EFFECTS OF PROBLEM-BASED SCHEDULING ON PATIENT WAITING AND STAFF UTILIZATION OF TIME IN A PEDIATRIC CLINIC

The patient scheduling system in a pediatric outpatient clinic was changed from time-based to problem-based in an A-B-A-B reversal design. During baseline, time-based scheduling was in effect with patients being scheduled in 15-min periods regardless of presenting problem. During intervention, a receptionist matched client problems with time slots so that a more extensive treatment was allocated more time. Problem-based scheduling resulted in a substantial decrease in mean number of minutes spent in clinic across all presenting problems. Waiting time increased to baseline levels when problem-based scheduling was removed and decreased again on reintroduction of the program. A follow-up check conducted 1 month after the end of the second intervention phase revealed that the effects were maintained. The problem-based schedule also resulted in an increase in the proportion of extra time that medical staff had available and produced a positive consumer response.     

A goal programming model for crew duties generation

An Erratum has been published for this article in Journal of Multi‐Criteria Decision Analysis 10(5) 2001, 285. This paper proposes a model for the generation of daily work duties of airside crew (being bus drivers) at the Hong Kong International Airport. The results can be adopted as a good crew schedule, in the sense that it is both feasible, satisfying requirements of various work conditions, and ‘optimal’ in minimizing overtime shifts. It is formulated as a goal programme, specifically designed to cater for the manpower planning issues to handle frequent changes of flight schedules by flexibility in work patterns of driver duties. Illustrative results from an actual case study are given. Copyright © 2001 John Wiley & Sons, Ltd.     

The impact of an implementation intention to improve mealtimes and reduce jet lag in long-haul cabin crew

Objective: Jet lag is common place amongst long-haul cabin crew. Timed food has been shown to reset the circadian rhythm in rodents. Implementation intentions have been used to change eating behaviour. Mealtimes could therefore be used as a countermeasure to reduce jet lag and improve alertness in long-haul cabin crew through forming an implementation intention to improve the regularity of meals on days off.

Design: Sixty long-haul crew took part in a randomised controlled trial, with two conditions: forming an implementation intention to eat regular meals on days off vs. no implementation intention. Pre-intervention measurements were taken at baseline (before a long-haul trip) and post-intervention measures were taken on the first and second days off post-trip.

Main outcome measures: Subjective jet lag (unidimensional and multidimensional) and objective alertness (Psychomotor Vigilance Task (PVT)).

Results: Mixed ANOVA showed a significant condition x time interaction for unidimensional jet lag but not for multidimensional jet lag and objective alertness. In particular, the formation of an implementation intention to alter mealtimes resulted in a reduction of unidimensional jet lag.

Conclusion: Implementation intentions can be used to alleviate jet lag in long-haul crew through promoting a change in mealtimes.     

Predicting jet lag in long-haul cabin crew: The role of illness cognitions and behaviour

Objective: Established risk factors for jet lag are mostly physiological including circadian preference, age, gender, the number of flight zones crossed and to some extent direction of travel. Some research has also highlighted a role for psychosocial factors including sleep, diet and ‘circadian’ health behaviours and illness cognitions although this remains relatively untested. The aim of this study was to evaluate the role of sleep, diet and illness cognitions in predicting perceived jet lag amongst long-haul crew.

Design: Sixty long-haul crew took part in a longitudinal study. Profile characteristics (including chronotype), preparation strategies (sleep, eating and ‘circadian’ behaviours) and illness cognitions were measured at baseline (before a trip).

Main outcome measures: Subjective jet lag (unidimensional and multidimensional) was measured on the crews’ second day off (post-trip).

Results: Hierarchical regression analyses showed that unidimensional jet lag was predicted by the belief in a cyclical timeline, whereas multidimensional jet lag was predicted by multidimensional jet lag at baseline and to a lesser extent by identity. No role was found for profile characteristics and preparation strategies.

Conclusion: Illness cognitions partly explain the experience of perceived jet lag in long-haul cabin crew indicating that jet lag is in part a psycho-social construct, not just a biological one.     

The influence of event-time (vs. clock-time) scheduling style on satiation

Consumers often need to schedule different activities. While consumers who adopt a clock-time scheduling style decide when to transition from one activity to the next according to external temporal cues (e.g., clock), those who adopt an event-time scheduling style tend to perform each activity until they feel internally that it is completed. This research showed that consumers' scheduling style (clock-time vs. event-time) could influence their satiation with repeated consumption. Four studies involving actual consumption across various domains (e.g., music, artwork, food) demonstrated that an event-time scheduling style leads to more rapid satiation with repeated consumption than a clock-time scheduling style because event-timers (vs. clock-timers) have higher private self-focus. The results further revealed that the satiation effect of scheduling style is mitigated when consumers are distracted from their private self or informed of additional sensitization cues in the consumption stimuli.     

Influence of practice schedules and attention on skill development and retention

Focus of attention during dual-tasks and practice schedules are important components of motor skill performance and learning; often studied in isolation. The current study required participants to complete a simple key-pressing task under a blocked or random practice schedule. To manipulate attention, participants reported their finger position (i.e., skill-focused attention) or the pitch of an auditory tone (i.e., extraneous attention) while performing two variations of a dual-task key-pressing task. Analyses were conducted at baseline, 10 min and 24 h after acquisition. The results revealed that participants in a blocked schedule, extraneous focus condition had significantly faster movement times during retention compared to a blocked schedule, skill focus condition. Furthermore, greatest improvements from baseline to immediate and delayed retention were evident for an extraneous attention compared to the skill-focused attention, regardless of practice schedule. A discussion of the unique benefits an extraneous focus of attention may have on the learning process during dual-task conditions is presented.