Identification Of Improvement Opportunities Research Articles

Study of the principles and strategic directions of cultivation and use of industrial hemp in Ukraine

The article examines: brief information about hemp cultivation and its origin, the current state of cultivation of industrial hemp in Ukraine and identification of opportunities for improvement; the experience of the EU countries and the obligations of Ukraine; principles of the United Nations (UN) conference; horizons of legalization and deregulation of hemp cultivation in the legislative field of Ukraine; key principles of the development of modern hemp cultivation in Ukraine and their verification. The basic components of the strategy for the production, processing and use of industrial hemp in Ukraine should include: expanded information policy, accelerated development of regulatory and institutional foundations for supporting the exploitation of all parts of industrial hemp, ensuring sustainable development of the industry, flexibility of the industrial strategy and improvement of the policy of stimulating the industry.

Management information system, a strategic tool to enhance decision making in micro and small businesses

Background Nowadays, companies face continuous changes, which force them to be more versatile by managing large volumes of data, which do not always become relevant information for decision making. Therefore, the objective of this research is to implement a management information system to improve administrative management in micro and small businesses. Method it was developed under the approach of the agile methodology “SCRUM” following its 5 phases; In addition, the visual basic programming language in ASP.NET was used for the development of the source code and Microsoft SQL Server 2019 and its extensions: Ma-nagement Studio for data processing, “Integration Services” for the migration to the new dimensional model, Reporting Services for reports and Looker Studio for dashboards. Results The implementation of a management information system based on a dashboard allowed managers to obtain relevant information quickly and easily, optimizing decision-making times. In addition, the system allowed for homogeneous comparisons by level, which made it easier to identify deviations in commercial goals and the implementation of corrective actions such as adjustments in goals, changes in productivity, among others. Another result was the visualization of the monthly behavior of the financial system, which helped management structure short, medium and long-term strategies; in addition to the export of reports for “offline” analysis, which facilitates the work of employees in the field. Conclusions This allows reducing the time invested in generating reports, improving the efficiency and precision of the analysis. In addition, it has facilitated the identification of opportunities for improvement in administrative and commercial management, specifically in average productivity and the weighted average rate per advisor.

Evaluation of a Structured Review Process for Emergency Department Return Visits with Admission

Review of emergency department (ED) revisits with admission allows the identification of improvement opportunities. Applying a health equity lens to revisits may highlight potential disparities in care transitions. Universal definitions or practicable frameworks for these assessments are lacking. The authors aimed to develop a structured methodology for this quality assurance (QA) process, with a layered equity analysis. The authors developed a classification instrument to identify potentially preventable 72-hour returns with admission (PPRA-72), accounting for directed, unrelated, unanticipated, or disease progression returns. A second review team assessed the instrument reliability. A self-reported race/ethnicity (R/E) and language algorithm was developed to minimize uncategorizable data. Disposition distribution, return rates, and PPRA-72 classifications were analyzed for disparities using Pearson chi-square and Fisher's exact tests. The PPRA-72 rate was 4.8% for 2022 ED return visits requiring admission. Review teams achieved 93% agreement (κ = 0.51) for the binary determination of PPRA-72 vs. nonpreventable returns. There were significant differences between R/E and language in ED dispositions (p < 0.001), with more frequent admissions for the R/E White at the index visit and Other at the 72-hour return visit. Rates of return visits within 72 hours differed significantly by R/E (p < 0.001) but not by language (p = 0.156), with the R/E Black most frequent to have a 72-hour return. There were no differences between R/E (p = 0.446) or language (p = 0.248) in PPRA-72 rates. The initiative led to system improvements through informatics optimizations, triage protocols, provider feedback, and education. The authors developed a review methodology for identifying improvement opportunities across ED 72-hour returns. This QA process enabled the identification of areas of disparity, with the continuous aim to develop next steps in ensuring health equity in care transitions.

Unlocking Continuous Improvement in Heart Failure Remote Monitoring: A Participatory Approach to Unveil Value Dimensions and Performance Indicators.

Introduction: Heart failure (HF) constitutes a public health concern affecting quality of life, survival, and costs. Remote patient monitoring (RPM) can enhance HF management, involving patients actively and improving follow-up. While current HF RPM assessments emphasise cost-effectiveness analysis, there is a need to consider wider RPM impacts and integrate stakeholders' perspectives into assessments for better comprehensiveness. Methods: We developed a four-stage participatory approach to select value dimensions and indicators for continuous HF RPM assessment: Stage 1 involved building a literature-informed initial list; Stage 2 utilized expert interviews for validation and list expansion; Stage 3 involved a web-Delphi process with Portuguese stakeholders and experts for agreement assessment; and Stage 4 included a conclusive expert interview. Results: A literature review identified fourteen studies on telehealth, RPM, and HF, informing an initial list of four value dimensions (Access, Clinical aspects, Acceptability, and Costs) and 22 indicators. Seven semistructured interviews validated and further adjusted the list to 38 indicators. Subsequently, the web-Delphi process engaged 29 stakeholders, giving their opinions regarding assessment aspects' relevance and proposing additional elements - 1 dimension and 12 indicators. Five value dimensions and 38 indicators (76.0%) reached group agreement for selection, while 12 did not reach an agreement. Upon expert appreciation, 5 dimensions, 43 indicators, and 6 case-mix parameters were considered relevant. Discussion: This comprehensive social approach captured diverse stakeholder perspectives, achieving agreement on pertinent HF RPM monitoring and evaluation indicators. Findings can inform visualization and management tool development, aiding day-to-day RPM evaluation and identification of improvement opportunities.

Features of the legal regulation of the use of artificial intelligence in Ukraine

Introduction. The rapid development of information technologies in general, and artificial intelligence in particular, significantly outpaces the introduction of legal regulation in this area. The relevance of the research topic is determined by the imperfection and the presence of gaps in the legislation regarding the use of artificial intelligence technologies. The purpose of the article is to analyze the peculiarities of the legal regulation of the use of artificial intelligence in Ukraine and to determine the possibilities of increasing its effectiveness. The main tasks of the research are the analysis of current legislation in the field of artificial intelligence in Ukraine; outline of the main risks and problems of the spread of artificial intelligence technologies that require regulatory regulation; identification of gaps and shortcomings and identification of opportunities for improvement of legislation in the field of use of artificial intelligence. Summary of the main results of the study. The article analyzes regulatory and legal documents regulating the use of artificial intelligence in Ukraine: the Concept of Artificial Intelligence Development, the Roadmap for the Regulation of Artificial Intelligence, the "Strategy for the Development of Artificial Intelligence in Ukraine for 2022-2030", the Law "On Copyright and Related Rights". The main theories regarding the definition of legal personality of artificial intelligence are considered. The risks of using artificial intelligence technologies are identified, which should be taken into account when developing legislation in this area. An opinion is expressed regarding the need to apply a comprehensive approach to the development of the legislative framework for artificial intelligence. Conclusions. The conducted research made it possible to determine the possibilities of improving the legislation in the field of using artificial intelligence. It was noted that, in addition to the Law on Artificial Intelligence, it is expedient to develop and implement related laws that will regulate legal relations in the field of using artificial intelligence. It is important to adopt the Law on Artificial Intelligence, which will establish norms for determining the legal personality of artificial intelligence systems, ethical aspects of the use of artificial intelligence technologies, cover various areas of use of artificial intelligence, define rights and obligations when using such technologies and responsibility for violations of these norms .

