Efficiency from pharmacy inventory technology: A means to improving quality in non-profit hospitals

Hospitals, like all organizations, have both a mission and a finite supply of resources with which to accomplish that mission. Because the inventory of therapeutic drugs is among the more expensive resources needed by a hospital to achieve its mission, a conceptual model of structure plus process equals outcome posits that adequate emphasis should be placed on optimization of the organization's investment in this important structural resource to provide highest quality outcomes. Therefore emphasis should be placed on the optimization of pharmacy inventory because lowering the financial investment in drug inventory and associated costs increases productive efficiency, a key element of quality. ^ In this study, a post-intervention analysis of a hospital pharmacy inventory management technology implementation at The University of Texas M.D. Anderson Cancer Center was conducted to determine if an intervention which reduced a hospital's financial investment in pharmaceutical inventory provided an opportunity to incrementally optimize the organization's mix of structural resources thereby improving quality of care. The results suggest that hospital pharmacies currently lacking technology to support automated purchasing logistics and perpetual, real-time inventory management for drugs may achieve measurable benefits from the careful implementation of such technology, enabling the hospital to lower its investment in on-hand inventory and, potentially, to reduce overall purchasing expenditures. ^ The importance of these savings to the hospital and potentially to the patient should not be underestimated for their ability to generate funding for previously unfunded public health programs or in their ability to provide financial relief to patients in the form of lower drug costs given the current climate of escalating healthcare costs and tightening reimbursements.^

Ciudadanos, administración pública y control

Este trabajo responde al propósito de reflexionar acerca de las formas que toma el control de la administración pública en nuestro país, ahondando especialmente en el control social. El recorrido y análisis de diversas normas y programas, además de su cruce con las distintas modalidades del control, muestran diferentes instancias de participación que constituyen nuevos campos de intervención ciudadana. En todas y cada una de ellas, el acceso a la información pública aparece como auténtico presupuesto de la participación. Nuevos instrumentos y modalidades en los que, sin embargo, debemos resaltar el carácter de no vinculante que tienen las audiencias públicas y el escaso margen generado para la participación activa en los distintos programas. De todas maneras esos instrumentos son perfectibles y a futuro habrá de pensarse en el modo de transformar esta incipiente participación en una intervención activa y vigorosa que defina una nueva relación Estado/sociedad.

Análisis de algoritmos para posicionamiento de aeronaves mediante respuestas SSR utilizando recepción omnidireccional

