Search results for: lean healthcare

Authors: Bahareh Amirjabbari, Nadia Bhuiyan

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In recent decades, the lean methodology, and the development of its principles and concepts have widely been applied in supply chain management. One of the most important strategies of being lean is having efficient inventory within the chain. On the other hand, managing inventory efficiently requires appropriate management of safety stock in order to protect against increasing stretch in the breaking points of the supply chain, which in turn can result in possible reduction of inventory. This paper applies a safety stock cost minimization model in a manufacturing company. The model results in optimum levels and locations of safety stock within the company-s supply chain in order to minimize total logistics costs.

Keywords: Cost, efficient inventory, optimization, safety stock, supply chain

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Authors: Bitan Kumar Sarkar, Akashdeep Agarwal, Rajib Dey, Gopes Chandra Das

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The rapid depletion of high-grade iron ore (Fe₂O₃) has gained attention on the use of other sources of iron ore. Titaniferous magnetite ore (TMO) is a special type of magnetite ore having high titania content (23.23% TiO₂ present in this case). Due to high TiO₂ content and high density, TMO cannot be treated by the conventional smelting reduction. In this present work, the TMO has been collected from high-grade metamorphic terrain of the Precambrian Chotanagpur gneissic complex situated in the eastern part of India (Shaltora area, Bankura district, West Bengal) and the hematite ore has been collected from Visakhapatnam Steel Plant (VSP), Visakhapatnam. At VSP, iron ore is received from Bailadila mines, Chattisgarh of M/s. National Mineral Development Corporation. The preliminary characterization of TMO and hematite ore (HMO) has been investigated by WDXRF, XRD and FESEM analyses. Similarly, good quality of coal (mainly coking coal) is also getting depleted fast. The basic purpose of this work is to find how lean grade coal can be utilised along with TMO for smelting to produce pig iron. Lean grade coal has been characterised by using TG/DTA, proximate and ultimate analyses. The boiler grade coal has been found to contain 28.08% of fixed carbon and 28.31% of volatile matter. TMO fines (below 75 μm) and HMO fines (below 75 μm) have been separately agglomerated with lean grade coal fines (below 75 μm) in the form of briquettes using binders like bentonite and molasses. These green briquettes are dried first in oven at 423 K for 30 min and then reduced isothermally in tube furnace over the temperature range of 1323 K, 1373 K and 1423 K for 30 min & 60 min. After reduction, the reduced briquettes are characterized by XRD and FESEM analyses. The best reduced TMO and HMO samples are taken and blended in three different weight percentage ratios of 1:4, 1:8 and 1:12 of TMO:HMO. The chemical analysis of three blended samples is carried out and degree of metallisation of iron is found to contain 89.38%, 92.12% and 93.12%, respectively. These three blended samples are briquetted using binder like bentonite and lime. Thereafter these blended briquettes are separately smelted in raising hearth furnace at 1773 K for 30 min. The pig iron formed is characterized using XRD, microscopic analysis. It can be concluded that 90% yield of pig iron can be achieved when the blend ratio of TMO:HMO is 1:4.5. This means for 90% yield, the maximum TMO that could be used in the blend is about 18%.

Keywords: Briquetting reduction, lean grade coal, smelting reduction, TMO.

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Authors: Marcelo Dias Carvalho, Leticia Ishikawa

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Supply Chain Risk Management refers to a set of strategies used by companies to avoid supply chain disruption caused by damage at production facilities, natural disasters, capacity issues, inventory problems, incorrect forecasts, and delays. Many companies use the techniques of the Toyota Production System, which in a way goes against a better management of supply chain risks. This paper studies key events in some multinationals to analyze the trade-off between the best supply chain risk management techniques and management policies designed to create lean enterprises. The result of a good balance of these actions is the reduction of losses, increased customer trust in the company and better preparedness to face the general risks of a supply chain.

Keywords: Supply chain disruptions, supply chain management, supply chain resilience, just-in-time production, lean manufacturing.