RENAL7: Unmet Needs In Nephrology: Survey Results to Drive Innovation

Background: Renal Disease is an increasing cause of morbidity and mortality in the U.S. and around the world. Despite advances in diagnosis and therapy, as well as improvements in care technology, long-term outcomes for renal disease patients remain suboptimal. Innovation, as a science and methodology, is focused on developing solutions for advancement beyond the status quo. Central in innovation, is clear identification of opportunities for improvement. In medicine the main driver of innovation is the unmet need. We conducted a survey to identify unmet needs in Nephrology. Here we report on the results. Methods: A multi-question survey was developed by a team of practicing academic nephrologists, biomedical scientists, and innovators. The survey was distributed across the U.S. to practicing academic and non-academic nephrologists. The survey was web-based. The survey collected information on participants’ identification of unmet needs, barriers to achieving solutions to needs, and suggestions for improvement of current therapeutics and technology. Survey questions ranged from more general to specific, also addressing the specific topics of: hemodialysis, interventional nephrology, and transplantation. Results: A broad group of nephrologists responded to the survey from across the U.S. 76 % of respondents felt that Nephrology lags behind other specialties regarding innovation. In the general questionnaire, participants felt that treatment of inflammation and cardiac complications were the most significant unmet needs. The need to develop a bioartificial kidney for patients on hemodialysis was the most significant future need, recognized by 53.5% of respondents. Interestingly, at the same time, respondents felt that technical challenges and lack of investment might limit artificial kidney development. For interventional nephrology, 26% thought creating an AV fistula, which matures fast, is the most significant need. The availability of living donors was the most critical unmet need in transplantation. Conclusion: A broad survey of unmet needs was conducted across the U.S. which revealed a perspective of opportunity. Nephrology was generally felt to have lagged somewhat compared to other medical subspecialties. It was recognized however that there are unmet needs, many of which are ripe for incremental innovation; though some opportunities for revolutionary innovation exist as well. Through further analysis of this data details of specifics will provide starting points for the advance of nephrology into the future.

Context-aware workflow management for smart manufacturing: A literature review of semantic web-based approaches

Smart Manufacturing Systems (SMS) are software systems that identify opportunities for automating manufacturing operations by using Internet of Things (IoT) devices and services connected to machines. An active challenge of SMS is to satisfy the ever-changing conditions of industries, supply networks, and customer needs. To operate effectively, SMS should be flexible enough to perform automatic or semi-automatic adjustments to manufacturing processes in response to unexpected changes, a feature called context awareness. Recent advances in interpreting context data in the semantic web have permitted SMS to understand the active situation of manufacturing processes. This paper presents a literature analysis of context-aware workflow management approaches in the smart manufacturing domain, with a particular focus on semantic web-based approaches published from 2015 to 2022. A Systematic Literature Review (SLR) methodology was applied to analyze the state-of-the-art via the PICOC method. The contributions of this work are (1) an SLR about context-aware workflow management for smart manufacturing systems focusing on semantic web-based approaches, (2) a systematic taxonomy to break down the approaches in conformity based on content and main workflow management function area, and (3) identification of opportunities for improvement in technical features such as context awareness, use case implementation, tools employed, licensing, security, and scalability. A novel architecture and components are also proposed to address the identified active challenges.

Abstract TMP19: Development Of A Pediatric Stroke Dashboard To Assess Pediatric Stroke Metrics Across A Fourteen Hospital Healthcare System In Southern California

Background: Delays in pediatric stroke recognition and treatment are significant factors contributing to the high rate of morbidity and mortality. There is a lack of national standards for pediatric stroke quality measures. We created a dashboard to abstract pediatric stroke data, including patient volume and established quality measures, from our organization’s 14 hospitals. Methods: The regional pediatric stroke dashboard was created using the organization’s existing adult stroke dashboard as a template. The monitoring system was designed using PowerBI™ and Microsoft Suite™. Dashboard elements were modified to capture pediatric stroke demographics and quality indicators identified by the region’s multidisciplinary pediatric stroke workgroup. Data were abstracted using the organization’s electronic medical record system. Results: The dashboard provides a regionwide, visual representation of this organization’s pediatric stroke data. It is an automated and systematic graphic report describing pediatric stroke volumes and quality metrics. Between 1/2021-6/2022, there were 39 stroke cases: 15% subarachnoid hemorrhage(6/39), 56% intracerebral hemorrhage (22/39), 28% ischemic (11/39). Nine percent of ischemic strokes received a thrombolytic (1/11); 27% had thrombectomy (3/11); 54% were discharged to home (21/39) with no mortalities. The median age was 7.5 years and 66.7% were female. Future dashboard elements will include times for door-to-initial physician evaluation, door-to-Stroke Team notification, door-to-CT or MRI interpretation and door-to-lab results. Conclusion: The Pediatric Stroke Dashboard is an important component of the organization’s regional Pediatric Stroke Program. Leveraging this technology to track and trend the patient volumes and performance measures allows for continuous assessment and identification of opportunities for improvement to achieve pediatric stroke care excellence.

