Managing Waiting Times to Predict No-shows and Cancelations at a Children’s Hospital

Purpose: Since long waits in hospitals have been found to be related to high rates of no-shows and cancelations, managing waiting times should be considered as an important tool that hospitals can use to reduce missed appointments. The aim of this study is to analyze patients’ behavior in order to predict no-show and cancelation rates correlated to waiting times. Design/methodology/approach: This study is based on the data from a US children’s hospital, which includes all the appointments registered during one year of observation. We used the call-appointment interval to establish the wait time to get an appointment. Four different types of appointment-keeping behavior and two types of patients were distinguished: arrival, no-show, cancelation with no reschedule, and cancelation with reschedule; and new and established patients. Findings: Results confirmed a strong impact of long waiting times on patients’ appointment-keeping behavior, and the logarithmic regression was found as the best-fit function for the correlation between variables in all cases. The correlation analysis showed that new patients tend to miss appointments more often than established patients when the waiting time increases. It was also found that, depending on the patients’ appointment distribution, it might get more complicated for hospitals to reduce missed appointments as the waiting time is reduced. Originality/value: The methodology applied in our study, which combines the use of regression analysis and patients’ appointment distribution analysis, would help health care managers to understand the initial implications of long waiting times and to address improvement related to patient satisfaction and hospital performance.Peer Reviewe

Special issue: Industrial Engineering: Overcoming the crisis. CIO2012

This special issue of the Journal of Industrial Engineering and Management contains a selection of the papers that were accepted at the CIO2012 International Conference, developed in Vigo (Spain) under the motto “Industrial Engineering: Overcoming the Crisis”. CIO 2012 gives continuity to the series of annual Conferences initiated in September 1986 in La Rábida (Huelva, Spain). This conference is a very significant scientific event in Business & Operations Management and related areas. Researchers, academics, scientists and managers of diverse parts of the world have the opportunity to exchange experiences, new ideas and topics, in those fields related to Industrial Engineering. The 6th International Conference addresses the great multidisciplinary field formed by Industrial Engineering, from an international point of view. The papers here presented cover a number of consolidated and emerging topics of the conference scope and they may help readers to gain a deeper understanding of how Industrial Engineering could contribute to overcome the economic crisis. We would like to express our gratitude to all the authors, reviewers and the Organizing Committee for their enthusiastic work and magnificent support during CIO 2012

Promoting Structured Participation for Competitiveness in Services Companies

Purpose: To identify the main drivers that facilitate the successful deployment of a participation program aimed at improving competitiveness, as a prior step to analyze and discuss the implementation of these drivers in three services companies. Design/methodology/approach: The selection of the drivers was based on a “content analysis” of recent literature (2007-2017). To test the level of deployment of these drivers, the “case study” technique was chosen. The authors have selected two public transport companies and one bank, which have more than twenty years’ experience in the development of participation programs. Findings: From the case studies analysis, we conclude that participation can successfully improve a company’s competitiveness, provided that the drivers are developed with this specific aim. Thus, the analysis of these drivers allows to identify some gaps in aspects such as, the extension of participation throughout the company, the methodology adopted in the deployment of participation programs, the organizational structure for monitoring the program tasks, the reward/recognition systems and, especially, the implementation of KPIs for connecting participation and competitiveness. Research limitations/implications: This paper is based on a review of current literature, the analysis of three case studies, and our own personal experience. Our observations and comments may be qualified by future investigation with an increased sample of companies. Practical implications: This paper could be of interest to companies due to outlines the drivers that are critical to implementing participation programs focused on competitiveness. This could help companies that are thinking of implementing such programs, or those that are unhappy with their current programs, to re-design their plans in line with their business strategy. Originality/value: The main contribution of this paper lies in its theoretical and applied approach, analyzing in a comparative and longitudinal way the deployment of the drivers in services companies. This analysis allows the identification of strengths and weaknesses in the implementation of these participation programs focused on competitiveness. This combined and comparative approach is considered especially novel in the academic and professional world. Likewise, the analysis of companies with a longstanding history in their participation programs is also relevant, particularly, in the services sector.Peer Reviewe

Packaging design for competitiveness. Contextualizing the search and adoption of changes from a sustainable supply chain perspective

[EN] The Sustainable Packaging Logistics (SPL) approach seeks sustainable integration of the combined packaging-product-supply chain system orientated to increase competitiveness. However, characterizing which changes make it possible to guide such design in each company and supply chain is an aspect that has not been covered in the literature from different supply chain perspectives. The main goal of this paper is to identify and justify the main actions for improvement in SPL, combined with a proposal of methodology for contextualizing, selecting and implementing each of these potential actions, applying the Action Research approach. Likewise, this paper illustrates the interest of this methodology with its adoption in four different companies and supply chains. This paper opens up new avenues of applied research in packaging design, generating knowledge that contributes to sustainable and competitive improvement.García-Arca, J.; González-Portela Garrido, AT.; Prado-Prado, JC.; González-Boubeta, I. (2022). Packaging design for competitiveness. Contextualizing the search and adoption of changes from a sustainable supply chain perspective. International Journal of Production Management and Engineering. 10(2):115-130. https://doi.org/10.4995/ijpme.2022.16659OJS11513010

Combined therapies of antithrombotics and antioxidants delay in silico brain tumor progression

