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South Carolina HIV/AIDS Council Outreach Improvement Project

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Fall 2016

MGSC 485

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Project Team

  • Matt Celani
    • (404) 771-3190
    • ccelani@email.sc.edu

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  • Audrey Davis
    • (713) 870-2886
    • acd@email.sc.edu

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  • Nicholas Durr
    • (615) 627-8785
    • ndurr@email.sc.edu

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  • Kirstin McWhite
    • (803) 403-5050
    • kmcwhite@email.sc.edu

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  • Briana Young
    • (513) 288-5538
    • beyoung@email.sc.edu

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  • Faculty Mentor: Dr. Sanjay Ahire
    • (803) 767-7609
    • ahire@moore.sc.edu

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Client Team

  • Dr. Gaddist
  • Dr. White
  • Cynthia Howell
  • Sandra Wise

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S.C.H.A.C. Resource Pool Information

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S.C.H.A.C. Resource Pools

Resource #

Resource Pool

Resource Units

Hours per Year

Total Hours per Year

(A)

Dr. White

1

50hr/wk*50wk/yr*.9

2250

(B)

Dr. Gaddist

1

50hr/wk*50wk/yr*.9

2250

(C)

Dr. Rojas

1

6hr/wk*25wk/yr*.9

270

(D)

Nurse

1

6hr/wk*25wk/yr*.9

270

(E)

Counselors

12

50hr/wk*50wk/yr*12*.9

27,000

*Based on 90% utilization

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S.C.H.A.C. Resource Pools

Resource #

Resource Pool

Resource Units

Hours per Year

Total Hours per Year

(F)

Office Manager

1

45hr/wk*50wk/yr*.9

2025

(G)

Admin

2

55hr/wk*50wk/yr*2*.9

4950

(H)

Sandra Wise

1

50hr/wk*50wk/yr*.9

2250

(I)

Mobile Unit

1

50hr/wk*50wk/yr*.9

2250

*Based on 90% utilization

Total Budget: $2,300,000

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S.C.H.A.C. Outreach Efforts Information

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S.C.H.A.C. Outreach Efforts

Effort number

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1

2

3

4

5

Effort name

​

Condom Distribution DHEC

Condom Distribution CDC

B.I. Safety Counts

Dining Out for Life

B.I. Healthy Relationships (Sumter)

At risk clients yielded

14

1 site=350 condoms

1person=5 condoms

1 visit=8 sites

560 persons reached every visit

2.5% yield = 0.025*560=14

14

1 site=350 condoms

1person=5 condoms

1 visit=8 sites

560 persons reached every visit

2.5% yield = 0.025*560=14

60

(cohort of 60 for 7 sessions)

25

20 restaurants 500*.05=25

5% will get tested

40

(cohort of 40 for 5 sessions)

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S.C.H.A.C. Outreach Efforts

Effort number

​

6

7

8

9

10

Effort name

​

B.I. Healthy Relationships (11-1113)

World AIDS Day

B.I. VOICES

B.I. SiHLE

Mobile Unit: Outlying Colleges

At risk clients yielded

24

(cohort of 24 for 5 sessions)

290

2900*10%=290

5% likely to get tested, 5% off site referral

200

(cohort of 200 for year)

40

(cohort of 40 for 5 sessions)

40

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S.C.H.A.C. Outreach Efforts

Effort number

​

11

12

13

14

15

Effort name

​

Mobile Unit: Local Colleges

Mobile Unit: Local Community

Mobile Unit: Outlying Community

B.I. Safe in the City

B.I. Healthy Relationships (15-1502)

At risk clients yielded

40

25

25

40

(cohort of 40)

24

(cohort of 24 for 5 sessions)

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S.C.H.A.C. Outreach Efforts

Effort number

​

16

17

18

Effort name

​

B.I. 3MV (11-1113)

B.I. 3MV (12-1201B)

B.I. 3MV Sumter

(12-1201A)

At risk clients yielded

40

(cohort of 40 for 7 sessions)

40

(cohort of 40 for 7 sessions)

40

(cohort of 40 for 7 sessions)

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S.C.H.A.C. Resource Capacity Bills for Outreach Efforts

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Example Capacity Bill: World AIDS Day

Resource Pool

Planning and Execution Time per Effort (minutes)

Treatment Time of In-Clinic Patients from one Effort (minutes)

Total Time per Effort Required (minutes)

Dr. White

12480

2900

15380

Dr. Gaddist

14800

580

15380

Dr. Rojas

0

348

348

Nurse

0

105

105

Counselors

6240

17400

23640

Office Manager

2925

2900

5825

Admin

62400

2900

65300

Sandra Wise

11700

0

11700

Mobile Unit

300

0

300

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Example Capacity Bill: World AIDS Day

