Applying Value Stream Mapping to Improve the Delivery of Patient Care in the Oncology Day Hospital

[EN] Improving the delivery of patient care is an ongoing challenge in the National Health Service (NHS). This challenge is not insignificant in the process of chemotherapy administration for oncology patients. The present research is motivated by a public Spanish hospital in which oncology patients receive medical care in the Oncology Day Hospital (ODH). At the ODH, oncology patients receive different health services by different specialists on a single day. Any discoordination in patient flow will contribute to longer waiting times and stays in the ODH. As oncology patients tend to have special health conditions, any extra time in the hospital is a source of risk and discomfort. This study applies value stream mapping methodology in a Spanish ODH to improve this situation, reducing hospital waiting times and shorting the length of stay. For that purpose, the path of the oncology patients is mapped and the current state of the system is analyzed. Working at takt time and levelling the workload are proposed for improving the working conditions for healthcare personnel. As a result, the quality of service for oncology patients who need a well-defined care profile is improved. The singular characteristics of the Spanish NHS make it challenging to implement new ways of working, so this study has significant theoretical and managerial implications offering directions in which improvement is possible.Vidal-Carreras, PI.; García Sabater, JJ.; Marin-Garcia, JA. (2022). Applying Value Stream Mapping to Improve the Delivery of Patient Care in the Oncology Day Hospital. International Journal of Environmental research and Public Health. 19(7):1-18. https://doi.org/10.3390/ijerph1907426511819

The Role of Value Stream Mapping in Healthcare Services: A Scoping Review

[EN] Lean healthcare aims to manage and improve the processes in the healthcare sector by eliminating everything that adds no value by improving quality of services, ensuring patient safety and facilitating health professionals' work to achieve a flexible and reliable organization. Value Stream Mapping (VSM) is considered the starting point of any lean implementation. Some papers report applications of VSM in healthcare services, but there has been less attention paid to their contribution on sustainability indicators. The purpose of this work is to analyze the role of VSM in this context. To do so, a scoping review of works from recent years (2015 to 2019) was done. The results show that most applications of VSM reported are in the tertiary level of care, and the United States of America (USA) is the country which leads most of the applications published. In relation with the development of VSM, a heterogeneity in the maps and the sustainability indicators is remarkable. Moreover, only operational and social sustainability indicators are commonly included. We can conclude that more standardization is required in the development of the VSM in the healthcare sector, also including the environmental indicators.Marin-Garcia, JA.; Vidal-Carreras, PI.; García Sabater, JJ. (2021). The Role of Value Stream Mapping in Healthcare Services: A Scoping Review. International Journal of Environmental research and Public Health (Online). 18(3):1-25. https://doi.org/10.3390/ijerph18030951S12518

Operations Management at the service of health care management: Example of a proposal for action research to plan and schedule health resources in scenarios derived from the COVID-19 outbreak

[EN] With this work, we intend to promote research on the application of Operations Management tools in order to assist with decision-making in health crisis situations. During the first six weeks of the COVID-19 crisis in Spain, we have contacted a large number of hospital and health department managers in the Valencian Community and other regions of Spain. The result is that very few, at least when contact was made and at the time of writing this article, had consulted staff members in the Operations Management area for advice on this situation, and they are quite reluctant to do so. This is in spite of the fact that some medical sources also consider this crisis to be one of resources, not merely a medical crisis. Our opinion is that Operations Management can make a useful and valuable contribution to anticipate and improve the management of scarce resources, even in times of crisis. If those responsible for public health or heads of hospitals do not see this usefulness, then there is a huge gap between research and practice in Operations Management and what is transmitted to the healthcare sector. Our aim is to help reduce this gap.Marin-Garcia, JA.; García Sabater, JP.; Ruiz, A.; Maheut, J.; García Sabater, JJ. (2020). Operations Management at the service of health care management: Example of a proposal for action research to plan and schedule health resources in scenarios derived from the COVID-19 outbreak. Journal of Industrial Engineering and Management. 13(2):213-227. https://doi.org/10.3926/jiem.3190S21322713