El transporte aéreo constituye un sector estratégico para el crecimiento económico de cualquier país. El sistema de gestión de tráfico aéreo ATM tiene como objetivo el movimiento seguro y eficiente de las aeronaves dentro del espacio aéreo y de los aeropuertos, siendo la seguridad, en la fase táctica, gestionada por el servicio de control de la circulación aérea. Mediante los procesos de control el tráfico aéreo es vigilado a través de sensores, regulado y guiado de forma organizada y segura. Es precisamente sobre la vigilancia donde se enfoca el contenido de la tesis, en el desarrollo de nuevos conceptos que proporcionen información de vigilancia de ‘bajo coste’ basados en las señales existentes proporcionadas por la infraestructura actual de radar secundario y por los sistemas de posicionamiento basados en satélite que utiliza la ADS-B. El conocimiento y acceso en tiempo real a las trayectorias de las aeronaves es un elemento de valor añadido no sólo para la provisión de los servicios de control de tránsito aéreo, sino para todos los actores del transporte aéreo o de la investigación, siendo uno de los elementos clave en el concepto operacional de los dos grandes proyectos tecnológicos, SESAR en Europa y NextGen en EE.UU.. En las últimas décadas el control de la circulación aérea en espacios aéreos de media y alta densidad de tráfico se ha basado en tecnologías complejas que requieren importantes infraestructuras como son el radar primario de vigilancia (PSR) y el radar secundario de vigilancia (SSR). La filosofía de los programas SESAR y NextGen siguiendo las directrices de la OACI es la de alejarse de las tecnologías basadas en tierra para evolucionar hacia nuevas tecnologías más dinámicas basadas en satélite como la ADS-B. Pero hasta que la implementación y operación de la ADS-B sea completa, existirá un período de transición que implica la coexistencia de aeronaves equipadas o no con ADS-B. El objetivo de la presente Tesis es determinar las metodologías y algoritmos más adecuados para poder hibridar las dos tecnologías descritas anteriormente, utilizando para ello un receptor de bajo coste con antena estática omnidireccional, que analice todas las señales presentes en el canal que comparten el SSR y ADS-B. Mediante esta hibridación se podrá obtener la posición de cualquier aeronave que transmita respuestas a interrogaciones SSR, en cualquiera de sus modos de trabajo, o directamente mensajes de posición ADS-B. Para desarrollar los algoritmos propuestos, además del hardware correspondiente, se han utilizado las aplicaciones LabVIEW para funciones de adquisición de datos reales, y el software MATLAB® para el desarrollo de algoritmos y análisis de datos. La validación de resultados se ha realizado mediante los propios mensajes de posición ADS-B y a través de las trazas radar proporcionadas por la entidad pública empresarial ENAIRE. La técnica desarrollada es autónoma, y no ha requerido de ninguna otra entrada que no sea la recepción omnidireccional de las señales. Sin embargo para la validación de resultados se ha utilizado información pública de las ubicaciones de la red de estaciones SSR desplegadas sobre territorio español y portugués y trazas radar. Los resultados obtenidos demuestran, que con técnicas basadas en superficies de situación definidas por los tiempos de llegada de las respuestas, es posible determinar con una precisión aceptable la posición de las estaciones SSR y la posición de cualquier aeronave que responda mediante el Modo A a éstas. ABSTRACT Air transport is a strategic sector for the economic growth of any country. The air traffic management system (ATM) aims at the safe and efficient movement of aircraft while operating within the airspace and airports, where safety, in the tactical phase, is managed by the air traffic control services. Through the air traffic control processes, aircraft are monitored by sensors, regulated and guided in an organized and safe manner. It is precisely on surveillance where this thesis is focused, developing new concepts that provide a 'low cost' surveillance information based on existing signals provided by currently secondary radar infrastructure and satellite-based positioning systems used by ADS-B. Having a deeper knowledge and a real-time access to the trajectories of the aircraft, is an element of added value not only for the provision of air traffic control services, but also for all air transport or research actors. This is one of the key elements in the operational concept proposed by the two large scale existing technological projects, SESAR in Europe and NextGen in the US. In recent decades, air traffic control in medium and high traffic density areas has been based on complex technologies requiring major infrastructures, such as the primary surveillance radar (PSR) and secondary surveillance radar (SSR). The philosophy of SESAR and NextGen programs, both following the guidelines of ICAO, is to move away from land-based technologies and evolving into some new and more dynamic satellite-based technologies such as ADS-B. Nevertheless, until the ADS-B implementation and operation is fully achieved, there will be a transitional period where aircraft with and without ADS-B equipment will have to coexist. The main objective of this thesis is to determine those methodologies and algorithms which are considered more appropriate to hybridize those two technologies, by using a low cost omnidirectional receiver, which analyzes all signals on the SSR and ADS-B shared channel. Through this hybridization, it is possible to obtain the position of any aircraft answering the SSR interrogations, in any of its modes of operation, or through the emission of ADS-B messages. To develop the proposed algorithms, LabVIEW application has been used for real-time data acquisition, as well as MATLAB software for algorithm development and data analysis, together with the corresponding hardware. The validation of results was performed using the ADS-B position messages and radar tracks provided by the Public Corporate Entity ENAIRE The developed technique is autonomous, and it does not require any other input other than the omnidirectional signal reception. However, for the validation of results, not only radar records have been used, but also public information regarding the position of SSR stations spread throughout the Spanish and Portuguese territory. The results show that using techniques based in the definition of positioning surfaces defined by the responses’ times of arrival, it is possible to determine with an acceptable level of accuracy both the position of the SSR stations as well as the position of any aircraft which transmits Mode A responses.

Transcript: Regional Public Meetings on the Resource Conservation and Recovery Act of 1976 and an appendix, Conference on the Management of Non-Nuclear Hazardous Wastes, February 23, 1977, New York City, ... proceedings... /

Mode of access: Internet.

