310 research outputs found

    Management-By-Objectives in Healthcare

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    Multi-criteria decision methods to support the maintenance management of complex systems

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    [ES] Esta tesis doctoral propone el uso de métodos de toma de decisiones multi-criterio (MCDM, por sus iniciales en inglés) como herramienta estratégica para apoyar la gestión del mantenimiento de sistemas complejos. El desarrollo de esta tesis doctoral se enmarca dentro de un acuerdo de cotutela entre la Università degli Studi di Palermo (UNIPA) y la Universitat Politècnica de València (UPV), dentro de sus respectivos programas de doctorado en 'Ingeniería de Innovación Tecnológica' y 'Matemáticas'. Estos programas están estrechamente vinculados a través del tópico MCDM, ya que proporciona herramientas cruciales para gestionar el mantenimiento de sistemas complejos reales utilizando análisis matemáticos serios. El propósito de esta sinergia es tener en cuenta de forma sólida la incertidumbre al atribuir evaluaciones subjetivas, recopilar y sintetizar juicios atribuidos por varios responsables de la toma de decisiones, y tratar con conjuntos grandes de esos elementos. El tema principal del presente trabajo de doctorado es el gestionamiento de las actividades de mantenimiento para aumentar los niveles de innovación tecnológica y el rendimiento de los sistemas complejos. Cualquier sistema puede ser considerado objeto de estudio, incluidos los sistemas de producción y los de prestación de servicios, entre otros, mediante la evaluación de sus contextos reales. Esta tesis doctoral propone afrontar la gestión del mantenimiento a través del desarrollo de tres líneas principales de investigación estrechamente vinculadas. ¿ La primera es el núcleo, e ilustra la mayoría de los aspectos metodológicos de la tesis. Se refiere al uso de métodos MCDM para apoyar decisiones estratégicas de mantenimiento, y para hacer frente a la incertidumbre que afecta a los datos/evaluaciones, incluso cuando están involucrados varios responsables (expertos en mantenimiento) en la toma de decisiones. ¿ La segunda línea desarrolla análisis de fiabilidad para sistemas complejos reales (también en términos de fiabilidad humana) sobre cuya base se debe implementar cualquier actividad de mantenimiento. Estos análisis consideran la configuración de fiabilidad de los componentes del sistema en estudio y las características específicas del entorno operativo. ¿ La tercera línea de investigación aborda aspectos metodológicos importantes de la gestión de mantenimiento y enfatiza la necesidad de monitorizar el funcionamiento de las actividades de mantenimiento y de evaluar su efectividad utilizando indicadores adecuados. Se ha elaborado una amplia gama de casos de estudio del mundo real para evaluar la eficacia de los métodos MCDM en el mantenimiento y así probar la utilidad del enfoque propuesto.[CA] Aquesta tesi doctoral proposa l'ús de mètodes de presa de decisions multi-criteri (MCDM, per les seves inicials en anglès) com a eina estratègica per donar suport a la gestió del manteniment de sistemes complexos. El desenvolupament d'aquesta tesi doctoral s'emmarca dins d'un acord de cotutela entre la Università degli Studi di Palermo (UNIPA) i la Universitat Politècnica de València (UPV), dins dels seus respectius programes de doctorat en 'Enginyeria d'Innovació Tecnològica' i ' Matemàtiques '. Aquests programes estan estretament vinculats a través del tòpic MCDM, ja que proporciona eines crucials per gestionar el manteniment de sistemes complexos reals utilitzant anàlisis matemàtics profunds. El propòsit d'aquesta sinergia és tenir en compte de forma sòlida la incertesa en atribuir avaluacions subjectius, recopilar i sintetitzar judicis atribuïts per diversos responsables de la presa de decisions, i tractar amb conjunts grans d'aquests elements en els problemes plantejats. El tema principal del present treball de doctorat es la gestió de les activitats de manteniment per augmentar els nivells d'innovació tecnològica i el rendiment dels sistemes complexos. Qualsevol sistema pot ser considerat objecte d'estudi, inclosos els sistemes de producció i els de prestació de serveis, entre d'altres, mitjançant l'avaluació dels seus contextos reals. Aquesta tesi doctoral proposa afrontar la gestió del manteniment mitjançant el desenvolupament de tres línies principals d'investigació estretament vinculades. ¿ La primera és el nucli, i il·lustra la majoria dels aspectes metodològics de la tesi. Es refereix a l'ús de mètodes MCDM per donar suport a decisions estratègiques de manteniment, i per fer front a la incertesa que afecta les dades/avaluacions, fins i tot quan estan involucrats diversos responsables (experts en manteniment) en la presa de decisions. ¿ La segona línia desenvolupa anàlisis de fiabilitat per a sistemes complexos reals (també en termes de fiabilitat humana) sobre la qual base s'ha d'implementar qualsevol activitat de manteniment. Aquestes anàlisis consideren la configuració de fiabilitat dels components del sistema en estudi i les característiques específiques de l'entorn operatiu. ¿ La tercera línia d'investigació aborda aspectes metodològics importants de la gestió de manteniment i emfatitza la necessitat de monitoritzar el funcionament de les activitats de manteniment i d'avaluar la seva efectivitat utilitzant indicadors adequats. S'ha elaborat una àmplia gamma de casos d'estudi del món real per avaluar l'eficàcia dels mètodes MCDM en el manteniment i així provar la utilitat de l'enfocament proposat.[EN] This doctoral thesis proposes using multi-criteria decision making (MCDM) methods as a strategic tool to support maintenance management of complex systems. The development of this doctoral thesis is framed within a cotutelle (co-tutoring) agreement between the Università degli Studi di Palermo (UNIPA) and the Universitat Politècnica de València (UPV), within their respective programmes of doctorates in 'Technological Innovation Engineering' and 'Mathematics'. Regarding this thesis, these programmes are closely linked through the topic of MCDM, providing crucial tools to manage maintenance of real complex systems by applying in-depth mathematical analyses. The purpose of this connection is to robustly take into account uncertainty in attributing subjective evaluations, collecting and synthetizing judgments attributed by various decision makers, and dealing with large sets of elements characterising the faced issue. The main topic of the present doctoral work is the management of maintenance activities to increase the levels of technological innovation and performance of the analysed complex systems. All kinds of systems can be considered as objects of study, including production systems and service delivery systems, among others, by evaluating their real contexts. Thus, this doctoral thesis proposes facing maintenance management through the development of three tightly linked main research lines. ¿ The first is the core and illustrates most of the methodological aspects of the thesis. It refers to the use of MCDM methods for supporting strategic maintenance decisions, and dealing with uncertainty affecting data/evaluations even when several decision makers are involved (experts in maintenance). ¿ The second line develops reliability analyses for real complex systems (also in terms of human reliability analysis) on the basis of which any maintenance activity must be implemented. These analyses are approached by considering the reliability configuration of both the components belonging to the system under study and the specific features of the operational environment. ¿ The third research line focuses on important methodological aspects to support maintenance management, and emphasises the need to monitor the performance of maintenance activities and evaluate their effectiveness using suitable indicators. A wide range of real real-world case studies has been faced to evaluate the effectiveness of MCDM methods in maintenance and then prove the usefulness of the proposed approach.Carpitella, S. (2019). Multi-criteria decision methods to support the maintenance management of complex systems [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/11911

