A Business Process Reengineering of the Surgical Path through Lean Technique: The Real Case Study of a Midsize Italian Hospital

This period of pandemic has had important consequences on the flow and the entire organization of any hospital. In particular, the number of accesses to the emergency room has increased, with the consequent urgent need to reorgani ze it quickly. The model proposed in this paper allows to respond to these needs by freeing not only shifts of nursing staff but also surgical staff. This workforce can then be relocated in the emergency room or of the intensive care unit who are in fact at the forefront of emergency management. The aim of this study conducted by the authors is to analyze, inside the context of a midsize Italian hospital, the actual organization model, and then to approach it by Business Process Reengineering (BPR) methodology with the goal to propose a KPI management system that evaluates the efficiency of the whole surgical path. The second objective of the study is to verify if the Operating Rooms (ORs) are properly sized to cover the surgical workload or if it would be necessary to build new ORs (answer to this question is the project mandate by Surgical Wards Chiefs). The last objective is to implement a flexible to cope with emergency situations such as a pandemic. The main result is the approximate maintenance of surgical annual activity (8169 vs 7889). The fewer resources required can be reallocated to deal with emergencies such as the current COVID-19 pandemic. In fact, the surgical shifts decreased during the test case from 464 versus 365 (-15,32%). The rooms’ utilization coefficient rose from 41% to over 52%, whereas the surgeons’ utilization coefficient rose to 61% (with values over 68% for parallel shifts). The results achieved demonstrate that improving efficiency of surgical processes is feasible and a systematic approach allows to respond to new global health challenges. © 2022, AIDI - Italian Association of Industrial Operations Professors. All rights reserved.

Engineering Solutions 4.0 in the fight against the spread of Covid 19 A new Methodology including processes, procedures and devices

Thanks to the principles and technologies made available by Industry 4.0, the authors conceptualized and modeled a new strategy, capable of making an effective contribution to the problem of limiting contagion from Covid19 today, and tomorrow from any possible other type virus, bacteria or pathogen agent introduced by subjects who, although unaware of being vectors, develop the infection only after their access to the places of stay (Hotel, office, Infrastructure, etc.) where they go to reside. The key point of the strategy is a 4.0 thermoscanner, created by the authors, which is positioned in appropriately chosen locations of the settlement and an innovative method of disinfection of the same implemented by means of UV-C rays and Ozone in the gaseous state, produced by a machine, also conceptualized and developed by the authors, capable of reproducing the Chapman Cycle with the associated advantages. Therefore, it is operated an absolute disinfection based on a reversible cycle Oxygen-Ozone-Oxygen, with a prompt re-habitability of the treated rooms, with minimal treatment costs and without the use of expensive and unhealthy chemicals or wet water vapor (incompatible with paper and electronics). This technology was described in the paper “Sanitizing of Confined Spaces Using Gaseous Ozone Produced by 4.0 Machines” presented by the authors to the WCE 2021 IAENG Congress and awarded with the “Best Paper Award of the 2021 International Conference of Systems Biology and Bioengineering”. In the presence of a Person with a fever, the thermoscanner automatically launches an alert to the site Safety officers, who confine him to an isolated place and make the Health Institutions intervene and take it over. © 2022, AIDI - Italian Association of Industrial Operations Professors. All rights reserved.

Sanitizing of Confined Spaces Using Gaseous Ozone Produced by 4.0 Machines

A fundamental aspect of the fight against the Coronavirus and against any other virus, is represented by the sanitization of the sites and objects contained therein. This operation is normally carried out using mixtures of ozone and steam and it is certainly effective but also limited due the damages that the vapor can cause to rooms and objects. The following paper introduce machines able to overcome this issue thanks to innovative systems based on the principles of Engineering 4.0. Those systems reproduce the Chapman cycle in the to-be sanitized environments which allows producing ozone in a gaseous state, in the proper quantity and for the time necessary for sanitization. At the end of the operation, the ozone will be converted back into oxygen, leaving the environment re-habitable by humans and pets in a short time. The operation has low costs and times and guarantees positive results. This is therefore a real revolution to be considered today against the COVID-19. © 2021 Newswood Limited. All rights reserved.

The COVID-19 epidemic and evaluating the corresponding responses to crisis management in refugees: a system dynamic approach

Purpose: The COVID-19 pandemic is a new crisis in the world that caused many restrictions, from personal life to social and business. In this situation, the most vulnerable groups such as refugees who are living in the camps are faced with more serious problems. Therefore, a system dynamic approach has been developed to evaluate the effect of applying different scenarios to find out the best response to COVID-19 to improve refugees’ health and education. Design/methodology/approach: The interaction of several health and education factors during an epidemic crisis among refugees leads to behavioral responses that consequently make the crisis control a complex problem. This research has developed an SD model based on the SIER model that responds to the public health and education system of Syrian refugees in Turkey affected by the COVID-19 virus and considered three policies of isolation, social distance/hygiene behavior and financial aid using the available data from various references. Findings: The findings from the SD simulation results of applying three different policies identify that public health and education systems can increase much more by implementing the policy of social distance/hygiene behavior, and it has a significant impact on the control of the epidemic in comparison with the other two responses. Originality/value: This paper contributes to humanitarian organizations, governments and refugees by discussing useful insights. Implementing the policy of social distance and hygiene behavior policies would help in a sharp reduction of death in refugees group. and public financial support has improved distance education during this pandemic. © 2021, Emerald Publishing Limited.