Application of the QFD-fuzzy-SERVQUAL methodology as a quality planning tool at the surgical centre of a public teaching hospital

BACKGROUND

In Brazil, many public hospitals face constant problems related to high demand vis-à-vis an overall scarcity of resources, which hinders the operations of different sectors such as the surgical centre, as it is considered one of the most relevant pillars for the proper hospital functioning, due to its complexity, criticality as well as economic and social importance. Proper asset management based on well-founded decisions is, therefore, a sine-qua-non condition for addressing such demands. However, subjectivity and other difficulties present in decisions make the management of hospital resources a constant challenge.

METHODS

Thus, the present work proposes the application of a hybrid approach, formed by the QFD tools, fuzzy logic and SERVQUAL as a decision support tool for the quality planning of the surgical centre of the Onofre Lopes Teaching Hospital (Hospital Universitário Onofre Lopes-HUOL). To accomplish such objective, it was necessary to discover and analyse the main needs of the medical team working in the operating room, through the application of the SERVQUAL questionnaire, associated with fuzzy logic.

RESULTS

Then, the most relevant deficiencies were transformed into entries for the QFD-fuzzy, where they were translated into project requirements. Soon after, the analysis of the existing relationships between the inputs and these requirements was carried out, generating the ranking of actions with the greatest impact on the improvement of the surgical centre overall quality.

CONCLUSIONS

As a result, it was found that the proposed methodology can optimize the decision process to which hospital managers are submitted, improving the surgical centre operation efficiency.

Metaheuristics in the decentralization of SAMU bases using simulation in northeastern Brazil

BACKGROUND AND OBJECTIVE

The growth of the urban population exerts considerable pressure on municipalities' public managers to focus their attention on providing emergency medical care that meets the growing demand for emergency pre-hospital medical care. Currently, there are a significant number of traffic accidents and other serious occurrences, such as heart attacks, drownings, epidemics, fires and disasters (floods, landslides, earthquakes) that demand a prompt and seamless response from pre-hospital medical care. As a result of such scenario, the present article endeavours to apply a dual-coverage mathematical model (DSM-Double Standard Model) to define the optimal location of the Emergency Medical Service (SAMU) decentralized dispatch bases in Natal/RN and conduct a simulation study to evaluate the displacement of ambulances between such bases.

METHODS

The methodological course that was followed by this research constitutes of 12 steps. The location of decentralized bases for sending emergency ambulances was established using the DSM model and the simulation model was performed using the FlexSim© software version 2018 evaluating base coverage in relation to the total number of calls by demand points for different scenarios.

RESULTS

The results obtained throughout the research demonstrated the feasibility of redefining the decentralized bases of SAMU/Natal ambulances as a strategy to reduce response time and guarantee compliance with performance parameters established by international organizations (the World Health Organization, for instance, establishes the time of 8 minutes for emergency medical service calls response). The simulation study showed a significant reduction in response time, by up to 60% in some cases.

CONCLUSION

The proposition of new locations for the decentralized dispatch bases of the SAMU/Natal can provide an overall significant reduction on the ambulance response time, so as to contribute to expedite the initiation of treatment of patients, if necessary, sent to hospitals.

Analysis of Shared Services Center Deployment at a University Hospital (CENTROMED) in Natal, Brazil: A Study on Availability and Capacity

Purpose

The hospital is an organization that has its own characteristics that differentiate it from other institutions. It is characterized as a company providing services of social purpose, with a great operational complexity, due to the diversity of services provided. These organizations are dependent on technology to play the role of assisting society. Technology is onerous: it is up to the aforementioned institutions to adopt management tools to control these costs. The present study explains the process of implementing a shared service centre (CENTROMED) for the management of hospital medical equipment (HME) at the Hospital Universitário Onofre Lopes (HUOL) in the city of Natal, RN.

Patients and Methods

In order to achieve a successful implementation, four key steps were taken: process modelling; determination of key performance indicators, organization of physical arrangement; and adequate training and development of human resources. The work followed an action research approach focusing on three main methodological steps: identification of HUOL clinical engineering team’s demands, definition of the process for providing the equipment service, and definition of the supply items that will be managed.

Results

The preliminary results of this research indicate that the centralization of the management of the HME contributed to the optimization of the processes, the reduction of the costs and the availability of the equipment, thus providing a powerful management tool to support the hospital operational management.

Conclusion

The utilization of the shared service center for the management of hospital medical equipment is ultimately linked to the patient’s well-being as it contributes to the agility in hospital procedures and provides support in maintaining the capacity of attendance of the assistance teams.

Ergonomics and telework: A systematic review

BACKGROUND: Telework has been widely studied by public and private organizations; however, in ergonomics, studies that focused on this topic are still sporadic. OBJECTIVE: Thus, this article endeavours to systematize the qualified scientific research related to ergonomics and teleworking to determine the main benefits and disadvantages and to identify the main issues addressed by authors. METHODS: A thorough research was conducted in the Scopus/Embase and Web of Science databases for this review. The following descriptors were used for the cataloguing of articles: “teleworking”, “telecommuting”, “telecommuters”, “home office”, “ergonomics” and “human factors”. 36 studies were selected. RESULTS: The study highlights four relevant questions in the scientific literature: a) where is the discussion of these themes consolidated; b) what are the main descriptors related to the discussion; c) which journals and conferences establish a scientific debate on the topic; and d) what are its main advantages and disadvantages. CONCLUSIONS: Results suggest that telecommuting can be a valuable tool for balancing professional and family life, which helps to improve the well-being of workers; however, several factors can influence the overall remote working experience which leads to the need for companies to adopt unique strategies reflecting their unique situation.

Response time in the emergency services. Systematic review

The growth of the urban population raises concern about municipal public managers in the sense of providing emergency medical services (EMS) that are aligned with the needs of prehospital emergency medical care demanded by the population. The literature review aims at presenting the response time of emergency medical services in several parts of the world and discussing some factors that interfere in the result of this indicator such as GDP (Gross Domestic Product) percentage spent on health and life expectancy of countries. The study will also show that in some of the consulted articles, authors suggest to EMS recommendations for decreasing the response time using simulations, heuristics and metaheuristics. Response time is a basic indicator of emergency medical services, in such a way that researchers use the descriptive statistics to evaluate this parameter. Europe and the USA outstand in the publication of studies that present this information. Some articles use stochastic and mathematical methods to suggest models that simulate scenarios of response time reduction and suggest such proposals to the local EMS. Countries in which the response time was identified have a high index of human development and life expectancy between 74.7 and 83.7 years.