Search results for: preventive healthcare.

Authors: Mehdi Seifbarghy, Keyvan Roshan

Abstract:

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: M. Emmanouilidou

Abstract:

The Internet of Things (IoT) is a disruptive technological paradigm that is at the center of the digital evolution by integrating physical and virtual worlds leading to the creation of extended interconnected ecosystems that are characterized as smart environments. The concept of the IoT has a broad range of applications in different industries including the healthcare sector. The Internet of Healthcare Things (IoHT), a branch of the IoT, is expected to bring promising benefits to all involved stakeholders and accelerate the revolution of the healthcare sector through a transition towards preventive and personalized medicine. The socio-economic challenges that the healthcare sector is facing further emphasize the need for a radical transformation of healthcare systems in both developed and developing countries with the role of pervasive technological innovations, such as IoHT, recognized as key to counteract the relevant challenges. Besides the number of potential opportunities that IoHT presents, there are fundamental ethical concerns that need to be considered and addressed in relation to the application of IoHT. This paper contributes to the discussion of the emerging topic of IoHT by providing an overview of the role and potential of IoHT, highlighting the characteristics of the current and future healthcare landscape, reporting on the up-to-date status of IoHT in Europe and reflecting upon existing research in the ethics of IoHT by incorporating additional ethical dimensions that have been ignored which can provide pathways for future research in the field.

Keywords: Ethics, Europe, healthcare, internet of things.

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Authors: Tero Huhtala, Minna Pikkarainen, Saila Saraniemi

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Information technology has long been used as an enabler of exchange for goods and services. Services are evolving from generic to personalized, and the reverse use of customer data has been discussed in both academia and industry for the past few years. This article presents the results of an empirical case study in the area of preventive health care services. The primary data were gathered in workshops, in which future personal data-based services were conceptualized by analyzing future scenarios from a business perspective. The aim of this study is to understand business model transformation in emerging personal data ecosystems. The work was done as a case study in the context of occupational healthcare. The results have implications to theory and practice, indicating that adopting personal data management principles requires transformation of the business model, which, if successfully managed, may provide access to more resources, potential to offer better value, and additional customer channels. These advantages correlate with the broadening of the business ecosystem. Expanding the scope of this study to include more actors would improve the validity of the research. The results draw from existing literature and are based on findings from a case study and the economic properties of the healthcare industry in Finland.

Keywords: Ecosystem, business model, personal data, preventive healthcare.

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Authors: Mahmud Fotuhi-Firuzabad, Saeed Afshar

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This paper presents the results of a preventive maintenance application-based study and modeling of failure rates in breakers of electrical distribution systems. This is a critical issue in the reliability assessment of a system. In the analysis conducted in this paper, the impacts of failure rate variations caused by a preventive maintenance are examined. This is considered as a part of a Reliability Centered Maintenance (RCM) application program. A number of load point reliability indices is derived using the mathematical model of the failure rate, which is established using the observed data in a distribution system.

Keywords: Reliability-Centered Maintenance (RCM), failure rate, preventive maintenance (PM), Distribution System Reliability.

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Authors: Ellysa Nursanti, Anas Ma'ruf, Tota Simatupang, Bermawi P. Iskandar

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This study proposes a hybrid minimal repair policy which combines periodic maintenance policy with age-based maintenance policy for a serial production system. Parameters of such policy are defined as
and  which indicate as hybrid minimal repair time and planned preventive maintenance time respectively  . Under this hybrid policy, the system is repaired minimally if it fails during ,
. A perfect repair is conducted on the first failure after
at any machines. At the same time, we take opportunity to advance the preventive maintenance of other machines simultaneously. If the system is still operating properly up to , then the preventive maintenance is carried out as its predetermined schedule. For a given , we obtain the optimal value
which minimizes the expected cost per time unit. Numerical example is presented to illustrate the properties of the optimal solution.

