Lean logistics management in healthcare: A case study

Objetivo: estudiar la aplicabilidad de los principios del Justo a Tiempo o Just in Time (JIT) o Lean Production a la gestión de la cadena de suministros de un hospital. En concreto, tratamos de conocer qué prácticas y principios de Lean son aplicables, los beneficios que se pueden obtener y las principales barreras para su aplicación. La gestión de la cadena de suministros de los hospitales es un tema importante, tanto por su incidencia en la calidad asistencial como por su impacto en los costes. Métodos: Este trabajo se basa en un estudio de caso durante el periodo 2005-2010. Ámbito: Hospital Virgen Macarena de Sevilla. Proceso de implantación de un plan integral de gestión logística basado en la aplicación de principios Lean y en el desarrollo de inversiones tecnológicas. Resultados: La implantación del plan integral ha reducido los inventarios, disminuido los plazos de entrega y mejorado la calidad del servicio. Asimismo, se han producido otras mejoras importantes: mejora en la satisfacción de los trabajadores e incremento de la productividad del personal, tanto sanitario como del dedicado a tareas logísticas. Conclusiones: La experiencia analizada ha permitido comprobar la aplicabilidad e idoneidad de los principios Lean y de algunas de sus técnicas a la gestión de la logística de hospitales. También se han identificado algunas de las principales dificultades que pueden presentarseObjective: To study the applicability of the principles of Just in Time (JIT) or Lean Production to manage the supply chain of a hospital. In particular, we seek to know what Lean practices and principles are applicable, the benefits to be gained and the main barriers for implementation. Managing the supply chain of hospitals is an important issue, both for its effect on the quality of care and its impact on costs. Methods: This study is based on a case study during the period 2005-2010. Scope: Hospital Virgen Macarena in Seville. Process of implementing a comprehensive logistics management plan based on Lean principles and technology investments. Results: The implementation of the comprehensive plan has reduced inventory, reduced lead times and improved service quality. Also, there have been other important improvements: improved worker satisfaction and increased staff productivity, both dedicated to health and the logistics. Conclusions: The experience analyzed has shown the applicability and appropriateness of the principles Lean and some of his techniques to manage the logistics of hospitals. Also identifies some of the main difficulties that may aris

Improving a hospital's supply chain through lean management

Objetivos: La gestión del suministro constituye un área en la que los hospitales tienen importantes oportunidades de mejora. Este trabajo pretende analizar cómo la aplicación de los principios de Lean puede mejorar los costes logísticos y la satisfacción de los usuarios. Métodos: Análisis de los resultados de una experiencia de reorganización del sistema logístico de un hospital basada en algunos principios Lean. Para el cálculo de los costes logísticos se ha utilizado el método del coste completo o full costing de contabilidad analítica de gestión. La satisfacción del usuario se evaluó mediante encuesta anónima. El tratamiento de los datos de la encuesta incluyó análisis factorial y el modelo de análisis de la varianza ANOVA. Resultados: Los datos obtenidos mostraron una mejora en la gestión de logística tras la implantación de Lean, con reducción de costes y mejora del nivel de satisfacción del usuario interno. Se ha observado que el personal sanitario percibe y valora el servicio logístico de manera global, sin diferenciar los aspectos del servicio, detectándose diferencias en cuanto al grado de satisfacción percibida por distintos grupos de usuarios. Conclusiones: La experiencia analizada ha permitido comprobar la aplicabilidad e idoneidad de los principios Lean para mejorar los costes e incrementar la satisfacción de los usuarios de servicios logísticos hospitalarios. Palabras clave: Logística. Suministros de hospitales. Suministro y distribución. Gestión Lean. Satisfacción del personal. Costes y análisis de costes.Objectives: Supply management is an area where hospitals have significant opportunities for improvement. The main objective of this paper has been to analyze how the application of Lean principles can improve logistics costs and user satisfaction. In connection with satisfaction, it also aimed to examine which aspects of the service define it and check for differences between different groups of users. Methods: The results of an experience to reorganize the hospital logistic system based on some Lean principles have been studied. This is therefore a case study, which combine different methods of data collection. The logistics cost calculation was carried out using the full costing method. To measure satisfaction of healthcare personnel, the internal logistics service users, an anonymous survey was conducted. Processing of the data obtained from the survey have included exploratory analysis, factor analysis and ANOVAs. Results: The data have showed an improvement in logistics management after the implemen- tation of Lean principles. Logistics costs were reduced and the satisfaction level of the internal users with the new logistics system was increased. Some differences in the degree of satisfac- tion by different groups of users were also detected, although they did not seem to distinguish between different aspects of logistic service. Conclusions: The analyzed experience shows the applicability and suitability of Lean principles to improve logistics operational costs and increase user satisfaction

