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In the late nineteenth century, the anthropology curators of the Smithsonian Institution consulted their cataloguing systems and storerooms, assessing specimens in order to determine which could be designated as duplicate specimens and exchanged with museums domestically and abroad. The status of ‘duplicate’ for specimens was contingent on conceptions of similiarity impacted by disciplinary classification praxis, with particular emphasis on object nomenclature and formal attributes. Using rattles from Haida Gwaii collected between 1881 and 1885 by James Swan for the Smithsonian Institution, this article explores how anthropology curators designated rattles as exchangeable duplicate specimens. It considers cataloguing and spatial arrangements, as well as changing populations and formal characteristics of rattles, in order to explore how similarity was operationalized in the museum to produce duplicate anthropological specimens.

There are common problems in realistic medical consumables management such as inconsistent material names, irregular billing, extensive management of sub-warehouse. It is necessary to use information systems to achieve full-process, refined, traceable management of medical consumables. A cloud-based information management system of medical consumables is introduced, which connects consumables access, acceptance, consumption and settlement by matching UDI code, charge code and medical insurance code. The system connects to external systems such as charging system. The system realizes traceable management of full-process from manufacture, supplier to hospital material management department, and finally to consumption department. The management efficiency of medical consumables supply chain is improved.

A real-time model for monitoring the microbial quantity based on the microbial intrinsic fluorescence information of cucumber storeroom gas was established. Firstly, 3D fluorescence data of the storeroom gas were collected on different storage days. Secondly, the number of components of a parallel factor model was determined to be 3 using the core consistency diagnostic. Thirdly, parallel factor analysis was used to decompose the fluorescence data to obtain the excitation spectra, emission spectra and concentration scores of 3 components. The positions of the fluorescence peaks were consistent with the fingerprints of tryptophan-like, tyrosine-like and phenylalanine-like substances in the characteristic spectrum of each component. And then the prediction model was constructed by fitting the concentration scores of the 3 components with the microbial quantity, and the coefficient of determination was 98.27%, and the cross-validation determination coefficient could reach 91.97%. Finally, after integrating the predicted value of the microbial quantity and the total chromatism of the cucumber pericarp during cucumber storage, the spoilage date was determined to be the 7

The COVID-19 pandemic has highlighted the many challenges that provincial health systems have experienced while scaling health services to protect Canadians from viral transmission and support care for those who get infected. Supply chain capacity makes it possible for health systems to deliver care and implement public health initiatives safely. In this paper, we present emerging findings from a national research study that documents the key features of the fragility of the health supply chain evident across the seven Canadian provinces. Results suggest that the fragility of the health supply chain contributes to substantive challenges across health systems, thus limiting or precluding proactive and comprehensive responses to pandemic management. These findings inform strategies to strengthen supply chain capacity and performance in order to enable health systems to effectively respond to pandemic events.

Background During the coronavirus disease-2019 (COVID-19) pandemic, Italian hospitals faced the most daunting challenges of their recent history, and only essential therapeutic interventions were feasible. From March to April 2020, the Laboratory of Advanced Cellular Therapies (Vicenza, Italy) received requests to treat a patient with severe COVID-19 and a patient with acute graft-versus-host disease with umbilical cord-derived mesenchymal stromal cells (UC-MSCs). Access to clinics was restricted due to the risk of contagion. Transport of UC-MSCs in liquid nitrogen was unmanageable, leaving shipment in dry ice as the only option. Methods We assessed effects of the transition from liquid nitrogen to dry ice on cell viability; apoptosis; phenotype; proliferation; immunomodulation; and clonogenesis; and validated dry ice-based transport of UC-MSCs to clinics. Results Our results showed no differences in cell functionality related to the two storage conditions, and demonstrated the preservation of immunomodulatory and clonogenic potentials in dry ice. UC-MSCs were successfully delivered to points-of-care, enabling favourable clinical outcomes. Conclusions This experience underscores the flexibility of a public cell factory in its adaptation of the logistics of an advanced therapy medicinal product during a public health crisis. Alternative supply chains should be evaluated for other cell products to guarantee delivery during catastrophes.

Accurate demand forecasting is always critical to supply chain management. However, many uncertain factors in the market make this issue a huge challenge. Especially during the current COVID-19 outbreak, the shortage of certain types of medical consumables has become a global problem. The intermittent demand forecast of medical consumables with a short life cycle brings some new challenges, such as the demand occurring randomly in many time periods with zero demand. In this research, a seasonal adjustment method is introduced to deal with seasonal influences, and a dynamic neural network model with optimized model selection procedure and an appropriate model selection criterion are introduced as the main forecasting models. In addition, in order to reduce the impact of zero demand, it adds some input nodes to the neural network by preprocessing the original input data. Lastly, a modified error measurement method is proposed for performance evaluation. Experimental results show that the proposed forecasting framework is superior to other intermittent demand models.

