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Using simulation model as a tool for analyzing bus service reliability and implementing improvement strategies.

ABSTRACT: Bus services naturally tend to be unstable and are not always capable of adhering to schedules without control strategies. Therefore, bus users and bus service providers face travel time variation and irregularity. After a comprehensive review of the literature, a significant gap was recognized in the field of public transportation reliability. According to literature, there is no consistency in reliability definition and indicators. Companies have their own definition of bus service reliability, and they mostly neglect the passengers' perspective of reliability. Therefore, four reliability indicators were selected in this study to fill the gap in the literature and cover both passengers' and operators' perceptions of reliability: waiting time and on-board crowding level from passengers' perspective, and headway regularity index at stops (HRIS) and bus bunching/big gap percentage from operators' perspective. The primary objective of this research is to improve the reliability of high frequency of bus service and simulation tools currently being used by the public transportation companies. Therefore, a simulation model of bus service was developed to study the strategies to alleviate it. Four different types of strategies were selected and implemented according to Route U32 (Kuala Lumpur) specifications. Model out-put showed that control strategies such as headway-based dispatching could significantly improve headway regularity by almost 62% and the waiting time by 51% on average. Both holding strategies at key stops (previous and Prefol holding) have shown an almost similar impact on reliability indicators. Waiting time was reduced by 44% and 43% after the previous and Prefol Headway strategies were adopted, respectively. However, the implementation of the component of headway-based strategies at the terminal and key stops showed the best impact on reliability, in terms of passenger waiting time. Waiting time and excess waiting time were both significantly reduced by 52.86% and 81.44%, respectively. Nevertheless, the strategies did not show any significant positive effect on the level of crowding during morning peak hours.

SUBMITTER: Moosavi SMH

PROVIDER: S-EPMC7205290 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Using simulation model as a tool for analyzing bus service reliability and implementing improvement strategies.

Moosavi Seyed Mohammad Hossein SMH Ismail Amiruddin A Yuen Choon Wah CW

PloS one 20200507 5

Bus services naturally tend to be unstable and are not always capable of adhering to schedules without control strategies. Therefore, bus users and bus service providers face travel time variation and irregularity. After a comprehensive review of the literature, a significant gap was recognized in the field of public transportation reliability. According to literature, there is no consistency in reliability definition and indicators. Companies have their own definition of bus service reliability ...[more]

PMID: 32379848

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Project description:BackgroundAssessing implementation fidelity is highly recommended, but successful approaches can be challenging. Family Planning Elevated (FPE) is a statewide contraceptive initiative which partnered with 28 health clinics across Utah. To assess implementation fidelity, we developed in-situ high-fidelity simulation training to both determine clinic adherence to FPE and offer education to implementing teams. This study aimed to develop, pilot, and assess the use of simulation as a tool for measuring implementation fidelity.MethodsWe developed two simulation scenarios to determine implementation fidelity: one scenario wherein a client is seeking a new method of contraception and another in which the same client has returned to discontinue the method. Both simulations contained multiple aspects of program implementation (e.g., determining program eligibility). We then offered simulations to all FPE partner organizations. To assess simulation training as a tool for determining implementation fidelity, we developed strategies aligned with each aspect of an adapted RE-AIM framework, including pre-post surveys, acceptability and self-efficacy testing, a checklist for programmatic adherence, field notes, action planning and analysis of monitoring data.ResultsFifteen clinical sites and 71 team members participated in the in-situ simulations. Assessment of the checklist showed that 90% of the clinics successfully demonstrated key program components, including person-centered counseling techniques such as sitting at the patient's level (95.8%); asking open-ended questions (100%); and explaining how to use the contraceptive method selected (91.7%). More than half of clinics fell short in programmatic areas including: confirmation that the FPE program covered same-day intrauterine device insertion (54.2%), and education on health risks associated with the selected contraceptive method (58.3%). After simulation, participants reported improved knowledge of how FPE works (p = < 0.001), increased ability to identify FPE-eligible clients (p = 0.02) and heightened self-efficacy in helping clients select a method (p = 0.03). Participants were satisfied with the simulations, with most (84.1%) reporting that the simulation exceeded their expectations.ConclusionsHighly-realistic in-situ family planning simulations are acceptable to participants, positively change knowledge and clinical team confidence, and can identify systems gaps in clinical care and program implementation. Simulation offers a reciprocal way of monitoring implementation fidelity of a family planning access initiative.Trial registrationThis project was determined to be exempt by the IRB of the University of Utah, the larger Family Planning Elevated program under which this pilot study was nested is registered at ClinicalTrials.gov Identifier: NCT03877757 .