VALUE CHAINS OF BASIC AGRICULTURAL PRODUCTS IN THE REPUBLIC OF ARMENIA AND OPPORTUNITIES FOR INCREASING COMPETITIVENESS

Opportunities to increase the competitiveness of agricultural products become more visible when considering them in the chain from the producer to the consumer. Such an approach makes it possible to form a more complete picture of the competitiveness of agricultural products in individual links of the chain and to take measures aimed at increasing it, taking into account the uniqueness of the value chains of each of these products in this or that country. In this sense, it is of particular interest to develop the value chains of a number of important products in our republic: cereals, in particular: wheat, vegetables, fruits and berries, milk and meat, the comparative analysis of competitiveness in their separate links and the identification of opportunities for improvement. As a result of the development of the mentioned securities, the analysis of the competitiveness of these products in their separate links, the article presents the possibilities of increasing the competitiveness.

Performance Evaluation of Bangalore Metropolitan Transport Corporation: An Application of Data Envelopment Analysis

Maintaining and enhancing public transit services in Indian cities is important to meet rapidly-growing mass mobility needs. Indian cities rely predominantly on buses for public transportation, and issues of performance measurement and efficiency analyses for bus companies have been gaining significance due to severe operational stress and financial constraints in which these bus companies provide service to people. In public transportation, multiple parameters are involved that influence the efficiency of operation. This study measures the performance of premium bus services operated by Bangalore Metropolitan Transport Corporation (BMTC) using data envelopment analysis. This approach enabled the identification of opportunities for improvement at the bus depot and route levels. The analysis indicates that most depots are efficient, but some routes have significant opportunities for improvement.

PrEP program experience in a hospital HIV unit. Description of baseline user profile and identification of opportunities for improvement

IntroductionPre-Exposure Prophylaxis (PrEP) is a biomedical intervention to prevent HIV infection in seronegative people at high risk of becoming infected. This strategy was endorsed in October 2019 by the Spanish Ministry of Health. ObjectiveTo present the PrEP initial experience in the HIV Unit of the Hospital Clínic of Barcelona, paying special attention to the analysis of the vulnerability factors in the cohort. Materials and methodsRetrospective, descriptive study. The epidemiological, sociodemographic, and clinical characteristics of the users included in the program during the first year are analyzed, paying particular attention to Infections, risky practices, and substance use. Results190 individuals were included, 177 men and 12 trans women with a mean age of 35 years (8 SD). 70% had higher education, and half had Spanish nationality. An average of 10 couples per trimester and 60% reported unprotected anal sex. 31% had at least one positive PCR for STIs, with N. gonorrhoeae being the most prevalent microorganism (51%) and the rectal sample the most affected (21%). 63% reported chemsex use, 19% polydrug use, and 8% “slamming”. Half expressed concern about consumption and/or sexual practices and 25% the need for help. ConclusionsThe PrEP user profile attended in our Hospital Unit justifies the creation of multidisciplinary teams that allow us to provide holistic attention to the sexual life of these people.

Lean Management Systems in Health Care: A Review of the Literature.

