PASSENGER ARRIVAL RATES AT PUBLIC TRANSPORT STATIONS

Predictors of access to pediatric eye care appointments.

Public transport administrators rely on efficient algorithms to tackle various challenges in public transportation networks. In this paper, we primarily focus on designing near-linear-time algorithms for two fundamental path problems: the Earliest Arrival Time (EAT) and the Fastest Path Duration (FPD). Given a temporal graph <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">G</i>, a source vertex <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">s</i>, and a ready time <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">rt</i> at <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">s</i>, the EAT problem aims to compute the earliest possible arrival times for all vertices from <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">s</i>, ensuring that each path departs no earlier than <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">rt</i>. Given a temporal graph <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">G</i> and a source vertex <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">s</i>, the FPD problem is to compute the minimum journey time from <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">s</i> to all vertices, where the journey time of a path is the difference between its arrival time and departure time. We characterise the earliest arrival and fastest paths in temporal graphs and leverage these insights to design pruning and cache-friendly algorithms for efficiently solving EAT and FPD in public transport networks. Our results show a significant improvement over the state-of-the-art algorithms, with up to a 58-fold speedup for the EAT problem and an even more remarkable 69-fold speedup for the FPD problem. These findings underscore the potential of our algorithms to enhance public transport optimisation, ultimately aiding administrators in improving urban mobility.

AimsTo investigate impediments in the discharge process and ward round efficiency within a general paediatric ward for future flow and discharge improvement.MethodsDuring a 6-month seconded post as the paediatric patient...

Background/Introduction Access to timely healthcare in disadvantaged areas remains essential to achieving equitable health outcomes, especially in regions facing structural and social vulnerabilities. Purpose To assess wait times for cardiovascular disease consultations in US-Mexico border regions compared to non-border regions among US Veterans. Methods This cross-sectional analysis included all veteran cardiovascular consultations referred through the Veterans Choice Program to community healthcare centers from 2014 to 2020. We obtained the average wait times in days for consultation approval, scheduling, completion, and total wait time from approval to consultation completion. All consultations were classified by county of residence as either within a US-Mexico border region or a non-border region, as per the La Paz Agreement. Multivariable linear regression analyses were performed to evaluate the impact of border status on average wait times. ARIMA modeling was completed to estimate forecasted wait times during the COVID-19 pandemic. Results A total of 485,158 consultations related to outpatient cardiovascular disease were retrieved from the VA Healthcare System. Amongst these, 461,696 of the consultations were placed in non-border regions whereas 23,462 consultations were placed in US-Mexico border regions. The most common consultation requests were made for general cardiology clinic (n=365,227), echocardiography (n=32,017), cardio-pulmonary rehabilitation (n=40,699), and cardiac stress testing (n=16,258). Wait times for cardiovascular disease consultations were not higher in US-Mexico border counties than in non-border regions. For electrophysiology consultations specifically, border counties exhibited significantly shorter total wait times (coeff = -10.81, p=0.008). Additionally, while the COVID-19 pandemic led to increased total wait times in non-border areas (Figure 1), total wait times in border regions remained stable during this period (Figure 2). Conclusions Our findings suggest that US-Mexico border region status does not result in longer wait times for cardiovascular disease consultations, with the exception of shorter wait times for electrophysiology services. This study provides important insights into the unique dynamics of healthcare access in structurally disadvantaged regions, highlighting that wait times are not a significant barrier to cardiovascular care in border areas, and emphasizes the need to consider regional differences in healthcare delivery policies.

In the developing countries along with formal public transport network (FPTN), informal public transport network (IPTN) also plays an integral role by achieving high public transport ridership. IPTN caters effectively to the user’s expectations and appears to be highly integrated with urban fabric. IPTN either complements or compete with the existing FPTN, even though due credit is not given to IPTN and considered as unlawful entities. Efficiency and robustness of transport network is based on topological structure of network. To summarize which network is more efficient and robust, the study tests the network parameters of formal Public Transport Network and Informal Public Transport Network of Nagpur (India). A topological measure of network structure has tested based on elementary concepts of graph theory. We explore the network structure and their properties. The practical significance of the network parameters was then analysed. In the IPTN the degree of small-worldliness is smaller, as compared to FPTN, indicative of IPTN being more robust as compared to FPTN. This study provides an approach to understand the efficiency of an Informal public transport network in combination with Formal public transport network. The article identifies the importance of Informal public transport network to improve the Complementarity with the formal public transport network. Integrating formal and informal transportation network into a hybrid network has the potential to induce the desired relationships amongst FPTN and IPTN, i.e. competing or complimenting nature to improve the overall efficiency of FPTN.