Keywords: Hybrid minimal repair, opportunistic maintenance, preventive maintenance, series system

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Authors: Jakob Renko, Deja Praprotnik, Kristina Martinovič, Igor Karnjuš

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Catheter-related bloodstream infections are a major burden for healthcare and patients. Although infections of this type cannot be completely avoided, they can be reduced by taking preventive measures. The aim of this study is to review and analyze the existing literature on preventive interventions to prevent central venous catheters (CVC) infections. A systematic literature review was carried out. The international databases CINAHL, Medline, PubMed, and Web of Science were searched using the search strategy: "catheter-related infections" AND "intensive care units" AND "prevention" AND "central venous catheter." Articles that met the inclusion and exclusion criteria were included in the study. The literature search flow is illustrated by the PRISMA diagram. The descriptive research method was used to analyze the data. Out of 554 search results, 22 surveys were included in the final analysis. We identified seven relevant preventive measures to prevent CVC infections: washing the whole body with chlorhexidine gluconate (CHG) solution, disinfecting the CVC entry site with CHG solution, use of CHG or silver dressings, alcohol protective caps, CVC care education, selecting appropriate catheter and multicomponent care bundles. Both single interventions and multicomponent care bundles have been shown to be currently effective measures to prevent CVC infections in adult patients in the ICU. None of the measures identified stood out in terms of their effectiveness. Prevention work to reduce CVC infections in the ICU is a complex process that requires the simultaneous consideration of several factors.

Keywords: Central venous access, critically ill patients, hospital-acquired complications, prevention.

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Authors: Lalit Garg, Sally McClean, Maria Barton

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Healthcare issues continue to pose huge problems and incur massive costs. As a result there are many challenging problems still unresolved. In this paper, we will carry out an extensive scientific survey of different areas of management and planning in an attempt to identify where there has already been a substantial contribution from management science methods to healthcare problems and where there is a clear potential for more work to be done. The focus will be on the read-across to the healthcare domain from such approaches applied generally to management and planning and how the methods can be used to improvement patient care. We conclude that, since the healthcare domain significantly differs from traditional areas of management and planning, in some cases there is a need to modify the approaches so as to incorporate the complexities of healthcare, and fully exploit the potential for improvement.

Keywords: Management science, management and planning, transforming services, healthcare.

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Authors: M. Bouguerra, H. Meglouli, I. Habi

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The great majority of the electric installations belong to the first and second category. In order to ensure a high level of reliability of their electric system feeder, two power supply sources are envisaged, one principal, the other of reserve, generally a cold reserve (electric diesel group). The principal source being under operation, its control can be ideal and sure, however for the reserve source being in stop, a preventive maintenance-s which proceeds on time intervals (periodicity) and for well defined lengths of time are envisaged, so that this source will always available in case of the principal source failure. The choice of the periodicity of preventive maintenance of the source of reserve influences directly the reliability of the electric feeder system. On the basis of the semi-markovians processes, the influence of the periodicity of the preventive maintenance of the source of reserve is studied and is given the optimal periodicity.

Keywords: Semi Markovians processes, reliability, optimization, electric network.

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Authors: Inas S. Khayal, Weiping Zhou, Jonathan Skinner

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Healthcare delivery systems around the world are in crisis. The need to improve health outcomes while decreasing healthcare costs have led to an imminent call to action to transform the healthcare delivery system. While Bioinformatics and Biomedical Engineering have primarily focused on biological level data and biomedical technology, there is clear evidence of the importance of the delivery of care on patient outcomes. Classic singular decomposition approaches from reductionist science are not capable of explaining complex systems. Approaches and methods from systems science and systems engineering are utilized to structure healthcare delivery system data. Specifically, systems architecture is used to develop a multi-scale and multi-dimensional characterization of the healthcare delivery system, defined here as the Healthcare Delivery System Knowledge Base. This paper is the first to contribute a new method of structuring and visualizing a multi-dimensional and multi-scale healthcare delivery system using systems architecture in order to better understand healthcare delivery.

Keywords: Health informatics, systems thinking, systems architecture, healthcare delivery system, data analytics.

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Authors: Nikunj Agarwal, M. P. Sebastian

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Cloud computing can reduce the start-up expenses of implementing EHR (Electronic Health Records). However, many of the healthcare institutions are yet to implement cloud computing due to the associated privacy and security issues. In this paper, we analyze the challenges and opportunities of implementing cloud computing in healthcare. We also analyze data of over 5000 US hospitals that use Telemedicine applications. This analysis helps to understand the importance of smart phones over the desktop systems in different departments of the healthcare institutions. The wide usage of smartphones and cloud computing allows ubiquitous and affordable access to the health data by authorized persons, including patients and doctors. Cloud computing will prove to be beneficial to a majority of the departments in healthcare. Through this analysis, we attempt to understand the different healthcare departments that may benefit significantly from the implementation of cloud computing.

Keywords: Cloud computing, smart devices, healthcare, telemedicine.

