scholarly journals Planning for the First and Last Mile: A Review of Practices at Selected Transit Agencies in the United States

2021 ◽  
Vol 13 (4) ◽  
pp. 2222
Author(s):  
Hossain Mohiuddin
Keyword(s):  
Los Angeles ◽  
Gap Analysis ◽  
The United States ◽  
Design Guidelines ◽  
Plan Implementation ◽  
Marginalized Communities ◽  
Transit Ridership ◽  
Last Mile ◽  
Transit Agencies

A transit trip involves travel to and from transit stops or stations. The quality of what are commonly known as first and last mile connections (regardless of their length) can have an important impact on transit ridership. Transit agencies throughout the world are developing innovative approaches to improving first and last mile connections, for example, by partnering with ride-hailing and other emerging mobility services. A small but growing number of transit agencies in the U.S. have adopted first and last mile (FLM) plans with the goal of increasing ridership. As this is a relatively new practice by transit agencies, a review of these plans can inform other transit agencies and assist them in preparing their own. Four FLM plans were selected from diverse geographic contexts for review: Los Angeles County Metropolitan Transportation Authority (LA Metro), Riverside (CA) Transit Agency (RTA), and Denver Regional Transit District (RTD), and City of Richmond, CA. Based on the literature, we developed a framework with an emphasis on transportation equity to examine these plans. We identified five common approaches to addressing the FLM issue: spatial gap analysis with a focus on socio-demographics and locational characteristics, incorporation of emerging mobility services, innovative funding approaches for plan implementation, equity and transportation remedies for marginalized communities, and development of pedestrian and bicycle infrastructures surrounding transit stations. Strategies in three of the plans are aligned with regional goals for emissions reductions. LA Metro and Riverside Transit incorporate detailed design guidelines for the improvement of transit stations. As these plans are still relatively new, it will take time to evaluate their impact on ridership and their communities’ overall transit experience.

scholarly journals Delivering Equitable Care to Underserved Neuro-oncology Populations

2021 ◽  
pp. 1-9
Author(s):  
Alyx B. Porter ◽  
Ugonma N. Chukwueke ◽  
Aaron G. Mammoser ◽  
Bret Friday ◽  
Shawn Hervey-Jumper
Keyword(s):  
Clinical Trials ◽  
Multidisciplinary Care ◽  
The United States ◽  
Limited Attention ◽  
Provider Education ◽  
Supportive Services ◽  
Marginalized Communities ◽  
Underserved Groups ◽  
Oncologic Diseases

It is widely recognized that subspecialized multidisciplinary care improves neuro-oncology outcomes. Optimizing patient outcomes relies on the expertise of the treating physicians, neuroradiology and neuropathology, and supportive services familiar with common neurologic syndromes that occur after brain tumor diagnosis and treatment. Despite an increasing number of providers, patient access to specialized multidisciplinary care and clinical trials remains limited. Barriers to equitable health care exist across the United States, with marginalized communities being impacted disproportionately. Such disparity causes increased morbidity and mortality for patients from backgrounds with various elements of diversity. Limited attention to this inequity has resulted in an incomplete understanding of the spectrum of experiences that patients with neuro-oncologic diseases encounter. Clinical trials represent the highest standard and quality of care in medicine, but inclusion of under-represented and underserved groups consistently lags behind counterpart participants from majority racial and ethnic groups. Through provider education as it pertains to issues from bias and health literacy to increasing clinical trial enrollment and offering opportunities through telemedicine, opportunities for improving access to high-quality neuro-oncologic care are explored.