    Dimensionality reduction for multi-criteria problems: an application to the decommissioning of oil and gas installations

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    This paper is motivated by decommissioning studies in the field of oil and gas, which comprise a very large number of installations and are of interest to a large number of stakeholders. Generally, the problem gives rise to complicated multi-criteria decision aid tools that rely upon the costly evaluation of multiple criteria for every piece of equipment. We propose the use of machine learning techniques to reduce the number of criteria by feature selection, thereby reducing the number of required evaluations and producing a simplified decision aid tool with no sacrifice in performance. In addition, we also propose the use of machine learning to explore the patterns of the multi-criteria decision aid tool in a training set. Hence, we predict the outcome of the analysis for the remaining pieces of equipment, effectively replacing the multi-criteria analysis by the computational intelligence acquired from running it in the training set. Computational experiments illustrate the effectiveness of the proposed approach

    Modelo Multicritério de Gerenciamento do Sortimento de Produtos para o Setor de Panificação

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    Product assortment management is a key factor as it involves customer satisfaction, due to their needs for more choice, and the management of companies, due to the high cost associated with large assortments. In this context, the aim of this study was to develop a multicriteria model of product assortment management for the bakery sector. For this, nine criteria divided into four categories were considered for evaluating of products from the bakery sector of a supermarket chain in the Northeast region of Brazil. The method used was TOPSIS and the results were presented through rankings of the alternatives involved in the research and their implications. From the results, it was possible to show how the product assortment can be more efficient given the market’s competitiveness, with emphasis on suggestions for maintenance and improvement of leading sales products, elimination of redundant products and others with high losses/sales rates or costs, as well as the preservation of products with competitive differentials. It was concluded that the model was satisfactory in meeting the proposed objective.A gestão do sortimento de produtos é um fator-chave por envolver a satisfação dos clientes, devido às suas necessidades por mais opções de escolha, e a gestão das empresas, devido ao alto custo associado a grandes sortimentos. Nesse contexto, o objetivo deste estudo foi o de desenvolver um modelo multicritério de gerenciamento do sortimento de produtos para o setor de panificação. Para isso, foram considerados nove critérios divididos em quatro categorias para avaliação de produtos do setor de panificação de uma rede de supermercados do nordeste brasileiro. O método utilizado foi o TOPSIS e os resultados foram apresentados por meio de rankings das alternativas envolvidas na pesquisa e suas implicações. A partir dos resultados, foi possível apresentar de que forma o sortimento dos produtos pode ser mais eficiente dada a competitividade do mercado, com destaque para sugestões de manutenção e melhoria de produtos líderes de vendas, eliminação de produtos redundantes e de outros com elevados índices de perdas/vendas ou custos, bem como a preservação de produtos com diferenciais competitivos. Concluiu-se que o modelo foi satisfatório em atender o objetivo proposto

