Optimization of Decision Making in the Supply of Medicinal Gases Used in Health Care

María Carmen Carnero,Andrés Gómez

doi:10.3390/su11102952

Abstract

Systems that supply medicinal gases—oxygen, nitrous oxide and medical air—serve all care units of a hospital; for example, they feed distribution systems for operating theatres, neonatal and pediatric units, dialysis, X-ray, casualty, special tests, outpatients, etc. Systems for the provision of medicinal gases are therefore critical in guaranteeing hospital sustainability, since the functionality or availability of other hospital systems depends on them. Availability of 100% in these systems would avoid the need to reschedule patient appointments. It would also eliminate repeat testing, which poses risk to staff and patients, and could avoid affecting people’s lives through unavailability of, for example, operating theatres or intensive care units. All this contributes to a more rational resource consumption and an increase in quality of care both for the hospital itself and for patients and visitors. Although these systems are of vital importance to health care organizations, no previous work has been found in the literature that optimizes the technical decisions on supply in these systems. This research describes a model for these systems via continuous-time Markov chains. The results obtained are used in a multicriteria model constructed with the measuring attractiveness by a categorical-based evaluation technique (MACBETH) approach. In order to assess reliability when incorporating doubt or uncertainty via the MACBETH approach, the model has been validated by means of the fuzzy analytic hierarchy process. The aim is to obtain the best objective decision, with respect to the design of these systems, by analyzing the use of economic resources, the risks, and the impact on hospital activity, all with the aim of guaranteeing the best quality of care. The models constructed by means of MACBETH and the fuzzy analytic hierarchy process give, as the most suitable alternatives, duplicate the external supply in medical oxygen systems and maintain the original design conditions for supply systems of nitrous oxide and medicinal air.

Highlights

Medicinal gases are gases or mixtures of gases with known concentrations and impurity content intended for direct contact with humans or animal organisms
The distribution of medicinal gases in hospitals is usually carried out through systems involving long sections of tubing and many supply points originating in cryogenic tanks or bottles
The rankings of alternatives in each device were obtained by assigning the impact of each fundamental point of view (FPV) on each alternative

Summary

Introduction

Medicinal gases are gases or mixtures of gases with known concentrations and impurity content intended for direct contact with humans or animal organisms. They act pharmacologically, immunologically, or metabolically with the goal of preventing, diagnosing, treating, relieving, or curing illnesses and ailments [1]. When handling oxygen or performing maintenance work in the presence of it, a flame or spark may lead to a fire, which may affect care and noncare staff, patients, and visitors. Oxygen can impregnate the clothing of workers without leaving any sign, and so any source of ignition can cause it to burst into flame It is stored in cryogenic form, which may cause burns if it leaks. It is recommended that staff use suitable individual protective equipment (grease-free gloves, protective goggles, etc.) when handling these gases

Objectives

Methods

Results

Conclusion