Partnerships in Urban Mobility: Incentive Mechanisms for Improving Public Transit Adoption

2021 ◽  
Author(s):  
Auyon Siddiq ◽  
Christopher S. Tang ◽  
Jingwei Zhang
Keyword(s):  
Public Transit ◽  
Cost Effective ◽  
The United States ◽  
The Public ◽  
Direct Mechanism ◽  
Indirect Mechanism ◽  
Transit Ridership ◽  
Last Mile ◽  
Transit Station ◽  
The Government

Problem definition: Because of a prolonged decline in public transit ridership over the last decade, transit agencies across the United States are in financial crisis. To entice commuters to travel by public transit instead of driving personal vehicles, municipal governments must address the “last-mile” problem by providing convenient and affordable transportation between a commuter’s home and a transit station. This challenge raises an important question: Is there a cost-effective mechanism that can improve public transit adoption by solving the last-mile problem? Academic/practical relevance: In this paper, we present and analyze two incentive mechanisms for increasing commuter adoption of public transit. In a direct mechanism, the government provides a subsidy to commuters who adopt a “mixed mode,” which involves combining public transit with hailing rides to/from a transit station. The government funds the subsidy by imposing congestion fees on personal vehicles entering the city center. In an indirect mechanism, instead of levying congestion fees, the government secures funding for the subsidy from the private sector. We examine the implications of both mechanisms on relevant stakeholders. These two mechanisms are especially relevant because several jurisdictions in the United States have begun piloting incentive programs, in which commuters receive subsidies for ride-hailing trips that begin or end at a transit station. Methodology: We present a game-theoretic model to capture the strategic interactions among five self-interested stakeholders (commuters, public transit agency, ride-hailing platform, municipal government, and local private enterprises). Results: By examining equilibrium outcomes, we obtain three key findings. First, we characterize how the optimal interventions associated with the direct or the indirect mechanism depend on: (a) the coverage level of the public transit network; (b) the public transit adoption target; and (c) the relative strength of commuter preferences between driving and taking public transit. Second, we show that the direct mechanism cannot be budget-neutral without undermining commuter welfare. However, when the public transit adoption target is not too aggressive, we find that the indirect mechanism can increase both commuter welfare and sales to the private-sector partner while remaining budget-neutral. Finally, we show that, although the indirect mechanism restricts the scope of government intervention (by eliminating the congestion fee), it can dominate the direct mechanism by leaving all stakeholders better off, especially when the adoption target is modest. Managerial implications: Our findings offer cost-effective prescriptions for improving urban mobility and public transit ridership.

National Assessment of Melanoma Care Using Formally Developed Quality Indicators

2009 ◽  
Vol 27 (32) ◽  
pp. 5445-5451 ◽  
Author(s):  
Karl Y. Bilimoria ◽  
Mehul V. Raval ◽  
David J. Bentrem ◽  
Jeffrey D. Wayne ◽  
Charles M. Balch ◽  
...  
Keyword(s):  
United States ◽  
Los Angeles ◽  
Quality Indicators ◽  
The United States ◽  
National Cancer Data Base ◽  
Hospital Level ◽  
Cancer Data ◽  
Cancer Registry Data ◽  
The Individual

Purpose There is considerable variation in the quality of cancer care delivered in the United States. Assessing care by using quality indicators could help decrease this variability. The objectives of this study were to formally develop valid quality indicators for melanoma and to assess hospital-level adherence with these measures in the United States. Methods Quality indicators were identified from available literature, consensus guidelines, and melanoma experts. Thirteen experts ranked potential measures for validity on the basis of the RAND/University of California, Los Angeles Appropriateness Methodology. Adherence with individual valid indicators and a composite measure of all indicators were assessed at 1,249 Commission on Cancer hospitals by using the National Cancer Data Base (NCDB; 2004 through 2005). Results Of 55 proposed quality indicators, 26 measures (47%) were rated as valid. These indicators assessed structure (n = 1), process (n = 24), and outcome (n = 1). Of the 26 measures, 10 are readily assessable by using cancer registry data. Adherence with valid indicators ranged from 11.8% to 96.5% at the patient level and 3.7% to 83.0% at the hospital level. (Adherence required that ≥ 90% of patients at a hospital receive concordant care.) Most hospitals were adherent with 50% or fewer of the individual indicators (median composite score, five; interquartile range, four to seven). Adherence was higher for diagnosis and staging measures and was lower for treatment indicators. Conclusion There is considerable variation in the quality of melanoma care in the United States. By using these formally developed quality indicators, hospitals can assess their adherence with current melanoma care guidelines through feedback mechanisms from the NCDB and can better direct quality improvement efforts.

