Browsing by Author "Cataldo, Alejandro"
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- ItemAn approximate dynamic programming approach to network-based scheduling of chemotherapy treatment sessions(2024) Wenzel, Arturo; Saure, Antoine; Cataldo, Alejandro; Rey, Pablo A.; Sanchez, CesarA solution approach is proposed for the interday problem of assigning chemotherapy sessions at a network of treatment centres with the goal of increasing the cost-efficiency of system-wide capacity use. This network-based scheduling procedure is subject to the condition that both the first and last sessions of a patient's treatment protocol are administered at the same centre the patient is referred to by their oncologist. All intermediate sessions may be administered at other centres. It provides a systematic way of identifying effective multi-appointment scheduling policies that exploit the total capacity of a networked system, allowing patients to be treated at centres other than their home centre. The problem is modelled as a Markov decision process which is then solved approximately using techniques of approximate dynamic programming. The benefits of the approach are evaluated and compared through simulation with the existing manual scheduling procedures at two treatment centres in Santiago, Chile. The results suggest that the approach would obtain a 20% reduction in operating costs for the whole system and cut existing first-session waiting times by half. A key conclusion, however, is that a network-based scheduling procedure brings no real benefits if it is not implemented in conjunction with a proactive assignment policy like the one proposed in this paper.
- ItemComparing Strategic IT Alignment versus Process IT Alignment in SMEs(AUSTRALIAN COMPUTER SOC INC, 2012) Cataldo, Alejandro; McQueen, Robert J.; Hardings, JensRecently researchers have begun to suggest that the study of IT alignment in SMEs should be based on organizational processes rather than on strategy. This research investigated both approaches in a comparative exploratory study of 38 SMEs in Chile and Colombia. Regression was used to compare both types of alignment against IT success.
- ItemExpanding ICU facilities in a pandemic scenario(SOC MEDICA SANTIAGO, 2020) Andresen, Max; Born, Pablo; Kattan, Eduardo; Vera, Magdalena; Cataldo, Alejandro; Ruiz, Carolina; Bravo, SebastianOur country is suffering the effects of the ongoing pandemic of coronavirus disease (COVID-19). Because the vulnerability of healthcare systems, especially the intensive care areas they can rapidly be overloaded. That challenge the ICUs simultaneously on multiple fronts making urgent to increase the number of beds, without lowering the standards of care. The purpose of this article is to discuss some aspects of the national situation and to provide recommendations on the organizational management of intensive care units such as isolation protocols, surge in ICU bed capacity, ensure adequate supplies, protect and train healthcare workers maintaining quality clinical management.
- ItemExploring the IT usage in SMEs from New Zealand, Colombia and Chile using action-research methodology(2012) Sepúlveda Fernández, Marcos Ernesto; Cataldo, Alejandro; McQueen, Robert J.The theory on the adoption and use of information technology (IT) in small and medium enterprises (SMEs) is abundant. However, methodologically speaking, action-research (AR) has been little explored as a method of construction of this theory, despite the use of this methodology could improve understanding of how SMEs use IT. Therefore, we researched the use of IT in SMEs using a methodology adapted from AR. The methodology was tested in companies from New Zealand, Colombia and Chile. The use of this methodology was well evaluated by the top management of SMEs; in fact, the recommendations coming from the analysis were well received by the management of participants. These results are auspicious regarding the use of AR in SMEs and could help encourage other researchers to use this methodology, which remains little used in information systems research.
- ItemIdentifying proactive ICU patient admission, transfer and diversion policies in a public-private hospital network(2021) Marquinez, Jose Tomas; Saure, Antoine; Cataldo, Alejandro; Ferrer, Juan-CarlosManagement of hospital beds is a high-impact issue for two-tier healthcare systems, due principally to their critical importance and high costs. Bed capacity in the public sector is generally insufficient to provide immediate care to all critical patients and thus a significant proportion of public expenditure is assigned to the diversion of patients for treatment in the private sector. We formulate and approximately solve a discounted infinite-horizon Markov Decision Process (MDP) that seeks to identify cost-effective policies for transferring ICU patients between hospitals or diverting them to private clinics. The solution approach employs an affine architecture for approximating the value function of the MDP model and solves the equivalent linear programming model using column generation. The approach can handle a high level of dimensionality, enabling it to consider the arriving patients' many different diagnostic groups and their corresponding lengths of stay. The decisions generated through this approach often differ from the intuitive ones produced in a typical day-by-day decision process, that does not consider the impact of the current day's decisions on the future performance of the system. In particular, the resulting policies will in many cases proactively transfer patients to a different public facility or divert them to a private one even though the hospital they first arrived at had beds available. The performance of the proposed method was evaluated by simulating a case study based on data from a hospital network in Santiago, Chile, producing savings of almost 49% due mostly to reduced usage of private services.
- ItemMulti-stage process for chemotherapy scheduling and effective capacity determination(2023) Cataldo, Alejandro; Sufan, Sebastian; Lorca, Alvaro; Andresen, Max; Sanchez, Cesar; Saure, AntoineA novel solution approach is developed for the scheduling of chemotherapy sessions at cancer treatment centers. The problem is divided into two subproblems determining the day (interday scheduling) and the time slots (intraday scheduling), respectively. The interday subproblem is solved by a model that allows for effective treatment center capacity choices while the intraday subproblem is addressed using two optimization models. New patient arrivals and treatment protocols specifying the latest starting date and session spacing are sources of uncertainty. Unlike other existing approaches, the proposed method incorporates the concept of effective treatment capacity which facilitates the interaction between the interday and intraday subproblems allowing them to be solved sequentially and iteratively to thus achieve much more resource-efficient solutions. A case study using real data from a Chilean cancer center to conduct comparative simulations of its manual scheduling methods and the proposed methodology found that the latter almost always performed better, often significantly so, on makespan, resource utilization, overtime, and patient diversion metrics.
- ItemThe impact of a better coordination between emergency and intensive care units in the care of critically ill patients(SOC MEDICA SANTIAGO, 2016) Lara, Barbara A.; Cataldo, Alejandro; Castro, Ricardo; Aguilera, Pablo R.; Ruiz, Carolina; Andresen, MaxThe need for critical care services is increasing in Chile. Critical care beds and specialists in this area are scarce. In this article we discuss some aspects that hamper the care of critically ill patients from their arrival to the emergency department to their transfer to the ICU. Special emphasis is given to system saturation and its multiple causes. The benefits of an integrative approach between emergency medicine and critical care specialists are highlighted and some solutions are proposed to strengthen this partnership.