Purpose This case study describes the development and empirical validation of an easy-to-implement practical framework for improving hospital pharmacy inventory management. Summary Research suggests various inventory optimization models, which can lead to cost reductions while maintaining adequate service levels; however, they are facing limited adoption in healthcare settings. The main barriers appear to be the high effort and complexity of implementation, the dependence on data that are not available or might not be in the right form, and the one-size-fits-all approach often followed without addressing healthcare sector–specific particularities. A research framework was developed by adapting relevant inventory models to the healthcare context using the concept of data segmentation on the basis of a three-dimensional classification of hospital pharmacy inventory items based on their relative importance, clinical criticality, and consumption pattern. Suitable replenishment policies were assigned to high-impact classes, and an integrated performance-measurement component assesses the framework’s effectiveness. The suggested approach was implemented and empirically tested at the pharmacy of a large public hospital using longitudinal data. The results demonstrate substantial improvements with respect to all of the selected key performance indicators and translate into inventory cost savings due to reduced stockholding costs and better synchronization of inventories to demand. Conclusion Use of standard software functionalities combined with targeted data segmentation efforts significantly improves hospital pharmacy inventory cost performance.

Objective: To identify the main challenges described and the management of the nursing team at the Central Sterile Material Center. Methodology: This is an integrative review of qualitative nature that used 12 articles in Portuguese and English extracted from the Scientific Electronic Library Online (Scielo) and Public Medline (PubMed), with the help of descriptors available in the Health Science Descriptors (DeCS) in Portuguese and English. Results: The nursing staff in front of the CME is routinely exposed to risks by chemical, physical and biological agents, as well as risk related to ergonomic factors. These health risk problems can be added to the work overload, and the lack of experience and training for the development of their activities. Conclusion: Given the discussion of this article, the nursing practice at the Central Sterilized Material Center is surrounded by challenges and problems that need more attention from the institutional management team, as well as from its technical leaders in the segments of personnel management and continuing education. Objetivo: Identificar los principales desafíos descritos y la gestión del equipo de enfermería de la Central de Material Esterilizado. Metodología: Se trata de una revisión integradora de corte cualitativo que utilizó 12 artículos en lengua portuguesa e inglesa extraídos de la Scientific Electronic Library Online (Scielo) y de Public Medline (PubMed), con ayuda de los descritos disponibles en los Descritores en Ciencia de la Salud (DeCS) en los idiomas portugués e inglés. Resultados: El equipo de enfermería antes del CME está expuesto de forma rutinaria a riesgos por agentes químicos, físicos y biológicos, así como a riesgos relacionados con factores ergonómicos. A estos problemas de riesgo para la salud se suma la sobrecarga de trabajo y la falta de experiencia y de formación para el desarrollo de sus actividades. Conclusión: Visto el debate del presente artículo, el ejercicio de la enfermería frente a la Central de Material Esterilizado está lleno de desafíos y problemas que requieren una mayor atención por parte del equipo gestor institucional, así como de sus responsables técnicos en los segmentos de gestión de personal y educación continua. Objetivo: Identificar os principais desafios descritos e o gerenciamento da equipe de enfermagem diante da Central de Material Esterilizado. Metodologia: Trata-se de uma revisão integrativa de cunho qualitativa que utilizou 12 artigos na língua português e inglesa extraídos da Scientific Electronic Library Online (Scielo) e Public Medline (PubMed), com auxilio dos descritores disponíveis nos Descritores em Ciência da Saúde (DeCS) nos idiomas português e inglês. Resultados: A equipe de enfermagem diante da CME está rotineiramente exposta à riscos por agentes químicos, físicos e biológicos, bem como risco relacionados a fatores ergonômicos. Esses problemas de risco à saúde podem ser somados com a sobrecarga de trabalho, e a falta de experiência e ausência treinamento para o desenvolvimento de suas atividades. Conclusão: Haja visto a discussão do presente artigo, o exercício da enfermagem frente a Central de Material Esterilizado é cercado de desafios e problemas que precisam de maior atenção por parte da equipe gestora institucional, assim como de seus responsáveis técnicos nos segmentos de gestão de pessoal e educação continuada.

Background: An efficient inventory control system would help optimize the use of resources and eventually help improve patient care. Objectives: The study aimed to find out the surgical consumables using always, better, and control (ABC) and vital, essential, and desirable (VED) technique as well as calculating the lead time of specific category A and vital surgical consumables. Methods: This was a descriptive, record-based study conducted from January to March 2016 in the surgical stores of the All India Institute of Medical Sciences, New Delhi. The study comprised all the surgical consumables which were procured during the financial year 2014–2015. Stores ledger containing details of the consumption of the items, supply orders, and procurement files of the items were studied for performing ABC analysis and calculating the lead time. A list of surgical consumables was distributed to the doctors, nursing staff, technical staff, and hospital stores personnel to categorize them into VED categories after explaining them the basis for the classification. Results: ABC analysis revealed that 35 items (14%), 52 items (21%), and 171 items (69%) were categorized into A (70% annual consumption value [ACV]), B (20% ACV), and C (10% ACV) category, respectively. In the current study, vital items comprised the majority of the items, i.e., 73% of the total items and essential (E) category of items comprised 26% of all the items. The average internal, external, and total lead time was 17 days (range 3–30 days), 25 days (range 5–38) and 44 days (range 18–98 days), respectively. Conclusions: Hospitals stores need to implement inventory management techniques to reduce the number of stock-outs and internal lead time.