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Authors: T. Hui Teo, Wee Tiong Tan, Pradeep K. Gopalakrishnan, Victor K. H. Phay, Ma Su M. M. Shwe

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A healthcare monitoring system is presented in this paper. This system is based on ultra-low power sensor nodes and a personal server, which is based on hardware and software extensions to a Personal Digital Assistant (PDA)/Smartphone. The sensor node collects data from the body of a patient and sends it to the personal server where the data is processed, displayed and made ready to be sent to a healthcare network, if necessary. The personal server consists of a compact low power receiver module and equipped with a Smartphone software. The receiver module takes less than 30 × 30 mm board size and consumes approximately 25 mA in active mode.

Keywords: healthcare monitoring, sensor node, personal server, wireless.

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Authors: Shogo Kato, Daisuke Okamoto, Satoko Tsuru, Yoshinori Iizuka, Ryoko Shimono

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Healthcare safety has been perceived important. It is essential to prevent troubles in healthcare processes for healthcare safety. Trouble prevention is based on trouble prediction using accumulated knowledge on processes, troubles, and countermeasures. However, information on troubles has not been accumulated in hospitals in the appropriate structure, and it has not been utilized effectively to prevent troubles. In the previous study, however a detailed knowledge acquisition process for trouble prediction was proposed, the knowledgebase for countermeasures was not involved. In this paper, we aim to propose the structure of the knowledgebase for countermeasures, in the knowledge acquisition process for trouble prediction in healthcare process. We first design the structure of countermeasures and propose the knowledge representation form on countermeasures. Then, we evaluate the validity of the proposal, by applying it into an actual hospital.

Keywords: Trouble prevention, knowledge structure, structured knowledge, reusable knowledge.

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Authors: Tal Ben-Zvi, Donald N. Lombardi

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This study uses a simulation to establish a realistic environment for laboratory research on Accountable Care Organizations. We study network attributes in order to gain insights regarding healthcare providers- conduct and performance. Our findings indicate how network structure creates significant differences in organizational performance. We demonstrate how healthcare providers positioning themselves at the central, pivotal point of the network while maintaining their alliances with their partners produce better outcomes.

Keywords: Social Networks, Decision-Making, Accountable Care Organizations, Performance

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Authors: Jih-Rue Pan, Feng-Chuan Pan

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Today-s healthcare industries had become more patient-centric than profession-centric, from which the issues of quality of healthcare and the patient safety are the major concerns in the modern healthcare facilities. An unplanned extubation (UE) may be detrimental to the patient-s life, and thus is one of the major indexes of patient safety and healthcare quality. A high UE rate not only defeated the healthcare quality as well as the patient safety policy but also the nurses- morality, and job satisfaction. The UE problem in a psychiatric hospital is unique and may be a tough challenge for the healthcare professionals for the patients were mostly lacking communication capabilities. We reported with this essay a particular project that was organized to reduce the UE rate from the current 2.3% to a lower and satisfactory level in the long-term care units of a psychiatric hospital. The project was conducted between March 1st, 2011 and August 31st, 2011. Based on the error information gathered from varied units of the hospital, the team analyzed the root causes with possible solutions proposed to the meetings. Four solutions were then concluded with consensus and launched to the units in question. The UE rate was now reduced to a level of 0.17%. Experience from this project, the procedure and the tools adopted would be good reference to other hospitals.

Keywords: Unplanned extubation, patient safety, error information

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Authors: Pradeep Kumar, Shibashish Chakraborty, Sasadhar Bera

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In the anticipation of demand fluctuations, services cannot be inventoried and hence it creates a difficult problem in marketing of services. The inability to meet customers (patients) requirements in healthcare context has more serious consequences than other service sectors. In order to meet patient requirements in the current uncertain environment, healthcare organizations are seeking ways for improved service delivery. Flexibility provides a mechanism for reducing variability in service encounters and improved performance. Flexibility is defined as the ability of the organization to cope with changing circumstances or instability caused by the environment. Patient satisfaction is an important performance outcome of healthcare organizations. However, the paucity of information exists in healthcare delivery context to examine the impact of flexibility on patient satisfaction and behavioral intention. The present study is an attempt to develop a conceptual foundation for investigating overall impact of flexibility on patient satisfaction and behavioral intention. Several dimensions of flexibility in healthcare context are examined and proposed to have a significant impact on patient satisfaction and intention. Furthermore, the study involves a critical examination of determinants of patient satisfaction and development of a comprehensive view the relationship between flexibility, patient satisfaction and behavioral intention. Finally, theoretical contributions and implications for healthcare professionals are suggested from flexibility perspective.

