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# · Homework week 2</o:p> o Chapter 2: Exercises 2-1 through 2-5 (page 48 of the text)</o:p> EXERCISES</o:p> · 2-1Your organization collects data on individual patients shown...

· Homework week 2

o Chapter 2: Exercises 2-1 through 2-5 (page 48 of the text)

EXERCISES

· 2-1Your organization collects data on individual patients shown inAppendix Table 2. Identify whether each variable is measured nominally, ordinally, or as an interval/ratio variable.

· 2-2What statistical measures would you use to summarize the variable for age? Ordinal. What about for gender? Nominal. For convenience satisfaction? Ordinal. How would you present these graphically?

· 2-3If you are interested in whether satisfaction scoring differed by the amount the individual paid as a co-pay, how would you state this inquiry as testable hypotheses (the null and alternative)? What statistical test would you run to test this hypothesis?

· 2-4Perform the test defined inTable 2-3. State your conclusions.

· 2-5Compare gender and having Rx coverage. State your hypotheses. Perform the appropriate statistical test and interpret.

o Chapter 3: Exercise 3-3 (page 61 of the text)

EXERCISES

· 3-1Develop a general systems flow chart that describes the process of filling a car with gasoline. After “start” have as the first process “Arrive at Gas Station.” Immediately before “stop” have as the last process “Leave Gas Station.”

· 3-2Using a general systems flow chart design a system for arrivals at an emergency room of a hospital.

· 3-3Using the following narrative, create a general system flow chart. When a patient arrives at the clinic the patient first sees the receptionist, who checks to see if the patient was seen before. If so, the receptionist pulls the medical record from the file. If the patient is new, the receptionist has the patient complete the necessary forms and creates a medical record. Patients are seen by the physician in the order they arrive. If one of the two examination rooms is empty, the nurse escorts the patient to the examination room and records the complaint. The nurse performs routine tests. The nurse writes the complaint and findings on a medical examination form, a form that will be subsequently filed with the patient’s medical record. The physician examines the patient and orders medical tests, if necessary. A diagnosis and treatment plan is presented to the patient by the physician; a written copy of this plan and any other appropriate instructions. [Notes are written on the medical examination form.] When the physician releases the patient, the patient returns to the receptionist, who prepares a bill. If the patient has health insurance, the bill is sent to the health insurance carrier. The patient leaves after either paying the bill (by cash, check, or credit card) or signing the forms to authorize payment by his or her health insurance company. If the health insurance company refuses to pay or partially pays the bill, the receptionist bills the patient by mail. Any patient with an unpaid bill or bad credit history is refused subsequent treatment until the old bill is paid.

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o Chapter 4: Exercise 4-1 through 4-4 (page 72 of the text)

EXERCISES

· 4-1You decide to invest \$100,000 in a program that is guaranteed to grow by 2.5% for each of the next 5 years. At the end of the 5 years, how much is your investment worth?

· 4-2What is the effective annual rate of an investment that pays 6% for 5 years, compounded semiannually?

· 4-3What is the present value of a single cash flow of \$25,000 received at the end of 10 years, if we assume a discount rate of 5% annually? With a discount rate of 7%?

· 4-4Suppose you deposit \$100 in a savings account that compounds annually at 2%. After 1 year at this rate, the bank changes its rate of compounding to 1.5% annually. Assuming the compounding rate does not change for 4 additional years, how much will your account be worth at the end of the 5-year period?

· Homework

o Chapter 8: Exercises 8-1 through 8-5 (page 155 of the text)

EXERCISES

· 8-1Two types of visits are provided by the Durham Health Clinic, first-time visits and return visits.Table 8-5provides the processing time for each work station and the available staff hours per week. Determine the production frontiers for this clinic and indicate which station should be expanded to increase the overall capacity of the clinic. Which service station could be reduced?

Table 8-5Processing Time and Staff Hours Data for Durham Health Clinic (Exercise 14-1)

 Work station Time estimates (hours) First Visit Return Visit Reception/discharge 0.25 0.12 Nursing and testing 0.40 0.38 Medical exam and treatment 0.50 0.25

· 8-2Durham Health Clinic has a contribution margin of \$35 per visit. Calculate the break-even point in visits with fixed costs at \$4000, \$6500, and \$8500 per week. Given this analysis, as a manager, what would you recommend and why?

· 8-3Durham Health Clinic is considering signing a contract to perform 50 pre-employment physicals per week for a specific corporation. In terms of staff time, a pre-employment physical requires 0.20 hours in Reception/Discharge, 0.45 hours in Nursing and Testing, and 0.20 hours in Medical Examination. By work-station, determine how many work hours per week will be needed to perform these physicals.