Glioblastoma multiforme, the most frequent type of primary brain tumor, is a rapidly evolving and spatially heterogeneous high-grade astrocytoma that presents areas of necrosis, hypercellularity and microvascular hyperplasia. The aberrant vasculature leads to hypoxic areas and results in an increase of the oxidative stress selecting for more invasive tumor cell phenotypes. In our study we assay in silico different therapeutic approaches which combine antithrombotics, antioxidants and standard radiotherapy. To do so, we have developed a biocomputational model of glioblastoma multiforme that incorporates the spatio-temporal interplay among two glioma cell phenotypes corresponding to oxygenated and hypoxic cells, a necrotic core and the local vasculature whose response evolves with tumor progression. Our numerical simulations predict that suitable combinations of antithrombotics and antioxidants may diminish, in a synergetic way, oxidative stress and the subsequent hypoxic response. This novel therapeutical strategy, with potentially low or no toxicity, might reduce tumor invasion and further sensitize glioblastoma multiforme to conventional radiotherapy or other cytotoxic agents, hopefully increasing median patient overall survival time.Comment: 8 figure

Sub-bandgap spectral photo-response analysis of Ti supersaturated Si

We have analyzed the increase of the sheet conductance (ΔG□) under spectral illumination in high dose Ti implanted Si samples subsequently processed by pulsed-laser melting. Samples with Ti concentration clearly above the insulator-metal transition limit show a remarkably high ΔG□, even higher than that measured in a silicon reference sample. This increase in the ΔG□ magnitude is contrary to the classic understanding of recombination centers action and supports the lifetime recovery predicted for concentrations of deep levels above the insulator-metal transition

Molecular profile and cellular characterization of human bone marrow mesenchymal stem cells: donor influence on chondrogenesis

[Abstract] Background. The use of autologous or allogenic stem cells has recently been suggested as an alternative therapeutic approach for treatment of cartilage defects. Bone marrow mesenchymal stem cells (BM-MSCs) are well-characterized multipotent cells that can differentiate into different cell types. Understanding the potential of these cells and the molecular mechanisms underlying their differentiation should lead to innovative protocols for clinical applications. The aim of this study was to evaluate the usefulness of surface antigen selection of BM-MSCs and to understand the mechanisms underlying their differentiation. Methods. MSCs were isolated from BM stroma and expanded. CD105+ subpopulation was isolated using a magnetic separator. We compared culture-expanded selected cells with non-selected cells. We analyzed the phenotypic profiles, the expression of the stem cell marker genes Nanog, Oct3/4, and Sox2 and the multi-lineage differentiation potential (adipogenic, osteogenic, and chondrogenic). The multi-lineage differentiation was confirmed using histochemistry, immunohistochemistry and/or real-time polymerase chain reaction (qPCR) techniques. Results. The selected and non-selected cells displayed similar phenotypes and multi-lineage differentiation potentials. Analyzing each cell source individually, we could divide the six donors into two groups: one with a high percentage of CD29 (β1-integrin) expression (HL); one with a low percentage of CD29 (LL). These two groups had different chondrogenic capacities and different expression levels of the stem cell marker genes. Conclusions. This study showed that phenotypic profiles of donors were related to the chondrogenic potential of human BM-MSCs. The chondrogenic potential of donors was related to CD29 expression levels. The high expression of CD29 antigen seemed necessary for chondrogenic differentiation. Further investigation into the mechanisms responsible for these differences in BM-MSCs chondrogenesis is therefore warranted. Understanding the mechanisms for these differences will contribute to improved clinical use of autologous human BM-MSCs for articular cartilage repair.Servizo Galego de Saúde; PS07/84Instituto de Salud Carlos III; CIBER BBN CB06-01-004

Dificultades en el manejo cognitivointerpersonal del trastorno narcisista de la personalidad: Estudio de caso

Examination of the significant interpersonal interactions that occur during psychotherapy is essential to understanding the change processes of psychotherapy. These interactions are micromoments that occur between therapist and patient, which yield therapeutic effects. Psychotherapy difficulties can be conceptualized by analyzing the working alliance and the concept of alliance ruptures. We present a description of psychotherapeutic process of a patient with Narcissistic Personality Disorder, who had two past unsuccessful experiences with previous interventions. We discuss the difficulties encountered in the successful implementation of Interpersonal-Cognitive Therapy and the importance of re-conceptualizing psychotherapy difficulties in a constructive way as key factor in improving our insight into the value of the techniques implemented

La participación estructurada del personal orientada a la mejora de productividad. Un caso práctico

[ESP] Actualmente, las empresas deben enfrentarse a los desafíos de la innovación, la disminución de los ciclos de vida en los productos, la proliferación de productos, la demanda de precios bajos y estándares de calidad elevados. Por ello, muchas organizaciones buscan ventajas competitivas en una mejor gestión de sus procesos basadas, tanto en el ámbito de la inversión (tecnologías, equipos,…) como en pequeñas mejoras que incrementen, paulatinamente, la eficiencia de los mismos. Esta última opción de mejora, casi sin inversión, se denomina "mejora continua" o "Kaizen" y constituye la base de diferentes enfoques, tales como Just in Time (JIT), Lean Production o Total Quality Management (TQM). Boer et al. (2000) definen la mejora continua como "un proceso organizado y planificado de cambio en toda la organización, orientado hacia la mejora de los resultados empresariales"