Keywords: Healthcare, flexibility, patient satisfaction, behavioral intention.

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Authors: N. Clavijo Buriticá, L. M. Correa Lópezand J. R., Sánchez Rodríguez

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The environmental impact caused by industries is an issue that, in the last 20 years, has become very important in terms of society, economics and politics in Colombia. Particularly, the tannery process is extremely polluting because of uneffective treatments and regulations given to the dumping process and atmospheric emissions. Considering that, this investigation is intended to propose a management model based on the integration of Lean Supply Chain, Green Supply Chain, Cleaner Production and ISO 14001-2004, that prioritizes the strategic components of the organizations. As a result, a management model will be obtained and it will provide a strategic perspective through a systemic approach to the tanning process. This will be achieved through the use of Multicriteria Decision tools, along with Quality Function Deployment and Fuzzy Logic. The strategic approach that embraces the management model using the alignment of Lean Supply Chain, Green Supply Chain, Cleaner Production and ISO 14001-2004, is an integrated perspective that allows a gradual frame of the tactical and operative elements through the correct setting of the information flow, improving the decision making process. In that way, Small Medium Enterprises (SMEs) could improve their productivity, competitiveness and as an added value, the minimization of the environmental impact. This improvement is expected to be controlled through a Dashboard that helps the Organization measure its performance along the implementation of the model in its productive process.

Keywords: Integration, environmental impact, management, systemic organization.

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Authors: Towards Better Quality in Healthcare, Operations Management: A Developmental Literature Review

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This work presents the various perspectives, dimensions, components and definitions given to quality in the operations management (OM) and healthcare services (HCS) literature in time, highlighting gaps and learning opportunities between the two disciplines through a thorough search into their rich and distinct body of knowledge. Greater and new insights about the general nature of quality are obtained with findings such as in OM, quality has been approached in six fairly distinct paradigms (excellence, value, conformity to specifications, attributes, satisfaction and meeting or exceeding customer expectations), whereas in HCS, two approaches are prominent (Donabedian’s structure, process and outcomes model and Lohr and Schroeder’s circumscribed definition). The two disciplines views on quality seem to have progressed much in parallel with little cross-learning from each other. This work then proposes an encompassing definition of quality as a lever and suggests further research and development avenues for a better use of the concept of quality by academics and practitioners alike toward the goals of greater organizational performance and improved management in healthcare and possibly other service domains.

Keywords: Healthcare, management, operations, quality, services.

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Authors: M. P. Sebastian

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Health for all is considered as a sign of well-being and inclusive growth. New healthcare technologies are contributing to the quality of human lives by promoting health education and awareness, leading to the prevention, early diagnosis and treatment of the symptoms of diseases. Healthcare technologies have now migrated from the medical and institutionalized settings to the home and everyday life. This paper explores these new technologies and investigates how they contribute to health education and awareness, promoting the objective of high-value health system for all. The methodology used for the research is literature review. The paper also discusses the opportunities and challenges with futuristic healthcare technologies. The combined advances in genomics medicine, wearables and the IoT with enhanced data collection in electronic health record (EHR) systems, environmental sensors, and mobile device applications can contribute in a big way to high-value health system for all. The promise by these technologies includes reduced total cost of healthcare, reduced incidence of medical diagnosis errors, and reduced treatment variability. The major barriers to adoption include concerns with security, privacy, and integrity of healthcare data, regulation and compliance issues, service reliability, interoperability and portability of data, and user friendliness and convenience of these technologies.

Keywords: Bigdata, education, healthcare, ICT, patients, technologies.

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Authors: Gaurav Shinde, Sai Charan Gongiguntla, Prajwal Shirur, Ahmed Hambaba

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Health issues are significantly increasing, putting a substantial strain on healthcare services. This has accelerated the integration of machine learning in healthcare, particularly following the COVID-19 pandemic. The utilization of machine learning in healthcare has grown significantly. We introduce DeClEx, a pipeline which ensures that data mirrors real-world settings by incorporating gaussian noise and blur and employing autoencoders to learn intermediate feature representations. Subsequently, our convolutional neural network, paired with spatial attention, provides comparable accuracy to state-of-the-art pre-trained models while achieving a threefold improvement in training speed. Furthermore, we provide interpretable results using explainable AI techniques. We integrate denoising and deblurring, classification and explainability in a single pipeline called DeClEx.

Keywords: Machine learning, healthcare, classification, explainability.

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Authors: Aravindkumar B. Harwalkar, S. S. Awanti

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Use of fly ash as a supplementary cementing material in large volumes can bring both technological and economic benefits for concrete industry. In this investigation mix proportions for high volume fly ash concrete were determined at cement replacement levels of 50%, 55%, 60% and 65% with low calcium fly ash. Flexural and compressive strengths of different mixes were measured at ages of 7, 28 and 90 days. Flexural strength of composite section prepared from pavement quality and lean high volume fly ash concrete was determined at the age of 28 days. High volume fly ash concrete mixes exhibited higher rate of strength gain and age factors than corresponding reference concrete mixes. The optimum cement replacement level for pavement quality concrete was found to be 60%. The consideration of bond between pavement quality and lean of high volume fly ash concrete will be beneficial in design of rigid pavements.

Keywords: Keywords—Composite section, Compressive strength, Flexural strength, Fly ash.

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Authors: Mehdi Seifbarghy, Keyvan Roshan

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Main goal of preventive healthcare problems are at decreasing the likelihood and severity of potentially life-threatening illnesses by protection and early detection. The levels of establishment and staffing costs along with summation of the travel and waiting time that clients spent are considered as objectives functions of the proposed nonlinear integer programming model. In this paper, we have proposed a bi-objective mathematical model for designing a network of preventive healthcare facilities so as to minimize aforementioned objectives, simultaneously. Moreover, each facility acts as M/M/1 queuing system. The number of facilities to be established, the location of each facility, and the level of technology for each facility to be chosen are provided as the main determinants of a healthcare facility network. Finally, to demonstrate performance of the proposed model, four multi-objective decision making techniques are presented to solve the model.

Keywords: Preventive healthcare problems, Non-linear integer programming models, Multi-objective decision making techniques

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Authors: Tim Wollert, Fabian Behrendt

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Value Stream Management (VSM) is a widely used methodology in the context of Lean Management for improving end-to-end material and information flows from a supplier to a customer from a company’s perspective. Whereas the design principles, e.g. Pull, value-adding, customer-orientation and further ones are still valid against the background of an increasing digitalized and dynamic environment, the methodology itself for mapping a value stream is characterized as time- and resource-intensive due to the high degree of manual activities. The digitalization of processes in the context of Industry 4.0 enables new opportunities to reduce these manual efforts and make the VSM approach more agile. The paper at hand aims at providing a modular data and calculation framework, utilizing the available business data, provided by information and communication technologies for automizing the value stream mapping process with focus on the manufacturing process.

Keywords: Industry 4.0, lean management 4.0, value stream management 4.0, value stream mapping.

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Authors: B. Stroetmann, A. Aisenbrey

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The Siemens Healthcare Sector is one of the world's largest suppliers to the healthcare industry and a trendsetter in medical imaging and therapy, laboratory diagnostics, medical information technology, and hearing aids. Siemens offers its customers products and solutions for the entire range of patient care from a single source – from prevention and early detection to diagnosis, and on to treatment and aftercare. By optimizing clinical workflows for the most common diseases, Siemens also makes healthcare faster, better, and more cost effective. The optimization of clinical workflows requires a multidisciplinary focus and a collaborative approach of e.g. medical advisors, researchers and scientists as well as healthcare economists. This new form of collaboration brings together experts with deep technical experience, physicians with specialized medical knowledge as well as people with comprehensive knowledge about health economics. As Charles Darwin is often quoted as saying, “It is neither the strongest of the species that survive, nor the most intelligent, but the one most responsive to change," We believe that those who can successfully manage this change will emerge as winners, with valuable competitive advantage. Current medical information and knowledge are some of the core assets in the healthcare industry. The main issue is to connect knowledge holders and knowledge recipients from various disciplines efficiently in order to spread and distribute knowledge.