Health systems worldwide are challenged by the growing costs and demands of delivering high-quality healthcare services that are safe and cost-effective to support health and wellness for populations. This paper proposes a system-level transformation of clinical environment infrastructure to advance quality and strengthen patient safety at sustainable costs. Evidence of the impact and value of the clinically integrated supply chain strategy is emerging in three global health systems: Alberta Health Services (Canada), Mercy (US) and the National Health Service (UK) to inform a strategic roadmap for health system leaders to leverage supply chain infrastructure in clinical environments as a strategic asset to strengthen quality, safety and cost.

This case study provides evidence of the impact of the Scan4Safety program demonstrated in six National Health Service (NHS) Trusts, funded to achieve supply chain transformation to improve safety, quality and performance in the NHS in England. All 154 Trusts were mandated to adopt GS1 global standards for supply chain processes and Pan-European Public Procurement On-Line standards in 2014 to enable digital transactions across the NHS. The outcomes of this case reflect the early implementation of the program infrastructure in surgical theatre and cardiac programs. Outcomes include a 4:1 return on investment and projected savings of £1 billion pounds when scaled across the NHS.

With the continuous improvement of the difficulty of surgery, we need to investigate and analyze the current situation, to understand the structure and related attributes of medical consumables. Rely on the information construction of medical consumables; Improve the supervision method and further improve the refined management effect; Establish multi-modal procurement management; Improve management methods; Maximize the benefits of transformation structure and study the trace management of medical consumables in the key areas of the hospital's full life process at the same time. Provide data decision-making services for hospitals through the early warning management of medical consumables based on clinical quality management, and use tools such as HB-HTA to further construct a reasonable evaluation system for medical consumables.

Highlights • The COPIL allowed the restructuring of the ICU in record time to double its capacity. • The CCP, integrated in the COPIL and already a member of the ICU team for a few years, provided an essential link between the ICU and the pharmacy during the COVID-19 pandemic. • The CCP implemented actions to avoid health products shortages, to secure practices and played a key role in the critical analysis of emerging published data in COVID-19 potential treatments., On January 4 2020, the World Health Organization (WHO) reported the emergence of a cluster of pneumonia cases in Wuhan, China due to a new coronavirus, the SARS-CoV-2. A few weeks later, hospitals had to put in place a series of drastic measures to deal with the massive influx of suspected COVID-19 (COronaroVIrus Disease) patients while securing regular patient care, in particular in the intensive care units (ICU). Since March 12th, 77 of the 685 COVID-19 patients admitted to our hospital required hospitalization in the ICU. What are the roles and the added-value of the critical care pharmacist during this period? His missions have evolved although they have remained focused on providing health services for the patients. Indeed, integrated into a steering committee created to organize the crisis in the intensive care units, the role of the clinical pharmacist was focused on the organization and coordination between ICU and the pharmacy, the implementation of actions to secure practices, to train new professionals and the adaptation of therapeutic strategies. He participated to literature monitoring and increased his involvement in the clinical research team. He provided a link between the ICU and the pharmacy thanks to his knowledges of practices and needs.

