Construccion de un prototipo sobre la base de indicadores de gestion y tecnologia OLAP para el apoyo a la toma de decisiones en el area de operacion comercial en Aguas Nuevo Sur del Maule S.A

89 p.La Empresa Aguas Nuevo Sur del Maule S.A. (ANSMI S.A.), como toda empresa, determina objetivos estratégicos para guiar su gestión, los cuales deben estar directamente relacionados con los objetivos de cada área funcional. Dentro de la organización de la empresa, se encuentra el área de Servicio al Cliente la que se divide en dos sub-áreas que son: Subgerencia de Operación Comercial y Subgerencia de Desarrollo Comercial. El presente proyecto se desarrolla sobre la Subgerencia de Operación Comercial. Ella utiliza como base los objetivos estratégicos definidos por la empresa para definir sus propias metas. El cumplimiento de estas, se mide a través de un conjunto de Indicadores de Gestión que se enmarca dentro de un proceso de Control de Gestión, el que permite monitorear el proceso de Plantación Estratégica y determinar las desviaciones para poder tomar las medidas correctivas que correspondan. La finalidad del proyecto consiste en desarrollar el prototipo de un sistema informático de apoyo a la toma de decisiones que permita obtener el conjunto de indicadores conducentes a evaluar el cumplimiento de los objetivos planteados para el área de Operación Comercial en ANSM S.A. El conjunto de indicadores debe conformar una familia coherente de criterios, la cual cumpla con las condiciones de: Exhaustividad, Cohesión y No Redundancia (Bernard, 1996). Con ello se espera que el conjunto de indicadores sea suficiente para medir el cumplimiento de los objetivos del área en cuestión, para tomar las decisiones necesarias que permitan lograr los resultados deseados

Intubation Practices and Adverse Peri-intubation Events in Critically Ill Patients from 29 Countries

Importance: Tracheal intubation is one of the most commonly performed and high-risk interventions in critically ill patients. Limited information is available on adverse peri-intubation events. Objective: To evaluate the incidence and nature of adverse peri-intubation events and to assess current practice of intubation in critically ill patients. Design, Setting, and Participants: The International Observational Study to Understand the Impact and Best Practices of Airway Management in Critically Ill Patients (INTUBE) study was an international, multicenter, prospective cohort study involving consecutive critically ill patients undergoing tracheal intubation in the intensive care units (ICUs), emergency departments, and wards, from October 1, 2018, to July 31, 2019 (August 28, 2019, was the final follow-up) in a convenience sample of 197 sites from 29 countries across 5 continents. Exposures: Tracheal intubation. Main Outcomes and Measures: The primary outcome was the incidence of major adverse peri-intubation events defined as at least 1 of the following events occurring within 30 minutes from the start of the intubation procedure: cardiovascular instability (either: systolic pressure <65 mm Hg at least once, <90 mm Hg for >30 minutes, new or increase need of vasopressors or fluid bolus >15 mL/kg), severe hypoxemia (peripheral oxygen saturation <80%) or cardiac arrest. The secondary outcomes included intensive care unit mortality. Results: Of 3659 patients screened, 2964 (median age, 63 years; interquartile range [IQR], 49-74 years; 62.6% men) from 197 sites across 5 continents were included. The main reason for intubation was respiratory failure in 52.3% of patients, followed by neurological impairment in 30.5%, and cardiovascular instability in 9.4%. Primary outcome data were available for all patients. Among the study patients, 45.2% experienced at least 1 major adverse peri-intubation event. The predominant event was cardiovascular instability, observed in 42.6% of all patients undergoing emergency intubation, followed by severe hypoxemia (9.3%) and cardiac arrest (3.1%). Overall ICU mortality was 32.8%. Conclusions and Relevance: In this observational study of intubation practices in critically ill patients from a convenience sample of 197 sites across 29 countries, major adverse peri-intubation events - in particular cardiovascular instability - were observed frequently