Keywords: Business Excellence, Clinical Knowledge, Knowledge Management, Knowledge Services, Learning Organizations, Trust.

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Authors: T. Yuri M. Zagloel, Inaki M. Hakim, A. M. Syarafi

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Manufacturing process has been considered as one of the most important activity in business process. It correlates with productivity and quality of the product so industries could fulfill customer’s demand. With the increasing demand from customer, industries must improve their manufacturing ability such as shorten lead-time and reduce wastes on their process. Lean manufacturing has been considered as one of the tools to waste elimination in manufacturing or service industry. Workforce development is one practice in lean manufacturing that can reduce waste generated from operator such as waste of unnecessary motion. Anthropometric approach is proposed to determine the recommended measurement in operator’s work area. The method will get some dimensions from Indonesia people that related to piston workstation. The result from this research can be obtained new design for the work area considering ergonomic aspect.

Keywords: Adjustable, anthropometric, ergonomic, waste.

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Authors: Sh.Khalilarya, H.Oryani, S.Jafarmadar, H.Khatamnezhad, A.Nemati

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Understanding of how and where NOx formation occurs in industrial burner is very important for efficient and clean operation of utility burners. Also the importance of this problem is mainly due to its relation to the pollutants produced by more burners used widely of gas turbine in thermal power plants and glass and steel industry. In this article, a numerical model of an industrial burner operating in MILD combustion is validated with experimental data.. Then influence of air flow rate and air temperature on combustor temperature profiles and NOX product are investigated. In order to modification this study reports on the effects of fuel and air dilution (with inert gases H2O, CO2, N2), and also influence of lean-premixed of fuel, on the temperature profiles and NOX emission. Conservation equations of mass, momentum and energy, and transport equations of species concentrations, turbulence, combustion and radiation modeling in addition to NO modeling equations were solved together to present temperature and NO distribution inside the burner. The results shows that dilution, cause to a reduction in value of temperature and NOX emission, and suppresses any flame propagation inside the furnace and made the flame inside the furnace invisible. Dilution with H2O rather than N2 and CO2 decreases further the value of the NOX. Also with raise of lean-premix level, local temperature of burner and the value of NOX product are decreases because of premixing prevents local “hot spots" within the combustor volume that can lead to significant NOx formation. Also leanpremixing of fuel with air cause to amount of air in reaction zone is reach more than amount that supplied as is actually needed to burn the fuel and this act lead to limiting NOx formation

Keywords: Mild combustion, Flameless, Numerical simulation, Burner, CFD.

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Authors: Faraj El Dabee, Romeo Marian, Yousef Amer

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Just-In-Time (JIT) is a lean manufacturing tool, which provides the benefits of efficiency, and of minimizing unnecessary costs for many organisations. However, the risks arising from these benefits have been disregarded. These risks impact on system processes disrupting the whole supply chain. This paper proposes an inventory model that can simultaneously reduce costs and risks in JIT systems. This model is developed to ascertain an optimal ordering strategy for procuring raw materials by using regular multi-external and local backup suppliers to reduce the total cost of the products, and at the same time to reduce the risks arising from this cost reduction within production systems. Some results that will be illustrated in the second part of this paper are presented.

Keywords: Lean manufacturing, Just-in-Time (JIT), production system, cost-risk reduction, inventory model, eternal supplier, local backup supplier.

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Authors: V. Emery David Jr., J. Wenchao, D. Mmereki, Y. John, F. Heriniaina

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Healthcare waste management continues to present an array of challenges for developing countries, and Liberia is of no exception. There is insufficient information available regarding the generation, handling, and disposal of health care waste. This face serves as an impediment to healthcare management schemes. The specific objective of this study is to present an evaluation of the current health care management practices in Liberia. It also presented procedures, techniques used, methods of handling, transportation, and disposal methods of wastes as well as the quantity and composition of health care waste. This study was conducted as an investigative case study, covering three different health care facilities; a hospital, a health center, and a clinic in Monrovia, Montserrado County. The average waste generation was found to be 0-7kg per day at the clinic and health center and 8-15kg per/day at the hospital. The composition of the waste includes hazardous and non-hazardous waste i.e. plastic, papers, sharps, and pathological elements etc. Nevertheless, the investigation showed that the healthcare waste generated by the surveyed healthcare facilities were not properly handled because of insufficient guidelines for separate collection, and classification, and adequate methods for storage and proper disposal of generated wastes. This therefore indicates that there is a need for improvement within the healthcare waste management system to improve the existing situation.