    Unsupervised learning for anomaly detection in Australian medical payment data

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    Fraudulent or wasteful medical insurance claims made by health care providers are costly for insurers. Typically, OECD healthcare organisations lose 3-8% of total expenditure due to fraud. As Australia’s universal public health insurer, Medicare Australia, spends approximately A34billionperannumontheMedicareBenefitsSchedule(MBS)andPharmaceuticalBenefitsScheme,wastedspendingofA 34 billion per annum on the Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme, wasted spending of A1–2.7 billion could be expected.However, fewer than 1% of claims to Medicare Australia are detected as fraudulent, below international benchmarks. Variation is common in medicine, and health conditions, along with their presentation and treatment, are heterogenous by nature. Increasing volumes of data and rapidly changing patterns bring challenges which require novel solutions. Machine learning and data mining are becoming commonplace in this field, but no gold standard is yet available. In this project, requirements are developed for real-world application to compliance analytics at the Australian Government Department of Health and Aged Care (DoH), covering: unsupervised learning; problem generalisation; human interpretability; context discovery; and cost prediction. Three novel methods are presented which rank providers by potentially recoverable costs. These methods used association analysis, topic modelling, and sequential pattern mining to provide interpretable, expert-editable models of typical provider claims. Anomalous providers are identified through comparison to the typical models, using metrics based on costs of excess or upgraded services. Domain knowledge is incorporated in a machine-friendly way in two of the methods through the use of the MBS as an ontology. Validation by subject-matter experts and comparison to existing techniques shows that the methods perform well. The methods are implemented in a software framework which enables rapid prototyping and quality assurance. The code is implemented at the DoH, and further applications as decision-support systems are in progress. The developed requirements will apply to future work in this fiel

    Rethinking the risk matrix

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    So far risk has been mostly defined as the expected value of a loss, mathematically PL (being P the probability of an adverse event and L the loss incurred as a consequence of the adverse event). The so called risk matrix follows from such definition. This definition of risk is justified in a long term “managerial” perspective, in which it is conceivable to distribute the effects of an adverse event on a large number of subjects or a large number of recurrences. In other words, this definition is mostly justified on frequentist terms. Moreover, according to this definition, in two extreme situations (high-probability/low-consequence and low-probability/high-consequence), the estimated risk is low. This logic is against the principles of sustainability and continuous improvement, which should impose instead both a continuous search for lower probabilities of adverse events (higher and higher reliability) and a continuous search for lower impact of adverse events (in accordance with the fail-safe principle). In this work a different definition of risk is proposed, which stems from the idea of safeguard: (1Risk)=(1P)(1L). According to this definition, the risk levels can be considered low only when both the probability of the adverse event and the loss are small. Such perspective, in which the calculation of safeguard is privileged to the calculation of risk, would possibly avoid exposing the Society to catastrophic consequences, sometimes due to wrong or oversimplified use of probabilistic models. Therefore, it can be seen as the citizen’s perspective to the definition of risk

    The effectiveness of IF-MADM (intuitionistic-fuzzy multi-attribute decision-making) for group decisions: methods and an empirical assessment for the selection of a senior centre

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    This study determines the effectiveness of intuitionistic-fuzzy multi-attribute decision-making (IF-MADM) for making group decisions in practice. The effectiveness of the method is measured in terms of four dimensions: applicability, efficacy, efficiency and informativeness. To measure the efficacy, an IF-MADM model that has been recently proposed, AHP and the TOPSIS approach, which are compensatory models for group MADM, are used to model and solve the same collective decision. Using non-parametric statistical tests for data analytics, a ‘similarity confirmation method’ is proposed for a pair-wise test. This is to determine whether the score vectors are similar. Score vectors are used to determine the final ordinal ranks and whose scales differ greatly for different MADM methods. Since the latter two MADM models are both trustworthy with a known range of applications, any similarity in the results verifies the efficacy of IF-MADM. Using this process, the applicability of IF-MADM modelling is demonstrated. The efficiency and informativeness are also benchmarked and justified in terms of the model’s ability to produce a more informed decision. These results are of interest to practitioners for the selection and application of MADM models. Finally, the selection of a senior centre, which is a real group decision problem, is used to illustrate these. This extends the empirical application of IF-MADM, as relatively few studies practically compare issues for IF-MADM with those for other MADM models. The study also supports a rarely studied non-clinical healthcare decision that is relevant because there are many aging societies