Many health care organizations now employ Lean tools to improve value in health care, yet reports of their effectiveness vary. This variation may be explained by the context in which Lean is implemented, whether as a tool or as a management system. This article reports on a structured literature review conducted to understand the evidence base for the impact of Lean Management System implementation in health care. A search of PubMed, Scopus, Emerald, EMBASE, CINAHL, and Business Source Complete databases was conducted in November 2017 and repeated in July 2020 to assess the evidence for the impact of Lean Management Systems in health care from 2000 to July 2020. Articles were included if they (1) reported on a Lean Management System or (2) reported on Lean Management System components as described by Mann 1 (ie, leader standard work, visual controls, daily accountability process, and discipline). A total of 52 articles met the inclusion criteria. Although all articles described some combination of leader standard work, visual management, and daily accountability as part of their Lean Management System, only a handful described use of all 3 components together. Only one explicitly mentioned the fourth component, discipline, required to consistently apply the first 3. The majority reported on single-unit or department implementations and most described daily huddles at the unit level that included review of key performance indicators, identification of improvement opportunities, and problem solving. The role of the leader in a Lean Management System was described a coach and a mentor. Barriers to adoption such as insufficient training and increased workload for nurses were noted along with the importance of relevance to the local context for unit teams to find value in huddle boards and huddles. As yet, evidence of Lean Management System effectiveness in driving health care improvement is absent due to weak study designs and lack of statistical rigor. Well-designed research on Lean Management Systems in health care is lacking. Despite increasing adoption of Lean Management Systems over the past 10 years and anecdotal reports of its effectiveness, very few articles provide quantitative data. Those that do report unit-level implementation only, little use of a comprehensive package of Lean Management Systems elements, and weaker study designs and statistical methods. More rigorous study designs and robust statistical analysis are needed to evaluate effectiveness of Lean Management Systems in health care. This represents a rich area for future health care management research.

A Pragmatic Method for Measuring Inpatient Complications and Complication-Specific Mortality.

The primary objective of this study was to develop hospital-level metrics of major complications associated with mortality that allows for the identification of opportunities for improvement. The secondary objective is to improve upon current metrics for failure to rescue (i.e., death from serious but treatable complications.). Agency for Healthcare Research and Quality metrics served as the basis for identifying specific complications related to major organ system morbidity associated with death. Complication-specific occurrence rates, observed mortality, and risk-adjusted mortality indices were calculated for the study institution and 182 peer organizations using component International Classification of Disease, Tenth Revision codes. Data were included for adults over a 4-year period, with exclusion of hospice patients and complications present on admission. Temporal visualizations of each metric were used to compare past and recent performance at the study hospital and in comparison to peers. The complication-specific method showed statistically significant differences in the study hospital occurrence rates and associated mortality rates compared with peer institutions. The monthly control-chart presentation of these metrics provides assessment of hospital-level interventions to prevent complications and/or reduce failure to rescue deaths. The method described supplements existing metrics of serious complications that occur during the course of acute hospitalization allowing for enhanced visualization of opportunities to improve care delivery systems. This method leverages existing measure components to minimize reporting burden. Monthly time-series data allow interventions to prevent and/or rescue patients to be rapidly assessed for impact.

Enhancing hydraulic data reliability in sewers

Abstract Recently, water utilities have been making considerable investments in sewers' monitoring; however, in most cases, assuring data reliability is yet a challenge. Often, hydraulic data is collected in sewers overlooking best practice aspects. Assuming confidence in data, while disregarding cautions verifications, might lead to inadequate uses of data. The paper presents a methodology aiming to narrow the gap between science and industry, regarding monitoring programs in urban drainage. A procedure to enhance hydraulic data reliability, in line with ISO/IEC 17025:2017, was developed, applied and validated, enabling a final evaluation on data and site adequacy and an overall identification of improvement opportunities. The availability of a valuable case study comprising 32 flowmeters from Portuguese utilities, in eastern Europe, presented an opportunity to create a story line, test the procedure's coherence, present it to the technical community and evaluate the constraints that utilities, in their everyday working context, are faced with. The procedure is presented in detail and a collection of examples of its application is shown. In the final evaluation, most monitoring stations' alignment with best practice requirements were either high (25%) or acceptable (44%), regarding their overall performance and compliance with both data and site adequacy. For all of them, improvement opportunities were identified.