Keywords: Disposal, Healthcare waste, management, Montserrado County, Monrovia.

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Authors: Kgabo H. Badimo, Sheryl Buckley

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Knowledge is increasingly recognised in this, the knowledge era, as a strategic resource, by public sector organisations, in view of the public sector reform initiatives. People and knowledge play a vital role in attaining improved organisational performance and high service quality. Many government departments in the public sector have started to realise the importance of knowledge management in streamlining their operations and processes. This study focused on knowledge management in the public healthcare service organisations, where the concept of service provider competitiveness pales to insignificance, considering the huge challenges emanating from the healthcare and public sector reforms. Many government departments are faced with challenges of improving organisational performance and service delivery, improving accountability, making informed decisions, capturing the knowledge of the aging workforce, and enhancing partnerships with stakeholders. The purpose of this paper is to examine the knowledge management practices of the Gauteng Department of Health in South Africa, in order to understand how knowledge management practices influence improvement in organisational performance and healthcare service delivery. This issue is explored through a review of literature on dominant views on knowledge management and healthcare service delivery, as well as results of interviews with, and questionnaire responses from, the general staff of the Gauteng Department of Health. Web-based questionnaires, face-to-face interviews and organisational documents were used to collect data. The data were analysed using both the quantitative and qualitative methods. The central question investigated was: To what extent can the conditions required for successful knowledge management be observed, in order to improve organisational performance and healthcare service delivery in the Gauteng Department of Health. The findings showed that the elements of knowledge management capabilities investigated in this study, namely knowledge creation, knowledge sharing and knowledge application, have a positive, significant relationship with all measures of organisational performance and healthcare service delivery. These findings thus indicate that by employing knowledge management principles, the Gauteng Department of Health could improve its ability to achieve its operational goals and objectives, and solve organisational and healthcare challenges, thereby improving organisational performance and enhancing healthcare service delivery in Gauteng.

Keywords: Knowledge Management, Healthcare Service Delivery, Public Healthcare, Public Sector.

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Authors: Saumyaranjan Sahoo, Sudhir Yadav

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Indian manufacturing firms operating in rapidly changing and highly competitive market, over the last few decades, have embraced organization-wide transformation to achieve cultural and operational excellence. In recent years, numerous approaches have been proposed to improve business and manufacturing performance. Lean practices in particular, Total Productive Management (TPM) and Total Quality Management (TQM) have received considerable attention, as they being adopted and adapted for raising the performance standard of Indian manufacturing firms to world class levels. The complementary nature of TPM and TQM is being practiced in many companies to achieve synergy. Specifically, this research investigates whether joint TPM-TQM implementation contribute to higher business performance when compared to individual implementation. Data from 160 manufacturing firms were analyzed that demonstrate synergetic implementation of both TPM-TQM practices over a reasonable period of time, contributed in delivering better business performance as compared to individual implementation strategy.

Keywords: Total productive management, total quality management, Indian manufacturing firms, business performance.

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Authors: Waldemiro Francisco Sorte Junior

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The Japanese integrative approach to social systems can be observed in supply chain management as well as in the relationship between public and private sectors. Both the Lean Production System and the Developmental State Model are characterized by efforts towards the achievement of mutual goals, resulting in initiatives for capacity building which emphasize the system level. In Brazil, although organizations undertake efforts to build capabilities at the individual and organizational levels, the system level is being neglected. Fieldwork data confirmed the findings of other studies in terms of the lack of integration in supply chain management in the Brazilian automobile industry. Moreover, due to the absence of an active role of the Brazilian state in its relationship with the private sector, automakers are not fully exploiting the opportunities in the domestic and regional markets. For promoting a higher level of economic growth as well as to increase the degree of spill-over of technologies and techniques, a more integrative approach is needed.