Profile and competences of Spanish industrial engineers in the European Higher Education Area (EHEA)

The aim of this document is to develop a clear definition of the role of the industrial engineer. This is important in the Spanish context, where the engineer curricula are evolved in a different way than in other countries, due to the role developed by the Professional Associations of Engineers and Technical Engineers. To this end we identify here the professional profiles to be expected of those graduating from such courses, the sectors where they are most likely to be recruited, and the context within which industrial engineers are employed. We deal with meanings and proposals for Industrial Engineers within a European context, drawing information from the academic debate which has been launched in a number of scientific publications. The text summarizes our personal reflections, which are integrated within a proposal for action intended as an additional contribution to the critical debate as to the situation, rather than a final responsePeer Reviewe

Resting-state functional connectivity and socioemotional processes in male perpetrators of intimate partner violence against women

Intimate partner violence against women (IPVAW) is a serious and overwhelming public concern. Neuroimaging techniques have provided insights into the brain mechanisms underlying IPVAW perpetration. The purpose of this study is to examine the resting-state functional connectivity (rsFC) involving the process of social decision-making of male perpetrators. Twenty-six male perpetrators convicted for an IPVAW crime were compared to 29 men convicted for crimes other than IPVAW (other offenders) and 29 men with no criminal records (non-offenders) using a seed-based approach. Seeds were located in areas involved in reflective (prefrontal), impulsive (amygdala and striatum) and interoceptive (insula) processing. Then, as an exploratory analysis, the connectivity networks on male perpetrators were correlated with measures of executive functions and socioemotional self-report measures. Male perpetrators in comparison to other offenders and non-offenders, presented higher rsFC between prefrontal, limbic, brainstem, temporal and basal ganglia areas. Also male perpetrators showed higher rsFC between insula, default mode network and basal ganglia, while lower rsFC was found between prefrontal and motor areas and between amygdala, occipital and parietal areas. Exploratory correlations suggest that the specific rsFC in male perpetrators might be more related to socioemotional processes than to executive functions. These results showed that male perpetrators present a specific rsFC in brain systems that are essential for an adaptive social decision-making

Interlaboratory study on Sb2S3 interplay between structure, dielectric function, and morphous-to-crystalline phase change for photonics

Antimony sulfide, Sb2S3, is interesting as the phase-change material for applications requiring high transmission from the visible to telecom wavelengths, with its band gap tunable from 2.2 to 1.6 eV, depending on the amorphous and crystalline phase. Here we present results from an interlaboratory study on the interplay between the structural change and resulting optical contrast during the amorphous-to-crystalline transformation triggered both thermally and optically. By statistical analysis of Raman and ellipsometric spectroscopic data, we have identified two regimes of crystallization, namely 250_C % T < 300_C, resulting in Type-I spherulitic crystallization yielding an optical contrast Dn _ 0.4, and 300 % T < 350 _ C, yielding Type-II crystallization bended spherulitic structure with different dielectric function and optical contrast Dn _ 0.2 below 1.5 eV. Based on our findings, applications of on-chip reconfigurable nanophotonic phase modulators and of a reconfigurable high-refractive-index core/phase-change shell nanoantenna are designed and proposed.The authors acknowledge the support from the European Union’s Horizon 2020 research and innovation program (No 899598 - PHEMTRONICS)

Exploring working conditions as determinants of job satisfaction: an empirical test among Catalonia service workers

Job satisfaction is particularly important in the service industry since it involves direct contact with customers and thus has a direct influence on company performance. We analyzed the impact of ten working conditions on job satisfaction by means of structural equation modelling in a representative stratified random sample of 1553 service sector employees in Catalonia (Spain). We found significant effects in social aspects (recognition of a job well done and social support), followed by psychological loads (emotional demands and job insecurity) and by task contents (development & meaning and predictability). These variables explained 50% of the variance in job satisfaction

