Un estudio de la insatisfacción generada por la certificación ISO9000 en la pequeña empresa

Documento de Trabajo 11/03 perteneciente a la colección de documentos de trabajo "Nuevas Tendencias en Dirección de Empresas", dentro del Máster en Investigación en Economía y Empresa.[ES]El objetivo de este estudio es analizar la insatisfacción generada por la certificación ISO9000 en la pequeña empresa. La certificación es sólo una prueba de que la empresa, tras cumplir unos requisitos y ajustarse a una serie de procedimientos, ha puesto en marcha un sistema de gestión de la calidad. Sin embargo, se le han atribuido beneficios y ventajas por encima de sus posibilidades, lo que ha llevado a las empresas a generar expectativas que pocas veces son alcanzadas. Estos razonamientos se confirman sobre una muestra de 131 empresas certificadas en Castilla y León, en la que además se estudia el efecto que tiene la antigüedad como empresa certificada en la realización de ventajas y la satisfacción de expectativas.[EN]The aim of this study is to analyze the dissatisfaction generated by the ISO9000 certification in the small business. Certification is only a proof that the company, after complying with certain requirements and adhere to a range of procedures, has launched a system of quality management. However, it was attributed to benefits and advantages beyond their means, which has led companies to raise expectations that are rarely achieved. These arguments are confirmed on a sample of 131 certified companies in Castilla y León, which also studies the effect of age as a company registered in the realization of benefits and satisfaction of expectations

La vida es posible con lupus

Esta cartilla ha sido diseñada para pacientes con lupus eritematoso sistémico (LES) y para familiares de estos pacientes que quieran conocer más acerca de esta condición de vida. Fue escrita por personas que tienen contacto directo con los pacientes, o son pacientes. Esperamos que sea de gran utilidad para cada uno de los lectores como una herramienta para saber, recordar y reforzar que la vida es posible con LES, y que se puede vivir en armonía con esta realidad. A lo largo de la cartilla se podrá encontrar información pertinente y actualizada, recomendaciones, consejos y algunas propuestas de ejercicios para asumir los desafíos que se presentan en el día a día de los pacientes y sus cuidadores o familiares.Bogot

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

Colombian consensus recommendations for diagnosis, management and treatment of the infection by SARS-COV-2/ COVID-19 in health care facilities - Recommendations from expert´s group based and informed on evidence

La Asociación Colombiana de Infectología (ACIN) y el Instituto de Evaluación de Nuevas Tecnologías de la Salud (IETS) conformó un grupo de trabajo para desarrollar recomendaciones informadas y basadas en evidencia, por consenso de expertos para la atención, diagnóstico y manejo de casos de Covid 19. Estas guías son dirigidas al personal de salud y buscar dar recomendaciones en los ámbitos de la atención en salud de los casos de Covid-19, en el contexto nacional de Colombia

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

La relación entre las prácticas y el desempeño de la función de compras en la industria española: el papel de la integración estratégica y de la implantación de tecnologías de la información y la comunicación

La gestión de compras en la actualidad ejerce un papel más relevante al interior de las organizaciones, entre otras cosas debido al reconocimiento estratégico de su función y al desarrollo de actividades o prácticas avanzadas de compra encaminadas a fortalecer o entablar relaciones más compenetradas y fructíferas entre compradores y proveedores. El objetivo de esta investigación es abordar el desarrollo de las prácticas avanzadas de compra y su relación con los resultados de la función de compras, así mismo observar el papel que tanto la integración estratégica de compras como las Tecnologías de la Información y la Comunicación (TIC) ejercen sobre dicha relación. Tras una revisión exhaustiva de la literatura para conformar las distintas medidas que permitieran la contrastación empírica de las hipótesis, mediante una encuesta digital colgada en la red de Internet y aplicada a profesionales y directores de compras del sector industrial español asociados a AERCE (Asociación Española de Profesionales de Compras, Contratación y Aprovisionamiento), se obtuvieron un total de 156 repuestas válidas con lo cual comprobamos la validez de las hipótesis planteadas.Los resultados obtenidos apoyan a diferentes investigaciones que plantean la importancia de desarrollar prácticas avanzadas de compra para mejorar los resultados de la función de compras. Así mismo, se observa que tanto las TICs como la Integración estratégica de compras, facilitan o potencian la implantación de prácticas avanzadas de compra. En función a los resultados se sugiere que es necesario implicar a la función de compras en el proceso de planificación estratégica, de forma que las decisiones que se tomen al interior del departamento de compras, estén alineadas con los objetivos organizativos y las actuaciones de las demás áreas funcionales. Así mismo, se plantea que las TICs solas no alcanzan mejores resultados, sin embargo si pueden ser consideradas como un soporte válido para la puesta en marcha de sistemas de abastecimiento más sofisticados que propician mejores resultados en compras.The purchasing actually represents a relevant role into the organizations, perhaps, to the strategic recognition of its function and the development of activities or advanced practices of purchase directed to strengthening or beginning more shared feelings and fruitful relations between(among) buyers and suppliers. The aim of this research is to approach the development of the advanced practices and the relation with the results of the function of purchasing, likewise to observe the paper(role) that both the strategic integration of purchases and the Technologies of the Information and the Communication (TIC) they exercise on the above mentioned relation.After an exhaustive review of the literature to shape the different measures that were allowing the empirical contrastación of the hypotheses, by means of a digital survey hung on the Internet network(net) and applied to professionals and the directors of purchases of the industrial Spanish sector the associated with AERCE (Professionals' Spanish Association of Purchases, Contracting and Provisioning), there was obtained a whole of 156 valid reputtings with which we verify the validity of the raised hypotheses.The obtained results rest to different researches that raise the importance of developing advanced practices of purchase to improve the results of the function of purchases. Likewise, is observed that both the TICs and the strategic Integration of purchases, facilitate or promote the introduction of advanced practices of purchase. In function to the results it is suggested that it is necessary to imply to the function of purchases in the process of strategic planning, so that the decisions that take to the interior of the purchasing department, are aligned by the organizational aims(lenses) and the performances of other functional areas. Likewise, one raises that the alone TICs do not reach better results, nevertheless if they can be considered to be a valid support for the putting in system march of supply more sophisticated that they propitiate(cause) better results in purchases

Evaluando la evaluación. Reflexiones en torno a la evaluación en la educación superior y experiencias pedagógicas

Evaluación en educación superiorEvaluando la Evaluación. Reflexión en torno a la evaluación en educación superior y experiencias pedagógicas tiene el propósito de continuar con la serie de libros de la Vicerrectoría Académica de Sede Principal, que inicio con el Didáctica para no Didácticos en 2017, con el fin de compartir con la comunidad de UNIMINUTO algunas reflexiones teóricas sobre la docencia en educación superior. Este libro busca hacer visible las buenas prácticas pedagógicas de los profesores de la Sede Principal. Este ejemplar toca el tema de la evaluación desde distintos puntos de vista. La evaluación (tanto interna como externa), autoevaluación de programas e instituciones y la evaluación del aprendizaje tienen un rol preponderante en los procesos de calidad en la educación superior en Colombia. Por ello, es importante hacer reflexión constante al respecto y conocer las tendencias teóricas, prácticas y políticas a nivel nacional e internacional sobre evaluación. Este libro es una invitación a la reflexión en torno a la evaluación en la educación superior y a identificar buenas prácticas que puedan nutrir la labor del profesor de UNIMINUTO