Suchergebnisse

Purpose
– As reimbursements fall and costs for services climb, organizations are forced to follow the painful motto of doing more with less. A solution could be the adaptation of industrial business process improvement (BPI) methods such as Lean to the hospital setting (HS). The purpose of this paper is to analyze if Lean approaches related in the literature provide sufficient methodological support for other practitioners to reproduce the reported results.


Design/methodology/approach
– The authors analyzed the published Lean literature in the HS using a methodological maturity-level framework and what the authors defined as the 11 characteristic activities of BPI.


Findings
– The literature analysis reveals that a Lean approach with a high-methodological maturity level that includes the 11 characteristic activities of BPI has never been reported. Considering this, the paper suggests a meta model for a high-methodological maturity-level Lean method based on the characteristic activities of BPI.


Originality/value
– This is the first study on the Lean approach in the HS that evidences the absence of a robust Lean methodology in the literature. For Lean to be adopted and implemented by hospital practitioners a structured robust method should be provided.

1 pag. -- This is a 2020 ARVO Annual Meeting abstract. ; Support COFUND Multiply: European Research Council (ERC) under European Union's Horizon 2020 research and innovation programme H2020-MSCA-COFUND-2015-FP-713694; Spanish government grant FIS2017-84753-R ; Peer reviewed

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019 ; Support European Project Multiply H-2020-MSCA-COFUND-2015 Ref. 713694, Spanish Government Grant FIS2017-84753-R, European Project Presbyopia ERC-2011-AdG Ref. 294099, European Project Imcustomeye H2020-ICT-2017 Ref. 779960, BES-2015-072197 ; Peer reviewed

AbstractThe treatment of municipal wastewater produces clean water and sewage sludge (MSS), the management of which has become a serious problem in Europe. The typical destination of MSS is to spread it on land, but the presence of heavy metals and pollutants raises environmental and health concerns. Bioconversion mediated by larvae of black soldier fly (BSFL) Hermetia illucens (Diptera, Stratiomyidae: Hermetiinae) may be a strategy for managing MSS. The process adds value by generating larvae which contain proteins and lipids that are suitable for feed and/or for industrial or energy applications, and a residue as soil conditioner. MSS from the treatment plant of Ladispoli (Rome province) was mixed with an artificial fly diet at 50% and 75% (fresh weight basis) to feed BSFL. Larval performance, substrate reduction, and the concentrations of 12 metals in the initial and residual substrates and in larval bodies at the end of the experiments were assessed. Larval survival (> 96%) was not affected. Larval weight, larval development, larval protein and lipid content, and waste reduction increased in proportion the increase of the co-substrate (fly diet). The concentration of most of the 12 elements in the residue was reduced and, in the cases of Cu and Zn, the quantities dropped under the Italian national maximum permissible content for fertilizers. The content of metals in mature larvae did not exceed the maximum allowed concentration in raw material for feed for the European Directive. This study contributes to highlight the potential of BSF for MSS recovery and its valorization. The proportion of fly diet in the mixture influenced the process, and the one with the highest co-substrate percentage performed best. Future research using other wastes or by-products as co-substrate of MSS should be explored to determine their suitability.

13 pags., 6 figs. ; Optical elastography is undergoing extensive development as an imaging tool to map mechanical contrast in tissue. Here, we present a new platform for optical elastography by generating sub-millimetre-scale mechanical contrast from a simple digital camera. This cost-effective, compact and easy-to-implement approach opens the possibility to greatly expand applications of optical elastography both within and beyond the field of medical imaging. Camera-based optical palpation (CBOP) utilises a digital camera to acquire photographs that quantify the light intensity transmitted through a silicone layer comprising a dense distribution of micro-pores (diameter, 30–100 µm). As the transmission of light through the micro-pores increases with compression, we deduce strain in the layer directly from intensity in the digital photograph. By pre-characterising the relationship between stress and strain of the layer, the measured strain map can be converted to an optical palpogram, a map of stress that visualises mechanical contrast in the sample. We demonstrate a spatial resolution as high as 290 µm in CBOP, comparable to that achieved using an optical coherence tomography-based implementation of optical palpation. In this paper, we describe the fabrication of the micro-porous layer and present experimental results from structured phantoms containing stiff inclusions as small as 0.5 × 0.5 × 1 mm. In each case, we demonstrate high contrast between the inclusion and the base material and validate both the contrast and spatial resolution achieved using finite element modelling. By performing CBOP on freshly excised human breast tissue, we demonstrate the capability to delineate tumour from surrounding benign tissue. ; Te authors acknowledge the facilities and scientifc and technical assistance of the Australian Microscopy & Microanalysis Research Facility at the Centre for Microscopy, Characterisation & Analysis, the University of Western Australia, a facility funded by the University, State and Commonwealth Governments. Tis work was supported by research grants from the Australian Research Council, the Department of Health, Western Australia and the Cancer Council, Western Australia; a research contract with OncoRes Medical; the Herta Massarik PhD Scholarship for Breast Cancer Research; and the War Widows Guild of Western Australia Top-up Scholarship for Research into Breast Cancer.