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Authors: Chuang-Chun Chiou, Chien-Ju Liu, Jenteng Tsai

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Due to the rise of aging population, effective utilization of healthcare resources has become an important issue. With the advance of ICT technology, the application of tele-healthcare service has received more attention than ever. The main purpose of this research is to investigate how to conduct innovative design for tele-healthcare service based on user-s perspectives. First, the healthcare service blueprint was used to describe the processes of tele-healthcare service delivery, and then construct PZB service quality gap model based on the literature and practitioners- interviews. Next, TRIZ theory is applied to implement service innovation. We found the proposed service innovation procedures can effectively improve the quality of service design.

Keywords: Tele-homecare, Service blueprint, TRIZ, PZB model

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Authors: Jaehun Joo, Mie-jung Kim, Ismatilla Normatov, Lyunhwa Kim

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The purpose of this paper is to analyze determinants of information security affecting adoption of the Web-based integrated information systems (IIS). We introduced Web-based information systems which are designed to formulate strategic plans for Peruvian government. Theoretical model is proposed to test impact of organizational factors (deterrent efforts and severity; preventive efforts) and individual factors (information security threat; security awareness) on intentions to proactively use the Web-based IIS .Our empirical study results highlight that deterrent efforts and deterrent severity have no significant influence on the proactive use intentions of IIS, whereas, preventive efforts play an important role in proactive use intentions of IIS. Thus, we suggest that organizations need to do preventive efforts by introducing various information security solutions, and try to improve information security awareness while reducing the perceived information security threats.

Keywords: Information security, Deterrent efforts, deterrentseverity, preventive efforts, information security awareness, information security threats, integrated information systems

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Authors: María Araya Léon, Ainoa Abella, Aura Murillo, Ricardo Guasch, Laura Clèries

Abstract:

This article aims to examine scientific theory framed within the term hospitals of the future from a multidisciplinary and cross-sectional perspective. To understand the connection that the various cross-sectional areas, we studied have with architectural spaces and to determine the future outlook of the works examined and how they can be classified into the categories of need/solution, evolution/revolution, collective/individual, and preventive/corrective. The changes currently taking place within the context of healthcare demonstrate how important these projects are and the need for companies to face future changes. A systematic review has been carried out focused on what will the hospitals of the future be like in relation to the elements that form part of their use, design, and architectural space experience, using the WOS database from 2016 to 2019. The large number of works about sensoring & big data and the scarce amount related to the area of materials is worth highlighting. Furthermore, no growth concerning future issues is envisaged over time. Regarding classifications, the articles we reviewed address evolutionary and collective solutions more, and in terms of preventive and corrective solutions, they were found at a similar level. Although our research focused on the future of hospitals, there is little evidence representing this approach. We also detected that, given the relevance of the research on how the built environment influences human health and well-being, these studies should be promoted within the context of healthcare. This article allows to find evidence on the future perspective from within the domain of hospital architecture, in order to create bridges between the productive sector of architecture and scientific theory. This will make it possible to detect R&D opportunities in each analyzed cross-section.

Keywords: Hospitals, trends, architectural space, disruptive approach.

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Authors: Nooshin Salari, Viliam Makis, Jane Doe

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This paper presents a maintenance policy for a system consisting of two units. Unit 1 is gradually deteriorating and is subject to soft failure. Unit 2 has a general lifetime distribution and is subject to hard failure. Condition of unit 1 of the system is monitored periodically and it is considered as failed when its deterioration level reaches or exceeds a critical level N. At the failure time of unit 2 system is considered as failed, and unit 2 will be correctively replaced by the next inspection epoch. Unit 1 or 2 are preventively replaced when deterioration level of unit 1 or age of unit 2 exceeds the related preventive maintenance (PM) levels. At the time of corrective or preventive replacement of unit 2, there is an opportunity to replace unit 1 if its deterioration level reaches the opportunistic maintenance (OM) level. If unit 2 fails in an inspection interval, system stops operating although unit 1 has not failed. A mathematical model is derived to find the preventive and opportunistic replacement levels for unit 1 and preventive replacement age for unit 2, that minimize the long run expected average cost per unit time. The problem is formulated and solved in the semi-Markov decision process (SMDP) framework. Numerical example is provided to illustrate the performance of the proposed model and the comparison of the proposed model with an optimal policy without opportunistic maintenance level for unit 1 is carried out.

Keywords: Condition-based maintenance, opportunistic maintenance, preventive maintenance, two-unit system.