Background Health systems need timely and reliable access to essential medicines and health commodities, but problems with access are common in many settings. Mobile technologies offer potential low‐cost solutions to the challenge of drug distribution and commodity availability in primary healthcare settings. However, the evidence on the use of mobile devices to address commodity shortages is sparse, and offers no clear way forward. Objectives Primary objective To assess the effects of strategies for notifying stock levels and digital tracking of healthcare‐related commodities and inventory via mobile devices across the primary healthcare system Secondary objectives To describe what mobile device strategies are currently being used to improve reporting and digital tracking of health commodities To identify factors influencing the implementation of mobile device interventions targeted at reducing stockouts of health commodities Search methods We searched CENTRAL, MEDLINE Ovid, Embase Ovid, Global Index Medicus WHO, POPLINE K4Health, and two trials registries in August 2019. We also searched Epistemonikos for related systematic reviews and potentially eligible primary studies. We conducted a grey literature search using mHealthevidence.org, and issued a call for papers through popular digital health communities of practice. Finally, we conducted citation searches of included studies. We searched for studies published after 2000, in any language. Selection criteria For the primary objective, we included individual and cluster‐randomised trials, controlled before‐after studies, and interrupted time series studies. For the secondary objectives, we included any study design, which could be quantitative, qualitative, or descriptive, that aimed to describe current strategies for commodity tracking or stock notification via mobile devices; or aimed to explore factors that influenced the implementation of these strategies, including studies of acceptability or feasibility. We included studies of all cadres of healthcare providers, including lay health workers, and others involved in the distribution of health commodities (administrative staff, managerial and supervisory staff, dispensary staff); and all other individuals involved in stock notification, who may be based in a facility or a community setting, and involved with the delivery of primary healthcare services. We included interventions aimed at improving the availability of health commodities using mobile devices in primary healthcare settings. For the primary objective, we included studies that compared health commodity tracking or stock notification via mobile devices with standard practice. For the secondary objectives, we included studies of health commodity tracking and stock notification via mobile device, if we could extract data relevant to our secondary objectives. Data collection and analysis For the primary objective, two authors independently screened all records, extracted data from the included studies, and assessed the risk of bias. For the analyses of the primary objectives, we reported means and proportions where appropriate. We used the GRADE approach to assess the certainty of the evidence, and prepared a 'Summary of findings' table. For the secondary objective, two authors independently screened all records, extracted data from the included studies, and applied a thematic synthesis approach to synthesise the data. We assessed methodological limitation using the Ways of Evaluating Important and Relevant Data (WEIRD) tool. We used the GRADE‐CERQual approach to assess our confidence in the evidence, and prepared a 'Summary of qualitative findings' table. Main results Primary objective For the primary objective, we included one controlled before‐after study conducted in Malawi. We are uncertain of the effect of cStock plus enhanced management, or cStock plus effective product transport on the availability of commodities, quality and timeliness of stock management, and satisfaction and acceptability, because we assessed the evidence as very low‐certainty. The study did not report on resource use or unintended consequences. Secondary objective For the secondary objectives, we included 16 studies, using a range of study designs, which described a total of eleven interventions. All studies were conducted in African (Tanzania, Kenya, Malawi, Ghana, Ethiopia, Cameroon, Zambia, Liberia, Uganda, South Africa, and Rwanda) and Asian (Pakistan and India) countries. Most of the interventions aimed to make data about stock levels and potential stockouts visible to managers, who could then take corrective action to address them. We identified several factors that may influence the implementation of stock notification and tracking via mobile device. These include challenges tied to infrastructural issues, such as poor access to electricity or internet, and broader health systems issues, such as drug shortages at the national level which cannot be mitigated by interventions at the primary healthcare level (low confidence). Several factors were identified as important, including strong partnerships with local authorities, telecommunication companies, technical system providers, and non‐governmental organizations (very low confidence); availability of stock‐level data at all levels of the health system (low confidence); the role of supportive supervision and responsive management (moderate confidence); familiarity and training of health workers in the use of the digital devices (moderate confidence); availability of technical programming expertise for the initial development and ongoing maintenance of the digital systems (low confidence); incentives, such as phone credit for personal use, to support regular use of the system (low confidence); easy‐to‐use systems built with user participation (moderate confidence); use of basic or personal mobile phones to support easier adoption (low confidence); consideration for software features, such as two‐way communication (low confidence); and data availability in an easy‐to‐use format, such as an interactive dashboard (moderate confidence). Authors' conclusions We need more, well‐designed, controlled studies comparing stock notification and commodity management via mobile devices with paper‐based commodity management systems. Further studies are needed to understand the factors that may influence the implementation of such interventions, and how implementation considerations differ by variations in the intervention., Plain language summary Using mobile phones to keep track of medicines and notify superiors when more are needed What is the aim of this review? In this Cochrane Review, we aimed to assess if health workers would have better access to medicines and other supplies, if they used mobile phones or other mobile devices to keep track of the amount of supplies they had available, and to notify superiors when they needed more supplies. We also described how health workers are currently using these mobile systems, and what factors influence their use. Key messages We do not know if using mobile phones to keep track of medical supplies gives primary healthcare workers better access to these supplies. This is because the certainty of the available evidence was very low. However, the evidence does point to several factors that could influence the implementation of these systems. These include the sharing of data across all levels of the health system; reliable access to electricity and the internet; easy‐to‐use and functional phones and systems; good technical support; and sufficient training and supervision. Well‐functioning digital systems will only succeed if medical supplies are actually available. What was studied in the review? Healthcare workers need medicines, vaccines, syringes, and other supplies to do their jobs properly. But many healthcare settings, particularly in poor countries, often lack supplies because governments cannot afford to buy them, or because they do not have good systems for distributing them to the right places at the right time. To address some of these problems, managers and health workers can use mobile phones to keep track of supplies, decide how much more to order and when, and let people at higher levels of the system know when supplies are running low. The main aim of our review was to find out if health workers who use these mobile systems had better access to supplies than health workers using other systems, or no systems at all. We also looked at how these mobile systems are being used in primary healthcare settings, and the factors that influences their use. What are the main results of the review? We found one study from Malawi that measured the effect of mobile phone systems on access to medicines and supplies in health facilities. However, we do not know whether these systems improve access or not, because the certainty of this evidence was very low. We found 16 studies conducted in African and Asian countries, in which study authors identified several factors that could help to set up systems successfully. ‐ Study authors suggested that allowing healthcare officials at all levels of the healthcare system to see the data could help them to respond on time and avoid supply shortages (low confidence). ‐ Study authors highlighted how poor access to electricity and internet could make it difficult for health workers to charge phones and send data (moderate confidence). ‐ Study authors pointed to the importance of user‐friendly systems, built with user participation (moderate confidence); access to technical experts to develop and maintain the system (low confidence); proper support and supervision for health workers (moderate confidence); and training of health workers in how to use the mobile system itself (moderate confidence). ‐ One author suggested that adding phone credits to health workers’ mobile phones for their personal use, could motivate them, and improve their use of the system (low confidence). Study authors also suggested several mobile phone functions that could be helpful to health workers using these systems. These included phones that could take pictures and map geographic locations, systems that allowed toll‐free text messaging, two‐way communication, and easy sharing of information (low confidence). But study authors also suggested that health workers might find it easier to use basic phones and maintain their own personal phones (low confidence). ‐ Study authors emphasised that digital notification systems will only give health workers better access to supplies if the supplies are actually available at the district or national level (low confidence). How up‐to‐date is this review? We searched for studies that had been published up to August 2019.