Keywords: Integration, Lean Production System, DevelopmentalState Model, Brazilian automobile industry.

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Authors: M. H. M. Rusli, A. Jaffar, M. T. Ali, S. Muhamud @ Kayat

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Lean manufacturing is a production philosophy made popular by Toyota Motor Corporation (TMC). It is globally known as the Toyota Production System (TPS) and has the ultimate aim of reducing cost by thoroughly eliminating wastes or muda. TPS embraces the Just-in-time (JIT) manufacturing; achieving cost reduction through lead time reduction. JIT manufacturing can be achieved by implementing Pull system in the production. Furthermore, TPS aims to improve productivity and creating continuous flow in the production by arranging the machines and processes in cellular configurations. This is called as Cellular Manufacturing Systems (CMS). This paper studies on integrating the CMS with the Pull system to establish a Big Island-Pull system production for High Mix Low Volume (HMLV) products in an automotive component industry. The paper will use the build-in JIT system steps adapted from TMC to create the Pull system production and also create a shojinka line which, according to takt time, has the flexibility to adapt to demand changes simply by adding and taking out manpower. This will lead to optimization in production.

Keywords: Big Island layout, Lean manufacturing, Material and Information Flow Chart, Pull system production, TPS.

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Authors: H. M. Nuralam, Z. Xiao-lan, B. K. Dubey, D. Wen-Chuan

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Healthcare waste (HCW) is one of the major concerns in environmental issues due to its infectious and hazardous nature that is requires specific treatment and systematic management prior to final disposal. This study aimed to assess HCW management system in Dhaka City (DC), Bangladesh, by investigating the present practices implemented by the city. In this study, five different healthcare establishments were selected in DC. Field visits and interviews with health personnel and staff who are concerned with the waste management were conducted. The information was gathered through questionnaire focus on the different aspect of HCW management like, waste segregation and collection, storage and transport, awareness as well. The results showed that a total of 7,215 kg/day (7.2 ton/day) of waste were generated, of which 79.36% (5.6 ton/day) was non-hazardous waste and 20.6% (1.5 ton/day) was hazardous waste. The rate of waste generation in these healthcare establishments (HCEs) was 2.6 kg/bed/day. There was no appropriate and systematic management of HCWs except at few private HCEs that segregate their hazardous waste. All the surveyed HCEs dumped their HCW together with the municipal waste, and some staff members were also found to be engaged in improper handling of the generated waste. Furthermore, the used sharp instruments, saline bags, blood bags and test tubes were collected for resale or reuse. Nevertheless, the lack of awareness, appropriate policy, regulation and willingness to act, were responsible for the improper management of HCW in DC. There was lack of practical training of concerned healthcare to handle the waste properly, while the nurses and staff were found to be aware of the health impacts of HCW.

Keywords: Awareness, disposal, Dhaka City, healthcare waste management, waste generation.

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Authors: Anass Rahouti, Guillaume Salze, Ruggiero Lovreglio, Sélim Datoussaïd

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In healthcare facilities, training the staff for firefighting and evacuation in real buildings is very challenging due to the presence of a vulnerable population in such an environment. In a standard environment, traditional approaches, such as fire drills, are often used to train the occupants and provide them with information about fire safety procedures. However, those traditional approaches may be inappropriate for a vulnerable population and can be inefficient from an educational viewpoint as it is impossible to expose the occupants to scenarios similar to a real emergency. Immersive serious games could be used as an alternative to traditional approaches to overcome their limitations. Serious games are already being used in different safety domains such as fires, earthquakes and terror attacks for several building types (e.g., office buildings, train stations, tunnels, etc.). In this study, we developed an immersive serious game to improve the fire safety skills of staff in healthcare facilities. An accurate representation of the healthcare environment was built in Unity3D by including visual and audio stimuli inspired from those employed in commercial action games. The serious game is organised in three levels. In each of them, the trainee is presented with a specific fire emergency and s/he can perform protective actions (e.g., firefighting, helping non-ambulant occupants, etc.) or s/he can ignore the opportunity for action and continue the evacuation. In this paper, we describe all the steps required to develop such a prototype, as well as the key questions that need to be answered, to develop a serious game for firefighting and evacuation in healthcare facilities.