Simplified size adjusted dose reference levels for adult CT examinations: A regional study

PurposeTo investigate retrospective classification of adult patients into small, average, and large based on effective diameter (EDia) from localizer image of computed tomography (CT) scans and to develop regional diagnostic reference levels (DRLs) and achievable doses (AD). MethodThe patients falling within the mean ± standard deviation (SD) of EDia were classified as average; those below this range as small and above as large. The CTDIvol,dose-length-product (DLP) and size-specific dose estimates (SSDE) of all adult patients undergoing CT examinations in 8 CT facilities for 11 months (Dec. 2019 - Oct. 2020) were evaluated. The 75th and 50th percentile values were compared with national and international values. ResultsOf the total of 69,434 CT examinations, nearly 80% fell within average size. The 75th percentile values of CTDIvol and DLP for small patients for abdomen-pelvic exams were nearly half of average sized patients. Similarly, the 75th percentile values for large patients were nearly double. Similar findings were not found for chest exams. Analysis of image quality and dose factors such as noise, mean axial length, slice thickness, mean number of sequences, use of iterative reconstruction and tube current modulation (TCM) resulted in identification of opportunities for improvement and optimization of different CT facilities. ConclusionsDRLs for adult patients were found to vary widely with patient size and thus establishing DRLs only for standard sized patient is not adequate. Simplified and intuitive methods for size classification was shown to provide meaningful information for optimization for patients outside the standard size adult.

Early impact of lung cancer screening program.

e18677 Background: Lung cancer has the highest mortality among the leading cancers in the U.S. Its detection in the early stages is one of the strategies to increase survival. This study aims to identify whether the implementation of a structured Lung Cancer Screening Program impacted the percentage of Early Stage Lung Cancer Diagnosis (ESLCD). Methods: Retrospective cohort study aiming to identify changes over time considering the following indicators: a) percentage of ESLCD; b) the percentage of lung resections for ESLCD. In October 2019, there was a restructuring of our institutional Lung Cancer Screening Program (LCSP). We analyzed quarterly incident lung cancer cases at our institution between October 2017 and December 2019. Descriptive, bivariate, and multivariate analyses were performed. Results: Our cohort comprised 736 patients. The age average was 69.3 years, 54.6% female, 96.5% white. Clinical Stage 1A to 2B corresponded to 43.3% of patients. 71.9% had their diagnosis and treatment in the institution. Factors associated with ESLCD were being in the LCSP (OR 4.4 [95%CI 2.3-8.1]); diagnosis and treatment in the institution (OR 2.2 [95%CI 1.6-3.2]); having 3 or less comorbidities (OR 1.6 [95%CI 1.2-2.1]) and female (OR 1.4 [95%CI 1.1-1.9]). In the last Quarter of 2017, the percentage of ESLCD through LCSP was 2.6%, and in the last Quarter of 2019 (2019Q4), 28.8%, representing a 1025% growth. Also, in 2019Q4, 44.8 % of the ESLCD cases that had surgery came through the LCSP, which is a significant increase from prior quarters. Conclusions: The restructuring of our LCSP may have resulted in an increase in ESLCD and the number of curative surgeries for Lung Cancer. Identification of opportunities for improvement of health care delivery can help to increase ESLCD; a longer time for follow-up is needed to observe if the upward trend is sustained and its effects on patient survival. Selected indicators by quarter, 2017 to 2019.[Table: see text]

Health care activity at the endocrinology and nutrition outpatient clinics of Castilla-La Mancha (the AACENCAM study)

IntroductionThis study was promoted by Sociedad Castellano Manchega de Endocrinología, Nutrición y Diabetes to ascertain the characteristics of patients seen at the outpatient clinics of endocrinology and nutrition of the Castilla-La Mancha Health Authority and the case mix of diagnoses. Patients and MethodsThis was a retrospective, cross-sectional study of the activity of the endocrinology and nutrition outpatient clinics of public hospitals of Castile-La Mancha during 2018. All visits made on 10% of the working days were analyzed. Data collected comprised patient age and sex, whether a first or subsequent had been made, and whether this was face-to-face or not, and up to five diagnoses per visit. ResultsA total of 10,709 visits with a subsequent/first visit ratio of 3.4 were analyzed. Patient age was 52.1?±?18.2 years, and 67.1% were women. Type 2 diabetes mellitus, primary hypothyroidism, thyroid nodular disease, and obesity/overweight were the most common conditions recorded as first diagnosis, accounting for more than half of the total number of visits. Type 1 diabetes mellitus and thyroid cancer were the diagnoses in which the subsequent/first visit ratio was greater. Type 2 diabetes mellitus, obesity, and primary hypothyroidism accounted for almost half of the first visits. ConclusionsA wide variety of conditions were seen, some of which are among the most prevalent in the general population, while others are not so prevalent, but are complex and difficult to manage by other specialties. Improved knowledge and analysis of the data should allow for the identification of opportunities for improvement and for the implementation of specific actions.

