Consultoria del procés de logística interna del laboratori d'anàlisis clíniques a l'Hospital General de Vic

Com a resultat de les politiques i estratègies de col·laboració entre la universitat de Vic i de l’hospital i de la voluntat de realitzar activitats formatives conjuntes , s’estableix un línia de treball orientada a l’estudi i anàlisi de la situació logística interna actual del laboratori d’anàlisis clíniques de l’Hospital General de Vic. El treball es centra en el procés intern del laboratori i l’abast de l’estudi es troba limitat a les àrees especifiques d’hematologia i coagulació i bioquí… [+]mica. D’aquestes dues àrees el treball realitza un estudi exhaustiu del seu procés intern, identifica les seves activitats i la seva metodologia de treball amb l’objectiu d’elaborar el Value Stream Map de cadascuna de les àrees. Les àrees de Microbiologia, Banc de Sang i Urgències resten fora d’aquest estudi exhaustiu tot i que són presents en el treball per la inevitable interacció que tenen en la globalitat del procés. El treball es centra bàsicament en els processos automatitzats tot i que els processos que es duen a terme en el laboratori són tant automatitzats com manuals. També es limita al sistema productiu intern del laboratori tot i la interacció que té aquest sistema intern amb altres centres productius del sistema com ara són els centres d’atenció primària, els diversos hospitals i centres d’atenció sociosanitària. El laboratori es troba immers en el moment de l’elaboració d’aquest treball en un situació de canvi i millora del seus processos interns que consisteixen principalment en la substitució de part la maquinària actual que obliguen a la definició d’un nou layout i d’una nova distribució de la producció a cada màquina. A nivell extern també s’estan produint millores en el sistema informàtic de gestió que afecten a part del seu procés. L’objectiu del treball és donar visibilitat total al procés de logística interna actual del laboratori, identificant clarament com són i quina seqüència tenen els processos logístics interns i els mètodes de treball actuals, tant de recursos màquina com recursos persona, per poder identificar sota una perspectiva de generació de valor, aquells punts concrets de la logística interna que poden ser millorats en quant a eficiència i productivitat amb l’objectiu que un cop identificats es puguin emprendre accions i/o projectes de millora. El treball finalitza amb un anàlisis final del procés logística interna des d’una òptica Lean. Per fer-ho, identifica aquelles activitats que no aporten valor al procés o MUDA i les classifica en set categories i es realitzen diverses propostes de millora com són la implantació d’un flux continu , anivellat i basat en un concepte pull , identifica activitats que poden ser estandarditzades i/o simplificades i proposa modificacions en les infraestructures físiques per donar major visibilitat al procés. L’aspecte humà del procés es planteja des d’un punt de vist de metodologia, formació, comunicació i aplicació de les 5S.

Improvement of genistein content in solid genistein/-cyclodextrin complexes β

Genistein:β-cyclodextrin complexes with high drug loading (19.22%) were prepared by freeze-drying and characterized by differential scanning calorimetry and hydrogen nuclear magnetic resonance spectroscopy. The spatial configuration of the complex was proposed by means of 2D-NOESY experiment combined with molecular modeling. According to the results obtained, the interaction of genistein with β -cyclodextrin in a 1:1 complex is supposed to occur mainly through the insertion of the guest A-ring in cyclodextrin cavity, without rule out the possibility of inclusion through the B-ring, as previously reported in the literature.

Corrosion resistance improvement of titanium base alloys

The corrosion resistance of the new Ti-6Al-4V-1Zr alloy in comparison with ternary Ti-6Al-4V alloy in Ringer-Brown solution and artificial Carter-Brugirard saliva of different pH values was studied. In Ringer-Brown solution, the new alloy presented an improvement of all electrochemical parameters due to the alloying with Zr; also, impedance spectra revealed better protective properties of its passive layer. In Carter-Brugirard artificial saliva, an increase of the passive film thickness was proved. Fluoride ions had a slight negative influence on the corrosion and ion release rates, without to affect the very good stability of the new Ti-6Al-4V-1Zr alloy.

Specificity and selectivity improvement in doping analysis using comprehensive two-dimensional gas chromatography coupled with time-of-flight mass spectrometry

Comprehensive two-dimensional gas chromatography coupled with time-of-flight mass spectrometry was used for the identification of forty doping agents. The improvement in the specificity was remarkable, allowing the resolution of analytes that could not be done by one-dimensional chromatographic systems. The sensitivity observed for different classes of prohibited substances was clearly below the value required by the World Anti-Doping Agency. In addition time-of-flight mass spectrometry gives full spectrum for all analytes without any interference from the matrix, resulting in selectivity improvements. These results could support the implementation of an exhaustive monitoring approach for hundreds of doping agents in a single injection.