Keywords: Fire Safety, healthcare, serious game, training.

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Authors: Supunmali Ahangama, Danny Chiang Choon Poo

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Health analytics (HA) is used in healthcare systems for effective decision making, management and planning of healthcare and related activities. However, user resistances, unique position of medical data content and structure (including heterogeneous and unstructured data) and impromptu HA projects have held up the progress in HA applications. Notably, the accuracy of outcomes depends on the skills and the domain knowledge of the data analyst working on the healthcare data. Success of HA depends on having a sound process model, effective project management and availability of supporting tools. Thus, to overcome these challenges through an effective process model, we propose a HA process model with features from rational unified process (RUP) model and agile methodology.

Keywords: Agile methodology, health analytics, unified process model, UML.

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Authors: Nathan C. Lea, Tony Austin, Stephen Hailes, Dipak Kalra

Abstract:

This paper introduces a tool that is being developed for the expression of information security policy controls that govern electronic healthcare records. By reference to published findings, the paper introduces the theory behind the use of knowledge management for automatic and consistent security policy assertion using the formalism called the Secutype; the development of the tool and functionality is discussed; some examples of Secutypes generated by the tool are provided; proposed integration with existing medical record systems is described. The paper is concluded with a section on further work and critique of the work achieved to date.

Keywords: Information Security Policy, Electronic Healthcare Records, Knowledge Management, Archetypes, Secutypes.

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Authors: Nevena Stolba, A Min Tjoa

Abstract:

Evidence-based medicine is a new direction in modern healthcare. Its task is to prevent, diagnose and medicate diseases using medical evidence. Medical data about a large patient population is analyzed to perform healthcare management and medical research. In order to obtain the best evidence for a given disease, external clinical expertise as well as internal clinical experience must be available to the healthcare practitioners at right time and in the right manner. External evidence-based knowledge can not be applied directly to the patient without adjusting it to the patient-s health condition. We propose a data warehouse based approach as a suitable solution for the integration of external evidence-based data sources into the existing clinical information system and data mining techniques for finding appropriate therapy for a given patient and a given disease. Through integration of data warehousing, OLAP and data mining techniques in the healthcare area, an easy to use decision support platform, which supports decision making process of care givers and clinical managers, is built. We present three case studies, which show, that a clinical data warehouse that facilitates evidence-based medicine is a reliable, powerful and user-friendly platform for strategic decision making, which has a great relevance for the practice and acceptance of evidence-based medicine.

Keywords: data mining, data warehousing, decision-support systems, evidence-based medicine.

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Authors: Trina Isabel D. Santiago, Daniel C. Chua, Jumee F. Tayaban, Joseph Daniel S. Timbol, Joshua M. Yanes

Abstract:

Numerous instances of human rights violations on healthcare workers have been reported during the COVID-19 pandemic in the Philippines. This paper aims to explore these civil and political rights violations and propose recommendations to address these. Our review shows that a wide range of civic and political human rights violations have been committed by individual citizens and government agencies on individual healthcare workers and health worker groups. These violations include discrimination, red-tagging, evictions, illegal arrests, and acts of violence ranging from chemical attacks to homicide. If left unchecked, these issues, compounded by the pandemic, may lead to the exacerbations of the pre-existing problems of the Philippine healthcare system. Despite all pre-existing reports by human rights groups and public media articles, there still seems to be a lack of government action to condemn and prevent these violations. The existence of government agencies which directly contribute to these violations with the lack of condemnation from other agencies further propagate the problem. Given these issues, this policy brief recommends the establishment of an interagency task force for the protection of human rights of healthcare workers as well as the expedited passing of current legislative bills towards the same goal. For more immediate action, we call for the establishment of a dedicated hotline for these incidents with adequate appointment and training of point persons, construction of clear guidelines, and closer collaboration between government agencies in being united against these issues.

Keywords: COVID-19 pandemic, healthcare workers, human rights violations, Philippines.

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