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Authors: Omar Farshad Jeelani, Makaire Njie, Viktoriia M. Korzhuk

Abstract:

Recently, the application of AI-powered algorithms in healthcare continues to flourish. Particularly, access to healthcare information, including patient health history, diagnostic data, and PII (Personally Identifiable Information) is paramount in the delivery of efficient patient outcomes. However, as the exchange of healthcare information between patients and healthcare providers through AI-powered solutions increases, protecting a person’s information and their privacy has become even more important. Arguably, the increased adoption of healthcare AI has resulted in a significant concentration on the security risks and protection measures to the security and privacy of healthcare data, leading to escalated analyses and enforcement. Since these challenges are brought by the use of AI-based healthcare solutions to manage healthcare data, AI-based data protection measures are used to resolve the underlying problems. Consequently, these projects propose AI-powered safeguards and policies/laws to protect the privacy of healthcare data. The project present the best-in-school techniques used to preserve data privacy of AI-powered healthcare applications. Popular privacy-protecting methods like Federated learning, cryptography techniques, differential privacy methods, and hybrid methods are discussed together with potential cyber threats, data security concerns, and prospects. Also, the project discusses some of the relevant data security acts/laws that govern the collection, storage, and processing of healthcare data to guarantee owners’ privacy is preserved. This inquiry discusses various gaps and uncertainties associated with healthcare AI data collection procedures, and identifies potential correction/mitigation measures.

Keywords: Data privacy, artificial intelligence, healthcare AI, data sharing, healthcare organizations.

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Authors: Eun-Jung Ko, Hyung-Jik Lee, Jeun-Woo Lee

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In ubiqutious healthcare environment, user's health data are transfered to the remote healthcare server by the user's wearable system or mobile phone. These collected user's health data should be managed and analyzed in the healthcare server, so that care giver or user can monitor user's physiological state. In this paper, we designed and developed the intelligent Healthcare Server to manage the user's health data using CDSS and ontology. Our system can analyze user's health data semantically using CDSS and ontology, and report the result of user's physiological raw data to the user and care giver.

Keywords: u-healthcare, CDSS, healthcare server, health data, ontology.

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Authors: Rusyaizila Ramli, Nasriah Zakaria, Putra Sumari

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Privacy issues commonly discussed among researchers, practitioners, and end-users in pervasive healthcare. Pervasive healthcare systems are applications that can support patient-s need anytime and anywhere. However, pervasive healthcare raises privacy concerns since it can lead to situations where patients may not be aware that their private information is being shared and becomes vulnerable to threat. We have systematically analyzed the privacy issues and present a summary in tabular form to show the relationship among the issues. The six issues identified are medical information misuse, prescription leakage, medical information eavesdropping, social implications for the patient, patient difficulties in managing privacy settings, and lack of support in designing privacy-sensitive applications. We narrow down the issues and chose to focus on the issue of 'lack of support in designing privacysensitive applications' by proposing a privacy-sensitive architecture specifically designed for pervasive healthcare monitoring systems.

Keywords: Human Factors, Pervasive Healthcare, PrivacyIssues

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Authors: Erika Ruiz, Nestor Ortiz

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Lean philosophy has evolved over time and has been implemented both in manufacturing and services, more recently lean has been integrated in the companies of the health sector. Currently it is important to understand the successful way to implement this philosophy and try to identify barriers and enablers to the sustainability of lean healthcare. The main purpose of this research is to identify the barriers and enablers in the implementation of Lean Healthcare based on case studies of Colombian healthcare centers. In order to do so, we conducted semi-structured interviews based on a maturity model. The main results indicate that the success of Lean implementation depends on its adaptation to contextual factors. In addition, in the Colombian context were identified new factors such as organizational culture, management models, integration of the care and administrative departments and triple helix relationship.

Keywords: Barriers, enablers, implementation, lean healthcare, sustainability.

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Authors: Khamis Al-Gharbi, Said M. Gattoufi, Ali H. Al-Badi, Ali Al-Hashmi

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The case study presents the progression of a project management of Al-Shifa, a healthcare information system in Oman. The case study describes the evolution of the implementation of a healthcare information system tailored to meet the needs of the healthcare units under the supervision of the Ministry of Health (MOH) in Oman. A focus group methodology was used for collecting the relevant information from the main project's stakeholders. In addition reports about the project made available for the researchers. The case analysis is made based on the Project Management approach developed by the Project Management Institute (PMI). The main finding that there was no formal project management approach adopted by the MOH for the development and implementation of the herewith mentioned healthcare information system project. Furthermore, the project had suffered a scope creep in terms of features, cost and time-schedule. The recommendations of the authors, for the rescue of the project from its current dilemma, consist of technological, administrative and human resources development actions.

Keywords: Al-Shifa, Information system, Healthcare, Oman, Project Management.