    Advances and Applications of Dezert-Smarandache Theory (DSmT) for Information Fusion (Collected Works), Vol. 4

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    The fourth volume on Advances and Applications of Dezert-Smarandache Theory (DSmT) for information fusion collects theoretical and applied contributions of researchers working in different fields of applications and in mathematics. The contributions (see List of Articles published in this book, at the end of the volume) have been published or presented after disseminating the third volume (2009, http://fs.unm.edu/DSmT-book3.pdf) in international conferences, seminars, workshops and journals. First Part of this book presents the theoretical advancement of DSmT, dealing with Belief functions, conditioning and deconditioning, Analytic Hierarchy Process, Decision Making, Multi-Criteria, evidence theory, combination rule, evidence distance, conflicting belief, sources of evidences with different importance and reliabilities, importance of sources, pignistic probability transformation, Qualitative reasoning under uncertainty, Imprecise belief structures, 2-Tuple linguistic label, Electre Tri Method, hierarchical proportional redistribution, basic belief assignment, subjective probability measure, Smarandache codification, neutrosophic logic, Evidence theory, outranking methods, Dempster-Shafer Theory, Bayes fusion rule, frequentist probability, mean square error, controlling factor, optimal assignment solution, data association, Transferable Belief Model, and others. More applications of DSmT have emerged in the past years since the apparition of the third book of DSmT 2009. Subsequently, the second part of this volume is about applications of DSmT in correlation with Electronic Support Measures, belief function, sensor networks, Ground Moving Target and Multiple target tracking, Vehicle-Born Improvised Explosive Device, Belief Interacting Multiple Model filter, seismic and acoustic sensor, Support Vector Machines, Alarm classification, ability of human visual system, Uncertainty Representation and Reasoning Evaluation Framework, Threat Assessment, Handwritten Signature Verification, Automatic Aircraft Recognition, Dynamic Data-Driven Application System, adjustment of secure communication trust analysis, and so on. Finally, the third part presents a List of References related with DSmT published or presented along the years since its inception in 2004, chronologically ordered

    Grabbing the Air Force by the Tail: Applying Strategic Cost Analytics to Understand and Manage Indirect Cost Behavior

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    Recent and projected reductions in defense spending are forcing the military services to develop systematic approaches to identify cost reduction opportunities and better manage financial resources. In response, the Air Force along with her sister services are developing strategic approaches to reduce front-line mission resources, commonly referred to as the Tooth . However, an underemphasized contributing source of costs are mission support activities, commonly referred to as the Tail . With the tail historically representing a sizable portion of the annual Air Force budget, strategically managing cost behavior of these indirect activities has the opportunity to generate significant cost reductions. However, very little applied or academic research have focused on advancing the knowledge behind the economics of, or the analytic techniques applied to, these activities for cost management purposes. To address this concern, this dissertation investigates i) how organizations use analytic methodologies and data sources to understand and manage cost behavior, ii) how to identify underlying cost curves of concern across tail activities, iii) how to distinguish historical relationships between the tooth and tail, iv) how to improve the performance assessment of tail activities for improved resource allocation, and v) how to provide a decision support tool for tooth-to-tail policy impact analysis

    A Fragmented Profession within the System of Professions: The Experience of the Audiology Professional in the United Kingdom

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    The main purpose of this study was to explore the lived experience of audiology professionals in the United Kingdom. For the purposes of this study an audiology professional is defined as someone who completed a United Kingdom or International course/training pathway in audiology and who is working in the UK. The definition can include audiologists, hear(ing) care assistants, hearing aid dispensers, hearing therapists and clinical scientists. Audiology professionals working in Higher Education were also included. Working in two different contexts with similar and dissimilar aspects of role descriptions, as well as boundaries of practice led to the research question: What is the experience of audiology professionals in becoming and being an audiology professional in the United Kingdom? The following strands narrowed the focus of the study and helped to identify the appropriate methodological approach: 1. The experience of becoming an audiology professional 2. The experience of being an audiology professional 3. The impact of change in education pathways and service delivery on the audiology professional The research question was explored through an Exploratory Sequential Mixed Methods approach starting with interviews of eight participants followed by a survey circulated to the wider profession with 329 respondents. Data analysis consists of interpretive phenomenological analysis of the interviews and descriptive statistics for the surveys. The results from both stages will be discussed in relation to the sociology of professions, specifically Abbott’s (1988) system of professions with elements of Bourdieu’s social world theory (1985). The results sketch a fragmented profession divided by titles, professional organisations, and regulatory bodies as well as many education pathways across the private sector and the NHS
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