AMPK Phosphorylation Modulates Pain by Activation of NLRP3 Inflammasome

Impairment in adenosine monophosphate-activated protein kinase (AMPK) activity and NOD-like receptor family, pyrin domain containing 3 (NLRP3) inflammasome activation are associated with several metabolic and inflammatory diseases. In this study, we investigated the role of AMPK/NLRP3 inflammasome axis in the molecular mechanism underlying pain perception. Results: Impairment in AMPK activation induced by compound C or sunitinib, two AMPK inhibitors, provoked hyperalgesia in mice ( p < 0.001) associated with marked NLRP3 inflammasome protein activation and increased serum levels of interleukin-1b (IL-1b) (24.56 – 0.82 pg/ml) and IL-18 (23.83 – 1.882 pg/ml) compared with vehicle groups (IL-1b: 8.15 – 0.44; IL-18:4.92 – 0.4). This effect was rescued by increasing AMPK phosphorylation via metformin treatment ( p < 0.001), caloric restriction diet ( p < 0.001), or NLRP3 inflammasome genetic inactivation using NLRP3 knockout (nlrp3-/ - ) mice ( p < 0.001). Deficient AMPK activation and overactivation of NLRP3 inflammasome axis were also observed in blood cells from patients with fibromyalgia (FM), a prevalent human chronic pain disease. In addition, metformin treatment (200 mg/daily), which increased AMPK activation, restored all biochemical alterations examined by us in blood cells and significantly improved clinical symptoms, such as, pain, fatigue, depression, disturbed sleep, and tender points, in patients with FM. Innovation and Conclusions: These data suggest that AMPK/NLRP3 inflammasome axis participates in chronic pain and that NLRP3 inflammasome inhibition by AMPK modulation may be a novel therapeutic target to fight against chronic pain and inflammatory diseases as FM. Antioxid. Redox Signal. 24, 157–170.Junta de Andalucía CTS11

Applying the theory of constraints to the logistics service of medical records of a hospital

Management of patient records in a hospital is of major importance, for its impact both on the quality of care and on the associated costs. Since this process is circular, the prevention of the building up of bottlenecks is especially important. Thus, the objective of this paper was to analyze whether the Theory of Constraints (TOC) can be useful to the logistics of medical records in hospitals. The paper is based on a case study conducted about the 2007-2011 period in the Medical Records Logistics Service at the Hospital Universitario Virgen Macarena in Seville (Spain). From April 2008, a set of actions in the clinical record logistics system were implemented based on the application of TOC principles. The results obtained show a significant increase in the level of service and employee productivity, as well as a reduction of cost and the number of patients’ complaints

Article A Green Solution for the Rehabilitation ofMarginal Lands: The Case of Lablab purpureus (L.) Sweet Grown in Technosols

Acknowledgments: Antonio Aguilar-Garrido (A.A.-G.) thanks the Spanish Ministry of Science, Innovation and Universities for its predoctoral fellowship and the mobility grant under application references FPU-18/02901 and EST21/00734, respectivelyReclamation of abandoned mining areas can be a potentially viable solution to tackle three major problems: waste mismanagement, environmental contamination, and growing food demand. This study aims to evaluate the rehabilitation of mining areas into agricultural production areas using integrated biotechnology and combining Technosols with a multipurpose (forage, food, ornamental and medicinal) drought-resistant legume, the Lablab purpureus (L.) Sweet. Two Technosols were prepared by combining gossan waste (GW) from an abandoned mining area with a mix of low-cost organic and inorganic materials. Before and after plant growth, several parameters were analysed, such as soil physicochemical characteristics, nutritional status, bioavailable concentrations of potentially hazardous elements (PHE), soil enzymatic activities, and development and accumulation of PHE in Lablab, among others. Both Technosols improved physicochemical conditions, nutritional status and microbiological activity, and reduced the bioavailability of most PHE (except As) of GW. Lablab thrived in both Technosols and showed PHE accumulation mainly in the roots, with PHE concentrations in the shoots that are safe for cattle and sheep consumption. Thus, this is a potential plant that, in conjunction with Technosols, constitutes a potential integrated biotechnology approach for the conversion of marginal lands, such as abandoned mining areas, into food-production areasPortuguese national funds through FCT—Fundação para a Ciência e a TecnologiaProject UIDB/04129/2020 of LEAF—Linking Landscape, Environment, Agriculture and Food, Research Unit (Instituto Superior de Agronomia, Universidade de Lisboa, Portugal

Hotel Room Cleaning: Time Study and Analysis of Influential Variables in a Spanish Hotel

Purpose: Housekeeping is an important hotel process from the point-of-view of the number of work hours it takes and its impact on customer satisfaction. However, few previous scientific studies have addressed this topic or the variables that are determinants of the time required to clean a room. Design/methodology/approach: A stopwatch Time Study has been performed in a 4-star-hotel. Additionally, data on several variables that could affect cleaning time have been collected and subjected to regression analysis. Findings: Results show that only the task-related variables have a statistically significant influence on total cleaning time. None of the analyzed employee-related variables have any effect on cleaning time. Moreover, five tasks represent over 2/3 of the total cleaning time. Originality/value: In addition to empirically identifying the variables that influence cleaning time and to what extent, this study demonstrates the advantages of using stopwatch time studies to establish cleaning times