This paper introduces the design and development of a light-weighted medical equipment management system in hospital based on structured information flow architecture, to collect and analyze data in medical equipment lifecycle management processes. It applies co-operative work flows both online and off-line to achieve high quality data collection, and to increase the efficiency for clinical personals and clinical engineers. This system manages to apply the UDI system, implements the intelligent access to medical equipments, uses data analysis to provide intelligent services. It will boost the quality control management and information construction synchronously.

Coronavirus disease 2019 (COVID-19) pandemic has put a huge pressure on healthcare systems across the globe, more so in developing countries. Not only patients of acute febrile illness and respiratory problems but also patients with other acute and chronic diseases are facing challenges while seeking healthcare, getting laboratory investigations done and obtaining medications. Healthcare workers have their challenges including limited resources, lack of personal protective equipments, and fear of contracting COVID-19. Resource husbandry, which refers to the judicious use of available stocks, is a vital concept that needs to be promoted during such challenging times to combat the shortage of medical resources while simultaneously providing effective treatment to the patients. Some easily implementable concepts of resource husbandry can have a significant impact and result in minimising trouble for many patients during a challenging time.

Opening Up New Supply Chains A Massachusetts economic-development agency assembled a diverse team to help manufacturers open up new supply chains and start producing materials needed to alleviate c...

In order to improve the efficiency of medical instrumentation management in hospital, reduce the management cost and save the human cost, this study analyzes the problems in the traditional hospital medical instrumentation management system, and develops a new system based on cloud computing. Through the characters of the SaaS Service Platform, the system improves the flow efficiency of the medical instrumentation in hospital, saves deployment and operating system costs, and improves the people's work efficiency.

The construction of county and district medical community is an important measure for high-quality medical resources to "double sink and improve". In this study, we have initially constructed a medical equipment quality control system for members of the regional medical community. The current situation of lack of professional medical equipment management personnel and quality control equipment in primary medical institutions has been alleviated, the quality control level of medical equipment in primary medical institutions has been improved, and a new management model for quality control of primary medical equipment has been explored.

IntroductionHospital supply chains are complex systems ensuring flow of products/services to satisfy patients. The aim of this exploratory study is to improve the Maltese health care system’s efficiency using supply chain management principles in three hospital settings. The theoretical basis underlying the study is the supply chain decision-making framework.MethodsUsing observation and focus groups, the following steps were undertaken: (i) mapping healthcare supply chain processes and identifying challenges; (ii) understanding competitive strategy through implied demand uncertainty; (iii) deriving supply chain strategies through supply chain drivers; (iv) optimizing healthcare supply chain (right balance between cost and responsiveness); (v) identifying critical success factors for healthcare supply chains.ResultsIn line with their competitive and supply chain strategies, the three settings have well-defined primary goals, stakeholders’ needs/demands/expectations, as well as clear-cut, albeit some similar, criteria and sub-criteria for improving the quality and quantity of their services. The trade-offs between efficiency and responsiveness for the supply chain drivers are distinctive and in line with their competitive strategies, hence achieving the desired fit with the healthcare supply chain strategies.ConclusionsBy adopting healthcare supply chain principles, there should be improved services in each setting, which in turn should lead to system-wide results.

Background The role of socioeconomic factors as determinants of oncology consultations for advanced cancers in public payer health care systems is unknown. This study examined the association between material deprivation and receipt of cancer care among patients with advanced gastrointestinal (GI) cancer. Methods This was a population-based, retrospective cohort study of noncuratively treated patients with GI cancer diagnosed from 2007 to 2017. Material deprivation, representing income, quality of housing, education, and family structure, was defined as quintiles on the basis of 2016 census data. The first consultation with a radiation oncologist or medical oncologist and the receipt of 1 or more instances of radiation and/or chemotherapy were measured in the year after diagnosis. Adjusted, cause-specific Cox proportional hazards competing risk analyses were used (competing event = death). Results This study included 34,022 noncuratively treated patients with GI cancer. Consultation rates ranged from 67.8% for those in the most materially deprived communities to 73.5% for those in the least materially deprived communities. Among those with a consult, rates of cancer-directed therapy ranged from 58.5% for patients in the most materially deprived communities to 62.3% for patients in the least materially deprived communities. Patients living in the most materially deprived communities were significantly less likely to see a radiation and/or medical oncologist after a diagnosis (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.85-0.92) and significantly less likely to receive radiation and/or chemotherapy (HR, 0.80; 95% CI, 0.76-0.85) than those living in the least materially deprived communities. Conclusions This study identified socioeconomic disparities in accessing cancer care. Continued efforts at examining and developing evidence-based policies for interventions that begin before or at the time of oncologist consultation are required to address root causes of inequities.

