Questionário de satisfação do utente e do profissional : impacto num laboratório de análises clínicas

RESUMO: Temos assistido a uma evolução impressionante nos laboratórios de análises clínicas, os quais precisam de prestar um serviço de excelência a custos cada vez mais competitivos. Nos laboratórios os sistemas de gestão da qualidade têm uma importância significativa nesta evolução, fundamentalmente pela procura da melhoria continua, que ocorre não só ao nível de processos e técnicas, mas também na qualificação dos diferentes intervenientes. Um dos problemas fundamentais da gestão e um laboratório é a eliminação de desperdícios e erros criando benefícios, conceito base na filosofia LeanThinking isto é “pensamento magro”, pelo que é essencial conseguir monitorizar funções críticas sistematicamente. Esta monitorização, num laboratório cada vez mais focalizado no utente, pode ser efetuada através de sistemas e tecnologias de informação, sendo possível contabilizar número de utentes, horas de maior afluência, tempo médio de permanência na sala de espera, tempo médio para entrega de análises, resultados entregues fora da data prevista, entre outros dados de apoio à decisão. Devem igualmente ser analisadas as reclamações, bem como a satisfação dos utentes quer através do feedback que é transmitido aos funcionários, quer através de questionários de satisfação. Usou-se principalmente dois modelos: um proposto pelo Índice Europeu de Satisfação do Consumidor (ECSI) e o outro de Estrutura Comum de Avaliação (CAF). Introduziram-se igualmente dois questionários: um apresentado em formato digital num posto de colheitas, através de um quiosque eletrónico, e um outro na página da internet do laboratório, ambos como alternativa ao questionário em papel já existente, tendo-se analisado os dados, e retirado as devidas conclusões. Propôs-se e desenvolveu-se um questionário para colaboradores cuja intenção foi a de fornecer dados úteis de apoio à decisão, face à importância dos funcionários na interação com os clientes e na garantia da qualidade ao longo de todo o processo. Avaliaram-se globalmente os resultados sem que tenha sido possível apresentá-los por política interna da empresa, bem como se comentou de forma empírica alguns benefícios deste questionário. Os principais objetivos deste trabalho foram, implementar questionários de satisfação eletrónicos e analisar os resultados obtidos, comparando-os com o estudo ECSI, de forma a acentuar a importância da análise em simultâneo de dois fatores: a motivação profissional e a satisfação do cliente, com o intuito de melhorar os sistemas de apoio à decisão. ------------------------ ABSTRACT: We have witnessed an impressive development in clinical analysis laboratories, which have to provide excellent service at increasingly competitive costs, quality management systems have a significant importance in this evolution, mainly by demanding continuous improvement, which does not occur only in terms of processes and techniques, but also in the qualification of the various stakeholders. One key problem of managing a laboratory is the elimination of waste and errors, creating benefits, concept based on Lean Thinking philosophy, therefore it is essential be able to monitor critical tasks systematically. This monitoring, in an increasingly focused on the user laboratory can be accomplished through information systems and technologies, through which it is possible to account the number of clients, peak times, average length of waiting room stay, average time for delivery analysis, delivered results out of the expected date, among other data that contribute to support decisions, however it is also decisive to analyzed complaint sand satisfaction of users through employees feedback but mainly through satisfaction questionnaires that provides accurate results. We use mainly two models one proposed by the European Index of Consumer Satisfaction (ECSI), directed to the client, and the Common Assessment Framework (CAF), used both in the client as the employees surveys. Introduced two questionnaires in a digital format, one in the central laboratory collect center, through an electronic kiosk and another on the laboratory web page, both as an alternative to survey paper currently used, we analyzed the results, and withdrew the conclusions. It was proposed and developed a questionnaire for employees whose intention would be to provide useful data to decision support, given the importance of employees in customer interaction and quality assurance throughout the whole clinical process, it was evaluated in a general way because it was not possible to show the results, however commented an empirical way some benefits of this questionnaire. The main goals of this study were to implement electronic questionnaires and analyze the results, comparing them with the ECSI, in order to emphasize the importance of analyzing simultaneously professional motivation with customer satisfaction, in order to improve decision support systems.