Optimizing Public Transit Quality and System Access: The Multiple-Route, Maximal Covering/Shortest-Path Problem

2005 ◽  
Vol 32 (2) ◽  
pp. 163-178 ◽  
Author(s):  
Changshan Wu ◽  
Alan T Murray
Keyword(s):  
Service Quality ◽  
Shortest Path ◽  
Public Transit ◽  
The United States ◽  
Path Model ◽  
Transit System ◽  
Transit Service ◽  
Maximal Covering ◽  
Transit Ridership ◽  
Transit Agencies

Public transit service is a promising travel mode because of its potential to address urban sustainability. However, current ridership of public transit is very low in most urban regions—particularly those in the United States. Low transit ridership can be attributed to many factors, among which poor service quality is key. Transit service quality may potentially be improved by decreasing the number of service stops, but this would be likely to reduce access coverage. Improving transit service quality while maintaining adequate access coverage is a challenge facing public transit agencies. In this paper we propose a multiple-route, maximal covering/shortest-path model to address the trade-off between public transit service quality and access coverage in an established bus-based transit system. The model is applied to routes in Columbus, Ohio. Results show that it is possible to improve transit service quality by eliminating redundant or underutilized service stops.

scholarly journals 668 The ASHS/People-To-People Mission to China

HortScience ◽  
2000 ◽  
Vol 35 (3) ◽  
pp. 513E-514
Author(s):  
Donald N. Maynard
Keyword(s):  
United States ◽  
Hong Kong ◽  
Los Angeles ◽  
Significant Contribution ◽  
The United States ◽  
Cultural Activities ◽  
The People ◽  
Horticultural Products ◽  
The U.S

The Citizen Ambassador Program was initiated in 1956 when President Dwight D. Eisenhower founded “People to People.” His vast perspective as a military and governmental leader led him to believe that individual citizens reaching out in friendship to the people of other nations could make a significant contribution to world understanding. From 14–28 Aug. 1998, ASHS took part in the “People-to People Mission to China.” Our delegation was composed of six ASHS Members and two guests. Delegates were from Canada and Brazil and the United States. After meeting in Los Angeles for a final briefing, the delegation departed for Hong Kong, where we immediately boarded a flight to Beijing. Our China experience began in Beijing, then on to Hangzhou, Shanghai, Guangzhou, and Hong Kong. All of these locations are in the densely populated eastern portion of China. (China has approximately the same area as the United States, but it has 1.25 billion people compared to only 270 million in the U.S.) Our time at each location was about equally divided between professional and cultural activities. Our Chinese horticultural colleagues were enthusiastic and well-trained. As in the United States, the quality of the facilities and the equipment varied somewhat among locations. Operating funds, never sufficient for research and maintenance of facilities, commonly were supplemented by sale of horticultural products.

Analysis of Effects of Fare-Free Transit Program on Student Commuting Mode Shares: BruinGo at University of California at Los Angeles

2003 ◽  
Vol 1835 (1) ◽  
pp. 101-110 ◽  
Author(s):  
Brent Boyd ◽  
Melissa Chow ◽  
Robert Johnson ◽  
Alexander Smith
Keyword(s):  
Los Angeles ◽  
University Of California ◽  
Walking Distance ◽  
First Year ◽  
Demonstration Program ◽  
Transit Ridership ◽  
Mode Share ◽  
Commuting Mode ◽  
Transit Agencies ◽  
The University