Measurement and Improvement of Wet Paper Web Strength

Various strength properties of paper are measured to tell how well it resists breaks in a paper machine or in printing presses. The most often measured properties are dry tensile strength and dry tear strength. However, in many situations where paper breaks, it is not dry. For example, in web breaks after the wet pressing the dry matter content can be around 45%. Thus, wet-web strength is often a more critical paper property than dry strength. Both wet and dry strength properties of the samples were measured with a L&W tensile tester. Originally this device was not designed for the measurement of the wet web tensile strength, thus a new procedure to handle the wet samples was developed. The method was tested with Pine Kraft (never dried). The effect of different strength additives on the wet-web and dry paper tensile strength was studied. The polymers used in this experiment were aqueous solution of a cationic polyamidoamine-epichlorohydrin resin (PAE), cationic hydrophilised polyisocyanate and cationic polyvinylamine (PVAm). From all three used chemicals only Cationic PAE considerably increased the wet web strength. However it was noticed that at constant solids content all chemicals decreased the wet web tensile strength. So, since all chemicals enhanced solid content it can be concluded that they work as drainage aids, not as wet web strength additives. From all chemicals only PVAm increased the dry strength and two other chemicals even decreased the strength. As chemicals were used in strong diluted forms and were injected into the pulp slurry, not on the surface of the papersheets, changes in samples densities did not happen. Also it has to be noted that all these chemicals are mainly used to improve the wet strength after the drying of the web.

Utilization of Automatic Meter Reading in the Improvement of a District Heating System

A district heating system comprises production facilities, a distribution network, and heat consumers. The utilization of new energy metering and reading system (AMR) is increasing constantly in district heating systems. This heuristic study shows how the AMR system can be exploited in finding optimization opportunities in district heating system. In this study, the district heating system is mainly considered from the viewpoint of operational optimization. The focus is on the core processes, heat production and distribution. Three objectives were set to this study. The first one was to examine general optimization opportunities in district heating systems. Second, to figure out the benefits of AMR for general optimization opportunities. Finally, to define a methodology for process improvement endeavors. This study shows, through a case study, the usefulness of AMR in specifying current deficiencies in a district heating system. Based on a literature review, the methodology for the improvement of business processes is presented. Additionally, some issues related to future competitiveness of district heating are concerned. As a conclusion, some optimization objectives are considered more desirable than others. Study shows that AMR is useful in the specification of optimization targets in the district heating system. Further steps in optimization process were not examined in detail. That would seem to be interesting topic for further studies.

Improvement of Surface Strength of Paper

Offset printing is a popular printing method that is especially suitable for large and fast print jobs. Newspapers, magazines and books are typical examples of products printed with offset method. In high volume printing production high efficiency is essential. Offset printing uses tacky inks that cause serious stress to the paper surface. Dusting and linting are terms that describe how loose and weakly bonded particles are removed from the paper surface in the printing process. The removed particles accumulate in the process causing deteriorating print quality. This forces the printing operators to stop production for washing and cleaning. Time and money are lost. Dusting and linting tendency of paper can be decreased by improving the surface strength of paper. In the present work a method to increase the surface strength of paper was studied. In the literature part offset printing method and challenges related to offset printing are presented. A review of new methods for surface sizing of paper is also presented. The experimental part presents trials where an apparatus for improving paper surface strength was tested and developed in mill scale. Laboratory work supporting the actual mill scale operations is also presented. The acquired results provide a solid base of information to make decisions on how to proceed with research in the present field of study.

Delay reduction in courts of justice – possibilities and challenges of process improvement in professional public organizations

Delays in the justice system have been undermining the functioning and performance of the court system all over the world for decades. Despite the widespread concern about delays, the solutions have not kept up with the growth of the problem. The delay problem existing in the justice courts processes is a good example of the growing need and pressure in professional public organizations to start improving their business process performance.This study analyses the possibilities and challenges of process improvement in professional public organizations. The study is based on experiences gained in two longitudinal action research improvement projects conducted in two separate Finnish law instances; in the Helsinki Court of Appeal and in the Insurance Court. The thesis has two objectives. First objective is to study what kinds of factors in court system operations cause delays and unmanageable backlogs and how to reduce and prevent delays. Based on the lessons learned from the case projects the objective is to give new insights on the critical factors of process improvement conducted in professional public organizations. Four main areas and factors behind the delay problem is identified: 1) goal setting and performance measurement practices, 2) the process control system, 3) production and capacity planning procedures, and 4) process roles and responsibilities. The appropriate improvement solutions include tools to enhance project planning and scheduling and monitoring the agreed time-frames for different phases of the handling process and pending inventory. The study introduces the identified critical factors in different phases of process improvement work carried out in professional public organizations, the ways the critical factors can be incorporated to the different stages of the projects, and discusses the role of external facilitator in assisting process improvement work and in enhancing ownership towards the solutions and improvement. The study highlights the need to concentrate on the critical factors aiming to get the employees to challenge their existing ways of conducting work, analyze their own processes, and create procedures for diffusing the process improvement culture instead of merely concentrating of finding tools, techniques, and solutions appropriate for applications from the manufacturing sector