Aim: Analysis of the use of ophthalmic instruments during surgical procedures in order to propose a material management method. Method: Mixed method study, sequential exploratory design, performed from January to June 2015, at a university hospital in southern Brazil. First, a qualitative approach was held from brainstorming and field observation. Themes were grouped into thematic categories. By connection, the quantitative stage happened through matrix arrangement and linear programming, culminating in the instrument management proposal. Results: Given categories - instruments reorganization according to the time of the surgical procedure and the need surgical instruments for in each procedure - guided the definition of existing restrictions and application of mathematical models. There was an average reduction of 13.10% in the number of surgical instruments per tray and an increase of 17.88% in surgical production. Final considerations: This proposal allowed the rationalization and optimization of ophthalmic instruments, favoring sustainability of the organization. RESUMEN Objetivo: Analizar el uso de instrumentos oftalmológicos durante los procedimientos quirúrgicos y proponer un método de gestión de materiales. Método: Estudio de método mixto, exploratorio secuencial, realizado entre enero y junio de 2015, en un hospital universitario en el sur de Brasil. Primero, se realizó un enfoque cualitativo a partir de la reflexión y la observación de campo. Los temas se agruparon en categorías temáticas. Por conexión, la etapa cuantitativa ocurrió por arreglos de matrices y programación linear, culminando con la propuesta de gestión de instrumentales. Resultados: Las categorías - reorganización del instrumental conforme tiempo del procedimiento quirúrgico y necesidad de piezas para cada procedimiento - orientaron la definición de las restricciones existentes y aplicación de los modelos matemáticos. Verificó una reducción media del 13,10% en el número de piezas por bandejas y aumento del 17,88% de la producción quirúrgica. Consideraciones finales: Esta propuesta permitió la racionalización y optimización de instrumentos oftalmológicos, favoreciendo la sostenibilidad de la organización. RESUMO Objetivo: Analisar o uso de instrumentais oftalmológicos durante os procedimentos cirúrgicos e propor um método de gerenciamento de materiais. Método: Estudo de método misto, exploratório sequencial, realizado entre janeiro e junho de 2015, em hospital universitário no sul do Brasil. Primeiramente, fez-se uma abordagem qualitativa a partir de brainstorming e observação de campo. Os temas foram agrupados em categorias temáticas. Por conexão, a etapa quantitativa aconteceu por arranjos de matrizes e programação linear, culminando à proposta de gerenciamento de instrumentais. Resultados: As categorias - reorganização do instrumental conforme tempo do procedimento cirúrgico e necessidade de peças para cada procedimento - orientaram a definição das restrições existentes e aplicação dos modelos matemáticos. Verificou-se uma redução média de 13,10% no número de peças por bandejas e aumento de 17,88% da produção cirúrgica. Considerações finais: Esta proposta permitiu a racionalização e otimização de instrumentais oftalmológicos, favorecendo a sustentabilidade da organização.

Objetivo: Analisar o uso de instrumentais oftalmológicos durante os procedimentos cirúrgicos e propor um método de gerenciamento de materiais. Método: Estudo de método misto, exploratório sequencial, realizado entre janeiro e junho de 2015, em hospital universitário no sul do Brasil. Primeiramente, fez-se uma abordagem qualitativa a partir de brainstorming e observação de campo. Os temas foram agrupados em categorias temáticas. Por conexão, a etapa quantitativa aconteceu por arranjos de matrizes e programação linear, culminando à proposta de gerenciamento de instrumentais. Resultados: As categorias - reorganização do instrumental conforme tempo do procedimento cirúrgico e necessidade de peças para cada procedimento - orientaram a definição das restrições existentes e aplicação dos modelos matemáticos. Verificou-se uma redução média de 13,10% no número de peças por bandejas e aumento de 17,88% da produção cirúrgica. Considerações finais: Esta proposta permitiu a racionalização e otimização de instrumentais oftalmológicos, favorecendo a sustentabilidade da organização Aim: Analysis of the use of ophthalmic instruments during surgical procedures in order to propose a material management method. Method: Mixed method study, sequential exploratory design, performed from January to June 2015, at a university hospital in southern Brazil. First, a qualitative approach was held from brainstorming and field observation. Themes were grouped into thematic categories. By connection, the quantitative stage happened through matrix arrangement and linear programming, culminating in the instrument management proposal. Results: Given categories - instruments reorganization according to the time of the surgical procedure and the need surgical instruments for in each procedure - guided the definition of existing restrictions and application of mathematical models. There was an average reduction of 13.10% in the number of surgical instruments per tray and an increase of 17.88% in surgical production. Final considerations: This proposal allowed the rationalization and optimization of ophthalmic instruments, favoring sustainability of the organization Objetivo: Analizar el uso de instrumentos oftalmológicos durante los procedimientos quirúrgicos y proponer un método de gestión de materiales. Método: Estudio de método mixto, exploratorio secuencial, realizado entre enero y junio de 2015, en un hospital universitario en el sur de Brasil. Primero, se realizó un enfoque cualitativo a partir de la reflexión y la observación de campo. Los temas se agruparon en categorías temáticas. Por conexión, la etapa cuantitativa ocurrió por arreglos de matrices y programación linear, culminando con la propuesta de gestión de instrumentales. Resultados: Las categorías - reorganización del instrumental conforme tiempo del procedimiento quirúrgico y necesidad de piezas para cada procedimiento - orientaron la definición de las restricciones existentes y aplicación de los modelos matemáticos. Verificó una reducción media del 13,10% en el número de piezas por bandejas y aumento del 17,88% de la producción quirúrgica. Consideraciones finales: Esta propuesta permitió la racionalización y optimización de instrumentos oftalmológicos, favoreciendo la sostenibilidad de la organización