Project description:BackgroundLetters of complaint written by patients and their advocates reporting poor healthcare experiences represent an under-used data source. The lack of a method for extracting reliable data from these heterogeneous letters hinders their use for monitoring and learning. To address this gap, we report on the development and reliability testing of the Healthcare Complaints Analysis Tool (HCAT).MethodsHCAT was developed from a taxonomy of healthcare complaints reported in a previously published systematic review. It introduces the novel idea that complaints should be analysed in terms of severity. Recruiting three groups of educated lay participants (n=58, n=58, n=55), we refined the taxonomy through three iterations of discriminant content validity testing. We then supplemented this refined taxonomy with explicit coding procedures for seven problem categories (each with four levels of severity), stage of care and harm. These combined elements were further refined through iterative coding of a UK national sample of healthcare complaints (n= 25, n=80, n=137, n=839). To assess reliability and accuracy for the resultant tool, 14 educated lay participants coded a referent sample of 125 healthcare complaints.ResultsThe seven HCAT problem categories (quality, safety, environment, institutional processes, listening, communication, and respect and patient rights) were found to be conceptually distinct. On average, raters identified 1.94 problems (SD=0.26) per complaint letter. Coders exhibited substantial reliability in identifying problems at four levels of severity; moderate and substantial reliability in identifying stages of care (except for 'discharge/transfer' that was only fairly reliable) and substantial reliability in identifying overall harm.ConclusionsHCAT is not only the first reliable tool for coding complaints, it is the first tool to measure the severity of complaints. It facilitates service monitoring and organisational learning and it enables future research examining whether healthcare complaints are a leading indicator of poor service outcomes. HCAT is freely available to download and use.

Project description:Clinician educators-who work at the intersection of patient care and resident education-are well positioned to respond to calls for better, safer patient care and resident education. Explicit lessons that address implementing health care improvement and associated residency training came out of the Academic Chronic Care Collaboratives and include the importance of: (1) redesigning the clinical practice as a core component of the residency curriculum; (2) exploiting the efficiencies of the practice team; (3) replacing "faculty development" with "everyone's a learner;" (4) linking faculty across learning communities to build expertise; and (5) using rigorous methodology to design and evaluate interventions for practice redesign. There has been progress in addressing three thorny academic faculty issues-professional satisfaction, promotion and publication. For example, consensus criteria have been proposed for both faculty promotion as well as the institutional settings that nurture academic health care improvement careers, and the SQUIRE Publication Guidelines have been developed as a general framework for scholarly improvement publications. Extensive curricular resources exist for developing the expert faculty cadre. Curricula from representative training programs include quantitative and qualitative research methods, statistical methodologies appropriate for measuring systems change, organizational culture, management, leadership and scholarly writing for the improvement literature. Clinician educators-particularly those in general internal medicine-bear the principal responsibility for both patient care and resident training in academic departments of internal medicine. The intersection of these activities presents a unique opportunity for their playing a central role in implementing health care improvement and associated residency training. However, this role in academic settings will require an unambiguous development strategy both for faculty and their institutions.

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Using simulation model as a tool for analyzing bus service reliability and implementing improvement strategies.

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Using simulation model as a tool for analyzing bus service reliability and implementing improvement strategies.

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