DESIGN OF WORK METHOD IN ORDER TO DECREASEILLNESS RATE CAUSED BY MUSCLE AND NERVE DUETO UNPROPER WORK METHOD USING OCRA INDEX ININSTALLATION DEPARTMENT POS INSTALL WOODENLH AND ROUTING WIRING IN PT. XYZ

Health is an important form of human capital. It can enhance worker?s productivity by increasing their physical capacities, such as strength and endurance, as well as their mental capacities, such as cognitive functioning and reasoning ability. Such in Vehicle logistics division, there is still 16% of total disease in PT XYZ are caused by nerve and muscle. By divide it into department category, the most common disease is in Installation Operation which contributed 60%, it means that from the 16% disease caused by nerve and muscle 60% of infected operator are work in Installation Operation. In Installation Department operation there are five lines that have responsibility to install the available or given car. From the five lines, the most common is in line 2 which contribute 25%. Then identify each job in line 2 is the next step, and the most common is in Pos 2D which responsibility to install the wooden LH and routing. Then, the existing condition is assess by OCRA Index which evaluate four main collective risk factors based on their respective duration, which are repetitiveness, force, awkward posture and movements, and lack of proper recovery periods. Then, from the given result of assessment will be used as parameter to give an improvement which in term of an improvement work method. By improving the work system, the gap that has been categorized in OCRA Index has been fixed. In other words the OCRA Index for improvement condition is lower than the existing one. Means that the improvement process is succesfully decreased the risk of illness from 2,449 to 1,054 by the OCRA Index assessment process. Key words: OCRA Index, Wooden LH, Nerve and Muscle, Routing, Repetitiveness, Awkward postur

Developing design capability in nonprofit organizations

© 2017 Massachusetts Institute of Technology. This article presents findings from a two-year longitudinal action, research study exploring the challenges and outcomes of attempting to develop design capability in one of Australia’s largest non-profit aged-care providers. The research identifies four distinct objectives for design utilization in practice, and suggests that existing approaches for design utilization overlook non-profit organizations that seek both economic and social viability. While the objectives of realizing economic and social outcomes are addressed in design literature, there is an absence of literature detailing how non-profit organizations could utilize design to realize these outcomes. This research, therefore, contributes the non-profit design ladder-a framework to assist non-profit organizations to further develop their utilization of design and foster design as an organizational capability

Outcome of revision total knee arthroplasty with bone allograft in 30 cases

Revision Total Knee Arthroplasty is often complicated by large bone defects in the distal femur and proximal tibia. These defects can be managed in a variety of ways including the use of allograft bone. The purpose of this study was to retrospectively evaluate the clinical outcome of revision total knee arthroplasty cases where allograft bone was used. Thirty revision TKA's (27 patients) performed between 1994 and 2009 were followed for a mean of 5 years (1- 14 years). Preoperative bone defects were classified using the Anderson Orthopaedic Research Institute classification system. Patient follow-up entailed calculation of the Knee Society Score and radiological assessment of the revision joint replacement in addition to review of complications. Kaplan Meier analysis predicted survivorship at 5 years as 93%, with further revision surgery as end point. The average Knee Society Score was 76.4, with 19 (63%) of knees scoring "excellent" results, 4 (14%) "good", 1 (3%) "fair" and 6 (20%) were "poor". The overall complication rate was 23.3%. Radiological lucency was demonstrated on recent radiographs for one patient. Three knees were re-revised at 1 year, 6 years and 8 years respectively. Our study demonstrates promising short to medium term results with the use of allograft bone in revision total knee replacement presenting with significant bone loss

A modified cementing technique using BoneSource to augment fixation of the acetabulum in a sheep model

Background and purpose Our aim was to prove in an animal model that the use of HA paste at the cement-bone interface in the acetabulum would improve fixation. We examined, in sheep, the effect of interposing a layer of hydroxyapatite cement around the periphery of a polyethylene socket prior to fixing it using polymethylemethacrylate (PMMA). Methods We made a randomized study involving 22 sheep to test whether the application of BoneSource hydroxyapatite material to the surface of the ovine acetabulum prior to cementing a polyethylene cup at hip arthroplasty improved the fixation and the nature of the interface. We studied the gross radiographical appearance of the implant-bone interface and the histological appearance at the interface. Results There were more radiolucencies evident in the control group. Histologically, only sheep randomized into the BoneSource group exhibited a fully osseointegrated interface. Use of the hydroxyapatite material did not confer any detrimental effects. In some cases the material appeared to have been fully resorbed. When the material was evident on histological section, it was incorporated into an osseointegrated interface. There was no giant cell reaction present in any case. There was no evidence of migration of BoneSource to the articulation. Interpretation The application of HA material prior to cementation of a socket produced an improved interface. The technique may be useful in man with to extend the longevity of the cemented implant by protecting the socket interface from the effect of hydrodynamic fluid flow and particulate debris

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

A non-profit design-led innovation journey

Non-profit organisations in the aged care sector are currently under pressure from more than just a sheer increase of customers. A need to respond to changing legislative requirements, increased expectations from customers and increasing likelihood of shortage in appropriate experienced staff are also contributing to instability within the sector. This paper will present a longitudinal action research study of a non-profit organisation revisiting its core purpose of providing relevant services and attempting to build a customer-centric method for addressing the current and upcoming change drivers in an Australian aged care context. The study found Design- Led Innovation to be an effective methodology for capturing deep customer insights and conceptualising new business models which address the prevalent change drivers. This paper details a design-led approach to innovation, tailored to a non-profit organisation seeking to better understand its stakeholders and redefine its value offering

Customer journey and experience canvas

A need to respond to changing legislative requirements, rising expectations from customers and shortages of suitably experienced staff are forcing non-profit organisations in the aged care sector to change. As new customer segments emerge and the existing aged care offering becomes less relevant, organisations must rethink the value they present to market, and adopt innovative strategies and approaches to care delivery in order to have a sustainable future. This paper presents a framework for unpacking a customer journey and experience, developed during a longitudinal study of a non-profit organisation redefining their core purpose and attempting to design a customer-centric business model

A design-led approach to innovation in aged care

This research explores the journey of a non-profit organisation seeking to respond to prominent change drivers in aged care through the strategic integration of design. A longitudinal action research project investigated the business models of aged care providers, the viability and capacity of existing aged care business models, and the ways aged care organisations could utilise design to drive innovation and address emerging challenges in practice. The thesis identified a new aged care business model typology, a framework and methods for integrating design in practice, offering new knowledge and approaches for leveraging design to realise social and economic outcomes

The challenges of adopting design-led innovative strategies in not for profits: the role of consumers, culture and employees

Major changes to regulations, funding and consumer demand in the Australian aged care industry are driving not for profits in this sector to reshape and rethink the services they offer and the ways in which they deliver their services to consumers. Many not for profit organisations facing these new challenges are also facing organisational cultural barriers in the development and implementation of innovative strategies. This paper presents a case study where one organisation, using design led innovation, explored consumer insights and employee values to find new ways to facilitate change