Spring 2002 concluded the second year of the BruinGo pilot demonstration program of the University of California at Los Angeles (UCLA). BruinGo allows students and employees of UCLA to board buses of the Santa Monica Municipal Bus Lines (Big Blue Bus) free of charge. At a time when the future of BruinGo is at stake (both its existence and the possible expansion of the program to other transit agencies), a brief analys is of what has been accomplished by the program at this stage is provided. The program is analyzed using two methods: ( a) the analysis of the changes in the commuting mode share for all off-campus student commuters and ( b) an intricate process of geocoding survey data in which the relationship of the proximity of a student’s residence to the Big Blue Bus lines and the corresponding choice of mode to campus is analyzed. The conclusion is that providing fare-free transit to students did, in fact, increase transit ridership and decrease students’ reliance on the automobile to reach campus. Transit ridership for 2001 (the first year of BruinGo) increased by more than 50% over ridership in 2000 (the year before BruinGo), while more than 1,000 fewer automobile trips were taken to the UCLA campus each day. Even more striking is the rate at which students are leaving their cars at home in the areas best served by the Big Blue Bus. After BruinGo, fully 50% of all students in walking distance of a direct line to campus took transit (compared with 35% before BruinGo). That is much higher than in other areas. The mode share of walking and bicycling also decreased dramatically, however.

scholarly journals TOD and Park-and-Ride: Which is Appropriate Where?

2021 ◽  
Author(s):  
John Niles ◽  
J.M. Pogodzinski
Keyword(s):  
Public Policy ◽  
Land Development ◽  
The United States ◽  
Housing Affordability ◽  
The Other ◽  
Strategic Decision ◽  
Professional Literature ◽  
Park And Ride ◽  
Transit Ridership ◽  
Transit Agencies

Despite the sharp drop in transit ridership throughout the USA that began in March 2020, two different uses of land near transit stations continue to be implemented in the United States to promote ridership. Since 2010, transit agencies have given priority to multi-family residential construction referred to as transit oriented development (TOD), with an emphasis on housing affordability. In second place for urban planners but popular with suburban commuters is free or inexpensive parking near rail or bus transit centers, known as park-and-ride (PnR). Sometimes, TOD and PnR are combined in the same development. Public policy seeks to gain high community value from both of these land uses, and there is public interest in understanding the circumstances and locations where one of these two uses should be emphasized over the other. Multiple justifications for each are offered in the professional literature and reviewed in this report. Fundamental to the strategic decision making necessary to allocate public resources toward one use or the other is a determination of the degree to which each approach generates transit ridership. In the research reported here, econometric analysis of GIS data for transit stops, PnR locations, and residential density was employed to measure their influence on transit boardings for samples of transit stops at the main transit agencies in Seattle, Los Angeles, and San José. Results from all three cities indicate that adding 100 parking spaces close to a transit stop has a larger marginal impact than adding 100 housing units. Previous academic research estimating the higher ridership generation per floor area of PnR compared to multi-family TOD housing makes this show of strength for parking an expected finding. At the same time, this report reviews several common public policy justifications for TOD as a preferred land development emphasis near transit stations, such as revenue generation for the transit agency and providing a location for below-market affordable housing where occupants do not need to have a car. If increasing ridership is important for a transit agency, then parking for customers who want to drive to a station is an important option. There may also be additional benefits for park-and-ride in responding to the ongoing pandemic.

scholarly journals 65 & Thrive: Improving Patient Length of Stay, Readmission, and Quality of Care by Becoming an Age-Friendly Hospital

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 594-595
Author(s):  
Tracey Vien ◽  
Stella Bobroff ◽  
Ricardo de Ocampo
Keyword(s):  
Los Angeles ◽  
Length Of Stay ◽  
Average Length ◽  
The United States ◽  
Holistic Care ◽  
Kaiser Permanente ◽  
Average Length Of Stay ◽  
Telemetry Unit ◽  
Management Staff

Abstract Data indicates that older persons will increase in numbers along with having an increase of life expectancy in the United States. Kaiser Permanente Los Angeles Medical Center’s Utilization Department developed “65 & Thrive”—an age-specialized initiative to provide holistic care that preserves independence, quality of life, prevents functional and cognitive decline, and promotes both patients and their families to continue thriving. The initiative’s focus is guided by the 5 M’s model on mobility, medication, mentation, multi-morbidity, and what matters. Case management staff were given age-sensitivity trainings, improved workflows and made assessments that identified, addressed, and secured resources for patients throughout their hospitalization. Silver Angel volunteers were specially trained to prevent physical and mental decline and focused on activities to prevent delirium, depression and falls. The volunteers visited with patients daily for these interactions. The initiative was piloted in April 2020 on a stroke telemetry unit and since then the hospital has seen a significant decrease in the overall annual readmission rates by 3.1% when compared to 2019. The average length of stay for older adult patients; however, increased from 4.05 to 4.83 days unfortunately due to COVID-19. This initiative demonstrates the necessity to expand “65 & Thrive” throughout the hospital and ultimately to other Kaiser Permanente medical centers to best provide holistic care to older adults.

