Logistics Improvement Strategy for Medical Units following the Lean Approach

Treballs Finals de Grau d'Enginyeria Biomèdica. Facultat de Medicina i Ciències de la Salut. Universitat de Barcelona. Curs: 2016-2017. Director: Eugeni Freixas, Co-Director: Rosa Oliveras, Tutor: Manel Puig.The logistics portrayed in medical environments is a field which is not usually visible towards patients, but directly affects the health service quality, so it is a very important aspect for healthcare organizations to take into account. Hospital logistics are in charge of managing the supply of drugs, equipment, materials, laundry and sometimes even the food catering, through transport, storing and heavy organization skills. This final degree project focuses on the elaboration of a new scheme for improving the logistics set behind Hospital Clinics' medical units, this being the management and supply chain of medical material and other items the hospital makes use of, by adopting more sophisticated technology. The improvement plan basically comes down to automating the systems used in the warehouse and storage rooms by using the popular Lean approach designed by the Japanese Toyota company in the mid 90s. In the paper, several Lean management and healthcare techniques are used - to study, analyse and advance the current logistics, the goal is to automate the main warehouse with robotic load systems and to pre set the current faulty Kanban used in the storage rooms with a new and improved Smart Kanban technique, based on radiofrequency and more advanced technology. The project verifies the necessity of biomedical engineers to not only provide a critical engineering point of view towards the systems used in hospital environments, but also to improve the lack of communication between the logistics team and the rest of the medical departments, which is a serious issue

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: executive summary.

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Volume Navigation with Contrast Enhanced Ultrasound and Image Fusion for Percutaneous Interventions: First Results

Percutaneous biopsies and drainages, even of small lesions involving complex access pathways, can be accomplished with a high success rate by using 3D real time image fusion together with real time needle tracking

Aerospace medicine and biology: A continuing bibliography with indexes (supplement 326)

This bibliography lists 108 reports, articles and other documents introduced into the NASA Scientific and Technical Information System during July, 1989. Subject coverage includes: aerospace medicine and psychology, life support systems and controlled environments, safety equipment, exobiology and extraterrestrial life, and flight crew behavior and performance

Aerospace medicine and biology: A continuing bibliography with indexes (supplement 309)

This bibliography lists 136 reports, articles and other documents introduced into the NASA scientific and technical information system in February, 1988

25th International Congress of the European Association for Endoscopic Surgery (EAES) Frankfurt, Germany, 14-17 June 2017 : Oral Presentations

Introduction: Ouyang has recently proposed hiatal surface area (HSA) calculation by multiplanar multislice computer tomography (MDCT) scan as a useful tool for planning treatment of hiatus defects with hiatal hernia (HH), with or without gastroesophageal reflux (MRGE). Preoperative upper endoscopy or barium swallow cannot predict the HSA and pillars conditions. Aim to asses the efficacy of MDCT’s calculation of HSA for planning the best approach for the hiatal defects treatment. Methods: We retrospectively analyzed 25 patients, candidates to laparoscopic antireflux surgery as primary surgery or hiatus repair concomitant with or after bariatric surgery. Patients were analyzed preoperatively and after one-year follow-up by MDCT scan measurement of esophageal hiatus surface. Five normal patients were enrolled as control group. The HSA’s intraoperative calculation was performed after complete dissection of the area considered a triangle. Postoperative CT-scan was done after 12 months or any time reflux symptoms appeared. Results: (1) Mean HSA in control patients with no HH, no MRGE was cm2 and similar in non-complicated patients with previous LSG and cruroplasty. (2) Mean HSA in patients candidates to cruroplasty was 7.40 cm2. (3) Mean HSA in patients candidates to redo cruroplasty for recurrence was 10.11 cm2. Discussion. MDCT scan offer the possibility to obtain an objective measurement of the HSA and the correlation with endoscopic findings and symptoms. The preoperative information allow to discuss with patients the proper technique when a HSA[5 cm2 is detected. During the follow-up a correlation between symptoms and failure of cruroplasty can be assessed. Conclusions: MDCT scan seems to be an effective non-invasive method to plan hiatal defect treatment and to check during the follow-up the potential recurrence. Future research should correlate in larger series imaging data with intraoperative findings

2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: executive summary.

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