The purpose of this article is to shed light on hospital supply expenses, which form the second largest expense category after payroll and hold more promise for improving cost-efficiency compared to payroll. However, limited research has rigorously scrutinized this cost category, and it is rarely given specific consideration across cost-focused studies in health services publications. After reviewing previously cited estimates, we examine and independently validate supply expense data (collected by the American Hospital Association) for over 3,500 U.S. hospitals. We find supply expenses to make up 15% of total hospital expenses, on average, but as high as 30% or 40% in hospitals with a high case-mix index, such as surgery-intensive hospitals. Future research can use supply expense data to better understand hospital strategies that aim to manage costs, such as systemization, physician–hospital arrangements, and value-based purchasing.

Storing bio-specimens in adequate temperatures is an important task in hospitals. Usually an assigned employee records manually the temperatures of the hospital cold storages such as refrigerators and freezers that keep them at regular intervals. In this research, a low power wireless Bluetooth Low Energy network is applied where the central monitoring personal computer, receives the temperature data and stores in a database. The system consists of many beacons which are wirelessly sending the measured temperature data, and the central monitoring computer which allows the user to monitor that data. In the case of wireless signals getting blocked due to obstacles, repeaters called bridges send the data to the central computer forming a so-called scatter net. Once the data is received by the Bluetooth module connected to the monitoring computer, an application saves the data into a database. This web application forms a website where the users holding the authentication information can log in and monitor the temperature data in the form of tables and graphs. The same information can be viewed by a smartphone and a person in charge receives a warning SMS message. This system also provides a scheduled backup system where the database is automatically backed up periodically. The suggested system has the advantage of managing reagent records with reduced manpower whilst coping for emergency situations automatically.

Aiming at the different characteristics of the various stages of medical equipment life cycle in hospital, research on the targeted and meticulous management mode.Divides the whole life cycle of medical equipment in hospital into four phases, which are the selection demonstration period, purchase acceptance period, maintenance period, and retirement disposal period, and comparison with human fetal period, infant stage, adult stage and old age.With the meticulous management mode, the service quality of medical equipment in hospital has been improved, and the service benefits have been enhanced.According to the respective characteristics of different stages, the corresponding meticulous management mode is implemented to make the management more scientific and standardized, and the operation is safer and more reliable, which escorts the whole life cycle of medical equipment in hospital.

The intelligent infusion management system is established through intelligent internet of things, by using the gravity sensor, acceleration sensor and other equipment.Establish an infusion management platform based on B/S architecture. Combined with the intelligent terminal and get the major values, including:the infusion speed, the remaining liquid and so on. Besides, it can integrate with the HIS, EMR and PDA.It has solved the data collection of the whole infusion process, realized the real-time visualization during the infusion, and improved the quality of nursing management.In the paper, it has been used in wards more than 2 years, which has reduced the workload of the infusion and improved the satisfaction of patients. At the same time, it has provided the infusion big data collection and statistics for the research and auxiliary treatment.

In order to improve the quality of medical equipment after-sales service quality and improve the quality of medical equipment maintenance, this paper discusses the establishment of an evaluation index system to evaluate the quality of ultrasonic diagnostic equipment. From the three aspects of maintenance results, maintenance process and maintenance coverage, the quality of the post-maintenance quality of hospital ultrasound diagnostic equipment manufacturers is objectively evaluated.

With the continuous improvement of the hospital diagnosis and treatment level and the continuous renewal of medical equipment in China, the mismatch between medical equipment management personnel training and the introduction of medical equipment, the development of medical technology and the requirements of modern hospital management is increasingly prominent. This article is based on a current situation survey of medical equipment and management personnel at all levels of hospitals in Shanghai. It discusses joint with professional colleges and universities, and gives suggestions about needs, objectives and practice of personnel training. It provides references to improve the personnel training of medical equipment.

The Mercy case study documents evidence of a clinically integrated supply chain strategy implemented in the peri-operative programs in three of the 46 hospitals in the Mercy system. Mercy became the first US health system to achieve "the perfect order," a supply chain industry standard with end-to-end integration of supply chain best practice in the Mercy system. To date, the Mercy strategy has demonstrated revenue growth of $8 billion, a 70% reduction in Never Events, a 33.3% reduction in supplies cost/case and a 29.5% reduction in labour costs/case in the perioperative programs in three hospitals.

