Lean healthcare project leader: a framework based on functions and competencies

Hospitals have been implementing lean projects in recent years and gaining significant results in diverse operational flows. Such developments are often not integrated with the hospital management system, nor performed according to the dynamics of each professional area, or even not governed by trained and empowered lean healthcare project leaders. This study proposes, by means of an action research approach, to raise the functions and competencies that a Lean Healthcare project manager needs to develop projects using DMAIC as general guide. From the case of a large hospital in southeastern Brazil, the researchers listed general project management functions, technical and behavioral competencies, and present a general method for conducting lean projects in a hospital environment. As a conclusion of the study is perceived that the required competencies are related to the literature studied in project management and lean thinking, namely, Communication, Teamwork, Focus on Results, and a Systemic Vision. These were evaluated as the basic competencies for a Lean Healthcare Project Leader.This work was partially supported by projects COMPETE-POCI-01-0145-FEDER-007043 and FCT-UID-CEC-00319-2013, from Portugal

Henkilöstön vaihtuvuus ja siihen liittyvät tekijät telemarkkinointialalla : case: Gainer Oy

Tämä opinnäytetyö toteutettiin toimeksiantosopimuksena Gainer Oy:lle, joka on toiminut telemarkkinoinnin alalla jo vuodesta 1984. Opinnäytetyön tutkimusstrategiaksi valittiin case study eli tapaustutkimus. Käytimme tutkimusmenetelmänä kvalitatiivista eli laadullista tutkimusta. Tavoitteenamme oli tutkia ja selvittää henkilöstön vaihtuvuutta ja siihen liittyviä tekijöitä alalla, jossa henkilöstön vaihtuvuus koetaan ongelmaksi. Teoriaosuudessa käsittelemme teoreettisen viitekehyksen liittyen työnantajan keinoihin vaikuttaa työntekijän sitouttamiseen. Tämä on jaettu kahteen osa-alueeseen, jotka ovat rekrytointi sekä työhyvinvointi ja osaamisen kehittäminen. Empiirisessä osiossa päädyimme käyttämään puolistrukturoitua teemahaastattelua, joka toteutettiin suurimmaksi osaksi puhelimitse sekä muutama haastattelu tehtiin kasvotusten. Teemahaastattelu valikoitui parhaimmaksi menetelmäksi johtuen aiheen moniulotteisuudesta. Avoimella haastattelulla emme olisi välttämättä saaneet merkittävää tietoa samassa mittakaavassa kuin puolistrukturoidulla mallilla. Opinnäytetyön tuloksena päädyimme esittämään toimeksiantajalle muutamia kehitysehdotuksia. Haastatteluista johdetuilla päätelmillä saatettaisiin parantaa rekrytoinnin onnistumista, joka osaltaan parantaa kannattavuutta niin tuloksellisesti, kuin henkilöstön resurssejakin säästäen. Kehitysehdotuksia muodostui myös muihin osa-alueisiin liittyen. Näillä on myös vaikutusta henkilöstön yleiseen työhyvinvointiin ja työssä jaksamiseen.This thesis was carried out as a commission agreement for Gainer Oy, which has operated in the field of telemarketing since 1984. Our study was carried out as a case study using qualitative approach as our research method. Our objective was to study personnel turnover and matters relating to it in a field where personnel turnover is seen as a problem. In the theoretical section of the study we deal with the theoretical frame of reference related to the employer's means to influence employee engagement. This is divided into two sections that are recruiting, and occupational health and development of skills. In the empirical part of our study, we ended up using half-structured theme interviews, which were mainly carried out by telephone. A few interviews were carried out face-to-face. Theme interview was selected to be the best method because of the multidimensionality of the subject. By using open interviews, we would not necessarily have received as much significant information as by using the half-structured model. As a result of our study, we presented a few development proposals for our client/commissioner. The conclusions drawn from the interviews may lead to more successful recruiting, which in turn improves viability both in terms of productivity and by saving the resources of the personnel. There were also other development proposals concerning other areas. The results of the study may also help to improve the general well-being at work and coping with one’s workload

Prostate-specific antigen velocity in a prospective prostate cancer screening study of men with genetic predisposition

Background:Prostate-specific antigen (PSA) and PSA-velocity (PSAV) have been used to identify men at risk of prostate cancer (PrCa). The IMPACT study is evaluating PSA screening in men with a known genetic predisposition to PrCa due to BRCA1/2 mutations. This analysis evaluates the utility of PSA and PSAV for identifying PrCa and high-grade disease in this cohort.Methods:PSAV was calculated using logistic regression to determine if PSA or PSAV predicted the result of prostate biopsy (PB) in men with elevated PSA values. Cox regression was used to determine whether PSA or PSAV predicted PSA elevation in men with low PSAs. Interaction terms were included in the models to determine whether BRCA status influenced the predictiveness of PSA or PSAV.Results:1634 participants had 3/43 PSA readings of whom 174 underwent PB and 45 PrCas diagnosed. In men with PSA > 3.0 ng ml -l, PSAV was not significantly associated with presence of cancer or high-grade disease. PSAV did not add to PSA for predicting time to an elevated PSA. When comparing BRCA1/2 carriers to non-carriers, we found a significant interaction between BRCA status and last PSA before biopsy (P=0.031) and BRCA2 status and PSAV (P=0.024). However, PSAV was not predictive of biopsy outcome in BRCA2 carriers.Conclusions:PSA is more strongly predictive of PrCa in BRCA carriers than non-carriers. We did not find evidence that PSAV aids decision-making for BRCA carriers over absolute PSA value alone

Concesión de viático a fray Buenaventura Malaquías, fray Guillermo Siredan y fray Bernardino Cornelio, religiosos de la orden de San Francisco, para ir a la Misión de Irlanda

Fecha del documento: 1640-11-21. 3 páginasAndrés de Rozas al secretario Juan de Otalora sobre la resolución regia de conceder a fray Buenaventura Malaquías, fray Guillermo Siredan y fray Bernardino Cornelio, religiosos de la orden de San Francisco, un viático de 100 ducados a cada uno para ir a la Misión de Irlanda. Acudan de Antonio de Campo Redondo. Orden del Antonio de Campo Redondo al secretario Juan García Dávila Muñoz para que haga la cédula para que el tesorero general Pedro Baza de Herrera libre el dinero del arca de las tres llaves y pueda entregarlo a don Alonso Pérez de Guzmán, patriarca de Indias. Hecha la cédula.Proyecto Proyección Política y Social de la Comunidad Irlandesa en la Monarquía hispánica y en la América Colonial de la Edad Moderna(siglos XVI-XVIII) (HAR2009-11339 - subprograma HIST) del Ministerio de Economía y Competitividad en colaboración con el Consejo Superior de Investigaciones Científicas (CSIC), Embajada de Irlanda en Madrid, National University of Ireland (NUI) Maynooth, University College Dublin y Trinity College DublinAndrés de Rozas, secretario del Consejo de EstadoJuan de Otalora, secretario del Consejo de HaciendaOrden de San FranciscoSí300 ducados (100x3)NoN