A simulation model for predicting hospital occupancy for Covid-19 using archetype analysis.

COVID-19 pandemic has sent millions of people to hospitals worldwide, exhausting on many occasions the capacity of healthcare systems to provide care patients required to survive. Although several epidemiological research works have contributed a variety of models and approaches to anticipate the pandemic spread, very few have tried to translate the output of these models into hospital service requirements, particularly in terms of bed occupancy, a key question for hospital managers. This paper proposes a tool for predicting the current and future occupancy associated with COVID-19 patients of a hospital to help managers make informed decisions to maximize the availability of hospitalization and intensive care unit (ICU) beds and ensure adequate access to services for confirmed COVID-19 patients. The proposed tool uses a discrete event simulation approach that uses archetypes (i.e., empirical models of trajectories) extracted from empirical analysis of actual patient trajectories. Archetypes can be fitted to trajectories observed in different regions or to the particularities of current and forthcoming variants using a rather small amount of data. Numerical experiments on realistic instances demonstrate the accuracy of the tool's predictions and illustrate how it can support managers in their daily decisions concerning the system's capacity and ensure patients the access the resources they require.

Applying Value Stream Mapping to Improve the Delivery of Patient Care in the Oncology Day Hospital.

Improving the delivery of patient care is an ongoing challenge in the National Health Service (NHS). This challenge is not insignificant in the process of chemotherapy administration for oncology patients. The present research is motivated by a public Spanish hospital in which oncology patients receive medical care in the Oncology Day Hospital (ODH). At the ODH, oncology patients receive different health services by different specialists on a single day. Any discoordination in patient flow will contribute to longer waiting times and stays in the ODH. As oncology patients tend to have special health conditions, any extra time in the hospital is a source of risk and discomfort. This study applies value stream mapping methodology in a Spanish ODH to improve this situation, reducing hospital waiting times and shorting the length of stay. For that purpose, the path of the oncology patients is mapped and the current state of the system is analyzed. Working at takt time and levelling the workload are proposed for improving the working conditions for healthcare personnel. As a result, the quality of service for oncology patients who need a well-defined care profile is improved. The singular characteristics of the Spanish NHS make it challenging to implement new ways of working, so this study has significant theoretical and managerial implications offering directions in which improvement is possible.

Empowerment and Employee Well-Being: A Mediation Analysis Study.

This study examines the relationship between structural and psychological empowerment and its effects on employees' psychological, physical, and social well-being. Despite the quantity of previously published works, empirical evidence about these relationships in the workplace is scarce. We developed a mediation model in which structural empowerment predicts employee well-being via psychological empowerment. We based our study on the EU-27 data from the 6th European Working Conditions Survey (EWCS). Data were collected from a questionnaire administered face-to-face to a random sample of employees and the self-employed representative of the working population in the European Union (number of valid responses in this study: 23,468). The effects of the relationships among the variables considered were evaluated using Partial Least Squares (PLS). Results indicate that structural empowerment was positively related to psychological empowerment, which was positively related to job satisfaction, work engagement, and social well-being. The expected relationships for work stress and physical well-being were not found.

The Role of Value Stream Mapping in Healthcare Services: A Scoping Review.

Lean healthcare aims to manage and improve the processes in the healthcare sector by eliminating everything that adds no value by improving quality of services, ensuring patient safety and facilitating health professionals' work to achieve a flexible and reliable organization. Value Stream Mapping (VSM) is considered the starting point of any lean implementation. Some papers report applications of VSM in healthcare services, but there has been less attention paid to their contribution on sustainability indicators. The purpose of this work is to analyze the role of VSM in this context. To do so, a scoping review of works from recent years (2015 to 2019) was done. The results show that most applications of VSM reported are in the tertiary level of care, and the United States of America (USA) is the country which leads most of the applications published. In relation with the development of VSM, a heterogeneity in the maps and the sustainability indicators is remarkable. Moreover, only operational and social sustainability indicators are commonly included. We can conclude that more standardization is required in the development of the VSM in the healthcare sector, also including the environmental indicators.

Scoping Review of Kaizen and Green Practices: State of the Art and Future Directions.

