Construction of a multidimensional performance model based on the perceptions of hospital stakeholders

Moroccan University Hospital Centers are facing pressures and constraints caused by a constantly changing, complex and turbulent environment. In this context, the vision of the UHCs has evolved towards new concepts of modernization of their internal management. Hence the importance of evaluating their performance if they want to offer quality services to patients in a cost-effective manner. Furthermore, hospitals are characterized by an organizational duality that often puts the vision of care providers and managers in competition. Managing its performance is therefore a very complex process. The objective of this article is to design a performance model based on research-intervention as a strategy for accessing the field by adopting a transformative approach combining observation, documentary study and semi-structured interviews with the various hospital stakeholders in order to identify their multiple perceptions of performance. The interviews were carried out through interview guides aimed at internal hospital stakeholders (26 actors interviewed) as well as external stakeholders (10 actors interviewed) having an influence on the performance of the university hospital in order to define a model reconciling the culture of care and the managerial culture. The model constructed shows that hospital performance is a multidimensional construct that is close to two theoretical performance models, namely the BSC and the WHO PATH model. The combination of the two models allowed for a reconciliation between the visions of the different professional categories of hospitals and brought out a performance model that reconciles the care and managerial visions. This study will provide a practical solution for the hospital manager to pilot the performance of the organization and monitor the execution of strategic projects. It will also add value to the scientific literature on the adaptability of the tool to public hospitals.   Keywords : Perception, Performance hospitalière, Modèle multidimensionnel, Conciliation JEL Classification: I10, P17 Paper type: Empirical research: intervention-researchLes Centre hospitalo-universitaires marocains font face à des pressions et contraintes causées par un environnement en constante évolution, complexe et turbulent. Dans ce cadre, la vision des CHUs a évolué vers de nouveaux concepts de modernisation de leur gestion interne. D’où l’importance de l’évaluation de leur performance s’ils veulent offrir aux patients des services de qualité et un bon rapport coût-efficacité. Par ailleurs, l’hôpital est caractérisé par une dualité organisationnelle mettant souvent en concurrence la vision des prestataires de soins et celle des gestionnaires. Le pilotage de sa performance est par conséquent une démarche des plus complexes. L’objectif de cet article est de concevoir un modèle de performance en se basant sur la recherche-intervention comme stratégie d’accès au terrain en adoptant une visée transformative combinant l’observation, l’étude documentaire et des entretiens semi-directifs auprès des différentes parties prenantes de l’hôpital afin d’identifier leurs perceptions multiples de la performance. Les entretiens ont été réalisés à travers des guides d’entretiens destinés aux parties prenantes internes de l’hôpital (26 acteurs interviewés) ainsi qu’aux parties prenantes externes (10 acteurs interviewés) et ayant une influence sur la performance du CHU afin de définir un modèle conciliant entre la culture de soins et la culture managériale. Le modèle construit montre que la performance hospitalière est un construit multidimensionnel qui se rapproche de 2 modèles de performances théoriques à savoir la BSC et le modèle PATH de l’OMS, la combinaison des deux modèles a permis une conciliation entre les visions des différentes catégories professionnelles des hôpitaux et a fait ressortir un modèle de performance conciliateur entre vision soignante et vision gestionnaire. Cette étude apportera une solution pratique au gestionnaire hospitalier pour piloter la performance de l’organisation et suivre l’exécution des projets stratégiques. Aussi, elle apportera une valeur ajoutée à la littérature scientifique sur l’adaptabilité de l’outil à l’hôpital public.   Mots clés : Perception, Performance hospitalière, Modèle multidimensionnel, Conciliation Classification JEL : I10, P17 Type de l’article : Recherche appliquée: recherche-intervention&nbsp

On a combination of the 1-2-3 conjecture and the antimagic labelling conjecture

International audienceThis paper is dedicated to studying the following question: Is it always possible to injectively assign the weights 1, ..., |E(G)| to the edges of any given graph G (with no component isomorphic to K2) so that every two adjacent vertices of G get distinguished by their sums of incident weights? One may see this question as a combination of the well-known 1-2-3 Conjecture and the Antimagic Labelling Conjecture. Throughout this paper, we exhibit evidence that this question might be true. Benefiting from the investigations on the Antimagic Labelling Conjecture, we first point out that several classes of graphs, such as regular graphs, indeed admit such assignments. We then show that trees also do, answering a recent conjecture of Arumugam, Premalatha, Bača and Semaničová-Feňovčíková. Towards a general answer to the question above, we then prove that claimed assignments can be constructed for any graph, provided we are allowed to use some number of additional edge weights. For some classes of sparse graphs, namely 2-degenerate graphs and graphs with maximum average degree 3, we show that only a small (constant) number of such additional weights suffices

A novel fuzzy logic control for a zero current switching-based buck converter to mitigate conducted electromagnetic interference

This research provides a new control technique for mitigating conducted electromagnetic interference (EMI) in a buck converter designed for solar applications. Indeed, hard-switching direct current to direct current (DC-DC) converters, commonly used in industrial applications, pose a significant risk to the surrounding environment regarding electromagnetic compatibility (EMC). Usually, the fast-switching phase induces abrupt changes in current and voltage, which adds to substantial electromagnetic interference in both conducted and radiated modes and excessive auditory noise. An architecture based on the duality of soft-switching topology and fuzzy logic control technology is developed to address these issues. On the one hand, resonant circuit topologies are used to induce switches to achieve soft switching conditions, which subsequently lessen the effects of EMI. On the other hand, the adoption of fuzzy logic control technology is interesting since it can reduce electrical stresses during switching. Furthermore, the simulation results show that zero current switching (ZCS) soft-switching closed-loop fuzzy logic converters outperform typical open-loop converters and soft-switching closed-loop converters with proportional integral (PI) control in terms of EMC requirements

Response of sugarcane (Saccharum sp.) varieties to embryogenic callus induction and in vitro salt stress

Response of three varieties of sugarcane (Saccharum sp.) to callus induction, embryogenic callus production and in vitro salt tolerance was studied. For callus induction and embryogenic callus production, leaf bases segments were subjected to in vitro culture on Murashige and Skoog (MS) medium supplemented with 3 mg 1-1 2,4 Dichlorophenoxyacetic acid for 4 weeks. To evaluate salt tolerance of the varieties, growing calli were exposed after two subsequent subcultures (4 weeks each) to different concentrations of NaCl (0, 17, 34, 68 and 102 mM) added to the culture medium for 4 weeks. Comparision of genotypes was based on callus induction percentage, embryogenic callus production percentage and relative fresh weight growth (RFWG). For salt tolerance, necrosis percentage and relative fresh weight growth of callus were used. The three varieties responded well to callus induction with a percentage of induction about 82, 84 and 100% for CP70-321, NCo310 and CP65-357, respectively. The high percentages of embryogenic callus obtained for the three varieties indicated that these varieties have a high capacity for embryogenic callus production. Relative fresh weight growth of callus was about 1.076, 1.282 and 0.925 for CP70-321, NCo310 and CP65-357, respectively. NaCl effect resulted in calli necrosis and a reduction of their growth. However, growing calli derived from varieties CP70-321 and NCo310 showed less necrosis percentages and less relative fresh weight growth reduction under salt stress. They appeared to be more salt tolerant in vitro than CP65-357.African Journal of Biotechnology Vol. 4 (4), pp. 350-354, 200