Active commuting is associated with a lower risk of obesity, diabetes and metabolic syndrome in Chilean adults

Background: There is limited evidence on how active commuting is associated with health benefits in developing countries. The aim of this study therefore was to investigate the associations between active commuting and markers of adiposity and cardiometabolic risk in the Chilean adult population. Methods: In total, 5157 participants from the Chilean National Health Survey 2009–10 were included in this cross-sectional study. Active commuting was measured using the Global Physical Activity Questionnaire (GPAQ v2). Body mass index (BMI) and waist circumference (WC) were measured and used to define obesity and central obesity. Type 2 diabetes (T2D) and metabolic syndrome were determined using WHO and updated ATPIII-NCEP criteria, respectively. Results: The main finding of this study is that a 30 min increase in active commuting is associated with lower odds for BMI &gt; 25.0 kg m−2 (0.93 [95% CI: 0.88–0.98, P = 0.010]). Similarly, the odds for central obesity was 0.87 [0.82–0.92, P &lt; 0.0001]. Similar associations were found for T2D (0.81 [0.75–0.88], P &lt; 0.0001) and metabolic syndrome (OR: 0.86 [0.80–0.92], P &lt; 0.0001). Conclusion: Our findings show that active commuting is associated with lower adiposity and a healthier metabolic profile including lower risk for obesity, diabetes and metabolic syndrome

Tic-tac, colecciona UCM. Tecnología de la información y las comunicaciones aplicada a las técnicas de aprendizaje cooperativo

Depto. de Física de MaterialesSección Deptal. de Arquitectura de Computadores y Automática (Físicas)Fac. de Geografía e HistoriaFac. de Ciencias FísicasFALSEsubmitte

PARP inhibition attenuates histopathological lesion in ischemia/reperfusion renal mouse model after cold prolonged ischemia

We test the hypothesis that PARP inhibition can decrease acute tubular necrosis (ATN) and other renal lesions related to prolonged cold ischemia/reperfusion (IR) in kidneys preserved at 4°C in University of Wisconsin (UW) solution. Material and Methods. We used 30 male Parp1+/+ wild-type and 15 male Parp10/0 knockout C57BL/6 mice. Fifteen of these wild-type mice were pretreated with 3,4-dihydro-5-[4-(1-piperidinyl)butoxyl]-1(2H)-isoquinolinone (DPQ) at a concentration of 15 mg/kg body weight, used as PARP inhibitor. Subgroups of mice were established (A: IR 45 min/6 h; B: IR + 48 h in UW solution; and C: IR + 48 h in UW solution plus DPQ). We processed samples for morphological, immunohistochemical, ultrastructural, and western-blotting studies. Results. Prolonged cold ischemia time in UW solution increased PARP-1 expression and kidney injury. Preconditioning with PARP inhibitor DPQ plus DPQ supplementation in UW solution decreased PARP-1 nuclear expression in renal tubules and renal damage. Parp10/0 knockout mice were more resistant to IR-induced renal lesion. In conclusion, PARP inhibition attenuates ATN and other IR-related renal lesions in mouse kidneys under prolonged cold storage in UW solution. If confirmed, these data suggest that pharmacological manipulation of PARP activity may have salutary effects in cold-stored organs at transplantation.Funding: This research was supported by CTS no. 138 Research Group and from the Carlos III Health Institute of the Spanish Ministery of Health and Consumer Affairs (Red de Investigación Renal, REDinREN 012/0021/0025). “FEDER una manera de hacer Europa”

Factores asociados a inactividad física en Chile: resultados de la Encuesta Nacional de Salud 2009-2010 = Correlates of physical inactivity: Findings from the Chilean National Health Survey 2009-2010

Background: Physical inactivity is an important risk factor for cardiovascular diseases. Aim: To identify factors associated with physical inactivity in Chilean adults. Material and Methods: Participants from the Chilean Health Survey (5,133 individuals) were included in this study. Physical activity was measured using the Global physical activity questionnaire (GPAQ). Physical inactivity was defined as &lt; 600 MET. min.week−1 of moderate to vigorous intensity physical activity. Logistic regression was used to identify correlates of physical inactivity. Results: The main finding of this study were that women (odds ratio (OR): 1.51 [95% confidence intervals (CI): 1.32-1.72]) were more likely to be inactive compared to men and that older adults were more likely to be inactive than their younger or middle age counterparts (OR: 3.06 [95% CI: 2.45-3.82]). Other correlates of physical inactivity were individuals with obesity (OR: 1.43 [95% CI: 1.20-1.70]), diabetes (OR: 1.96 [95% CI: 1.61-2.38]), hypertension (OR: 1.72 [95% CI: 1.50-1.97]), metabolic syndrome (OR: 1.42 [95% IC: 1.18-1.70]), a low education level (OR: 1.26 [95% CI: 1.06-1.49]) and higher levels of sedentary behavior (OR: 2.77 [95% CI: 2.36-3.25]). Conclusions: Women, older people and sedentary subjects with chronic non-transmissible conditions are at higher risk of being physically inactive