Napa Valley Care Center Database

Damla BayindirIvette Bigit

Robert Dooley Michael EllisonAshwini Purohit

Ma Than Than ThaikJannat Dena Vaziri

Final Presentation OverviewClient DescriptionOur GoalEERRelational SchemaRelational Schema ScreenshotNormalization AnalysisQueriesFormsReports

Client Description

Napa Valley Care Center is a nursing care center with ~100 employees

Focus on Station 2: rehabilitation and short-term care

43 beds in this section

All patient data and forms are currently recorded by hand

1000+ records of weekly summaries

Schedules of employees and shifts are confusing

Our Goal

Increase the efficiency of the care center

Save the employees time

Eliminate errors and inconsistencies in

scheduling

Reduce the number of duplicate charting errors

Make patient health information more consistent, reliable,

and accessible to nurses

Universalize all record keeping techniques

Patient Employee

Medication

InsuranceCompany

RNAperforms

Bed Shift

CNA

worksLives in Assigned to

(0,N)

(1,M)

(0,N) (1,N) (1,N) (0,N)

(1,1)

(0,N)

(0,N)

Center Assessmen

t

Center Prescription

p, d

p, d

Visitor

visits

includes

Meal Admin

(1,1)

(1,1)

(1,1)

(0,1)

(0,N)

(0,M)

(0,N) (1,N)

(1,N)

(1,N)

Assessment

about

Medication HistoryObservation

History p, d

PersonalMedication

Inventory

Center Treatment

Treatment History

uses

Treatment Types

includes

has(0,1)

(1,1)

(0,N)

(1,1)

(1,1)

(0,N)

(0,N)

(0,1)

(1,1)

(0,N)

has

Pre-existing Medical History

Permission

gives

Care Center Activityperforms

LVN

RN

ADL

Trained for

Activity Typesp, d

timestamp

Is a type of

(1,1)

(0,N)

(0,N)

(1,N)

assess(1,N) (1,N)

Trained for

(1,N)

(0,N)

t, d

IVs Non-IV Trained for

Trained for(1,N) (0,N)

(1,N)(0,N)

External treatment

type

Trained for

Supplier

Provided byhas

(General) Inventory item

(1,1)

(0,N)

(1,N)

(1,1)

Errorduring

Due to

(0,N)

(1,1)(0,N)

(1,N)

Procedures

t, d

has

(0,N)

(1,1)

uses

(1,1)

(0,N)

(1,N)(0,N)

p, d

involves

(0,N) (1,N)

Rehab Trained for(1,N) (0,N)

Medication Admininvolves

Food Item

(1,N)(1,N)

Insurance Plan from

has

(1,1) (0,N)

Relational Schema1.Patient(PSSN, Fname, Lname, PhoneNum, BedID5, PreMID13)2.Employee(ESSN, EmpFName,EmpLName)2a. RN(ESSN2)2b. LVN(ESSN2)

2c. RNA(ESSN2)2d. CNA(ESSN2)

3. Visitor(VID, Vfname, Vlname)4.Permission(PID,PermissionName, Description)5.Bed(BedID, RoomNum, XCoord, YCoord)6.PatientInsurance (PSSN1, PlanID36, MemberID)7.Shift(ShiftID, ShiftName, StartTime, EndTime)8.Error( ErrorID,ShiftID7,ErrorName,ErrorDescription)9.Supplier(SupID,SupName,Contact)10. Procedures(ProcedID) 10a. ExternalTreatmentType(ProcedID10, ExternalName,ExternalDescription)

Relational Schema (cont.) 10b. Non-IV(ActID11,NonlVName, Description) 10c. IV(ActID11,IVname,Description)11.Activity Types(ActID,ActName,ActDescription) 11a. ADL(ActID11,ADLName,ADLDescription) 11b. Assessment(ActID,AssessName,AssessDescription) 11c. Treatment Types(ActID11 ,ProcedID10, ProcedID, TreatmentName, TreatmentDescription) 11d. Meal Admin(AdminMealID,ActID11,TimeServed) 11e. Rehab(RehabID,RehabName,RehabDescription) 11f. Medication Admin(AdminMID,ActID11,MedID14)12. Care Center Activity(ActID,PSSN1,ESSN2,CCDate, CCName,CCDesc,) 12a. Center Treatment(ActID,PSSN1,ESSN2,CCDate,TTID11c, ProcedID,MedID14)

12b. Center Prescription (ActID,PSSN1,ESSN2,CCDate ,MedID14,TTID11c) 12c. Center Assessment(ActID,PSSN1,ESSN2,CCDate,Scale (1-10)) 13. Pre-existing Medical History (PSSN1)

