The Effectiveness of Healthcare System Resilience during the COVID-19 Pandemic: A Case Study.

Introduction: The outbreak of the COVID-19 pandemic was a period of uncertainty and stress for healthcare managers due to the lack of knowledge (about the transmission of the virus, etc.) and also due to the lack of uniform organisational and treatment procedures. It was a period where the ability to prepare for a crisis, to adapt to the existing conditions, and to draw conclusions from the situation were of critical importance to keep ICUs (intensive care units) operating. The aim of this project is to compare the pandemic response to COVID-19 in Poland during the first and second waves of the pandemic. This comparison will be used to identify the strengths and weaknesses of the response, including challenges presented to health professionals and health systems and ICUs with COVID-19 patients according to the European Union Resilience Model (2014) and the WHO Resilience Model (2020). The WHO Resilience model was suitable to the COVID-19 situation because it was developed based on this experience. Methods: A matrix of 6 elements and 13 standards assigned to them was created using the EC and WHO resilience guidelines. Results: Good governance in resilient systems ensures access to all resources without constraints, free and transparent flow of information, and a sufficient number of well-motivated human resources. Conclusions: Appropriate preparation, adaptation to the existing situation, and effective management of crisis situations are important elements of ensuring the resilience of ICUs.

Implementation of Lean Management Tools Using an Example of Analysis of Prolonged Stays of Patients in a Multi-Specialist Hospital in Poland.

Healthcare institutions in Poland constantly encounter challenges related both to the quality of provided services and to the pressures associated with treatment effectiveness and economic efficiency. The implemented solutions have a goal of improving the service quality of lowering the continuously increasing operational costs. The aim of this paper is to present the application of Lean Management (LM) tools in a Polish hospital, which allowed for the identification of prolonged stays as one of the main issues affecting the service costs and the deteriorating financial results of the hospital. The study was conducted in the neurology department and involved an analysis of data for the whole of 2019 and the first half of 2022. In addition, surveys were conducted among the medical staff to help identify the main causes of prolonged stays. Methods of data analysis and feasible solutions were developed in order to improve the economic efficiency of the unit. The analysis shows that the application of LM tools may contribute to improvement in the functioning of hospitals and that further studies should focus on the development of the method to evaluate efficiency of the implemented solutions intended at shortening the hospital stays of the patients.

Experimental identification of wheel-surface model parameters: various terrain conditions.

Since the wheel interaction with a certain terrain cases (asphalt, concrete) are known and well described in case of straightforward motion and non-slip and slip cornering conditions, the skid-steered wheeled vehicles case needs to be analyzed. Side-slip for various attack angle has to be investigated. The main area of interest of research that is shown in the project is energy demand calculation of skid-steered wheeled vehicles in various terrain conditions. Certain cases of all-electric vehicles with individual electric motors per wheel demand a precise assessment of longitudinal and lateral forces in order to perform the fully controlled turn. Experimental stand designed and developed by authors allows to test the wheel-surface interaction for various terrain conditions and different driving directions. Test data were acquired for dry and wet sand and granite pavement. Traction and side forces were acquired and used to identify the wheel-soil interaction model parameters for unpropelled wheel. Results in a form of time series including longitudinal and lateral forces show the relation between attack angle, load and surface conditions in terms of stick and slip phenomenon that is essential for skid-steering dynamics calculations. Measurement results are then used for calculation of longitudinal and lateral forces coefficients as a function of attack angle and vertical load. Test were performed in natural environment, thus they are affected by changeable conditions. Multiple runs are used for elimination of that influence. Described experiments are a part of the project that includes results generalization using test validated FEM model. Described work is not intended to develop new ground-tire interaction models, it is focused on numerically efficient traction effort calculation method for various conditions including passive mode-unpropelled wheel.

Implementation of Lean Management in a Multi-Specialist Hospital in Poland and the Analysis of Waste.

At the beginning of the 21st century, Lean Management (LM) tools were introduced into the healthcare sector around the world. In Poland, there are still few LM implementations, and they are not of a comprehensive nature. The aim of this article is to present the application of the LM concept in a hospital in Poland as a tool for the identification and analysis of waste and its impact on the process of organizing the provision of medical services on the example of improvements in the process of patient admission. In the period from 1 July 2019 to 31 December 2019, a project of LM implementation was carried out at the Provincial Specialist Hospital in Wroclaw. The project was based on the method of value-stream mapping and 5Why. Standardized interviews (before and after the project) were conducted with people from the hospital management and middle-level managers. The implementation of LM tools resulted in the identification of a number of wastes, which have been divided into groups. The most important waste was paper medical documentation. Its change to an electronic form allowed for a better use of human capital resources; savings included 2.3 nursing positions and 1.09 medical staff positions.