Using Smart Farecard Data to Support Transit Network Restructuring: Findings from Los Angeles

2019 ◽  
Vol 2673 (6) ◽  
pp. 202-213 ◽  
Author(s):  
Pragun Vinayak ◽  
Zeina Wafa ◽  
Conan Cheung ◽  
Stephen Tu ◽  
Anurag Komanduri ◽  
...  
Keyword(s):  
Los Angeles ◽  
Time Of Day ◽  
Transit Planning ◽  
Metropolitan Regions ◽  
Trip Purpose ◽  
Transit Ridership ◽  
Market Shares ◽  
Transit Market ◽  
Transit Agencies ◽  
In Transit

Recent technological innovations have changed why, when, where, and how people travel. This, along with other changes in the economy, has resulted in declining transit ridership in many U.S. metropolitan regions, including Los Angeles. It is important that transit agencies become data savvy to better align their services with customer demand in an effort to redesign a bus network that is more relevant and reflective of customer needs. This paper outlines a new data intelligence program within the Los Angeles County Metropolitan Transportation Authority (LA Metro) that will allow for data-driven decision-making in a nimble and flexible fashion. One resource available to LA Metro is their smart farecard data. The analysis of 4 months of data revealed that the top 5% of riders accounted for over 60% of daily trips. By building heuristics to identify transfers, and by tracking riders through space and time to systematically identify home and work locations, transit trip tables by time of day and purpose were extracted. The transit trip tables were juxtaposed against trip tables generated using disaggregate anonymized cell phone data to measure transit market shares and to evaluate transit competitiveness across several measures such as trip length, travel times relative to auto, trip purpose, and time of day. Relying on observed trips as opposed to simulated model results, this paper outlines the potential of using Big Data in transit planning. This research can be replicated by agencies across the U.S. as they reverse declining ridership while competing with data-savvy technology-driven competitors.

GTFS-Ride: Unifying Standard for Fixed-Route Ridership Data

2019 ◽  
Vol 2673 (12) ◽  
pp. 173-181
Author(s):  
Phillip Carleton ◽  
Sylvan Hoover ◽  
Ben Fields ◽  
Matthew Barnes ◽  
J. David Porter
Keyword(s):  
Public Transit ◽  
The United States ◽  
Lessons Learned ◽  
Digital Data ◽  
Related Data ◽  
Standard Data ◽  
Transit Ridership ◽  
Technological Developments ◽  
Transit Agencies ◽  
Additional Support

The rapid growth in the availability and utility of vast amounts of digital data is arguably one of the most significant technological developments in recent years. In public transit, many agencies utilize modern technologies to collect large amounts of data, whereas smaller agencies with fewer resources and less expertise still use more traditional, manual data collection methods. Regardless of their technological capabilities, transit agencies recognize that some amount of transit data is useful and required. To the best of our knowledge, no standard data description of detailed fixed-route ridership exists today in the United States, forcing transit agencies to develop their own system of collecting, storing, and analyzing ridership and related data. In response to this need, this research aimed at developing one of the first public transit ridership data standards for fixed-route services and to support and promote its adoption and use. The resulting standard, an extension to the General Transit Feed Specification (GTFS) data standard, is referred to as GTFS-ride. GTFS-ride is easy to understand, able to accommodate the complexities of larger transit agencies, and capable of establishing a strong connection to the state of a transit network as it existed when the ridership data was collected. The first complete draft of GTFS-ride was released on September 6, 2017. This paper explains the structure of the five files that compose GTFS-ride, introduces additional support elements developed to facilitate its promotion and adoption, and documents the lessons learned from pilot implementations of GTFS-ride at three Oregon public transit agencies.

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