Penentuan Rute Pengangkut Limbah Medis Optimal Menggunakan Vehicle Routing Problem with Time Window pada Kasus Multi Depot

The current COVID-19 pandemic has created new environmental problems. The increase of medical waste due to increased activity in public health facilities is a new threat to environmental health. Unfortunately, not all health facilities have the capacity to manage their own waste. This causes the medical waste need to be taken to a waste treatment center for proper treatment that meets environmental health standards. Reverse logistics is one of the activities that can help the process of transporting medical waste. This study uses a vehicle routing problem with a time window (VRPTW) for multi depot cases. The limitations used in this study are the operational time of each Puskesmas, vehicle capacity and operational working hours of waste transport officers. In this case, the optimization of the cost calculation for the transportation of waste from 42 health centers in the DKI Jakarta area is carried out to be taken to three central locations for waste treatment. The purpose of the model used is to minimize transportation costs, namely fixed costs and variable costs of the vehicle used. The routes generated from this research are six transportation routes with a total distance of 412,31 km, with a total cost of Rp 5.928.498,75

Design of the Reverse Logistics System for Medical Waste Recycling Part II: Route Optimization with Case Study under COVID-19 Pandemic

Medical waste recycling and treatment has gradually drawn concerns from the whole society, as the amount of medical waste generated is increasing dramatically, especially during the pandemic of COVID-19. To tackle the emerging challenges, this study designs a reverse logistics system architecture with three modules, i.e., medical waste classification & monitoring module, temporary storage & disposal site (disposal site for short) selection module, as well as route optimization module. This overall solution design won the Grand Prize of the "YUNFENG CUP" China National Contest on Green Supply and Reverse Logistics Design ranking 1st. This paper focuses on the design of the route optimization module. In this module, a route optimization problem is designed considering transportation costs and multiple risk costs (e.g., environment risk, population risk, property risk, and other accident-related risks). The Analytic Hierarchy Process is employed to determine the weights for each risk element, and a customized genetic algorithm is developed to solve the route optimization problem. A case study under the COVID-19 pandemic is further provided to verify the proposed model. Limited by length, detailed descriptions of the whole system and the other modules can be found at https://shorturl.at/cdY59.Comment: 6 pages, 4 figures, under review by the 26th IEEE International Conference on Intelligent Transportation Systems (ITSC 2023

Reverse Logistics Network Design with a 3-Phase Interactive Intuitionistic Fuzzy Goal Programming Approach: A Case Study of Covid-19 in Pathum Thani, Thailand

During outbreaks, a vast quantity of Infected Medical Waste (IMW) can be substantially generated in a short period, which poses a massive risk to medical personnel and surrounding communities. This study proposes an Intuitionistic Fuzzy Multi-Objective Multi-Period Mixed-Integer Linear Programming (IFMOMILP) model for effective IMW management in outbreaks under uncertainty, considering financial and risk factors subject to a priority from Decision Makers (DMs). The primary emphasis is on determining the optimal locations and capacity levels for temporary facilities, including temporary storage and treatment centers, as well as the optimal transportation routes. A 3-phase interactive Intuitionistic Fuzzy Goal Programming (i-IFGP) approach is developed to solve this IFMOMILP model. First, the Jiménez approach is applied to handle the uncertainties. Then, the problem is solved by Intuitionistic Fuzzy Goal Programming (IFGP). An actual case study of the COVID-19 outbreak in Pathum Thani province in Thailand was carried out to demonstrate the effectiveness of the proposed approach. The proposed approach yields solutions with varying feasibility degrees and scaling factors, providing alternatives for DMs. Then, the score function is utilized to imply DMs’ satisfaction with the outcomes, which is a concrete measure since it can reflect the intention of the DMs

Localización de centros de acopio de medicamentos caducados para un horizonte de tiempo dado

Después de una pequeña introducción en la que se exponen las causas y consecuencias de los medicamentos caducados, se presenta un problema de localización de centros de acopio, los cuales sean factibles para satisfacer la demanda de servicio de recolección de medicamentos de las farmacias en una región durante un determinado periodo de tiempo. Para la solución del problema, se propone un modelo de programación lineal entera mixta, el cual defina la cantidad y ubicación de los centros de acopio a un costo mínimo. Así mismo, se soluciona el mismo problema con la metaheuristica de algoritmos genéticos y se comparar ambas soluciones (tiempos de ejecución y centros de acopio abiertos). Para diferentes tamaños de instancias.Magíster en Ingeniería IndustrialMaestrí

