Table 4: Estimation of times of different processes, delays, and decisions.

 

Description

Probability Distribution

Avg.

Std. Dev.

Processes

Check-in (lab/infusion/office visit)

TRIA(0, 2, 5)*

2.33

1.03

Lab test

TRIA(22, 47.9, 120)

63.30

20.73

Nurse evaluation

TRIA(5, 15, 30)*

16.67

5.14

Provider office visit

UNIF(30, 60)

45.0

8.66

Each nurse check

TRIA(3, 5, 7)*

5.0

0.82

Pharmacy check

UNIF(10, 20)

15.0

2.89

Pick/set up premeds

UNIF(10, 20)

15.0

2.89

Pharmacist making chemos§

UNIF(15, 25)

20

2.89

Infusion (regular: No reaction)

TRIA(100, 120, 140)

120

8.16

Infusion (with supportive care)

TRIA(100, 120, 140)

120

8.16

Infusion (with lowering the rate)

110 + ERLA(51, 1)

161.0

7.14

Patient discharge

ERLA(29, 1)

29.0

5.39

Each nurse involvement during walk around

TRIA(1, 3, 5)*

3.0

0.82

Inter-arrival time between walk arounds (when there is no reaction)

TRIA(10, 15, 20)

15.0

2.04

Inter-arrival time between walk arounds (when there is a reaction)

TRIA(5, 10, 15)

10.0

2.04

Delays

Between activation of medication (by nurse) and modification made (by pharmacy)

TRIA(10, 15, 20)

15.0

2.04

Before chemotherapy start

TRIA(10, 15, 20)

15.0

2.04

Decisions

Drug reaction (only for the 1st cycle)

UNIF(0, 20)

10

5.77

Strategy after reaction (for any cycle): Continue with supporting care

Continue while lowering the rate

Completely stop the infusion

 

80 (all TDs)*

19 (TD = 1), 20 (TD 2)*

1 (TD = 1), 0 (TD 2)*

 

-

-

-

 

-

-

-

Red flag

UNIF(0, 50) (CYC = 1)

25

14.43

UNIF(0, 10) (CYC 2)

5

2.89

Go vs. no-go

UNIF(30, 70)*

50

11.55

Provider available

99

-

-

Instances shown by *are estimated based on expert opinions; This process is done in parallel with the previous row (pharmacy check); §If there are multiple drugs, UNIF (5, 15) is added for each extra drug;

Unit for processes and delays: Minutes; Unit for decisions: %; CYC: Cycle; TD: Treatment Day; ERLA: Erlang Distribution; TRIA: Triangular Distribution; UNIF: Uniform Distribution.