SmartHIV Manager: a web-based computer simulation system for better management of HIV services

© Journal of Public Health and Emergency. All rights reserved. This work is licensed under CC-BY-NC_ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/)Background: Life-changing developments enabled people living with HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) to live a relatively normal life like the general population. However, there is not any user-friendly platform that enables key decision-makers to assess scenarios for improvement. Therefore, the objective of this study is to demonstrate the potentials of a web-based simulation system for effective and efficient management of HIV services. Methods: SmartHIV Manager is a web-based interactive planning platform for management of HIV services. Discrete event simulation technique is used to capture real-life HIV patients through HIV care continuum and all the resources needed. Patient flow information from HIV caregivers in three HIV treatment centres in Kenya and Nigeria was tested and validated. A total of 93 input parameters were established in the HIV pathway of care. Dashboards, which are fed by the simulation outcomes, were prepared to assess the impact of several interventions. The dashboard components include graphs and tables on service demand and utilization, preventive strategies, UNAIDS (the joint United Nations programme on HIV/AIDS) 90-90-90 goals, human resource management, budgeting and financial planning. Results: The usefulness and functionalities of the system is demonstrated on capacity planning in prevention programmes and UNAIDS 90-90-90 target. We ran scenarios based on increasing prevention measures and increasing the number of people on treatment to reach UNAIDS 90-90-90 target for a service in Nigeria. More cases are expected to be averted, where naïve patients reduced due to prevention measures. As the service struggled to achieve UNAIDS target, necessary outputs were generated, in the form of required resources to reach the target by 2025 and assessed the overall impact on service outcomes. Conclusions: A novel simulation powered technology is developed for effective HIV/AIDS management and control. This would give a robust patient care which can be properly evaluated and predicted in interventional implementation for appropriate policy directions.Peer reviewe

Optimising hospital designs and processes to improve efficiency and enhance the user experience

The health sector is facing increasing pressure to provide effective, efficient, and affordable care to the population it serves. The National Health Service (NHS) of the United Kingdom (UK) has regularly faced scrutiny with NHS England being issued a number of challenges in recent years to improve operational efficiency, reduce wasted space, and cut expenditure. The most recent challenge issued to NHS England has seen a requirement to save £5bn per annum by 2020, while reducing wasted space from 4.4% to 2.5% across the NHS estate. Similarly, satisfaction in the health service is also under scrutiny as staff retention and patient experiences are used in determining the performance of facilities. [Continues.

Redesigning the Barranquilla's public emergency care network to improve the patient waiting time

