Unpublished Mediterranean and Black Sea records of marine alien, cryptogenic, and neonative species

To enrich spatio-temporal information on the distribution of alien, cryptogenic, and neonative species in the Mediterranean and the Black Sea, a collective effort by 173 marine scientists was made to provide unpublished records and make them open access to the scientific community. Through this effort, we collected and harmonized a dataset of 12,649 records. It includes 247 taxa, of which 217 are Animalia, 25 Plantae and 5 Chromista, from 23 countries surrounding the Mediterranean and the Black Sea. Chordata was the most abundant taxonomic group, followed by Arthropoda, Mollusca, and Annelida. In terms of species records, Siganus luridus, Siganus rivulatus, Saurida lessepsianus, Pterois miles, Upeneus moluccensis, Charybdis (Archias) longicollis, and Caulerpa cylindracea were the most numerous. The temporal distribution of the records ranges from 1973 to 2022, with 44% of the records in 2020–2021. Lethrinus borbonicus is reported for the first time in the Mediterranean Sea, while Pomatoschistus quagga, Caulerpa cylindracea, Grateloupia turuturu, and Misophria pallida are first records for the Black Sea; Kapraunia schneideri is recorded for the second time in the Mediterranean and for the first time in Israel; Prionospio depauperata and Pseudonereis anomala are reported for the first time from the Sea of Marmara. Many first country records are also included, namely: Amathia verticillata (Montenegro), Ampithoe valida (Italy), Antithamnion amphigeneum (Greece), Clavelina oblonga (Tunisia and Slovenia), Dendostrea cf. folium (Syria), Epinephelus fasciatus (Tunisia), Ganonema farinosum (Montenegro), Macrorhynchia philippina (Tunisia), Marenzelleria neglecta (Romania), Paratapes textilis (Tunisia), and Botrylloides diegensis (Tunisia).peer-reviewe

Practice of HB-HTA on the study of HIFU technology for the treatment of prostate cancer and uterine fibroma

The aim of the study has been the development of a Hospital Based - Health Technology Assessment, study directed to analyze the clinical, social and financial aspects derived from the use of the HIFU method for the treatment of prostate cancer and uterine fibroma in comparison with the traditional therapeutic approaches. A systematic literature review was carried out inspecting the treatment of prostate cancer through the use of HIFU technology as well as its use for the treatment of uterine fibroma. At a later stage, clinical, social and financial indicators (gathered from EUnetHTA Core Model as well as from scientific literature) were defined and evaluated and a single benefit index was drawn in the end to have a rapid and direct comparison among the various treatment methods. For the treatment of prostate cancer, HIFU reaches good results in the clinical setting obtaining 78% of negative biopsy results post-surgery and a 68% disease-free survival rate at 5 years. It also proves efficient in the social setting and equal to traditional surgeries. For the treatment of uterine fibroma, HIFU presents an improvement of post-surgery symptomology in 80% of cases, revealing a good clinical efficacy and showing particularly convenient in the patient quality of life. Even though the traditional techniques represent the current gold standard, the initial results for the treatment of prostate cancer, exclusive to low risk of illness, and of uterine fibroma through the use of HIFU appear positive and, therefore, encouraging for the immediate future even though it remains fundamental to have greater availability of evidence especially in the long run

Hospital-based expert model for health technology procurement planning in hospitals

Although in the last years technology innovation in healthcare brought big improvements in care level and patient quality of life, hospital complexity and management cost became higher. For this reason, necessity of planning for medical equipment procurement within hospitals is getting more and more important in order to sustainable provide appropriate technology for both routine activity and innovative procedures. In order to support hospital decision makers for technology procurement planning, an expert model was designed as reported in the following paper. It combines the most widely used approaches for technology evaluation by taking into consideration Health Technology Assessment (HTA) and Medical Equipment Replacement Model (MERM). The designing phases include a first definition of prioritization algorithms, then the weighting process through experts' interviews and a final step for the model validation that included both statistical testing and comparison with real decisions. In conclusion, the designed model was able to provide a semi-automated tool that through the use of multidisciplinary information is able to prioritize different requests of technology acquisition in hospitals. Validation outcomes improved the model accuracy and created different “user profiles” according to the specific needs of decision makers

Operating theatre model for activity monitoring and planning in hospitals

Operating Theatre (OT) is one of the most complex areas within the hospital in terms of activity management and safety control. Although OT activity represents a serious issue in hospital, there is still a lack of guidelines or regulations currently available. On the other hand for post-surgery infections many studies and guidelines have been already provided, especially regarding specific prevention and control measures. Moreover the high cost deriving from the OT management represent a further key which must be precisely monitored for its heavy weight on the hospital economic balance. Hence, the main goal of this paper is to develope a supporting model, which is based on specific performance indicators, able to support health departments. The aim of the model is to monitor and control the main aspects contributing to the efficiency of OT activity. This topic allows hospital decision makers to have a usable and widely accessible tool for planning and simulating possible modifications within the OT organization. Finally, for the tool validation, the dashboard is currently being applied to a real hospital department