Using antiretrovirals (ARVs) as tracer products, we identified the following key practices that may affect supply chain management at the facility level: order verification, actions taken when stock is received, changes in prescription and dispensing due to ARV stock-out, actions to ensure patient adherence, and communication with other affiliated facilities and higher-level supply chain management. We propose a set of indicators to measure these practices., Background: While measuring, monitoring, and improving supply chain management (SCM) for antiretrovirals (ARVs) is understood at many levels of health systems, a gap remains in the identification and measurement of facility-level practices and behaviors that affect SCM. This study identifies practices and behaviors that are associated with SCM of ARVs at the hospital level and proposes new indicators for measurement. Methods: We performed an in-depth literature review to identify facility-level practices and behaviors and existing indicators that are associated with SCM. We used the United States Agency for International Development's 2013 National Supply Chain Assessment Toolkit to define 7 supply chain function areas to frame the study. Qualitative, semistructured key informant and focus group interviews were conducted in hospitals with health professionals from Cameroon, Namibia, and Swaziland to understand facility-level practices and behaviors. Results: Using the results from 54 key informant and focus group interviews from 12 hospitals, we identified 30 practices and behaviors that may affect ARV SCM at the facility level. The following practice areas were particularly associated with SCM: order verification, actions taken when ARV stock is received, changes in prescription and dispensing due to ARV stock-out, actions to ensure patient adherence, and communication with other affiliated facilities and higher-level SCM. We subsequently developed measurable indicators for future research. Conclusion: This study characterizes facility-level practices and behaviors that can affect ARV SCM. It also identifies gaps in their measurement. While this study uses ARVs as a tracer medicine to understand gaps in practices at the facility level, many of the findings are more broadly applicable to other medicines in an integrated setting. This study provides real-world evidence and the groundwork for further research to characterize the link between 30 facility-level practices and behaviors and ARV SCM at the facility and central levels.

In supply chain literature, supplier evaluation and selection problem is one of the most studied subjects because of the significant roles of suppliers in terms of the chain’s sustainability and profitability. Therefore, it is important for organizations to adopt a systematic way to evaluate and select the best supplier according to their respective criteria in today’s competitive environment. Multicriteria decision-making methods provide for this need of organizations because determination of an appropriate supplier selection is a multicriteria decision-making (MCDM) problem essentially. Although a lot of applications of these methods for supplier evaluation and selection can be seen in the literature, studies in the health-care sector are insufficient. Hospitals in the health-care sector also have to consider their supplier-related decisions to decrease risks and threads which affect their effectiveness. The aim of this study was to fill this gap by providing different hybrid models for selecting the best supplier for hospitals. Supplier evaluation and selection process start with recognizing the related criteria according to the studies in the literature. Analytic hierarchy process (AHP) method is deployed to weight the criteria, and suppliers are listed via technique for order preference by similarity to ideal solution (TOPSIS), elimination and choice translating reality English (ELECTRE), grey relational analysis (GRA), and simple additive weighting (SAW) methods. The main aim of this study was to present different hybrid MCDM methods and show their efficiency and consistency with each other. In this study, hybrid multicriteria decision-making models (AHP-TOPSIS, AHP-ELECTRE, AHP-GRA, and AHP-SAW) are presented and compared. The results show that the presented hybrid methods in this study are consistent with each other and give the same ranking for the selection of the best supplier. It can be considered as a useful guideline for hospitals.

Background. Inefficient storage and sourcing of routinely required consumables located on procedure trolleys result in time wasted when preparing for common procedures in emergency centres (ECs), contributing to poor efficiency and quality of care.Objectives. We designed a novel purpose-orientated procedure trolley and evaluated its impact on time spent on procedure preparation and efficiency.Methods. In an urban EC, eight participants were measured each day over 24 days, once using the standard setup and once using the modified procedure setup. During each simulation, efficiency markers were assessed (time spent on procedure preparation, steps taken, stops made, and time spent opening drawers to locate required items).Results. The mean (standard deviation) time required to collect the required items for intravenous cannulation and blood sampling from the purpose-orientated trolley was 22.7 (3.66) seconds, compared with 49.2 (15.45) seconds using the standard trolley. There was a significant difference between the two trolleys in mean collection time (p

Introduction: Using mobile phones for communication in emergency departments is a common practice; however, several studies have demonstrated that they may act as vectors for bacteria and viruses. This study evaluated the effectiveness of plastic wrapping in decreasing bacterial contamination on mobile phone surfaces. Method: We used culture dishes and a luminometer to detect bacterial colonies and contamination on the phone surfaces. Result: Our experiment showed that bacterial colonies exist on mobile phones before and after work. We found that wiping with 75% alcohol sanitizers effectively reduces the number of colonies on either a mobile phone or a temporary plastic covering. In addition, we found that bacterial colonies do not contaminate or adhere to plastic wrap any easier than to mobile phones. Conclusion: These results demonstrated the effectiveness of plastic wrap for protecting mobile phone surfaces against bacterial colonization. In addition, applying a layer of plastic wrap protects the phone from potential damage due to the alcohol.