Tesis por compendio[ES] La oportunidad en la atención es uno de los críticos de mayor relevancia en la satisfacción de los pacientes que acuden a los servicios de Urgencias. Por tal motivo, las instituciones prestadoras de servicio y las organizaciones gubernamentales deben propender conjuntamente por una atención cada vez más oportuna a costos operacionales razonables. En el caso de la Red Pública en Servicios de Urgencias de Barrannquilla, compuesta por 8 puntos de atención y 2 hospitales, la tendencia marca un continuo crecimiento de la oportunidad en la atención con una tasa de 3,08 minutos/semestre y una probabilidad del 93,13% de atender a los pacientes después de una espera mayor a 30 minutos. Lo anterior se constituye en un síntoma inequívoco de la incapacidad de la Red para satisfacer los estándares de oportunidad establecidos por el Ministerio de Salud, hecho que podría desencadenar el desarrollo de sintomatologías de mayor complejidad, el incremento de la probabilidad de mortalidad, el requerimiento de servicios clínicos más complejos (hospitalización y cuidados intensivos) y el aumento de los costos asociados al servicio. En consecuencia, la presente tesis doctoral presenta el rediseño de la Red Pública en Servicios de Urgencias anteriormente mencionada a fin de otorgar a la población diana un servicio eficiente y altamente oportuno donde tanto las instituciones prestadoras del servicio como los organismos gubernamentales converjan efectivamente. Para ello, fue necesaria la ejecución de 4 grandes fases a través de las cuales se consolidó una propuesta orientada al desarrollo efectivo y sostenible de las operaciones de la Red. Primero, se caracterizó la Red Pública de Servicios de Urgencias en Salud considerando su comportamiento actual en términos de demanda y oportunidad de la atención. Luego, a través de una revisión sistemática de la literatura, se identificaron los enfoques metodológicos que se han implementado para la mejora de la oportunidad y otros indicadores de rendimiento asociados al servicio de Urgencias. Posteriormente, se diseñó una metodología para la creación de redes de Urgencias eficientes y sostenibles la cual luego se validó en la Red Pública sudamericana a fin de disminuir la oportunidad de atención promedio en Urgencias y garantizar la distribución equitativa de los beneficios financieros derivados de la colaboración. Finalmente, se construyó un modelo multicriterio que permitió evaluar el rendimiento de los departamentos de Urgencia e impulsó la creación de estrategias de mejora focalizadas en incrementar su respuesta ante la demanda cambiante, los críticos de satisfacción y las condiciones de operación estipuladas en la ley. Los resultados de esta aplicación evidenciaron que los pacientes que acceden a la Red tienden a esperar en promedio 201,6 min con desviación de estándar de 81,6 min antes de ser atendidos por urgencia. Por otro lado, de acuerdo con la revisión de literatura, la combinación de técnicas de investigación de operaciones, ingeniería de la calidad y analítica de datos es ampliamente recomendada para abordar este problema. En ese sentido, una metodología basada en modelos colaterales de pago, simulación de procesos y lean seis sigma fue propuesta y validada generando un rediseño de Red cuya oportunidad de atención promedio podría disminuir entre 6,71 min y 9,08 min con beneficios financieros promedio de US$29,980/nodo. En último lugar, un modelo compuesto por 8 criterios y 35 sub-criterios fue diseñado para evaluar el rendimiento general de los departamentos de Urgencias. Los resultados del modelo evidenciaron el rol crítico de la infraestructura (Peso global = 21,5i garantir la distribució equitativa dels beneficis financers derivats de la col´laboració. Finalment, es va construir un model multicriteri que va permetre avaluar el rendiment dels departaments d'Urgència i va impulsar la creació d'estratègies de millora focalitzades en incrementar la seva resposta davant la demanda canviant, els crítics de satisfacció i les condicions d'operació estipulades en la llei. Els resultats d'aquesta aplicació van evidenciar que els pacients que accedeixen a la Xarxa tendeixen a esperar de mitjana 201,6 min amb desviació d'estàndard de 81,6 min abans de ser atesos per urgència. D'altra banda, d'acord amb la revisió de literatura, la combinació de tècniques d'investigació d'operacions, enginyeria de la qualitat i analítica de dades és àmpliament recomanada per abordar aquest problema. En aquest sentit, una metodologia basada en models col´laterals de pagament, simulació de processos i llegeixin 6 sigma va ser proposada i validada generant un redisseny de Xarxa la oportunitat d'atenció mitjana podria disminuir entre 6,71 min i 9,08 min amb beneficis financers mitjana d'US$ 29,980 / node. En darrer lloc, un model compost per 8 criteris i 35 sub-criteris va ser dissenyat per avaluar el rendiment general dels departaments d'Urgències. Els resultats de el model evidenciar el paper crític de la infraestructura (Pes global = 21,5%) en el rendiment dels departaments d'Urgència i la naturalesa interactiva de la Seguretat de l'Pacient (C + R = 12,771).[EN] Waiting time is one of the most critical measures in the satisfaction of patients admitted within emergency departments. Therefore, hospitals and governmental organizations should jointly aim to provide timely attention at reasonable costs. In the case of Barranquilla's Pubic Emergency Service Network, composed by 8 Points of care (POCs) and 2 hospitals, the trend evidences a continuous growing of the waiting time with a rate of 3,08 min/semester and a 93,13% likelihood of serving patients after waiting for more than 30 minutes. This is an unmistakable symptom of the network inability for satisfying the standards established by the Ministry of Health, which may trigger the development of more complex symptoms, increase in the death rate, requirement for more complex clinical services (hospitalization and intensive care unit) and increased service costs. This doctoral dissertation then illustrates the redesign of the aforementioned Public Emergency Service Network aiming at providing the target population with an efficient and highly timely service where both hospitals and governmental institutions effectively converge. It was then necessary to implement a 4-phase methodology consolidating a proposal oriented to the effective and sustainable development of network operations. First, the Public Emergency Service Network was characterized considering its current behavior in terms of demand and waiting time. A systematic literature review was then undertaken for identifying the methodological approaches that have been implementing for improving the waiting time and other performance indicators associated with the emergency care service. Following this, a methodology for the creation of efficient and sustainable emergency care networks was designed and later validated in the Southamerican Public network for lessening the average waiting time and ensuring the equitable distribution of profits derived from the collaboration. Ultimately, a multicriteria decision-making model was created for assessing the performance of the emergency departments and propelling the design of improvement strategies focused on bettering the response against the changing demand conditions, critical to satisfaction and operational conditions. The results evidenced that the patients accessing to the network tend to wait 201,6 min on average with a standard deviation of 81,6 min before being served by the emergency care unit. On the other hand, based on the reported literature, it is highly suggested to combine Operations Research (OR) methods, quality-based techniques, and data-driven approaches for addressing this problem. In this sense, a methodology based on collateral payment models, Discrete-event simulation, and Lean Six Sigma was proposed and validated resulting in a redesigned network whose average waiting time may diminish between 6,71 min and 9,08 min with an average profit US$29,980/node. Lately, a model comprising of 8 criteria and 35 sub-criteria was designed for evaluating the overall performance of emergency departments. The model outcomes revealed the critical role of Infrastructure (Global weight = 21,5%) in ED performance and the interactive nature of Patient Safety (C + R = 12,771).Ortíz Barrios, MÁ. (2020). Redesigning the Barranquilla's public emergency care network to improve the patient waiting time [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/156215TESISCompendi

