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The profession of anaesthesia technologist is a relatively new profession in Germany. The German hospital Association published the first training guideline in 2011. Likewise the surgical technologist profession, the profession of anaesthesia technologists are not officially certified. Hence, similar disadvantages such as further career restrictions and uncertainties in case of unemployment exist. Even the hospitals need to cover the full training expenses. The training of an anaesthesia technologist lasts three years, containing of practical work experience within the anaesthesia units such as the post-anaesthesia caring unit and a theoretical education. The action site is limited to the anaesthesia units only. An anaesthesia technologist is an assistant to the doctor and takes care of the patient before, during and after the anaesthesia. Since the anaesthesia technologist profession is a very young profession group, little is known about the preferences of this group. However, hospital manager need to understand the individual preferences to be able to provide a target group tailored recruitment.
The motivation was to provide results to inform the human resource management of hospitals about the preferences of the very young profession group of anaesthesia technologist with respect to contribute to a successful development of this profession in order to cope with the current labour shortage crisis.
Nursing without caring?
(2019)
We know that existing professions in the health care sector value work environment and job conditions to a great extent. However, we are also witnessing an expansion of new roles into the health care sector, many of which substitutie the tasks of existing professions. This may be efficient, in that it releases professionals’ time. However, there is little understanding of what motivates these new professions in entering or remaining in these newly created roles. This study tries to evaluate the preference structure of one of these new staff groups, surgical technologist, through examining the preferences of trainees, defined over a number of attributes, in this group. The DCE study covers 80% of the target population. The results show a vigorous disfavour towards any perceived nursing job characteristics such as caring activities, hierarchical work environment or shift types. The results inform policy makers and hospital manager about the importance to focus not only on the nursing profession but also to take into account the existence of a group of people who is willing to work within the health care system however, associated with strong preferences against nursing activities, especially caring. Implementing and further development of new and specialised profession through reallocating former nursing tasks- should be considered while coping with labour shortage.
In this thesis, we(1) use operations research methods to provide insights into three areas associated with health care operations management. In Chapter 2, we use a discreteevent supply chain simulation to asses if coordination among partners is beneficial in a supply chain with the characteristics of the German pharmaceutical market. We find that the greatest cost savings and service levels could be achieved through a highly integrated collaboration although most of its impact could already be achieved through sharing point-of-sales demand information. Results suggest that coordination is most beneficial in situations where product shelf life is short and demand variation is high.
In Chapter 3 we consider quality-of-life maximizing sequences of prophylactic surgeries for female carriers of a BRCA1/2 genetic mutation, who face a significantly elevated breast and ovarian cancer risk. Using a Markov Decision Process model, we determine the optimal surgery sequence that maximizes the carrier’s expected lifetime qualityadjusted life years (QALYs). Baseline results demonstrate that a QALY-maximizing sequence recommends a bilateral mastectomy between ages 30 and 60 and bilateral salpingo-oophorectomy after age 40 for BRCA1 carriers. Surgeries are recommended later for BRCA2 carriers, as their cancer risk is lower. The model’s structural properties show that when one surgery has already been completed, there exists an optimal control limit after which performing the other surgery is always QALY-maximizing.
In Chapter 4, we develop a two-stage model for optimizing when and where to assign Ebola treatment unit (ETU) beds—across geographic regions—during an infectious disease outbreak’s early phase. The first stage includes a dynamic transmission model that forecasts occurrence of new cases at the regional level, thus capturing connectivity among regions; in this stage we introduce a coefficient for behavioral adaptation to changing epidemic conditions. The second stage includes two approaches to efficiently allocate intervention resources across affected regions. Such an allocation could have prevented up to 3,434 infections over an 18-week period during the 2014 Ebola outbreak in West Africa, a 58% improvement compared with the actual allocation.
(1) In Chapter 2, 3, and 4, the term ’we’ refers to the authors of Nohdurft & Spinler (2016), Nohdurft et al. (2016a), and Nohdurft et al. (2016b), respectively.