A Summary of Attorney General's opinions relating to public health /

Cover title.

Application of a policy framework for the public funding of drugs for rare diseases

BACKGROUND: In many countries, decisions about the public funding of drugs are preferentially based on the results of randomized trials. For truly rare diseases, such trials are not typically available, and approaches by public payers are highly variable. In view of this, a policy framework intended to fairly evaluate these drugs was developed by the Drugs for Rare Diseases Working Group (DRDWG) at the request of the Ontario Public Drug Programs. OBJECTIVE: To report the initial experience of applying a novel evaluation framework to funding applications for drugs for rare diseases. METHODS: Retrospective observational cohort study. MEASURES: Clinical effectiveness, costs, funding recommendations, funding approval. KEY RESULTS: Between March 2008 and February 2013, eight drugs were evaluated using the DRDWG framework. The estimated average annual drug cost per patient ranged from 28,000 to 1,200,000 Canadian dollars (CAD). For five drugs, full evaluations were completed, specific funding recommendations were made by the DRDWG, and funding was approved after risk-sharing agreements with the manufacturers were negotiated. For two drugs, the disease indications were determined to be ineligible for consideration. For one drug, there was insufficient natural history data for the disease to provide a basis for recommendation. For the five drugs fully evaluated, 32 patients met the predefined eligibility criteria for funding, and five were denied based on predefined exclusion criteria. CONCLUSIONS: The framework improved transparency and consistency for evaluation and public funding of drugs for rare diseases in Ontario. The evaluation process will continue to be iteratively refined as feedback on actual versus expected clinical and economic outcomes is incorporated. © 2014 Society of General Internal Medicine.

O acesso à habitação no Brasil em tempos de capitalismo financeirizado : uma análise do Programa Minha Casa, Minha Vida

Dissertação (mestrado)—Universidade de Brasília, Instituto de Ciências Humanas, Departamento de Serviço Social, Programa de Pós-Graduação em Política Social, 2016.

Library, Archives and Museum Annual Assessment Report, 2004-2005

The Library, Archives and Museum are a major component of South Carolina’s only state-assisted military college, The Citadel. They participate in the teaching, research, and public service programs of The Citadel: by providing scholarly information; by the acquisition, organization, management, preservation, and arrangement of collections for access and use; by provision of supportive reference and instruction services; and by a variety of cooperative and reciprocal programs in the local area, the region and the state. This annual report discusses their activities for the year 2004/05.

Tendering theory revisited

This paper discusses the content, origin and development of Tendering Theory as a theory of price determination. It demonstrates how tendering theory determines market prices and how it is different from game and decision theories, and that in the tendering process, with non-cooperative, simultaneous, single sealed bids with individual private valuations, extensive public information, a large number of bidders and a long sequence of tendering occasions, there develops a competitive equilibrium. The development of a competitive equilibrium means that the concept of the tender as the sum of a valuation and a strategy, which is at the core of tendering theory, cannot be supported and that there are serious empirical, theoretical and methodological inconsistencies in the theory.

Program your city : designing an urban integrated open data API

Cities accumulate and distribute vast sets of digital information. Many decision-making and planning processes in councils, local governments and organisations are based on both real-time and historical data. Until recently, only a small, carefully selected subset of this information has been released to the public – usually for specific purposes (e.g. train timetables, release of planning application through websites to name just a few). This situation is however changing rapidly. Regulatory frameworks, such as the Freedom of Information Legislation in the US, the UK, the European Union and many other countries guarantee public access to data held by the state. One of the results of this legislation and changing attitudes towards open data has been the widespread release of public information as part of recent Government 2.0 initiatives. This includes the creation of public data catalogues such as data.gov.au (U.S.), data.gov.uk (U.K.), data.gov.au (Australia) at federal government levels, and datasf.org (San Francisco) and data.london.gov.uk (London) at municipal levels. The release of this data has opened up the possibility of a wide range of future applications and services which are now the subject of intensified research efforts. Previous research endeavours have explored the creation of specialised tools to aid decision-making by urban citizens, councils and other stakeholders (Calabrese, Kloeckl & Ratti, 2008; Paulos, Honicky & Hooker, 2009). While these initiatives represent an important step towards open data, they too often result in mere collections of data repositories. Proprietary database formats and the lack of an open application programming interface (API) limit the full potential achievable by allowing these data sets to be cross-queried. Our research, presented in this paper, looks beyond the pure release of data. It is concerned with three essential questions: First, how can data from different sources be integrated into a consistent framework and made accessible? Second, how can ordinary citizens be supported in easily composing data from different sources in order to address their specific problems? Third, what are interfaces that make it easy for citizens to interact with data in an urban environment? How can data be accessed and collected?