Experience of Lean Six Sigma Quality Approach to Hospital Laboratory Services

The Lean Six Sigma method is a process analysis methodology that focuses on improving customer requirements understanding, business systems, productivity, and financial performance [1]. Motorola invented Six Sigma with the goal of setting tolerance limits for defective products at 3.4 units per million. The aim of this paper is to describe the application of a Lean Six Sigma approach to the medical laboratory services in hospital especially concerning with the front office performances and quality perception by patients. The project team, which included medical, technical and administrative personnel, defined four main Key Performance Indicators (KPIs): ‘waiting time’, ‘check-in time’, ‘number of queue abandonments’ and ‘number of check-ins.’ A Value Stream Mapping of the current state was implemented through the use of data from hospital software and field measurements. The methodology turned out to be a proper tool for the process optimization in designing the new front office at the laboratory services. It was able to provide important information to the decision management such as the workload assessment and the specific workstation planning. The check-in phase is already well sized for the customer needs while a light empowerment should be given to the payment machines. No need of further personnel is estimated for the future state according to the workload leveling. Further developments include periodic comparisons between the Key Performance Indicators (KPI) evaluated for the old and future front offices in order to validate the goals achievements

Lean Thinking in Hospital: Case Study at the Pathology Laboratory

When a good is produced a lot of transformations have to be made in order to satisfy client request. All of the phases are made in specific work-cells: the material is moved between the cells with an high risk of errors or lost of efficiency. Error free management is frequently used when the failure of the process is involved with a significant lost of production. A lot of tools (e.g. FMEA, FTA) are developed to increase reliability and efficiency too: lean thinking is one of these. Lean thinking is a specific method born in automotive but all the principles are applicable to hospital. The methodology uses “7 wastes analysis”, “Spaghetti Map” and “Value Stream Map” which are useful tools uses to describe the entire process by consumer point of view. “7 Wastes analysis” is used to divide value operations from non-value operations. “Spaghetti Map” is a specific diagram where it is easy to see useless movements. Lastly, “Value Stream Map” is the description of the process from the request to the delivery individuating the specific point of value. Takt Time and Cycle Time are calculated in order to define where the improvements have to be focused. In reference to histology a lot of improvement can be made: particularly, Takt Time showed unbalanced workload between the work-cells and cycle time revealed non-value added operations, some eliminated by software improvement. Goal of this paper is to show an application method of Lean Thinking for a complex healthcare process, which it is pathology laboratory

A queueing theory based model for business continuity in hospitals

Clinical activities can be seen as results of precise and defined events' succession where every single phase is characterized by a waiting time which includes working duration and possible delay. Technology makes part of this process. For a proper business continuity management, planning the minimum number of devices according to the working load only is not enough. A risk analysis on the whole process should be carried out in order to define which interventions and extra purchase have to be made. Markov models and reliability engineering approaches can be used for evaluating the possible interventions and to protect the whole system from technology failures. The following paper reports a case study on the application of the proposed integrated model, including risk analysis approach and queuing theory model, for defining the proper number of device which are essential to guarantee medical activity and comply the business continuity management requirements in hospitals

A simulation based model for planning operating theater activity in complex hospitals: Case study in orthopedics

Operating theaters (OT) in hospitals represent some of the highest sources of economic expenditures since their high complexity in terms of technology equipment (integration of different complex devices and specific technical requirements), organization (multi-personnel area with complex patients flow) and usage (optimum planning between regular activity and emergency management). For the above reasons, it is essential to understand and plan the whole surgical path (patient and personnel) by avoiding foreseeable inefficiencies, delays and risks. Hence, the aim of this study is fully modeling a generic orthopedics OT in order to support hospital decision makers in OT design and activity planning for both regular and emergency scenarios. In order to do that and due to the complexity of the OT system, a simulation approach is fundamental for properly understanding the whole process and for clearly controlling and analyzing all the factors involved (surgical durations, types, working times and rooms availability, etc..). Discrete event models have been found reliable and accurate to simulate complex health systems (e.g. emergency management, beds management, logistic and assets estimation, etc.). Finally, after selecting the most appropriate type of model, and using past surgical data and experts’ opinions from the hospital for its development and implementation, a more precise and reliable clinical validation of the model is currently in progress, by concluding a data verification that needs a period of on-site data collection. © Springer International Publishing Switzerland 2015

Impact assessment and risk analysis in the redevelopment of a healthcare structure

Any upgrading process aims for improving and optimizing operational conditions of every work environment. It generally includes the development of a change focused on organizational, technological and structural advancements in the expected conditions of specific active fields of interest. The upgrading process has to be always well planned and organized in order to be a source of growth for the structure considered and not becoming an obstacle for the daily routine of the structure itself. This aspect is much more relevant in case of health facilities since everyday activities must be constantly kept at a standard level and under an accurate control. To meet the needs of technological and legislative progress, the change following the upgrading process must be a long-term one. However, it will represent a significant variable both for the employees working conditions and the quality of the health care given to the patients. In this work an objective and complete procedure has been developed to quantify, in an impartial and univocal way, the impact that an upgrading process can have on health activities. In order to prevent and neutralize all the possible risks for patients, employees and health workers, it is of utmost importance the objectively evaluation of effects and hazards that these processes involve