13a. Observation History(PSSN1,ObsDate,ObsDescription)13b. Treatment History(PSSN1,ProcedID10,TreatmentName, TreatmentDescription,TTID11c,AID )

13c. Medication History(PSSN1,MedID13 MedDate,Medication) 14. Medication(MedID,MedName,Dosage, Frequency,SupID9,

LeadTime,InterestRate,UnitCostSetupCost,Demand)15. General Inventory Item(MedID14, InvName,InvType,CurrentInventory) 16. Food Item(FoodID,FoodName,FoodCalories) 17. PersonMedicationInventory(MedID14,PSSN1,Quantity)18.EmployeeJunctionShift(ShiftID7,ESSN2) 19.BedjuctionShift(BedID5,ShiftID7) 20.BedAssessShift(BedID5,ShiftID7,Assessment )

Relational Schema (cont.)

Relational Schema (cont.)21.GivesPermission(PID4,PSSN1, PerDate, Acc/Rej) 23.ErrorJunctionEmp(ErrorID8,ESSN2)24.PatVisJunc(VID3,PSSN1,VMonth, VDay,Vyear)25. AdminmealJunctionFood(AdminMealID11d,FoodID16)26. AdminMIDjunctionMED(MedID14,ActID11)27. PrescrıbedMedication(PSSN,AdminMID11d,MedID14 ,StartDate, EndDate) 28. EmployeeJunctionADL(ActID11,ESSN2)29. EmployeeJunctionCC(ESSN2,ActID12)30. LVNjunctionADMIN(ESSN2,ActID11,AdminMID11d,MedID14)32. PatientJunctionCarecenter ActID12,PSSN1)32. LVNjunctinNONIV(ESSN2,ProcedID10)33. RNAjunctionASSESS(ESSN2,ActID12c)34. RNAjunctinREHAB(rehabID11e,ESSN2)35. RNjunctionACTTYPE(ActID11,ESSN2)36. InsurancePlan(PlanID,InsurCompany)

Screenshot

Normalization 1 AnalysisVisiting(VID, PSSN, Vmonth, Vday, Vyear, Vfname, Vlname)

Not in 2NF because partial dependencies existFunctional dependencies:

{VID} {Vfname, Vlname} ⇒

The relationship can be normalized to 2NF by removing the partial dependencies:

Visitor(VID, Vfname, Vlname)Visit(VID, PSSN, Vmonth, Vday, Vyear)

The relation is also in 3NF because no non-prime attributes determine another non-prime attribute.

Normalization 2 AnalysisInsurance(PSSN, InsurCompany, PlanID, MemberID)

The following functional dependencies hold:{PSSN, InsurCompany} {PlanID, MemberID}⇒{MemberID, InsurCompany} {PSSN, PlanID}⇒{PlanID} {InsurCompany}⇒

• Still in 3NF because the InsurCompany attribute is a prime attribute• Not in BCNF because PlanID is not a primary key.

Normalizing to BCNF:

PatientInsurance(PSSN, PlanID, MemberID)InsurancePlans(PlanID,InsurCompany)

Objective:• Tracks number of errors committed

by Number of Employees per Shift, Employee, Shift, and Number beds full per shift, and calculates Chi Square correlation

Application:• Allows the client to pinpoint the

problem areas at the facility in order to minimize errors and improve the quality of life for patients.

[Query name: Errors by Employee]SELECT ErrorJunctionEmp.ESSN, Count(*) AS Number_of_ErrorsFROM ErrorJunctionEmpGROUP BY ErrorJunctionEmp.ESSNUNIONSELECT Employee.ESSN, 0FROM EmployeeWHERE Employee.ESSN not IN (SELECT ErrorJunctionEmp.ESSNFROM ErrorJunctionEmp);[Query name: AvgErrEmp]SELECT Avg([Errors by Employee].Number_of_Errors) AS AvgErrFROM [Errors by Employee];[Query name: Error-Employee Correlation]SELECT Sum(([Errors by Employee].Number_of_Errors - AvgErrEmp.AvgErr)^2) / Sum(AvgErrEmp.AvgErr) AS ChiSquare, IIf(Sum(([Errors by Employee].Number_of_Errors - AvgErrEmp.AvgErr)^2) / Sum(AvgErrEmp.AvgErr) > Sum(MaxChiSquare.MaxChiSquare), "95% chance that a correlation exists: see 'Errors by Employee' for more details", "No correlation exists") AS CorrelationFROM [Errors by Employee], AvgErrEmp, MaxChiSquare;

Error Tracking Query

Errors by Number of Employees per Shift

Errors by Employee

Error Tracking Query, cont.