Configuring Health Care Services - Service Control Improvement

The costs of health care are increasing, and at the same time, population is aging. This leads health care organizations to focus more on home based care services. This thesis focuses on the home care organization of the South Karelian District of Social and Health Services (Eksote), which was established in 2010; how its operation is organized and managed, and which problem types are faced in the daily operation of home care. This thesis examines home care services through an extensive interview study, process mapping and statistical data analysis. To be able to understand the nature of services and special environment theory models, such as service management and performance measurement, service processes and service design are introduced. This study is conducted from an external researcher‟s point of view and should be used as a discussion opener. The outcome of this thesis is an upper level development path for Eksote home care. The organization should evaluate and build a service offering, then productize home care services and modularize the products and identify similarities. Service processes should be mapped to generate efficiency for repeating tasks. Units should be reasonably sized and geographically located to facilitate management and operation. All this can be done by recognizing the different types of service products: runners repeaters and strangers. Furthermore, the organization should not hide behind medical issues and should understand the legislative, medical and operational frameworks in health care.

Improvement of open innovation processes: case Nokia

Open innovation is becoming increasingly popular in academic literature and in business life, but even if people heard about it, they might not understand what it really is, they may over-estimate it thinking that it is savior or underestimate it, concentrating on limitations and risks. Current work sheds light on most important concepts of open innovation theory. Goal of current research is to offer business processes improvement for both inbound and outbound modes in case company. It is relevant as open innovation proved to affect firms‘ performance in general case and in case company, and Nokia planned to develop open innovation implementation since 2008 but still competitors succeed in it more, therefore analysis of current situation with open innovation in Nokia and recommendations how to improve it are topical. Case study method was used to answer the question ―How open innovation processes can be improved?‖. 11 in-depth interviews with Nokia senior managers and independent consultants were used to reach the goal of the thesis, as well as secondary sources. Results of current work are as-is and to-be models (process models of today and best practices models) of several open innovation modes, and recommendation for case company, which will be presented to company representatives and checked for practical applicability.

Implementation of the trauma registry as a tool for quality improvement in trauma care in a brazilian hospital: the first 12 months

ABSTRACTObjective:to analyze the implementation of a trauma registry in a university teaching hospital delivering care under the unified health system (SUS), and its ability to identify points for improvement in the quality of care provided.Methods:the data collection group comprised students from medicine and nursing courses who were holders of FAPESP scholarships (technical training 1) or otherwise, overseen by the coordinators of the project. The itreg (ECO Sistemas-RJ/SBAIT) software was used as the database tool. Several quality "filters" were proposed to select those cases for review in the quality control process.Results:data for 1344 trauma patients were input to the itreg database between March and November 2014. Around 87.0% of cases were blunt trauma patients, 59.6% had RTS>7.0 and 67% ISS<9. Full records were available for 292 cases, which were selected for review in the quality program. The auditing filters most frequently registered were laparotomy four hours after admission and drainage of acute subdural hematomas four hours after admission. Several points for improvement were flagged, such as control of overtriage of patients, the need to reduce the number of negative imaging exams, the development of protocols for achieving central venous access, and management of major TBI.Conclusion: the trauma registry provides a clear picture of the points to be improved in trauma patient care, however, there are specific peculiarities for implementing this tool in the Brazilian milieu.

Configuration management process improvement : a case study of a Pan-Nordic insurance company

Configuration management is often seen as an enabler for the main IT Service Management (ITSM) processes such as Incident and Problem management. A decent level of quality of IT configuration data is required in order to carry out routines of these processes. This case study examines the state of configuration management in a multinational organization and aims at identification of methods for its improvement. The author has stayed five months with this company in order to collect different sources of evidence and to make observations. The main source of data for this study is interviews with some of the key employees of the assigned organization who are involved into the ITSM processes. This study concludes the maturity level of the existing configuration management process to be repeatable but intuitive, and outlines the principal requirements for its improvement. A match between the requirements identified in the organization and the requirements stated in the ISO/IEC 20000 standard indicates the possibility of adopting ITIL guidelines as a method for configuration management process improvement. The outcome of the study presents a set of recommendations for improvement that considers the process, the information model and the information system for configuration management in the case organization.

The key practices of customer portfolio management (CPM) process in the medical and healthcare B2B industry

The goal of this study is to deepen the understanding of the customer portfolio management process. There are many models for the process, and they are not necessarily exclusive of each other. Consequently, the inclusion of many models might even prove out to be beneficial. Other theoretical framework include the current economical situation and its propose on customer portfolio management. With an understanding of the theoretical models as a background, the empirical part of this study compares Finnish multinational medical and healthcare technology companies’ customer portfolio management practices. The empirical research was carried out with theme interviews held with 11 sales and marketing managers or directors from four different companies. The goal was to discover the most essential practices of the process steps in the companies. The result of this study is that there is a lack of systematic customer portfolio management, but most companies are aiming to improve this in the near future. The most essential practices are analysis of sales, communication level, learning, and commitment to strategy of the focal company. Special characteristics of this industry include large business networks that include customers, professional end-users, institutions, universities, researchers, and key opinion leaders. The management and analysis of this comprehensive network has been seen to be extremely important for this industry.