Semantic architecture for sensors

Based on the report for the unit “Sociology of New Information Technologies” of the Master on Computer Sciences at FCT/University Nova Lisbon in 2015-16. The responsible of this curricular unit is Prof. António Moniz

Business intelligence in banking: A literature analysis from 2002 to 2013 using Text Mining and latent Dirichlet allocation

telligence applications for the banking industry. Searches were performed in relevant journals resulting in 219 articles published between 2002 and 2013. To analyze such a large number of manuscripts, text mining techniques were used in pursuit for relevant terms on both business intelligence and banking domains. Moreover, the latent Dirichlet allocation modeling was used in or- der to group articles in several relevant topics. The analysis was conducted using a dictionary of terms belonging to both banking and business intelli- gence domains. Such procedure allowed for the identification of relationships between terms and topics grouping articles, enabling to emerge hypotheses regarding research directions. To confirm such hypotheses, relevant articles were collected and scrutinized, allowing to validate the text mining proce- dure. The results show that credit in banking is clearly the main application trend, particularly predicting risk and thus supporting credit approval or de- nial. There is also a relevant interest in bankruptcy and fraud prediction. Customer retention seems to be associated, although weakly, with targeting, justifying bank offers to reduce churn. In addition, a large number of ar- ticles focused more on business intelligence techniques and its applications, using the banking industry just for evaluation, thus, not clearly acclaiming for benefits in the banking business. By identifying these current research topics, this study also highlights opportunities for future research.

Design of a case-based reasoner for information security in military organizations

Information security is concerned with the protection of information, which can be stored, processed or transmitted within critical information systems of the organizations, against loss of confidentiality, integrity or availability. Protection measures to prevent these problems result through the implementation of controls at several dimensions: technical, administrative or physical. A vital objective for military organizations is to ensure superiority in contexts of information warfare and competitive intelligence. Therefore, the problem of information security in military organizations has been a topic of intensive work at both national and transnational levels, and extensive conceptual and standardization work is being produced. A current effort is therefore to develop automated decision support systems to assist military decision makers, at different levels in the command chain, to provide suitable control measures that can effectively deal with potential attacks and, at the same time, prevent, detect and contain vulnerabilities targeted at their information systems. The concept and processes of the Case-Based Reasoning (CBR) methodology outstandingly resembles classical military processes and doctrine, in particular the analysis of “lessons learned” and definition of “modes of action”. Therefore, the present paper addresses the modeling and design of a CBR system with two key objectives: to support an effective response in context of information security for military organizations; to allow for scenario planning and analysis for training and auditing processes.

Clustering-based approach for categorizing pregnant women in obstetrics and maternity care

When a pregnant woman is guided to a hospital for obstetrics purposes, many outcomes are possible, depending on her current conditions. An improved understanding of these conditions could provide a more direct medical approach by categorizing the different types of patients, enabling a faster response to risk situations, and therefore increasing the quality of services. In this case study, the characteristics of the patients admitted in the maternity care unit of Centro Hospitalar of Porto are acknowledged, allowing categorizing the patient women through clustering techniques. The main goal is to predict the patients’ route through the maternity care, adapting the services according to their conditions, providing the best clinical decisions and a cost-effective treatment to patients. The models developed presented very interesting results, being the best clustering evaluation index: 0.65. The evaluation of the clustering algorithms proved the viability of using clustering based data mining models to characterize pregnant patients, identifying which conditions can be used as an alert to prevent the occurrence of medical complications.

Benchmarking sobre técnicas de otimização para modelos de apoio à decisão na medicina intensiva

Dissertação de mestrado integrado em Engenharia e Gestão de Sistemas de Informação

Sistema de apoio à decisão clínica: quality of life system

Dissertação de mestrado integrado em Engenharia e Gestão de Sistemas de Informação

Pervasive patient timeline

Dissertação de mestrado integrado em Engenharia e Gestão de Sistemas de Informação

Apoio à decisão na análise inteligente de reclamações

Dissertação de mestrado integrado em Engenharia e Gestão de Sistemas de Informação

Plataforma de apoio à decisão nos cuidados de ginecologia e obstetrícia

Dissertação de mestrado integrado em Engenharia Biomédica (área de especialização em Informática Médica)

Oxygen therapy, continuous positive airway pressure, or noninvasive bilevel positive pressure ventilation in the treatment of acute cardiogenic pulmonary edema

OBJECTIVE: To compare the effects of 3 types of noninvasive respiratory support systems in the treatment of acute pulmonary edema: oxygen therapy (O2), continuous positive airway pressure, and bilevel positive pressure ventilation. METHODS: We studied prospectively 26 patients with acute pulmonary edema, who were randomized into 1 of 3 types of respiratory support groups. Age was 69±7 years. Ten patients were treated with oxygen, 9 with continuous positive airway pressure, and 7 with noninvasive bilevel positive pressure ventilation. All patients received medicamentous therapy according to the Advanced Cardiac Life Support protocol. Our primary aim was to assess the need for orotracheal intubation. We also assessed the following: heart and respiration rates, blood pressure, PaO2, PaCO2, and pH at begining, and at 10 and 60 minutes after starting the protocol. RESULTS: At 10 minutes, the patients in the bilevel positive pressure ventilation group had the highest PaO2 and the lowest respiration rates; the patients in the O2 group had the highest PaCO2 and the lowest pH (p<0.05). Four patients in the O2 group, 3 patients in the continuous positive pressure group, and none in the bilevel positive pressure ventilation group were intubated (p<0.05). CONCLUSION: Noninvasive bilevel positive pressure ventilation was effective in the treatment of acute cardiogenic pulmonary edema, accelerated the recovery of vital signs and blood gas data, and avoided intubation.