Given the importance that environmental management is acquiring, the main aim of this work is to know what the state of the field kaizen and green practices is at present. A systematic narrative review is conducted in accordance with the PRISMA Statement. Two databases (Web of Science and Scopus) were searched. Finally, after applying the defined inclusion and exclusion criteria, 19 documents were analyzed. Based on the results, it might be concluded that, despite the growing interest in the relationship between kaizen and green practices, this is a topic in the early stages of development, with a clear predominance of case studies. It is, therefore, necessary to develop more research on this kaizen and green issue as improving environmental management is undeniably becoming a must in today's competitive environment. For instance, more research is needed on the application of kaizen tools as results obtained so far seem not to be conclusive. Additionally, more academic and rigorous studies should be developed on this topic as many of the analyzed papers seem to be clearly created for dissemination among practitioners, some of them lacking the traditional academic structure and scientific method during their development.

Changes in the Association between European Workers' Employment Conditions and Employee Well-being in 2005, 2010 and 2015.

The aim of this paper is to study whether there is a change in the association between employment conditions and European employees' well-being at three different time points (the years 2005, 2010 and 2015), characterized by different socio-economic contexts. We based our study on the European Working Conditions Survey. Logistic regressions were performed by adjusting for gender, age, level of education, seniority, occupation, establishment size, activity sector and economic activity. Adjusted odds ratios (ORadj) and 95% confidence intervals (95% CI) are reported. In general, the association between employment conditions (type of employment contract, supervising, weekly working hours, long working hours, other paid jobs, working at weekends or doing shifts) and well-being indicators (anxiety, fatigue and dissatisfaction) seemed to continue being harmful, or had even changed for the worse since 2005. The paper briefly discusses the possible reasons for this situation and calls for future research on the relation between well-being and irregular type of contracts, self-employment, supervising others or hours worked per week. Some implications in public health policies are also discussed.

Spanish Validation of the Leader Empowering Behavior Questionnaire (LEBQ).

The concept of empowering leadership (EL) has attracted widespread academic and practical interest and different questionnaires have been developed to measure it. However, there are no instruments to measure EL in the Spanish language. This article presents the translation, adaptation, and validation of a scale to measure this construct. In addition, it analyzes the relationship between managers' EL and employees' job satisfaction. In turn, the study analyzes whether employees who participate in a greater number of continuous improvement (CI) programs have supervisors who favor more empowering behaviors. A total of 739 participants with various occupations from different companies that have implemented CI processes filled out the Spanish version of the Leader Empowering Behavior Questionnaire (LEBQ-sp). Two different subsamples were used to test the relationships between the LEBQ and job satisfaction and CI, by means of Pearson's correlation coefficient and analysis of variance, making it possible to provide evidence about the validity of the Spanish LEBQ. The confirmatory factor analysis supported the original structure of the six-factor model. The factors show a high level of internal consistency, as well as sufficient convergent and discriminant validity. Moreover, the results show that the more companies invest in formal CI programs, the more important it is for their leaders to adapt their behavior by displaying more EL. The LEBQ-sp is a valid and reliable instrument for use in research and a useful tool for applied purposes in the context of Spanish-speaking countries.

Three risk of bias tools lead to opposite conclusions in observational research synthesis.

OBJECTIVES: The aim of this study was to assess the agreement and compare the performance of three different instruments in assessing risk of bias (RoB) of comparative cohort studies included in a health psychology meta-analysis. STUDY DESIGN AND SETTING: Three tools were applied to 28 primary studies included in the selected meta-analysis: the Newcastle-Ottawa Scale, quality of cohort studies (Q-Coh), and risk of bias in nonrandomized studies of interventions (ROBINS-I). RESULTS: Interrater agreement varied greatly from tool to tool. For overall RoB, 75% of the studies were rated as low RoB with the Newcastle-Ottawa Scale, 11% of the studies with Q-Coh, and no study was found to be at low RoB using ROBINS-I. No influence of quality ratings on the meta-analysis results was found for any of the tools. CONCLUSION: Assessing RoB using the three tools may lead to opposite conclusions, especially at low and high levels of RoB. Domain-based tools (Q-Coh and ROBINS-I) provide a more comprehensive framework for identifying potential sources of bias, which is essential to improving the quality of future research. Both further guidance on the application of RoB tools and improvements in the reporting of primary studies are necessary.