Proyecto de factibilidad para el desarrollo de un sistema de franquicia en el restaurante de comida rápida Los Pingüinos en la ciudad de Ambato. 2020

La investigación se realizó mediante un estudio exploratorio y una investigación descriptiva para registrar y recolectar información de la situación en la que se encontraba la empresa, para establecer los aspectos más importantes a tomar en cuenta para la implementación del sistema de franquicia, con la ayuda de un manual. La investigación de corte transversal permitió determinar el nicho o muestra, para obtener información descriptiva, mediante la aplicación de encuestas, fichas de observación y entrevistas. El establecimiento ubicado en la ciudad de ambato en el cual se realizó el estudio, se evidencio mediante fichas de observación la funcionalidad del equipo en cocina, tanto en utensilios, maquinaria e insumos, recetas estándar, stock de bodega, horario de trabajo; mediante entrevistas y encuestas al cliente interno se identificó el nivel de desempaño en sus actividades y se encontró elementos para mejorar su trabajo, como, un buen ambiente laboral y un inventario completo para el desarrollo de sus deberes, se estableció el sistema de cobro, la emisión de comandas a cocina, protocolo de atención al público; en el área administrativa y financiera, se ha trabajado con un sistema contable de libro menor y mayor, proyección de ventas y control de gastos, alianzas estratégicas, buena relación con el personal y los proveedores, reclutamiento, contratación e inducción de personal. Se aplicó encuestas al cliente externo para conocer la tendencia del mercado actual, utilizando gráficos estadísticos de barras en donde se pudo encontrar una gran aceptación por el establecimiento de comida rapida con un menú variado, servicio a domicilio, envases amigables con el medio ambiente, oferta de promociones semanales. El manual de funciones es el resultado de todo este proyecto, que permite seguir una guía, para una mejora continua, con información estandarizada con ilustraciones de las actividades, métodos, técnicas que debe cumplir cada área de trabajo.The research was conducted by an exploratory and descriptive research to record and collect information about the situation in which the company was to establish the most important aspects to consider for the implementation of the franchise system, with the help of a manual. The cross-sectional investigation made it possible to determine the niche or sample, to obtain descriptive information, through the application of surveys, observation cards and interviews. The establishment located in the city of Ambato in which the study was carried out, the functionality of the kitchen equipment was evidenced by observation cards, both in utensils, machinery and supplies, standard recipes, warehouse stock, working hours; through interviews and surveys to the internal customer the level of performance identified in their activities and elements found to improve their work, like, a good working environment and a complete inventory for the performance of their duties, the charging system was established, issuance of orders to the kitchen, protocol for customer service; in the administrative and financial area, it has worked with retail accounting system and general ledger, sales projections and cost control, strategic alliances, good relations with staff and suppliers, recruitment, hiring and induction of personnel. It applied surveys the external customer to know the trend of the current market, using graphical statistical bar where could find wide acceptance by the establishment of fast food with a varied menu, home delivery, friendly packaging with the environment, offering weekly promotions. The manual functions are the result of this project, which allows you to follow a guide for continuous improvement, standardized information with illustrations of activities, methods, techniques must meet each work area

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease