The multicriteria analysis for construction of benchmarkers to support the Clinical Engineering in the Healthcare Technology Management

In developing countries, approximately half of the healthcare equipments are not in full use and the main cause of this is the inadequate management of them. The Clinical Engineering might face this problem in the healthcare environment analyzing the equipment with a health technological process perspective to identify opportunities of improvements. Generally, the inadequate management is a result of lack of systemized and contextualized information about the health technological process. The effort to make an adequate management generates an increasing interest in the use of benchmarker. Currently, the benchmarkers used by the Clinical Engineering are not representative of a health technological process as a whole. Health technological process concept is stated in this article. The multicriteria analysis methodology MCDA (Multicriteria Decision Aid) is used to obtain benchmarkers and to identify opportunities of improvements, thus generating conditions for that the Clinical Engineering consolidates its relevant contribution for the healthcare.     

Joint-optimization of inventory policies on a multi-product multi-echelon pharmaceutical system with batching and ordering constraints

This paper presents a methodology to find near-optimal joint inventory control policies for the real case of a one-warehouse, n-retailer distribution system of infusion solutions at a University Medical Center in France. We consider stochastic demand, batching and order-up-to level policies as well as aspects particular to the healthcare setting such as emergency deliveries, required service level rates and a new constraint on the ordering policy that fits best the hospital’s interests instead of abstract ordering costs. The system is modeled as a Markov chain with an objective to minimize the stock-on-hand value for the overall system. We provide the analytical structure of the model to show that the optimal reorder point of the policy at both echelons is easily derived from a simple probability calculation. We also show that the optimal policy at the care units is to set the order-up-to level one unit higher than the reorder point. We further demonstrate that optimizing the care units in isolation is optimal for the joint multi-echelon, n-retailer problem. A heuristic algorithm is presented to find the near-optimal order-up-to level of the policy of each product at the central pharmacy; all other policy parameters are guaranteed optimal via the structure provided by the model. Comparison of our methodology versus that currently in place at the hospital showed a reduction of approximately 45% in the stock-on-hand value while still respecting the service level requirements.     

基于溢出效应与平台服务的竞争网络平台的销售模式研究

网络平台竞争与发展成为平台运营理论与实践的关键问题,急需解决。本文应用博弈论研究存在溢出效应和网络平台竞争环境下平台服务内生的网络平台销售模式选择,即网络平台商是允许制造商在其网络平台上直销产品的平台销售模式,还是网络平台商先从制造商购买产品再销售给消费者的转销模式。主要研究竞争网络平台的三种结构模型:双转销模式、双平台销售模式和混合模式。研究结果显示:网络平台商的利润随正溢出效应增加而增加,随负溢出效应增加而减少。当网络平台服务敏感程度较高且网络平台竞争较为激烈时,两个网络平台商均选择平台销售模式,形成占优均衡;此时,网络平台商获得最高利润,而且网络零售价和网络平台服务水平最高。     

环形路网上带有服务时长的在线TSP问题

为了提高快递揽件的时效性,需要对快递车辆进行有效调度。针对环形路网上服务时长以及需求无法预知的揽件问题,本文提出了以服务总时间尽可能短为目标的环形路网上带有服务时长的在线旅行商问题。用在线算法分析了此问题竞争比的下界,设计了两个在线算法并分析了各自的竞争比,结果表明服务时长可以改善在线车的性能。最后通过简单算例对两个算法进行说明,本文研究结论可以为环形路网上的快递车辆实时调度提供指导。     

An algorithm for achieving proportional delay differentiation

We consider the implementation of the proportional delay differentiation model with adaptive waiting time priority scheduler and we address the problem of finding the appropriate scheduler differentiation parameters that achieve this model. In this paper, we propose an algorithm that can compute an analytical solution of this problem.     

Estimating the population utility function: A parametric Bayesian approach

In this paper we consider the health utility index mark II for quantifying and describing a population’s health related quality of life over health states composed of multiple attributes. This measure can be used for various purposes such as evaluating the severity of the effect of a disease or comparing different treatment methods. We present a Bayesian framework for population utility estimation and health policy evaluation by introducing a probabilistic interpretation of the multi-attribute utility theory (MAUT) used in health economics. In doing so, our approach combines ideas from the MAUT and Bayesian statistics and provides an alternative method of modeling preferences and utility estimation.     

The optimal allocation of server time slots over different classes of patients

We present a model for assigning server time slots to different classes of patients. The objective is to minimize the total expected weighted waiting time of a patient (where different patient classes may be assigned different weights). A bulk service queueing model is used to obtain the expected waiting time of a patient of a particular class, given a feasible allocation of service time slots. Using the output of the bulk service queueing models as the input of an optimization procedure, the optimal allocation scheme may be identified. For problems with a large number of patient classes and/or a large number of feasible allocation schemes, a step-wise heuristic is developed. A common example of such a system is the allocation of operating room time slots over different medical disciplines in a hospital.     

A multi-criteria model for auditing a Predictive Maintenance Programme

Auditing tools can play a key role in the continuous improvement of maintenance policies, in particular to enhance predictive maintenance (PM). This paper proposes a multi-criteria model for auditing a Predictive Maintenance Programme (PMP) developed and implemented in the General Hospital of Ciudad Real (GHCR) in Spain. The model has a two-level structure, with top level auditing areas specified by second level auditing criteria on which the performance of the PMP should be appraised. This structure resulted from the analysis and discussion of an internal questionnaire to the management, technical and consulting staff of GHCR. This also guided the association of a performance scale with each criterion, describing several reference levels of accomplishment. Using the MACBETH (Measuring Attractiveness by a Categorical Based Evaluation Technique) approach, a hierarchical additive value model was constructed, with criteria weights and value scales derived from staff judgments of comparison of different reference levels and profiles of performance. This model enables managers to measure the performance of the PMP and its added value for the hospital, not only against each audit criterion individually, but also on each area and in overall terms. Integrated in a management “tableau de bord”, the model outputs permit the identification of PMP deficiencies requiring urgent intervention and corrective measures for its continuous improvement.     

An integrated approach to the one-dimensional cutting stock problem in coronary stent manufacturing

This paper presents a two-stage approach for pattern generation and cutting plan determination of the one-dimensional cutting stock problem. Calculation of the total number of patterns that will be cut and generation of the cutting patterns are performed in the first stage. On the other hand, the second stage determines the cutting plan. The proposed approach makes use of two separate integer linear programming models. One of these models is employed by the first stage to generate the cutting patterns through a heuristic procedure with the objective of minimizing trim loss. The cutting patterns obtained from Stage 1 are then fed into the second stage. In this stage, another integer linear programming model is solved to form a cutting plan. The objective of this model is to minimize a generalized total cost function consisting of material inputs, number of setups, labor hours and overdue time; subject to demand requirements, material availability, regular and overtime availability, and due date constraints. The study also demonstrates an implementation of the proposed approach in a coronary stent manufacturer. The case study focuses on the cutting phase of the manufacturing process followed by manual cleaning and quality control activities. The experiments show that the proposed approach is suitable to the conditions and requirements of the company.     

KIBS员工需求驱动下行为决策的模拟——基于风险偏好视角

随着经济全球化的发展,知识密集型服务业(KIBS)越来越受到学术界的关注。本文研究员工的风险偏好对KIBS员工合作与冲突行为的影响演化规律,目的在于为KIBS的管理决策提供支持。为了发现风险偏好对员工合作与冲突行为的影响,设计效用函数,并建立了风险规避和风险中性下KIBS员工合作与冲突行为决策模型,给出了KIBS员工在不同风险假定下的最优行为决策,对风险规避员工组织应当给予适度的激励,这样能够提高员工的合作程度。之后使用MATLAB2010进行模拟,并使用EXCEL对数据进行分析,发现:(1)风险偏好程度不同对员工的决策行为的影响程度不同;(2)对于员工应该给予适当的激励措施,以便提高员工的合作程度;(3)当任务的工作量达到一定程度,应当增加的是员工的固定收益而不是激励程度。