Gestão de resíduos hospitalares em situação de pandemia

Dissertação de mestrado integrado em Engenharia Biológica (ramo Tecnologias do Ambiente)Desde 2020, enfrenta-se um dos maiores surtos pandémicos da história de Portugal, da COVID-19. Os resíduos produzidos pelo doente da COVID-19 e os resíduos que resultam da prestação de cuidados de saúde a doentes com o vírus são considerados contaminados, com risco infecioso. Sendo os resíduos hospitalares inevitáveis, a Gestão Hospitalar enfrenta atualmente um dos maiores desafios. O aumento exponencial de resíduos obrigou a uma adaptação dos sistemas de gestão, a uma implementação de medidas extraordinárias de Higiene e Segurança no Trabalho e uma reinvenção de soluções rápidas e práticas para uma maior eficiência em todos os processos de gestão. A presente dissertação aborda a temática da Gestão de Resíduos Hospitalares (RH) em contexto de pandemia, bem como a sua importância na quebra de cadeias de transmissão e salvaguarda dos operadores de saúde, que colaboram nos centros hospitalares de Portugal. Foi estudado um conjunto de soluções face à rotura no abastecimento de equipamentos de proteção pessoal e ao crescimento de RH. Estas passam pelo recurso a tecnologias existentes para o reprocessamento e reutilização de equipamentos de proteção pessoal e pela criação de novos modelos de gestão de resíduos hospitalares, respetivamente. O estudo das repercussões da COVID-19 demonstrou que a gestão hospitalar teve uma adaptação, adotando-se medidas excecionais para a salvaguarda dos intervenientes da mesma como a proibição de armazenamento de resíduos COVID-19 e uma maior frequência na recolha dos mesmos. Foi possível também perceber que o recurso a tecnologias de desinfeção por peróxido de hidrogénio, luz UV germicida e o calor húmido podem ser eficazes no reprocessamento de máscaras, mas são limitados aos modelos e respiradores estudados bem como o papel dos modelos logísticos para uma maior eficiência no combate a uma pandemia.Since 2020, we face one of the biggest pandemics that Portugal has ever seen, the new Coronavirus. The medical waste produced by COVID-19 patients and the waste coming from the treatment of those patients are considered contaminated and are infectious. As hospital waste is unavoidable, the Hospital Management faces one of the biggest challenges. The exponential increase in hospital waste required an adaptation of the management systems, to an implementation of extraordinary Health and Safety at Work measures and to reinvent quick and practical solutions for greater efficiency in all management processes. This dissertation addresses the theme Hospital Waste Management in a pandemic context, as well as its importance in breaking transmission chains and safeguarding health operators, who collaborate in health care centers in Portugal. It also referes the solutions in face of a disruption in supply of personal protective equipment and hospital waste growth. That includes the use of existing technologies for reprocessing and reuse of personal protective equipment and the creation of new design models for an effective management of medical waste. The study of the repercussions of COVID-19 demonstrated that hospital management had an adaptation, adopting exceptional measures to safeguard its interveners, such as the prohibition of the storage of COVID-19 residues and a greater frequency of their collection. It was possible to understand that the use of hydrogen peroxide disinfection technologies, germicidal UV light and moist heat could be useful in facemasks reprocessing, but only in the studied models and respirators, as well as the role of logistics models for greater efficiency in combating a pandemic