· 8-4Currently the clinic does 250 visits per week, with 50% of all visits as return visits. Each employee (physician, nurse, and receptionist) is scheduled to work 35 hours per week.

o a.How many employees by type does the clinic currently need?

o b.How many employees by type will the clinic need if it signs the contract for pre-employment physicals?

o c.If return visits shift to 10% of all regular visits, how many employees by type will the clinic need with and without the contract for pre-employment physicals?

o d.How will the answers to “b” and “c” change if the number of physicals is modified to 35 pre-employment physicals per week?

Throughout these analyses, specify all assumptions, including assumptions concerning worker productivity.

· 8-5How would your answers change for problem 8-1 if nursing and testing time was increased to 0.50 hours for both first and repeat visits, and medical exam and treatment time was reduced to 0.30 hours for a first visit and 0.20 hours for a return visit?

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o Chapter 9: Exercises 9-1 and 9-2 (page 174 of the text)

EXERCISES

· 9-1Alpha Walk-in Clinic operates as a single channel single server system. On Tuesdays, its average arrival rate (μ) per hour is 7.0. Analysis indicates that its service rate (λ) is 8.5 patients per hour. Using queuing theory, describe this service system. What is:

o a.The probability that the clinic is idle—no patients waiting or being served?

o b.The average number of patients in the system?

o c.The average time (hours) a patient spends in the system (waiting + service time)?

o d.The average number of patients in the queue waiting for service?

o e.The average time (hours) a patient spends in the queue waiting?

o f.The probability that the patient, upon arrival, must wait?

· 9-2The following data have been collected from a hospital pharmacy. This service system operates as a single server, single channel system.

 7–3PM 3–11PM 11–7AM Service rate per hour 200 100 50 Arrival rate per hour 60 50 40

· The service rate can be increased or decreased in increments of 50 prescriptions per hour. The expense associated with each 50-prescription increment is \$100. In other words, to be able to process 50 additional prescriptions will cost an additional \$100 per hour. If the current rate of processing or service is lowered by 50 prescriptions per hour, the savings are \$100 per hour. Using queuing theory, describe this service system. What is:

o a.The probability that the clinic is idle—no patients waiting or being served?

o b.The average number of patients in the system?

o c.The average time (hours) a patient spends in the system (waiting + service time)?

o d.The average number of patients in the queue waiting for service?

o e.The average time (hours) a patient spends in the queue waiting?

o f.The probability that a patient, upon arrival, must wait?

Given the associated costs, should the service rate be changed? What are the financial implications associated with your recommendations?

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Due Week 7 and worth 30 points

· Homework

o Chapter 10: Exercise 10-2 (page 208 of the text)

• 10-2In the clinic renovation example, what if management thinks that the likelihood of current demand remaining is 30%, the likelihood of a moderate increase is 25%, and the likelihood of a large increase is 45%? What should they do, according to the expected total payoff?

· Homework

o Chapter 12: Exercises 12-1 through 12-3 (page 248 of the text)

o Chapter 13: Exercises 13-1 through 13-3 (page 269 of the text)

## EXERCISES

· 12-1Using the information inTable 12-7, construct a PERT network and answer each of the following questions:

o a.What is the expected project completion data?

o b.What is the scheduled start and completion date for each activity?

o c.Which activities are on the critical path?

o d.How long can noncritical path activities be delayed without jeopardizing the overall completion date for this project?

· 12-2Assess the impact of the following changes to the time estimates provided in question 12-1. Individually, what is the impact if:

 Activity Predecessor New Time Estimate O. Advertise for new staff N 4 P. Interview for new staff O 6 Q. Select new staff P 1 Collectively, what is the impact of these changes?

· 12-3As project manager for the example included in question 12-1, what would you recommend to preserve the original project completion date if activity A was reestimated to take 8 weeks, not the original 4 weeks? Provide details.

· 12-4Develop a WBS and PERT network with no more than 20 activities for each of the following projects.

o b.Screening 1000 school-age children for high blood pressure and reporting the results to the child’s physician

## Table 12-7Project to Convert a 20-Bed Unit in a Nursing Home to Accommodate Patients with Dementia

 Activity Predecessor Time estimate (weeks) A Secure state approval – 4 B Identify 20-bed unit to be used A 1 C Move existing residents B 1 D Clean space C 2 E Develop architectural plans A 9 F Install new heating and ventilation systems E 4 G Install security systems E 2 H Move walls; renovate F 4 I Identify new equipment A 1 J Order new equipment I 1 K Unpack and inspect new equipment J 1 L Install new equipment D, K, H 3 M Reassign staff A 1 N Identify new staffing needs M 1 O Advertise for new staff N 3 P Interview for new staff O 2 Q Select new hires P 3 R Develop care plan protocols M 1 S Train staff R, Q, M, L 1 T Modify quality assurance plans S 2 U Coordinate with hospital discharge planners T 4 V Complete internal audit U, G 1

## EXERCISES

· 13-1A representative of a reputable financial services company has approached you as manager of a four-person group of anesthesiologists with an opportunity to purchase a 10-year annuity due for each member of the group. The annuity due would pay \$40,000 each year beginning 5 years from now (i.e., at time = 5). What is the most you would be willing to pay now, per each physician, for this investment? Assume an appropriate discount rate of 7%.

· 13-2The hospital’s marketing and finance departments have just provided you, as chief financial officer, with pro forma income statements for your proposed sonogram center. These statements appear in the following.

Pro forma Income Statement

(000)

 Time t+ 1 t+ 2 t+ 3 t+ 4 Service Revenues (net) \$425 \$500 \$580 \$700 Expenses \$400 \$450 \$525 \$600 Depreciation Expense \$35 \$35 \$35 \$35 Net Income (\$ 10) \$15 \$20 \$65

What is the project’s IRR? Assume an initial investment of \$175,000 and an appropriate discount rate of 6%. The hospital is operated as a not-for-profit facility.

· 13-3The chief operating officer (COO) of a small, not-for-profit community hospital has to make a recommendation to the board of trustees on choosing among three project options for an unrestricted gift of \$250,000 that has just been received. The board has established a time horizon of 5 years on this project. The options are described in the following.

o a.Purchase a 5-year treasury note at an interest rate (annual) of 7%.

o b.Purchase the practice of a young physician (the hospital’s third highest admitter). Estimates of projected cash flows for the practice (post-purchase), are:

Probability of Cash Flow

 Time 60% 20% 20% t+ 1 \$40,000 \$20,000 \$60,000 t+ 2 \$60,000 \$30,000 \$80,000 t+ 3 \$75,000 \$40,000 \$100,000 t+ 4 \$100,000 \$50,000 \$125,000 t+ 5 \$100,000 \$50,000 \$125,000

o c.Purchase an upgraded analyzer for the laboratory. Based on forecasts of laboratory utilization, the net cash flows for this project are:

 Time Net Cash Flow t+ 1 \$75,000 t+ 2 \$75,000 t+ 3 \$50,000 t+ 4 \$50,000 t+ 5 \$50,000

o Which investment should the COO recommend and why?

· 13-4What are some of the factors that can influence the riskiness of projects (investments) in healthcare organizations?

· Homework

o Chapter 14: Exercise 14-2 (page 297 of the text)

• 14-2Using the following data, prepare a run chart, scatter chart, and control chart. A late surgery is defined as any surgical operation that was started more than 30 minutes after its scheduled time (Table 14-4).

• Homework
• Chapter 15: Exercises 15-1 through 15-3 (page 314 of the text)

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EXERCISES

· 15-1Using the following data set on hospital admissions, define the service area for Hospital A, based only on quantitative factors (Table 15-5).

· 15-2Compute the target bed capacity of Cheswick Community Hospital 10 years from now, based on the following information:

Assume current population of Cheswick Community Hospital’s service area = 145,000

Assume projected population increase of 8% in service area over the next 10 years.

## Table 15-5Hospital Admissions, by Community

 Community Hospital A Hospital B Hospital C Other Hospitals North 45 64 76 123 South 159 324 12 521 East 65 24 137 311 West 145 68 95 113 Central 32 56 78 159 Upper 29 84 45 814 Lower 37 14 8 57

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## Solution

Monali answered on Dec 17 2021
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Table 2-1: Patient insurance type: Categorical data
Table 2-2: Port City Hospital daily chart filings per day: Interval data
Table 2-3: No of ED hospital visit and No. of Lab test: Nominal data
Table 2-5: Monthly birth: Nominal Data
Table 2-11: % of Patient over weight: Ratio data
Figure 2-7: Port City Hospital Medical surgical expenditure 2007: Categorical data
Figure 2-8: Port city Birth: Nominal data
Figure 2-9: FTE and Expenditure by Department: Nominal data
Appendix 2: Patient satisfaction survey
Gender: Categorical data
Age: Nominal Data. Can be presented as Ratio data on meaningful scale, as per requirement of presentation.
Covariance satisfaction: Categorical data
Insurer: Categorical data
Same day appointment: Categorical data
Rx-Coverage: Categorical data
Co-pay: Numerical data. Can be presented as Ratio data on meaningful scale, as per requirement of presentation.

2-2: What statistical measures would you use to surmise the variable age? Age can be surmise as mean, mode and median. What about Gender? Gender can...
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