable exposure to the system was obtained. The four implementation barriers and examples of the Eastern Cape system are integrated into a discussion of the entire teleradiology system. The assessment of the system is concluded with an engineering view point of providing an alternative solution and the evaluation of alternatives. It is anticipated that the project will contribute to the available literature on the sustained implementation of teleradiology and telemedicine in a developing country such as South Africa and provide decision makers and managers of telemedicine in the Eastern Cape with an original view on the system and a framework towards the enhanced implementation of the teleradiology system.
  • Thumbnail Image
    Item
    Designing a decision support tool for nurse scheduling at Stellenbosch Hospital
    (Stellenbosch : Stellenbosch University, 2011-12) Friedrich, Sonja; Van Dyk, L.; Stellenbosch University. Faculty of Engineering. Dept. of Industrial Engineering.
    ENGLISH ABSTRACT: Providing sufficient healthcare to all South African citizens is of significant concern to government. Major problem areas lie in the prevention and control of epidemics, allocation of resources and health systems management. The majority of the government facilitated hospitals in South Africa experience difficulty in attaining health care targets due to these problems. Stellenbosch Hospital, an 85- bed, non-profit public facility that serves a community of 170 000 people, is no exception. A root cause analysis revealed that an insufficient nurse scheduling process is the underlying cause of numerous problems and that a lack of worker morale is the largest predicament at Stellenbosch Hospital. Different motivational theories are investigated and it is concluded that worker morale at the hospital can be improved by empowering nurses to gain more control over schedules, and that the nurse scheduling process can be enhanced by supporting nurse scheduling with a decision support tool. The purpose of the decision support tool is scoped to deal with day and night scheduling and nurse-to-ward assignments particularly, as this is largest amount of work for the unit managers. Additionally it is decided to involve nurses in the annual day and night schedule as well as the ward preferences, as this has the most significant impact on nurses’ work lives. The inputs and expected outcomes of the decision support tool are discussed and the development platform was chosen to be a combination of Visual Basics and Microsoft Excel, as these programs are powerful and freely available. After careful consideration of different nurse scheduling methods linear programming and a self-developed algorithm were chosen by making use of the Analytical Hierarchy Process. The day and night schedule is solved with an integer programming model, with the drawback being the inflexibility of the fixed quarters which nurses can select, as well as the rigidity of the model and the suboptimal solution which needs rounding. The day and night scheduling results are an input to the self-developed algorithm, which imitates the thought process of the unit managers scheduling process to arrive at a feasible solution. The key to this method is the nurses available over nurses required ratio which drives the algorithm. A flowchart supporting the documentation and understanding of the code has been developed along with a testing table to verify the results of the code.
  • Thumbnail Image
    Item
    A health systems engineering approach to meeting the demand for skilled foetal ultrasound services in the Boland/Overberg public health district
    (Stellenbosch : Stellenbosch University, 2010-10) Uys, Nina; Van Dyk, L.; Stellenbosch University. Faculty of Engineering. Dept. of Industrial Engineering.
    ENGLISH ABSTRACT: In its Millennium Development Goals, the United Nations prioritizes the improvement of maternal health in developing countries. The World Health Organization argues that this can be done through improving the accessibility and quality of basic maternal health care, which includes ultrasound services. In South Africa, many clinics and hospitals have ultrasound machines, but there is a lack of skilled personnel to operate them and to provide safe and meaningful service. The purpose of this project was to find an optimal combination of technology and business processes to meet the sonography skills shortage in South Africa in a sustainable way. Alternative solutions to educating a nurse or midwife at a rural clinic in sonogram acquisitioning and interpretation were investigated. The technological requirements for each were identified. An information and communications technology audit was then done to determine if these solutions are technologically feasible. All of the systems were deemed feasible. These solutions were then tested for their economic feasibility through an analytic hierarchy process. From these two feasibility studies, the most feasible solution was an asynchronous tele-ultrasound system. This system was developed by the Biomedical Engineering Research Group and the Department of Obstetrics and Gynaecology (OB/GYN) at the University of Stellenbosch, in collaboration with the Department of Bioengineering at the University of Washington. The system is composed of a portable ultrasound machine, a laptop and a server. It was evaluated in 2008 by a midwife in South Africa and three OB/GYN specialists in the United States of America. The midwife had low-level pre-existing ultrasound knowledge and interpretation skills. The legal requirements for the implementation of the system in a Boland/Overberg public health district clinic were evaluated. Next, through process reengineering, the new system was designed to be incorporated in a typical consultation between a nurse and pregnant patient. Finally, the scheduling requirements to ensure the success evaluation and safety of the system were done. It was found that overall this system is feasible within the Boland/Overberg health district. Further studies were recommended for the further implementation of the system.