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Authors: Lynn. J. MacFarlane. A

Abstract:

Within the healthcare system, training and continued professional development although essential, can be effected by cost and logistical restraints due to the nature of healthcare provision e.g employee shift patterns, access to expertise, cost factors in releasing staff to attend training etc. The use of multimedia technology for the development of e-learning applications is also a major cost consideration for healthcare management staff, and this type of media whether optical or on line requires careful planning in order to remain inclusive of all staff with potentially varied access to multimedia computing. This paper discusses a project in which the use of DVD authoring technology has been successfully implemented to meet the needs of distance learning and user considerations, and is based on film production techniques and reduced product turnaround deadlines.

Keywords: DVD, healthcare, distance learning, cost.

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Authors: R. Poonsuph

Abstract:

Technological innovation plays a crucial role in virtual healthcare services. A growing number of telehealth platforms are concentrating on using digital tools to improve the quality and availability of care. As a result, telehealth represents an opportunity to redesign the way health services are delivered. The research objective is to discover a new business model for digital health services and related industries to participate with telehealth solutions. The business opportunity is valuable for healthcare investors as a startup company to further investigations or implement the telehealth platform. The paper presents a digital healthcare business model and business opportunities to related industries. These include digital healthcare services extending from a traditional business model and use cases of business opportunities to related industries. Although there are enormous business opportunities, telehealth is still challenging due to the patient adaption and digital transformation process within a healthcare organization.

Keywords: telehealth, Internet hospital, HealthTech, InsurTech

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Authors: Guanglin Song

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Situated within the context of China's tiered medical treatment system, this study aims to analyze spatial causes of urban healthcare access difficulties from the perspective of the configuration of healthcare facilities. A social network analysis approach is employed to construct a healthcare demand and supply flow network between major residential clusters and various tiers of hospitals in the city. The findings reveal that: 1) There exists overall maldistribution and over-concentration of healthcare resources in the study area, characterized by structural imbalance. 2) The low rate of primary care utilization in the study area is a key factor contributing to congestion at higher-tier hospitals, as excessive reliance on these institutions by neighboring communities exacerbates the problem. 3) Gradual optimization of the healthcare facility layout in the study area, encompassing holistic, local, and individual institutional levels, can enhance systemic efficiency and resource balance. This research proposes a method for evaluating urban healthcare resource distribution structures based on service flows within hierarchical networks. It offers spatially targeted optimization suggestions for promoting the implementation of the tiered healthcare system and alleviating challenges related to accessibility and congestion in seeking medical care. In addition, the study provides some new ideas for researchers and healthcare managers in countries, cities, and healthcare management around the world with similar challenges.

Keywords: Flow of public services, healthcare facilities, spatial planning, urban networks.

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Authors: Helena Kovačič, Andrej Rus

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The authors of this paper compared ratings for leadership competences of managers in the healthcare sector and professional managers in Slovenia. Managers’ competence scores were analyzed for Slovenia and compared with some other EU countries. Comparisons of correlations yielded significant differences in leader/non-leader healthcare professionals in their relational competences. Cross-cultural comparisons also point to these differences in many countries included in the survey. Comparing these managers with the professional managers, one of the relational competences significantly distinguishes the two groups, namely the competence of taking initiative in establishing contacts with experts outside the organization. What is surprising from our analysis is the high number of competences that significantly differentiate leaders in healthcare from professional managers. Empirically based assessment provided a robust method for assessing and comparing leadership competences and point out significant results for leadership development.

Keywords: Leadership, competences, healthcare.

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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

Abstract:

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: B. Dora Arul Selvi, .N. Kamaraj

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Transient Stability is an important issue in power systems planning, operation and extension. The objective of transient stability analysis problem is not satisfied with mere transient instability detection or evaluation and it is most important to complement it by defining fast and efficient control measures in order to ensure system security. This paper presents a new Fuzzy Support Vector Machines (FSVM) to investigate the stability status of power systems and a modified generation rescheduling scheme to bring back the identified unstable cases to a more economical and stable operating point. FSVM improves the traditional SVM (Support Vector Machines) by adding fuzzy membership to each training sample to indicate the degree of membership of this sample to different classes. The preventive control based on economic generator rescheduling avoids the instability of the power systems with minimum change in operating cost under disturbed conditions. Numerical results on the New England 39 bus test system show the effectiveness of the proposed method.

Keywords: Fuzzy Support Vector Machine (FSVM), Incremental Cost, Preventive Control, Transient stability

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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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