Incentivising private health insurance through the income tax regime : Capitalising on behavioural models

The Australian income tax regime is generally regarded as a mechanism by which the Federal Government raises revenue, with much of the revenue raised used to support public spending programs. A prime example of this type of spending program is health care. However, a government may also decide that the private sector should provide a greater share of the nation's health care. To achieve such a policy it can bring about change through positive regulation, or it can use the taxation regime, via tax expenditures, not to raise revenue but to steer or influence individuals in its desired direction. When used for this purpose, tax expenditures steer taxpayers towards or away from certain behaviour by either imposing costs on, or providing benefits to them. Within the context of the health sector, the Australian Federal Government deploys social steering via the tax system, with the Medicare Levy Surcharge and the 30 percent Private Health Insurance Rebate intended to steer taxpayer behaviour towards the Government’s policy goal of increasing the amount of health provision through the private sector. These steering mechanisms are complemented by the ‘Lifetime Health Cover Initiative’. This article, through the lens of behavioural economics, considers the ways in which these assorted mechanisms might have been expected to operate and whether they encourage individuals to purchase private health insurance.

Connecting across continents : collaborative learning in a Web 2.0 world

Purpose – The article aims to review a university course, offered to students in both Australia and Germany, to encourage them to learn about designing, implementing, marketing and evaluating information programs and services in order to build active and engaged communities. The concepts and processes of Web 2.0 technologies come together in the learning activities, with students establishing their own personal learning networks (PLNs). Design/methodology/approach – The case study examines the principles of learning and teaching that underpin the course and presents the students' own experiences of the challenges they faced as they explored the interactive, participative and collaborative dimensions of the web. Findings – The online format of the course and the philosophy of learning through play provided students with a safe and supportive environment for them to move outside of their comfort zones, to be creative, to experiment and to develop their professional personas. Reflection on learning was a key component that stressed the value of reflective practice in assisting library and information science (LIS) professionals to adapt confidently to the rapidly changing work environment. Originality/value – This study provides insights into the opportunities for LIS courses to work across geographical boundaries, to allow students to critically appraise library practice in different contexts and to become active participants in wider professional networks.

Contracting for infrastructure projects as credence goods

Large infrastructure projects are a major responsibility of urban and regional governments, who usually lack expertise to fully specify the demanded projects. Contractors, typically experts on such projects due to experience with similar projects elsewhere, advise of the needed design in their bids. Producing the right design is nevertheless costly. We model such infrastructure projects taking into account their credence goods feature and the costly design effort they require and examine the performance of commonly used contracting methods. We show that when building costs are homogeneous and public information, multi-stage competitive bidding involving shortlisting of two contractors and contingent compensation of both contractors on design efforts outperforms sequential search and the traditional Design-and-Build approach. If building costs are private information of the contractors and are revealed to them after design cost is sunk, sequential search may be superior to the other two methods.

Contracting for infrastructure projects as credence goods

Large infrastructure projects are a major responsibility of urban and regional governments, who usually lack expertise to fully specify the demanded projects. Contractors, typically experts on such projects due to experience with similar projects,advise of the needed design as well as the cost of construction in their bids. Producing the right design is costly. We model such infrastructure projects taking into account their credence goods feature and the costly design effort they require and examine the performance of commonly used contracting methods. We show that when building costs are homogeneous and public information, simultaneous bidding involving shortlisting of two contractors and contingent compensation of both contractors on design efforts outperforms sequential search. If building costs are private information of the contractors and are revealed to them after design cost is sunk,sequential search may be superior to simultaneous bidding.