Resource Pool

Dollars / Minute

Minutes Utilized per Effort

Total Cost per Effort

Dr. White

$0.96

15380

$14765

Dr. Gaddist

$1.05

15380

$16149

Dr. Rojas

$1.00

348

$348

Nurse

$0.40

105

$42

Counselors

$0.27

23640

$6383

Office Manager

$0.33

5825

$1922

Admin

$0.68

65300

$44404

Sandra Wise

$0.28

11700

$3276

Mobile Unit

Fixed cost (N/A)

300

$0

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$87289

*Net Cost = Operating Cost - Revenue

= $87289 - $80000 = $7,289

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Resource Allocation Linear Programming Model Layout

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Model Structure

    • Decision Variables (18)
      • How many instances of each effort should be conducted in a year?
    • Objective Function
      • Maximize the total number of at-risk clients reached over the year through an optimal mix of the decision variables
    • Constraints (46)
      • Resource Constraints: annual resource capacity of a resource pool cannot be exceeded by an optimal mix of efforts (10)
      • Upper Limits: maximum amount of efforts to be had (18)
      • Lower Limits: minimum amount of efforts to be had (18)

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Model Structure: Example Constraints

  • Resource Constraints (10)
    • Counselors: there are 12 that are able to work 50hr/wk
  • Lower Limit (18)
    • Lower Limit: World AIDS day, there must be at least 1
  • Upper Limit (18)
    • Upper Limit: World AIDS day, there must be no more than 1

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Lower Limit Constraints

Effort

Lower Limit

Logic

Condom Distribution DHEC

26

Twice a month throughout the year

Condom Distribution CDC

26

Twice a month throughout the year

B.I. Safety Counts

2

Current operating state

Dining out for Life

1

Current operating state

B.I. Healthy Relationships (Sumter)

4

Current operating state

B.I. Healthy Relationships (11-1113)

4

Current operating state

World AIDS Day

1

Current operating state

B.I. Voices

1

Current operating state

B.I. SiHLE

4

Current operating state

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Lower Limit Constraints

Effort

Lower Limit

Logic

Mobile Unit: Outlying Colleges

25

Twice a month throughout the year

Mobile Unit: Local Colleges

25

Twice a month throughout the year

Mobile Unit: Local Community

25

Twice a month throughout the year

Mobile Unit: Outlying Community

25

Twice a month throughout the year

B.I. 15-1502

4

Current operating state

B.I. Healthy Relationships (15-1502)

4

Current operating state

B.I. 3MV (12-1201B)

4

Current operating state

B.I. 3MV (11-1113)

4

Current operating state

B.I. 3MV (Sumter)

4

Current operating state

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Upper Limit Constraints

Effort

Upper Limit

Logic

Condom Distribution DHEC

208

26 visits * 8 sites = 208 sites/visit

Condom Distribution CDC

208

26 visits * 8 sites = 208 sites/visit

B.I. Safety Counts

7

52 wk/yr / 7 sessions = 7 possible cohorts/yr

Dining out for Life

1000

To see if the yield is worth the resources

B.I. Healthy Relationships (Sumter)

10

52 wk/yr / 5 sessions = 10 possible cohorts/yr

B.I. Healthy Relationships (11-1113)

10

52 wk/yr / 5 sessions = 10 possible cohorts/yr

World AIDS Day

1

Maximum of 1 event per year

B.I. Voices

1

Year-long process for 200 patient target

B.I. SiHLE

10

52 wk/yr / 5 sessions = 10 possible cohorts/yr

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Upper Limit Constraints

Effort

Upper Limit

Logic

Mobile Unit: Outlying Colleges

52

This reflects going out once a week, every week in the year

Mobile Unit: Local Colleges

52

This reflects going out once a week, every week in the year

Mobile Unit: Local Community

52

This reflects going out once a week, every week in the year

Mobile Unit: Outlying Community

52

This reflects going out once a week, every week in the year

B.I. 15-1502

7

52 wk/yr / 7 sessions = 7 possible cohorts/yr

B.I. Healthy Relationships (15-1502)

10

52 wk/yr / 5 sessions = 10 possible cohorts/yr

B.I. 3MV (12-1201B)

7

52 wk/yr / 7 sessions = 7 possible cohorts/yr

B.I. 3MV (11-1113)

7

52 wk/yr / 7 sessions = 7 possible cohorts/yr

B.I. 3MV (Sumter)

7

52 wk/yr / 7 sessions = 7 possible cohorts/yr

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Current State Mix Results

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The Current State Mix and At-risk Clients Reached

Effort #

Effort Name

Yield

Current Mix

At-Risk Clients Reached

1

Condom Distribution DHEC

14

26

364

2

Condom Distribution CDC

14

26

364

3

B.I. Safety Counts

60

2

120

4

Dining out for Life

25

1

25

5

B.I. Healthy Relationships (Sumter)

