Grado de madurez gerencial en la ejecución de proyectos de la empresa DLA construcciones SAS de la ciudad de Villavicencio

La gestión de proyectos debe ser una práctica administrativa adelantada en las empresas que así lo requieran, un ejemplo de ello son las del sector de la construcción. Entre las empresas llamadas a implementar un modelo óptimo de gestión en la ejecución de proyectos, se encuentra la empresa DLA Construcciones S.A.S., organización villavicense cuyo objeto social es la edificación y construcción de apartamentos, edificios entre otras construcciones en la región. Este estudio busca determinar el grado de madurez de la empresa DLA Construcciones S.A.S. respecto a la gestión de proyectos, para ello se tomó como punto de partida los procesos definidos en la Guía Técnica Colombiana GTC ISO 21500 y los parámetros de la metodología PMBOK. De esta manera, se adelantó un estudio definido bajo una metodología de enfoque mixto (cuanti-cualitativo), apoyado en la investigación de tipo descriptiva; para lo cual se diseñó un cuestionario de autoevaluación, con base al OPM3 del PMI® y la NTC – ISO 21500, el cual fue aplicado a 6 colaboradores de la organización, quienes son responsables de la gestión de proyectos en DLA Construcciones S.A.S; con la información obtenida y el análisis de los resultados, se halló que esta empresa posee grado de madurez en gestión de proyectos intermedio bajo, respecto a algunos de los procesos reunidos dentro de los grupos temáticos que se ejecutan dentro de la organización. En consideración se planteó una propuesta estratégica que le permita priorizar e implementar buenas prácticas de gestión de proyectos basadas en la GTC ISO 21500 y el modelo de madurez en gestión de proyectos de Harol Kerzner.Project management should be an advanced administrative practice in companies that require it, an example of which are those of the construction sector. Among the companies called to implement an optimal management model in the execution of projects is the company DLA Construcciones S.A.S., an organization from Villavicencio whose corporate purpose is the construction and construction of apartments, buildings and other constructions in the region. This study seeks to determine the degree of maturity of the company DLA Construcciones S.A.S. with respect to project management. For this purpose, the processes defined in the Colombian Technical Guide GTC ISO 21500 and the parameters of the PMBOK methodology were taken as a starting point. In this way, a study defined under a methodology of mixed approach (quantitative-qualitative) was advanced, supported by descriptive research; For which a self-assessment questionnaire was designed, based on the OPM3 of the PMI® and the NTC - ISO 21500, which was applied to 6 collaborators of the organization, who are responsible for the project management in DLA Construcciones SAS, with the Information obtained and the analysis of the results, it was found that this company has a degree of maturity in low intermediate project management, regarding some of the processes gathered within the thematic groups that are executed within the organization. In consideration, a strategic proposal was proposed that would allow it to prioritize and implement good project management practices based on ISO 21500 GTC and Harol Kerzner's project management maturity model

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030