BackgroundIn emergency departments (EDs), long wait times and overcrowding are major challenges, worsened by the pandemic's increased patient volumes and demands. Lean methodology could offer a structured approach to reduce inefficiencies, improve care quality, and support nursing staff. Aim of the study: This study aims to evaluate the impact of applying a Lean approach to optimize emergency nursing care post-pandemic within an ER setting.MethodsThis study utilized a mixed-methods design in the ER of a private hospital in Egypt. Data collection involved three Lean tools: the voice of the process observation sheet, which tracked the journeys of 100 patients; voice of customer structured interviews, conducted with 90 patients to assess satisfaction with waiting times; and voice of business interviews, held with 64 staff members to evaluate satisfaction with available resources. Additionally, a cause-and-effect analysis was conducted and summarized in an A3 report, identifying key factors contributing to extended wait times.ResultsThe average wait time in the emergency department was 157.87 min, making up 77.7% of the total length of stay. The consultation phase accounted for the longest delays, with an average wait of 92.46 min. Patient satisfaction with waiting times was moderate (61.74%), while staff satisfaction with resources was higher (71.09%), but only 53.1% were satisfied with patient wait times. Key causes of delays included non-compliance with triage protocols (95.0%), lack of care pathways (90.3%), and insufficient bed capacity (83.1%). An A3 report proposed strategies to reduce wait times and enhance satisfaction.ConclusionThis study highlights waiting times as a major challenge in EDs, significantly impacting service quality, patient outcomes, and nursing staff workload. Lean-based strategies, such as standardized triage and improved care pathways, are essential to reducing delays and enhancing both patient care and staff satisfaction in the post-pandemic healthcare environment.

The public transport network level is defined and is used to describe the performance and future improvement of the public transport system in Zurich, Switzerland. A public transport level is a specific type of service designed to serve a particular market. “Service” is defined as a combination of vehicles, infrastructure, and operating characteristics. A pure level occurs when the service is targeted specifically at one particular market. A hybrid level occurs when a service is targeted to serve several markets. Urban travel is generally described as three markets: short, inter mediate, and long-distance trips. Consequently many cities have developed three-level public transport networks: surface buses and trams to serve short trips, rapid rail to serve intermediate trips, and regional rail to serve longer-distance trips. Often, by design or for historic reasons, cities have additional levels, fewer levels, levels that are not precisely matched to their markets, or all three. For example, two-level networks are often found in medium-sized cities. Their advantage is lower costs, and their main disadvantage is a mismatch between transport mode and market that manifests itself in capacity limitations. The level concept to help analyze and plan public transport service is useful because it focuses attention on matching service qualities to markets. This approach, used here to analyze the success of the public transport system of Zurich, Switzerland, and to provide a structure for planning improvements that will be needed to meet rapidly increasing public transport demand, could help other cities design or redesign their public transport systems to be more attractive and efficient. More specifically, the approach could show how two-level public transport networks would be a viable option for medium-sized cities and large cities with dispersed settlement patterns.

Evaluation of public transport policy formulation and implementation: Case study of 24 mid-sized Nordic cities

Patients' Perspectives on Wait Times and the Referral-Consultation Process While Attending a Tertiary Diabetes and Endocrinology Centre: Is Econsultation an Acceptable Option?

44 Background: Intravenous hydration (IVH) is frequently administered to oncology patients in outpatient chemotherapy infusion units. High demand for IVH often leads to capacity restraints in the chemotherapy infusion unit, negatively impacting the availability of infusion chairs for cancer-directed therapy, causing long wait times and patient dissatisfaction. This feasibility study aimed to expand the capacity for IVH and chemotherapy at a regional site of an academic medical center, through a dedicated hydration station outside of the conventional infusion chairs. Methods: A mobile space adjacent to a nurses’ station, within the chemotherapy infusion unit, was designated and converted to accommodate two patients simultaneously for IVH. Privacy screens separated this area from the rest of the infusion unit. Patients were directly scheduled into hydration station chairs. One nurse provided patient monitoring within the hydration station. The hydration rate was standardized to 1 liter per hour, subject to change at the discretion of treating physicians. Outcomes collected included the number of patients treated, total hours of hydration, wait times, and patient satisfaction, which was ascertained by a survey administered during February 2023 of the pilot phase. Results: Over a six-month period from December 2022 through May 2023, a total of 784 patients received IVH in the hydration station. This equates to 11 hours of IVH per day, and a cumulative total of 1,590 hours over the course of six months. The average wait time from check-in to starting IVH was 7 minutes. During the same period, the average wait time for chemotherapy was halved to 16 minutes. Among 28 patients who completed the satisfaction survey and had previously received IVH in a conventional infusion chair, 24 (86%) reported that the hydration station was either better or equivalent to their prior hydration experience. 23 (82%) patients reported a shorter or similar wait time compared to the conventional process. Overall, 84% were satisfied with their experience. Importantly, no patient safety issues were reported during the six-month period. Conclusions: IVH can be safely and effectively administered outside the conventional infusion chair, resulting in decreased wait times and high patient satisfaction. This IVH model increased the capacity for cancer-directed therapy in the chemotherapy infusion unit, with no reported safety issues. It is being standardized and implemented across other infusion units across our institution.