40

4

160

6

B.I. Healthy Relationships (11-1113)

24

4

96

7

World AIDS Day

290

1

290

8

B.I. VOICES

200

1

200

9

B.I. SiHLE

40

4

160

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The Current State Mix and At-risk Clients Reached

Effort #

Effort Name

Yield

Current Mix

At-Risk Clients Reached

10

Mobile Unit: Outlying Colleges

40

25

1000

11

Mobile Unit: Local Colleges

40

25

1000

12

Mobile Unit: Local Community

25

25

625

13

Mobile Unit: Outlying Community

25

25

625

14

B.I. Safe in the City

40

4

160

15

B.I. Healthy Relationships (15-1502)

24

4

96

16

B.I. 3MV (11-1113)

40

4

160

17

B.I. 3MV (12-1201B)

40

4

160

18

B.I. 3MV Sumter

(12-1201A)

40

4

160

Total Clients Reached: 5,765

Total in-clinic patients per year: 1,043

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Resources Used for �Current Mix

Resource #

Resource Pool

Minutes Available per Year

Percent Utilization*

(A)

Dr. White

135000

17%

(B)

Dr. Gaddist

135000

13%

(C)

Dr. Rojas

8100

15%

(D)

Nurse

8100

57%

(E)

Counselors

1620000

29%

(F)

Office Manager

121500

12%

(G)

Admin

297000

27%

(H)

Sandra Wise

135000

26%

(I)

Mobile Unit

135000

34%

(J)

Cost

$2.3 million

28%

* Utilization for the 18 outreach efforts only, does not take into account other duties besides the efforts listed.

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Recommended Mix Results

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Recommended Mix and At-risk Clients Reached

Effort #

Effort Name

Yield

Recommended Mix

At-Risk Clients Reached

1

Condom Distribution DHEC

14

60

840

2

Condom Distribution CDC

14

26

364

3

B.I. Safety Counts

60

7

420

4

Dining out for Life

25

5

130

5

B.I. Healthy Relationships (Sumter)

40

10

400

6

B.I. Healthy Relationships (11-1113)

24

10

240

7

World AIDS Day

290

1

290

8

B.I. VOICES

200

1

200

9

B.I. SiHLE

40

10

400

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Recommended Mix and At-risk Clients Reached

Effort #

Effort Name

Yield

Recommended Mix

At-Risk Clients Reached

10

Mobile Unit: Outlying Colleges

40

52

2080

11

Mobile Unit: Local Colleges

40

52

2080

12

Mobile Unit: Local Community

25

52

1300

13

Mobile Unit: Outlying Community

25

52

1300

14

B.I. Safe in the City

40

7

280

15

B.I. Healthy Relationships (15-1502)

24

10

240

16

B.I. 3MV (11-1113)

40

7

280

17

B.I. 3MV (12-1201B)

40

7

280

18

B.I. 3MV Sumter

(12-1201A)

40

7

280

Total Clients Reached: 11,402

Total in-clinic patients per year:1,624

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Resources Used for �Recommended Mix

Resource #

Resource Pool

Minutes Available

Percent Utilization*

(A)

Dr. White

135000

21%

(B)

Dr. Gaddist

135000

13%

(C)

Dr. Rojas

8100

24%

(D)

Nurse

8100

100%

(E)

Counselors

1620000

58%

(F)

Office Manager

121500

18%

(G)

Admin

297000

34%

(H)

Sandra Wise

135000

100%

(I)

Mobile Unit

135000

70%

(J)

Cost

$2.3 million

60%

* Note that this is based on 90% availability of the resource pools.

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Conclusions

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Strategic Use of the Optimization Model

  • Helps understand current resource usage and bottlenecks and underutilized resources
  • Helps optimize the efforts (and increase outreach) for the current resource levels (5,765 to 11,402 per year)
  • Helps where to focus on process improvement by looking at the capacity bills (amount each resource pool used for each effort)
  • Helps to devise a strategy for achieving future targets of scale of outreach (e.g., how to attain outreach of 25,000 per year)

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Implications for Efforts and Resources

  • Implement Effort Budget
    • Impact: Prioritizing efforts based on respective budgets and keeping all efforts cost effective
  • Run this report each year
    • Impact: Gain visibility of resource and cost utilization through records
  • Increase Mobile Unit Outreach
    • Impact: Solver gave full potential to Mobile Outreach, hitting the max of 52 for each individual effort, highly increasing patient yield
  • Minimize rework and implement SOP’s
    • Impact: Decrease loss of funds due to incorrect testing procedures and no-show patients
    • This will have an impact on reducing capacity bills and we could do more of efforts with the same resources
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End of Presentation

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Thank You