Loneliness Query

Objective: • To mitigate loneliness among patients

by forecasting the number of expected visits in the next month using a weighted moving average.

Application:• Client can then schedule volunteers

accordingly, focusing on those patients with the fewest expected visitors.

SQL:

SELECT DISTINCT pvj.PSSN, p.Fname, p.Lname, ((0.5*Count1.count1)+(0.3*Count2.count2)+(0.2*Count3.count3)) AS Next_Month_ForecastFROM patient AS p, Count1 INNER JOIN ((Count3 INNER JOIN PatVisJunction AS pvj ON Count3.PSSN=pvj.PSSN) INNER JOIN Count2 ON pvj.PSSN=Count2.PSSN) ON Count1.PSSN=pvj.PSSNWHERE (((pvj.PSSN)=Count1.PSSN And (pvj.PSSN)=Count2.PSSN And (pvj.PSSN)=Count3.PSSN) And ((p.PSSN)=pvj.PSSN));

Sample Report of Loneliness Query

Location Tracking Query

Objective:Query will output a floor plan of the facility, providing a mapping of: 1) Patients with specified illness,

and average distance between afflicted patients, OR

2) Occupied beds

Application:• Allow the client to track and

analyze various types of information in a visual manner.

SQL: Select b.xcoordinate, b.ycoordinateFrom bed b patient p pre-existingmedicalhistory pmhWhere bed.BedID=p.BedID and pmh.flu=’yes’;

Matlab:A=[x y];dist=[0];for i=1:length(x)-1 for j=1+i:length(x) dist(end+1)=((A(i,2)-A(j,2))^2+(A(i,1)-A(j, 1))^2)^.5; endend dist(dist==0)=[];z=factorial(length(x))/(factorial(2)*factorial(length(x)-2));average=sum(dist)/z

Average=292.1Returns Average distance between infected beds

Location Tracking Query

Objective:• Query outputs Pearson Correlation

Coefficient, which can be used in a linear program to determine the ideal number of employees to minimize the number of mistakes.

Application:• Client can use this query to

determine how many employees to place on each shift, to reduce the overall errors.

SQL: Returns correlation coefficient (Errors vs. # Employees)SELECT SUM((Number_of_Employees - Avg.x_avg)*(Number_of_Errors- Avg.y_avg)) / SQR(SUM((Number_of_Employees - Avg.x_avg)^2) * SUM((Number_of_Errors - Avg.y_avg)^2)) AS pearson_rFROM ErrorsvsEmp, [Avg];

Correlation coefficient is inputted into AMPL

Schedule Optimization Query

EOQ Query

Objective:• It calculates the quantity to order, the reorder point, and the remaining

days of supply. It also calculates the average number of days in which the supplier has been delayed

Application• Indicates low levels of inventory, and whether the medicine should be

ordered now or later, taking into account the average delay of the supplier.

t

QReorder point if LD=0

Reorder point if LD>0

R

SELECT b.MedID AS MedID, b.Quantity_to_Order AS Quantity_to_Order, Round((m.LeadTime + b.AvgNoDaysDelayed) * m.Demand, 2) AS Reorder_Point, Round((g.CurrentInventory - (((m.LeadTime + b.AvgNoDaysDelayed) * m.Demand))) / m.Demand) AS Remaining_Days, IIf(g.CurrentInventory <= (Round((m.LeadTime + b.AvgNoDaysDelayed) * m.Demand)), "Order Now", "Wait") AS Indication, Round(Sum(DateDiff("d", o.PromisedDate, o.DateReceived)) / Count(o.MedID), 2) AS NewAvgNoDaysDelayedFROM GeneralInventory AS g INNER JOIN (([EOQ Theoretical] AS b INNER JOIN Medication AS m ON b.MedID = m.MedID) INNER JOIN MedOrdersQuery AS o ON b.MedID = o.MedID) ON g.MedID = m.MedIDWHERE (((b.MedID) = [m].[MedID] And (b.MedID) = [o].[MedID]))GROUP BY b.MedID, b.Quantity_to_Order, Round((m.LeadTime + b.AvgNoDaysDelayed) * m.Demand, 2), Round((g.CurrentInventory - (((m.LeadTime + b.AvgNoDaysDelayed) * m.Demand))) / m.Demand), IIf(g.CurrentInventory <= (Round((m.LeadTime + b.AvgNoDaysDelayed) * m.Demand)), "Order Now", "Wait");

EOQ Query

Report 1: Inventory

Report 2: Errors by Employee

Form 1: Initial Assessment

Form 2: New Patient Record

Thank you, and a special

thank you to Jaspreet Singh Buttar, R.N.