  • Thumbnail Image
    Item
    Paving the way for the use of prediction modelling in a health care environment
    (Stellenbosch : Stellenbosch University, 2011-10) Van Zyl, Ilse; Van Dyk, L.; Visser, T.; Stellenbosch University. Faculty of Engineering. Dept. of Industrial Engineering.
    ENGLISH ABSTRACT: The high cost of hospitalisation is a challenge for many health insurance companies, governments and individuals alike. In 2006, studies concluded that well over $30 billion was spent on unnecessary hospitalisations in the United States of America, where unnecessary hospitalisations are those that could have been prevented through early patient diagnosis and treatment. Undoubtedly, there is room for improvement in this regard and it can be agreed that where lives are at stake, prevention is always better than cure; successful hospitalisation prediction may make hospitalisation prevention a realistic possibility. The Heritage Provider Network, a health insurance and health care provider and sponsor of the Heritage Health Prize (HHP) Competition, have come to realise the potential benefits that a hospitalisation prediction model could effect (Heritage Provider Network Health Prize, 2011). The competition is aimed at producing an effective hospitalisation prediction patient admissions algorithm (PPAA) to predict the amount of days a member will be hospitalised in the next period using health insurance claims data of the current period. The goal is to ultimately prevent the unnecessary hospitalisation of identified members in their network. If successful this could have many benefits to the wider society including fewer critical medical cases, fewer claims and consequently lower expenses for all stakeholders in the affected system. The competition serves as inspiration for this study which aims to pave the way for the research team who will be developing such a PPAA. This was accomplished by providing insights and identifying possible pitfalls in the development of a Predictive Patient Admission Algorithm (PPAA) using the Heritage Health Prize case study as a reference. Typically available hospitalisation data that serves as input for the PPAA are briefly described, together with recommendations on methods and technologies with which to extract, transform and load (ETL) data within this context. A list of contender techniques was assembled based on the given data, the algorithm’s expected input requirements and the techniques’ ability to meet these needs. The prediction modelling techniques reviewed include classification and regression trees (CART), multivariate adaptive regression splines (MARS), neural networks and ensemble methods. Techniques were compared in terms of a set of criteria needed to use the available data and give the desired outputs. Page iv The data mining technologies considered to model with the preferred technique include Statistica data miner, SPSS Clementine, SAS Enterprise Miner, Matlab, Excel with VBA and R. These technologies were also compared on how well they can model available data with the contender techniques. The research team’s compatibility with technologies was also considered. Recommendations concerning the prediction modelling technique was using ensemble methods and the choice of technology for ETL was SQL Server and for prediction model building recommendations are Statistica, R or Matlab. Experimentation was conducted with selected CART, MARS and the Random Forests techniques in the available technologies in order to support future prediction modelling decisions of the research team. It was concluded that the included predictor variables do not have sufficient predictive power for the use of CART, MARS and Neural Networks and that Random Forests deliver more favourable results and it was recommended that this modelling should be explored further for the use of the HHP application.
  • Thumbnail Image
    Item
    Telemedicine for primary healthcare : development of a decision support framework for a clinical pull approach to telemedicine implementation
    (Stellenbosch : Stellenbosch University, 2009-11) Treurnicht, Maria Jacoba; Van Dyk, L.; Stellenbosch University. Faculty of Engineering. Dept. of Industrial Engineering.