Predicting triage waiting time in maternity emergency care by means of data mining

Healthcare organizations often benefit from information technologies as well as embedded decision support systems, which improve the quality of services and help preventing complications and adverse events. In Centro Materno Infantil do Norte (CMIN), the maternal and perinatal care unit of Centro Hospitalar of Oporto (CHP), an intelligent pre-triage system is implemented, aiming to prioritize patients in need of gynaecology and obstetrics care in two classes: urgent and consultation. The system is designed to evade emergency problems such as incorrect triage outcomes and extensive triage waiting times. The current study intends to improve the triage system, and therefore, optimize the patient workflow through the emergency room, by predicting the triage waiting time comprised between the patient triage and their medical admission. For this purpose, data mining (DM) techniques are induced in selected information provided by the information technologies implemented in CMIN. The DM models achieved accuracy values of approximately 94% with a five range target distribution, which not only allow obtaining confident prediction models, but also identify the variables that stand as direct inducers to the triage waiting times.

Optimization techniques to detect early ventilation extubation in intensive care units

The decision support models in intensive care units are developed to support medical staff in their decision making process. However, the optimization of these models is particularly difficult to apply due to dynamic, complex and multidisciplinary nature. Thus, there is a constant research and development of new algorithms capable of extracting knowledge from large volumes of data, in order to obtain better predictive results than the current algorithms. To test the optimization techniques a case study with real data provided by INTCare project was explored. This data is concerning to extubation cases. In this dataset, several models like Evolutionary Fuzzy Rule Learning, Lazy Learning, Decision Trees and many others were analysed in order to detect early extubation. The hydrids Decision Trees Genetic Algorithm, Supervised Classifier System and KNNAdaptive obtained the most accurate rate 93.2%, 93.1%, 92.97% respectively, thus showing their feasibility to work in a real environment.

A clinical recommendation system to maternity care

Nowadays in healthcare, the Clinical Decision Support Systems are used in order to help health professionals to take an evidence-based decision. An example is the Clinical Recommendation Systems. In this sense, it was developed and implemented in Centro Hospitalar do Porto a pre-triage system in order to group the patients on two levels (urgent or outpatient). However, although this system is calibrated and specific to the urgency of obstetrics and gynaecology, it does not meet all clinical requirements by the general department of the Portuguese HealthCare (Direção Geral de Saúde). The main requirement is the need of having priority triage system characterized by five levels. Thus some studies have been conducted with the aim of presenting a methodology able to evolve the pre-triage system on a Clinical Recommendation System with five levels. After some tests (using data mining and simulation techniques), it has been validated the possibility of transformation the pre-triage system in a Clinical Recommendation System in the obstetric context. This paper presents an overview of the Clinical Recommendation System for obstetric triage, the model developed and the main results achieved.

Lite4Life (Tier 2 adult weight management service)

This service Aims: To provide a multi-component weight management service that supports sustainable behaviour change and weight loss in adults 16 years and over with a BMI 28. To enable patients to develop the necessary personal attributes for their own long term weight management and to understand the impact of their weight on their health and co-morbidities. Objectives: To provide an evidence based, multi-component tier 2 weight management service that improves patients knowledge and skills for effective and sustainable weight loss helps patients identify their own facilitators for positive behaviour change and to address underlying barriers to long-term behaviour changeincreases patients self-efficacy and confidence in their ability to address their weight To be an integral part of the tiered approach to weight management services for the population of Stockton. To ensure equitable service provision across Stockton-on-Tees. To provide intensive group based service, one-to-one support and maintenance support. To support the service user to develop and review a personalised goal setting plan phase 2 and at discharge after phase 2. To ensure a smooth transition from the service (tier2) to tier 1 services to ensure continuity of care for service users.Recruit referrals using a variety of and appropriate methods. To establish a single point of contact for referrals into the service.Continually promote the service across a range of mediums and liaise and work in partnership with key interdependencies (refer to 2.4) To establish a robust database and data collection system in line with information governance. To ensure the access criteria, care pathway and referral process is clearly understood by all health care professionals and those who may refer into the service. To establish close links with, and signpost and/or enable service users to access suitable services where patient needs indicate this. This may include access to Tees Time to Talk (IAPT) for psychological therapies; Specialist Weight Management Service; physical activity programmes; Tier 1 services; and primary care. To provide the necessary venues, equipment and assets needed to deliver the programme, ensuring due regard is given to the quality and safety of all materials used. To collect and provide data in quarterly reports to the Commissioner to allow for continued monitoring and evaluation of the service in line with the Standard Evaluation Framework (available at www.noo.org.uk/core/SEF) and as specified by the Commissioner.