Equal access to opportunities has emerged in public transport planning as a social objective that many transport agencies are trying to achieve. Yet in practice, not all public transport agencies are currently providing urban residents with comparable levels of service due to physical barriers in the public transport network that can significantly hinder the ability of individuals with physical disabilities to access opportunities. In countries without a strong federal accessibility act and/or with major financial constraints, some public transport agencies fall behind in applying universal access design principles, making it even harder for people with a physical disability to access opportunities. The objective of this study is to develop a methodology that can be used by public transport agencies or disability advocates to clearly highlight and quantify the performance of the public transport network in a region, in terms of providing transit services to people in a wheelchair and compare that to the service offered to an individual not in a wheelchair. In this study we use accessibility, the ease of reaching destinations, by public transport as the key performance measure in two major Canadian Cities (Montreal and Toronto). Furthermore, we focus on job accessibility in the most socially vulnerable census tracts in both cities, to evaluate levels of job accessibility for wheelchair users residing in socially vulnerable areas. The findings from our study show striking contrasts between the numbers of accessible jobs by public transport for wheelchair users compared to the general population. On average, wheelchair users in Toronto have access to 75% of jobs that are accessible to users that are not in a wheelchair, whilst their counterparts in Montreal have access to only 46% of the jobs accessible to other users. This research is expected to highlight for public transport engineers, planners, policy makers and advocates for those with disabilities, the importance of universal access in a region, especially along public transport networks, using a widely used land use and transport performance measure.

Despite widespread implementation of predicted patient wait time information systems in hospital emergency departments (EDs), the relationship between quality of announced wait time information and ED overcrowding mitigation remains unclear. This study investigates how prediction accuracy, update frequency, and patient adoption rates affect ED overcrowding level. A data-calibrated simulation model was developed using patient visit records from three metropolitan EDs in Hong Kong. We systematically varied patient adoption rates and evaluated seven wait time prediction methods across four update frequencies. Key performance metrics included the mean and standard deviation of patient wait times and percentage of patients left without being seen (LWBS rate). Accurate prediction methods combined with frequent updates significantly reduced the mean and standard deviation of patient wait times and LWBS rate as patient adoption rate increased. Conversely, inaccurate prediction methods exhibited a U-shaped performance curve. Specifically, when the patient adoption rate was sufficiently high, these methods significantly increased the mean and standard deviation of wait times and LWBS rate, compared to the case with no predicted wait time. Implementing information systems to display predicted patient wait times requires carefully balancing prediction accuracy, update frequency, and patient adoption. Accurate and timely updates can help redistribute patient load across hospital networks and improve efficiency, while poor accuracy or infrequent updates risk worsening ED congestion, especially when patient adoption rate is high. Our study calls for immediate attention from ED managers to carefully evaluate the impact of announced wait time system before wide implementation.

150 Background: In 2013, a patient reported satisfaction survey indicated 19% of patients waited 20-40 minutes, 8% 40-60 minutes and 4% over 1 hour. We initiated a project to objectively quantify the components of wait times to investigate opportunities for improvement. Methods: Utilizing existing technology in the practice management system, clinic staff use the Day List feature to capture time stamps as patients move through the clinic. We focused on provider appointments but these visits could also include business office, labs, infusion and diagnostics. It was important to define where the wait(s) occurred. The Time Stamp durations measured are as follows: Arrival to Depart – duration of each appointment; Arrival to site to Exam Start – duration of activity until ready to be seen by the provider, includes rooming, labs and business office activity. Used to compare to the patient satisfaction survey responses; Exam Start to Depart – the provider portion of the office visit, includes patient wait plus exam time. Three reports are generated: Time Stamp Error Report indicating the completeness of data collection; Average Wait Times Report with appointment counts by physician by site and average durations; Provider Wait Times Report with office visit counts, Wait Time Category counts ( &lt; 10 min, 10-20, 20-40, 40-60, and &gt; 1 hour ) and average durations. Results: There was a correlation calculation to the patient satisfaction survey of .779, with long wait times more likely to be underreported by patients. Site and physician data were available for review at site Quality Committees. The data can be used by the site to improve processes, such as lab and infusion room scheduling. Time stamps are used to communicate patient readiness for next steps in the office visit. The time stamps provide objective data to discuss patient complaints with staff. Conclusions: Patient wait times are a valued measure of patient satisfaction and quality. Full utilization of the Day List and supporting technology allows us to objectively monitor and improve this aspect of patient care. Table 1: Sample Provider Report [Table: see text]

A discrete choice analysis of transport mode choice causality and perceived barriers of sustainable mobility in the MENA region

Discuss the urban traffic line network optimization principle, objective and constraints.Presents mathematical expression for distinct optimum objects function form and corresponding constraints.Finally, varied objectives and programming model of public traffic line network optimization is produced, but evaluated and discussed the objective mathematical expression.The public transit optimizing model for medium city is established by analysing the optimizing aim and the restrictive condition.