Avaliação da eficiência da metodologia 5S no Setor Público: uma pesquisa aplicada em uma Organização Militar

Over the last thirty years, after the promulgation of the 1988 constitution, through social control, which allows the effective participation of society, not only in the inspection of the application of public resources but also in the formulation and monitoring of the implementation of policies, public organizations have been increasingly demanded to provide better quality in services and reduction of waste. For this reason, it is observed that Total Quality Management models are becoming increasingly present in public administration. After all, these models allow the quality of public services and their organizational performance to reach higher levels, in addition to allowing the identification of opportunities for improvement for the sector. The 5S program, in addition to being cited in the literature as the basis for the implementation of any management system for its total quality, stands out for its simplicity, for encouraging the participation of all employees of the organization and increase the effectiveness of organizational processes. In view of the above, this paper proposes to analyze which organizational factors contribute to the implementation of the 5S Program, in the public sector, through a literature review, followed by a survey with specialists and a Focus Group Study, in a Military Organization in the city of Rio de Janeiro, more specifically, a warship, where one of its sectors showed superior performance, in relation to the others, through the implementation, in its daily routine, of the principles of the 5S program This research is classified as mixed, as it includes quantitative and qualitative approaches and as exploratory, as it seeks to explore what is happening and ask questions about a certain subject. The survey results show that the following factors contributed to the successful implementation of the 5S Program in the organization studied: Employee Engagement and Commitment, Employee Training, Good Internal Communication, Leadership, Monitoring or Auditing the implementation of the 5S Program, Presence of a facilitator of 5S, Top Management Commitment and Organizational Culture.

Proposition of a method for stochastic analysis of value streams

This article aims at proposing a method to stochastically analyze values streams taking into consideration the effect of critical uncertainty sources on lead time. The proposed method combines value stream mapping (VSM) and Monte Carlo simulation to identify improvement opportunities. To illustrate this approach, we carried out a case study in the special nutrition value stream of a Brazilian public hospital. Results show that the proposed method allows the identification of improvement opportunities that would not be considered in the classical deterministic VSM approach. Further, the integration of the stochastic analysis enables the determination of a more realistic lead time, which supports a more assertive planning and scheduling of the value stream. The proposed method addresses a fundamental gap in traditional VSM without adding much complexity to the analysis procedure, which is a common practical issue in previous works that integrated other stochastic methods into VSM.

Evaluation of Basic Trainings for Rescue Forces

Abstract Since members of rescue forces such as firefighters have to deal with sometimes extreme and dangerous situations, high-quality basic trainings are indispensable for their professional success. There is therefore an obvious need for standardized tools assessing the training quality. This paper aims to develop and validate such an evaluation instrument. In Study 1, a qualitative analysis (N = 21) was used to identify core characteristics of good firefighter basic trainings and served as theoretical basis for the generation of corresponding items. In Study 2 (N = 257), the item set was piloted and reduced, its structure was assessed in exploratory factor analyses, and first validations were conducted. Study 3 (N = 451) tested the proposed factor structure via confirmatory analyses and validated the questionnaire comprehensively. Factor analyses showed a six-factor structure. The scales of the newly created Feedback Instrument for Rescue forces Education – Basic education (FIRE-B) are to be judged as reliable. Moreover, there are several clear indications of validity. Thus, the present research contributes to the understanding of critical factors and processes of basic trainings. Furthermore, the FIRE-B has a high practical relevance, both in the assessment of training quality and in the identification of opportunities for improvement.