    ENGLISH ABSTRACT: Telemedicine refers to the delivery of healthcare services by means of information and communication technology (ICT). Telemedicine, being an ICT, has appealed to engineers as an opportunity for innovative development, making technology the primary driver of telemedicine development. This technology-push model where engineers pursue challenging technological goals primarily does not guarantee appropriate and quality healthcare. It is therefore also necessary to assess the true need of the population and develop a comprehensive framework to implement and develop technology only as a means and not a goal in itself. The Medical Research Council (MRC) and Stellenbosch University (SU) department of Electrical and Electronic engineering jointly developed a telemedicine workstation, specifically for primary healthcare in South Africa. This workstation ensures effective communication between healthcare facilities to capture and send diagnostic data of patients between the facilities. Although the technology-push approach followed was successful, further development of the workstation requires a clinical-pull approach to address the specific needs of the population. The purpose of this project is therefore to support decision making with respect to the future development and implementation of telemedicine workstations. A decision support framework is developed and validated using the MRC/SU telemedicine workstation as a reference. The decision support framework developed in this project can be used as a tool for developing regional telemedicine strategy. Future use of this tool requires the population of a data warehouse developed in this project by extracting, transforming and loading data from clinical data sources. The data warehouse serves as a platform for specification analysis and mathematical models to evaluate possibilities for telemedicine in the region. The data sources for this project are health information systems and patient files. Data are extracted from the patient files, transformed and loaded into a database, developed for this purpose. Data from three facilities (Grabouw Community Health Centre, Robertson- and Ceres Hospitals) in the Western Cape are used, representing a region relevant for telemedicine lementation. The data warehouse is populated from the data loaded into the database to package the data in a usable format for data analysis. Diagnosis data together with telemedicine device profiles are used in the data analysis.The possibility of telemedicine implementation at a facility is evaluated using mathematical models. Engineering economics are used to determine the economic feasibility of a basic telemedicine workstation at a chosen facility. Potential telemedicine device utilisation at this facility is evaluated using mixed integer programming. This study serves as a pilot project to develop and validate the decision support framework. The scope of this project is limited to a specific region suitable for telemedicine workstation implementation. This project is therefore not aimed to provide only general solutions for telemedicine. It is a generic tool to enable decision makers to implement telemedicine as a needs driven technology in specific regions in South Africa.
  • Thumbnail Image
    Item
    The telemedicine system to increase patient’s access to specialised cardiac care for assisting remote diagnosis.
    (Stellenbosch : Stellenbosch University, 2010-10) Triegaardt, M.; Van Dyk, L.; Doubell, A. F.; Stellenbosch University. Faculty of Engineering. Dept. of Industrial Engineering.
    ENGLISH ABSTRACT: Cardiology refers to the specialised study of heart disorders and is a focused field of knowledge practiced by cardiologists. Due to the specialised nature of cardiology, treatment is not given as idely and effectively in populated and under-resourced areas, like South Africa. In the public health sector there are too many cardiac patients and not enough doctors with the necessary expertise to attend to their needs. Cardiac specialists that are situated only in urban areas in South Africa, cannot attend to the needs of all the rural cardiac patients Therefore, cardiac specialists assist rural doctors in diagnosing patients remotely. The assistance currently offered is not optimal and patients do not get the needed tertiary specialist care that is available in urban areas. For specialists to provide assistance they have to fully understand they patient’s medical condition and therefore all the necessary patient data has to be transferred to the specialist. The various factors limiting the transfer of patient data and therefore also the patient’s access to tertiary care cardiac is the patient’s location relative to the specialist, the methods used to communicate patient data, human error in the diagnostic process, the complex nature of the diagnostic data , limited data transfer capabilities, the cost and the limitations of technology used. For the purpose of this study Tygerberg hospital will be used as the tertiary hospital and Eben Dönges hospital in Worcester as the rural hospital. The current situation at both hospitals was assessed and the structure used for communication between the two institutions was documented. It was found that the technology is being used to share patient data, such as faxes and telephone calls, results in an unnecessarily protracted process. The restrictions which limit the current system were identified. It was found that outdated technology is used to share patient data because there is no faster communication network and because patient data is complex and files are large. The existing and potential technology was explored to formulate alternatives namely: electronic transfer of files in DICOM format; compressing the DICOM files with MPEG and JPEG before electronic transfer; implementing a PACS intranet between hospitals; and lastly to use DICOM viewers on workstations to view the DICOM patient data. Ultimately, the possible solutions and their feasibility were explored using the Analytical Hierarchy Process (AHP) to illustrate that a DICOM viewer in conjunction with a PACS intranet is the best solution to increase a remote patient’s access to a specialist’s knowledge. If a PACS in conjunction with a DICOM viewer is implemented the effectiveness of data transfer procedure is increased, since data is always accessible via the PACS intranet and the DICOM viewer Chapter: Synopsis iv software allows post processing of DICOM files. The duration of the procedure is decreased for the doctor at Eben Dönges hospital, since files are automatically transferred to the central PACS server after study is completed; and for the specialist at Tygerberg Hospital time is saved since he can view the diagnostic images on a mobile device. The biggest cost for the solutions will be to implement a network between the hospitals and to acquire the PACS software license. The DICOM viewer software is free to download. The alternative is user-friendly since minimal effort has to be made to transfer data and the DICOM viewer user interface is simple to operate. This option enhances secondary and tertiary education most since DICOM files can be viewed on any standard of the self hardware with a DICOM viewer installed. Ethical or legal issues can develop with exchange of confidential patient information, but due to patient data only being connected to the patient MRN in the PACS system of Tygerberg, no patient’s confidentiality will be breached.