Immunometabolic actions of trabectedin and lurbinectedin on human macrophages: relevance for their anti-tumor activity

In recent years, the central role of cell bioenergetics in regulating immune cell function and fate has been recognized, giving rise to the interest in immunometabolism, an area of research focused on the interaction between metabolic regulation and immune function. Thus, early metabolic changes associated with the polarization of macrophages into pro-inflammatory or pro-resolving cells under different stimuli have been characterized. Tumor-associated macrophages are among the most abundant cells in the tumor microenvironment; however, it exists an unmet need to study the effect of chemotherapeutics on macrophage immunometabolism. Here, we use a systems biology approach that integrates transcriptomics and metabolomics to unveil the immunometabolic effects of trabectedin (TRB) and lurbinectedin (LUR), two DNA-binding agents with proven antitumor activity. Our results show that TRB and LUR activate human macrophages toward a pro-inflammatory phenotype by inducing a specific metabolic rewiring program that includes ROS production, changes in the mitochondrial inner membrane potential, increased pentose phosphate pathway, lactate release, tricarboxylic acids (TCA) cycle, serine and methylglyoxal pathways in human macrophages. Glutamine, aspartate, histidine, and proline intracellular levels are also decreased, whereas oxygen consumption is reduced. The observed immunometabolic changes explain additional antitumor activities of these compounds and open new avenues to design therapeutic interventions that specifically target the immunometabolic landscape in the treatment of cancer

Mortality prediction in chronic obstructive pulmonary disease comparing the GOLD 2015 and GOLD 2019 staging: a pooled analysis of individual patient data

In 2019, The Global Initiative for Chronic Obstructive Lung Disease (GOLD) modified the grading system for patients with COPD, creating 16 subgroups (1A–4D). As part of the COPD Cohorts Collaborative International Assessment (3CIA) initiative, we aim to compare the mortality prediction of the 2015 and 2019 COPD GOLD staging systems. We studied 17 139 COPD patients from the 3CIA study, selecting those with complete data. Patients were classified by the 2015 and 2019 GOLD ABCD systems, and we compared the predictive ability for 5-year mortality of both classifications. In total, 17 139 patients with COPD were enrolled in 22 cohorts from 11 countries between 2003 and 2017; 8823 of them had complete data and were analysed. Mean±sd age was 63.9±9.8 years and 62.9% were male. GOLD 2019 classified the patients in milder degrees of COPD. For both classifications, group D had higher mortality. 5-year mortality did not differ between groups B and C in GOLD 2015; in GOLD 2019, mortality was greater for group B than C. Patients classified as group A and B had better sensitivity and positive predictive value with the GOLD 2019 classification than GOLD 2015. GOLD 2015 had better sensitivity for group C and D than GOLD 2019. The area under the curve values for 5-year mortality were only 0.67 (95% CI 0.66–0.68) for GOLD 2015 and 0.65 (95% CI 0.63–0.66) for GOLD 2019

Análisis de programas de mejora continua. Un estudio longitudinal en una empresa industrial

Las empresas han utilizado diversas herramientas que permiten que los operarios contribuyan al proceso de mejora continua. Entre las herramientas más usadas podemos destacar los sistemas de sugerencias tanto individuales como en grupo. En esta comunicación haremos un repaso de las principales características de ambos sistemas y los modos habituales de implantación. Nuestra ponencia pretende intentar responder a estas preguntas de investigación. ¿Qué resultados se derivan de la implantación de sistemas de sugerencias individuales o en grupo? ¿Cuál de los dos sistemas es más beneficioso para la empresa? ¿Qué problemas surgen durante el funcionamiento de estos programas? Para ello, analizaremos los datos de un caso de empresa industrial donde hemos recogido los datos históricos de 5 años de aplicación de un programa de mejora continua. Ambos programas han demostrado ser provechosos para la empresa, aunque las posibilidades de los sistemas de grupo parecen ser significativamente mayores