User needs elicitation via analytic hierarchy process (AHP). A case study on a Computed Tomography (CT) scanner

Background: The rigorous elicitation of user needs is a crucial step for both medical device design and purchasing. However, user needs elicitation is often based on qualitative methods whose findings can be difficult to integrate into medical decision-making. This paper describes the application of AHP to elicit user needs for a new CT scanner for use in a public hospital. Methods: AHP was used to design a hierarchy of 12 needs for a new CT scanner, grouped into 4 homogenous categories, and to prepare a paper questionnaire to investigate the relative priorities of these. The questionnaire was completed by 5 senior clinicians working in a variety of clinical specialisations and departments in the same Italian public hospital. Results: Although safety and performance were considered the most important issues, user needs changed according to clinical scenario. For elective surgery, the five most important needs were: spatial resolution, processing software, radiation dose, patient monitoring, and contrast medium. For emergency, the top five most important needs were: patient monitoring, radiation dose, contrast medium control, speed run, spatial resolution. Conclusions: AHP effectively supported user need elicitation, helping to develop an analytic and intelligible framework of decision-making. User needs varied according to working scenario (elective versus emergency medicine) more than clinical specialization. This method should be considered by practitioners involved in decisions about new medical technology, whether that be during device design or before deciding whether to allocate budgets for new medical devices according to clinical functions or according to hospital department

Government policy and healthcare management: proposal of a shared decision-making model

As a consequence of the current economic crisis many changes have been introduced to health systems on national levels to reduce expenditure and to introduce more cost-effective methods. Then recent developments in medical technology have led to a shift in the traditional framework of physician-patient responsibility in health care decision making. In this context, the health community urges, in any case, decision makers to ensure that all changes introduced are in accordance with Health System Values. This paper presents a new decision making platform, as a tool to facilitate shared decision making, to improve the quality and transparency of tactical and strategic decisions. This new application, based on analytic quantitative method, is a component of a wider distribute web system under development, which aims to inform the new effective health technologies supporting designers in the user need elicitation and early stage health technology assessments. A case study aiming to elicit the user needs affecting the decision of whether to adopt a new magnetic resonance imaging (MRI) is also presented

Interactive management control via analytic hierarchy process (AHP). An empirical study in a public university hospital.

Management control in public university hospitals is a challenging task because of continuous changes due to external pressures (e.g. economic pressures, stakeholder focuses and scientific progress) and internal complexities (top management turnover, shared leadership, technological evolution, and researcher oriented mission). Interactive budgeting contributed to improving vertical and horizontal communication between hospital and stakeholders and between different organizational levels. This paper describes an application of Analytic Hierarchy Process (AHP) to enhance interactive budgeting in one of the biggest public university hospital in Italy. AHP improved budget allocation facilitating elicitation and formalization of units’ needs. Furthermore, AHP facilitated vertical communication among manager and stakeholders, as it allowed multilevel hierarchical representation of hospital needs, and horizontal communication among staff of the same hospital, as it allowed units’ need prioritization and standardization, with a scientific multi-criteria approach, without using complex mathematics. Finally, AHP allowed traceability of a complex decision making processes (as budget allocation), this aspect being of paramount importance in public sectors, where managers are called to respond to many different stakeholders about their choices

A multiple criteria decision-making approach for increasing the preparedness level of sales departments against COVID-19 and future pandemics: A real-world case

The impact of the pandemic and the lockdown has been more devastating than expected on the world economy. It is essential to formulate strategies in real-time. In this research, a multicriteria decision-making model for increasing the preparedness level of sales departments when facing COVID-19 waves and future pandemics is proposed. The model is comprised of 8 criteria, 29 sub-criteria, and 7 alternatives. The study is based on the integration of the AHP and TOPSIS techniques. AHP is used for calculating the criteria and sub-criteria weights. While, TOPSIS is used for calculating the preparedness level, ranking the companies, and identifying the weaknesses that should be addressed for increasing their effectiveness in the current market scenario. The model is developed with the aid of an experts’ group from the electrical appliance sector and studies from the reported literature. This application is completely novel in the literature and has been applied in the wild with remarkable companies in Colombia. A case study in the electrical appliance sector is presented as a pilot study but it should be noted that the methodology is flexible and scalable in any scenario

HEALTH TECHNOLOGY ASSESSMENT FOR MEDICAL DEVICES

Health Technology Assessment (HTA) methods have become a standard part of decision-making processes in healthcare service. Although it is routinely applied in drugs and surgery, HTA in medical devices is still quite challenging. The reason is that the main objective of HTA studies for devices is not optimization of the costeffectiveness ratio, but rather decisions about procurement and/or incorporation of the device. The clinical benefit is not expressed in terms of quality of life, but in the rate of diagnostic yield, and in the extent to which the technology makes the therapy shorter and/or more patient-friendly. Utilization of multiple-criteria decision-making methods for evaluation of the aggregated clinical, technical and user´s effect (outcome) is recommended as the input to costeffectiveness analyses. Different methods are derived for strategic and/or operational assessment of new technology. Other studied problems are identification of requirements for medical device selection and purchase, composition of expert panels, and assessment of medical device maintenance demandingness

An integrated approach of AHP-DEMATEL methods applied for the selection of allied hospitals in outpatient service

Nowadays, the citizens are more aware of high-quality medical care than ever. They pay much attention to medical treatment safety, instructions from physicians, and the overall service quality performed by the hospital. To manage a hospital successfully, the important goals are to attract and then retain as many patients as possible by meeting potential demands of various kinds of the patients. In this context the decision making process is important in order to achieve a strategic decision and strategy. When the decision making problem occurs there is usually a limited number of possible alternatives but a large number of criteria according to which the optimal solution is selected. It is important to use an appropriate approach. This study presents a hybrid methodological approach based on the Decision Making Trial and Evaluation Laboratory (DEMATEL) method and Analytic Hierarchy process method to define the best allied hospital for an integrated network of outpatient service. The goal of this paper is to present a methodological approach and a practical application of hybrid method in a real case study

Gesundheitsökonomische Aspekte zur Gesundheitsförderung und Prävention von chronischen Lungenerkrankungen

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