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Successful implementation of discrete event simulation: the case of an Italian emergency department

This paper focuses on the study of a practical management problem faced by a healthcare {\it emergency department} (ED) located in the north of Italy. The objective of our study was to propose organisational changes in the selected ED, which admits approximately 7000 patients per month, aiming at improving key performance indicators related to patient satisfaction, such as the waiting time. Our study is based on a design thinking process that adopts a {\it discrete event simulation} (DES) model as the main tool for proposing changes. We used the DES model to propose and evaluate the impact of different improving scenarios. The model is based on historical data, on the observation of the current ED situation, and information obtained from the ED staff. The results obtained by the DES model have been compared with those related to the existing ED setting, and then validated by the ED managers. Based on the results we obtained, one of the tested scenarios was selected by the ED for implementation.Comment: 24 pages, 8 figures and 4 table

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This aim of paper is to presents the development of a multidisciplinary project carried out by the cooperation between Politecnico di Torino and ITHACA (Information Technology for Humanitarian Assistance, Cooperation and Action). The goal of the project was the training in geospatial data acquiring and processing for students attending Architecture and Engineering Courses, in order to start up a team of "volunteer mappers". Indeed, the project is aimed to document the environmental and built heritage subject to disaster; the purpose is to improve the capabilities of the actors involved in the activities connected in geospatial data collection, integration and sharing. The proposed area for testing the training activities is the Cinque Terre National Park, registered in the World Heritage List since 1997. The area was affected by flood on the 25th of October 2011. According to other international experiences, the group is expected to be active after emergencies in order to upgrade maps, using data acquired by typical geomatic methods and techniques such as terrestrial and aerial Lidar, close-range and aerial photogrammetry, topographic and GNSS instruments etc.; or by non conventional systems and instruments such us UAV, mobile mapping etc. The ultimate goal is to implement a WebGIS platform to share all the data collected with local authorities and the Civil Protectio

Emerging Informatics

The book on emerging informatics brings together the new concepts and applications that will help define and outline problem solving methods and features in designing business and human systems. It covers international aspects of information systems design in which many relevant technologies are introduced for the welfare of human and business systems. This initiative can be viewed as an emergent area of informatics that helps better conceptualise and design new world-class solutions. The book provides four flexible sections that accommodate total of fourteen chapters. The section specifies learning contexts in emerging fields. Each chapter presents a clear basis through the problem conception and its applicable technological solutions. I hope this will help further exploration of knowledge in the informatics discipline

Decision Making Improvement for Disaster Risk Management (DRM) through technological support

The workshop “Decision Making Improvement for Disaster Risk Management (DRM) through technological support” was held in Bucharest, Romania on 16th of October 2019, part of the 4th DRMKC Annual Seminar. The key objective of the session was to increase the collaboration with national/regional/local authorities and other institutions, aligning the development of the tools to the needs and concerns expressed at local/national level. To accomplish its objective, the workshop brought together technical and scientific experts with end users of the platforms, who have faced the main challenges related to data, knowledge and institutional practices while offering technological support for DRM. Showcases and feedback from national authorities and institutions were presented, as they were experienced when using the platforms presented in the session: the DRMKC Risk Data Hub, GRRASP and RAPID-N. The session was divided in two parts, in the first it was presented the general characteristics and functionalities of the platforms, followed in the second part by showcases of using these platforms in various applications by the local authorities and institutions.JRC.E.1-Disaster Risk Managemen

Health and Care Infrastructure Research and Innovation Centre final report 2014

Improving healthcare, while containing costs, demands sophisticated understanding of three core elements in healthcare systems: infrastructure, technology and services. Their tripartite relationship is extremely complex, not least because the pace of change for each is different. That creates considerable challenges in planning for future needs and makes the management of innovation and change difficult. [Continues.