A MULTI-STAGE DECISION SUPPORT MODEL FOR COORDINATED SUSTAINABLE PRODUCT AND SUPPLY CHAIN DESIGN

In this research, a decision support model for coordinating sustainable product and supply chain design decisions is developed using a multi-stage hierarchical approach. The model evaluates alternate product designs and their corresponding supply chain configurations to identify the best product design and the corresponding supply chain configuration that maximizes the economic, environmental and societal benefits. The model considers a total life-cycle approach and incorporates closed-loop flow among multiple product lifecycles. In the first stage, a mixed integer linear programming model is developed to select for each product design an optimal supply chain configuration that maximizes the profit. In the subsequent stages, the economic, environmental and societal multiple life-cycle analysis models are developed which assess the economic, environment and the societal performance of each product design and its optimal supply chain configuration to identify the best product design with highest sustainability benefits. The decision support model is applied for an example problem to illustrate the procedure for identifying the best sustainable design. Later, the model is applied for a real-time refrigerator case to identify the best refrigerator design that maximizes economic, environmental and societal benefits. Further, sensitivity analysis is performed on the optimization model to study the closed-loop supply chain behavior under various situations. The results indicated that both product and supply chain design criteria significantly influence the performance of the supply chain. The results provided insights into closed-loop supply chain models and their behavior under various situations. Decision support models such as above can help a company identify the best designs that bring highest sustainability benefits, can provide a manager with holistic view and the impact of their design decisions on the supply chain performance and also provide areas for improvement

Evaluating the strategic roles of reverse logistics in private hospitals: case studies in Thailand

This thesis is a study of reverse logistics structures, processes and their characteristics in Thai private hospitals. The research evaluates the strategic importance and role of reverse logistics operations in creating business value in hospitals. The research literature suggests that the adoption of reverse logistics, specifically reverse logistics activities, can result, through the adoption of an RL strategy, in added business value. The intent in this research is to use the activities of Reverse Logistics (re-use, re-sale, re-distribution, repair, refurbishing, remanufacturing, retrieval, recycling and incineration) to examine how these activities are used strategically in hospitals in Thailand to create business value for these organisations. The research addresses the question: “What strategic roles does the implementation of reverse logistics activities play in private hospitals in Thailand?”. The research is grounded in a theoretical model that argues that an overall, front-stage, strategy drives organisations business goals and that this is supported by a ‘back-stage or hidden strategy that focuses on the operations of that organisation and that both are necessary for strategic success and the attainment of competitive advantage. In this research part of that back-stage strategy is the operationalization of reverse logistics activities and that these both support the overall company strategy and themselves create business value. The overall context of the research is an interpretivist multiple-case study based on interviews with key stakeholders and a focus group with relevant industry experience. The population and sample for this research includes three significant private hospitals in Bangkok (Bangkok Pattaya Hospital, Vejthani Hospital and Bumrungrad Hospital) as case studies. The research shows that reverse logistics activities in each of 4 similar departments in the three Thai private hospitals results in the creation of business value for each hospital. The research shows that the strategy of Bumrungrad, Vejthani, and Bangkok Pattaya Hospitals are relevant to their vision and mission focusing on customer satisfaction and the customer as the core business. This strategy, it is argued in the thesis, can be seen as a ‘front strategy’ or ‘obvious strategy’ resulting from the hospitals wanting to provide excellent medical services to people who will then be return customers. The front stage relates to the development of an image as a high quality provider of medical services. The research also argues there is a ‘back stage’ used to support the creation of that image, a strategy built on implementation of a supply chain strategy that becomes an integral part of hospital policy. The research shows that whilst much existing research literature supports a view that adopting reverse logistics, specifically reverse logistics activities in hospitals, can result in added business value, this research confirms that view but it questions the simplicity of the relationship proposed in the extant literature. This research demonstrates the complexity of the RL activities used in each hospital and the associated complexity of types of business value created. These complex relationships (between RL and business value) are all happening simultaneously. The strategy is not a simple one, but the research confirms the importance of strategy in healthcare operations. The research also shows that the back stage strategy of operations, the adoption of supply chain strategy and subsequent adoption of reverse logistics activities, re-enforces the intent and direction of the front stage focus of each hospital in terms of their ‘image’. The research shows that reverse logistics strategy in the Thai hospitals was driven by the need to save costs, use resources efficiently and maintain business plans that delivered high quality health services at high prices. The high level of competition in the Thai hospitals, however, is based on their image and reputations but the research also shows that where these hospitals get their competitive advantage is by focusing heavily on customers' wants and needs through operational efficiency and cost management, delivered through effective supply chain operations, specifically, through their adoption and use of reverse logistics