Title Process optimization of hospital units using life-cycle assessment methods Title (english) Process optimization of hospital units using life-cycle assessment methods Author Vitaliy Sarancha Mentor Stjepan Orešković (mentor)Mentor Ksenija Vitale (komentor)Committee member Miroslav Mastilica (predsjednik povjerenstva)Committee member Iskra Alexandra Nola (član povjerenstva)Committee member Zdenko Sonicki (član povjerenstva)Granter University of Zagreb Defense date and country 2020-10-26, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Universal decimal classificationUDC ) 614 - Public health and hygiene. Accident prevention Abstract The purpose of this study is to prove that the optimization of parameters of a given healthcare
system unit according to sustainability principles leads to higher efficiency. In this study, Department
of Medical Biochemistry at the Laboratory of Medical Biochemistry of the Zabok
General Hospital was chosen to represent a healthcare system unit. The actual research for this
thesis was performed at the University of Zagreb School of Medicine Andrija Stampar School
of Public Health from 30.03.2014 to 30.09.2015 (duration of study – 6 months). The hospital
in Zabok was chosen for the current study because it is one of the leading institutions in Croatia
and the laboratory where the study was performed occupies fully equipped premises with plenty
of materials, innovative equipment and professional staff, accordingly presenting sufficient
components for the present research. Quantitative and qualitative methods were employed to
reach our general aim of testing the hypothesis that the optimization of input parameters leads
to higher economic efficiency. The study was performed according to the working plan of data
acquisition and consisted of Initial Phase, Modelling phase and Analytical phase with the subsequent
data processing. We used methods such as Life Cycle Assessment, structured interview,
computer modelling, and direct content analysis. Life Cycle Assessment methodology
was effectively adopted for the purposes of health care system unit analysis and it is the first
study of LCA implementation in health care in Croatia. In the duration of the study the given
inputs and outputs such as chemical reagents, solutions, technical equipment, conditions of the
working environment, quantity of different types of waste over a period, working hours, expenses
were calculated. Also the interviews with medical staff with subsequent transcription
and Direct Content Analysis were introduced with the aim of obtaining a deep-level qualitative
data. Modelling and deep-level computer data analysis was performed, in order to find parameters
that could lead to optimization of the unit. It shows an opportunity to perform computer
based Data analysis of parameters inside the boundaries of a Laboratory. After precise analysis
we distinguished the key parameters that may lead to optimization the whole system. We labelled
them as Hard and Soft. The results obtained confirmed our initial hypothesis. Recommendations
are given. In addition, in the course of the study, the importance of the mental
condition of the staff and relationships among co-workers, which positively or negatively affect
the performance of their professional tasks were revealed. Introduction of LCA to healthcare
refers to one of the building blocks of the Europe 2020 Strategy – “Roadmap to a Resource
Efficient Europe” and proposes ways to increase resource productivity and to decouple economic growth from both resource use by units and environmental impacts. The permanent scarcity
of resources, materials and the emphasis on cost-saving procedures in the social sphere
lead us to try to find effective means for the optimization of economic and environmental performance
of a healthcare. Inside the proposed framework the identified parameters may lead to
the creation of new models and techniques for the final units’ optimization. Life Cycle Assessment
methodology should be successfully applied to analysis of healthcare system units (e.g.
department, laboratory, hospital, ambulance, and operating theatre), the study of a life cycle of
a single process, the efficiency of medical staff as well as for the analysis of the performance
of the healthcare system of a particular region or a whole country. Furthermore, the rising social
responsibility, corporate social responsibility and Life Cycle Management will be drivers for
the development and widespread application of such methods to processes and activities of
healthcare institutions worldwide. As a result, it would be of great importance to develop and
implement an effective public healthcare system model based on relevant, meaningful, robust
results of and principles for the careful use of resources, improvement of patient recovery and
economic efficiency of units. As a result, public health and health care sectors may become
sustainable and reliable social partners with a high level of responsibility encouraging committed
and motivated employees and satisfied patients.
Abstract (croatian) Svrha je ovog istraživanja dokazati da optimizacija parametara određene jedinice sustava
zdravstvene zaštite prema načelima održivosti povećava njezinu učinkovitost. Za potrebe ovog
istraživanja jedinicu sustava zdravstvene zaštite predstavlja Odjel za medicinsku biokemiju pri
Medicinsko biokemijskom laboratoriju Opće bolnice Zabok. Istraživanje za ovaj rad provedeno
je u Školi narodnog zdravlja „Andrija Štampar“ Medicinskog fakulteta Sveučilišta u Zagrebu
od 30.03.2014. do 30.09.2015., te bolnici u Zaboku. Bolnica u Zaboku odabrana je za ovo
istraživanje jer je jedna od vodećih ustanova u Hrvatskoj, a laboratorij u kojem je provedeno
istraživanje smješten je u potpuno opremljenim prostorijama s dovoljnom količinom materijala,
novom opremom i profesionalnim osobljem, što znači da sadrži dovoljno komponenti za predmetno
istraživanje. Kvantitativne i kvalitativne metode korištene su u svrhu postizanja općenitog
cilja koji se sastojao u ispitivanju hipoteze prema kojoj optimizacija ulaznih parametara
donosi veću ekonomsku učinkovitost. Istraživanje je provedeno u skladu s planom rada i
prikupljanjem podataka, a sastojalo se od početne faze, faze modeliranja i analitičke faze s
naknadnom obradom podataka. Služili smo se metodama kao što su procjena životnog ciklusa
(Life Cycle Assessment = LCA), strukturirani intervju, računalno modeliranje i direktna analiza
sadržaja. Metodologija procjene životnog ciklusa učinkovito je primijenjena u svrhu analize
jedinice sustava zdravstvene zaštite, a riječ je o prvom istraživanju implementacije LCA u
zdravstvenom sustavu u Hrvatskoj. Tijekom istraživanja izračunati su inputi i outputi, kao što
su kemijski reagensi, otopine, tehnička oprema, uvjeti u radnom okruženju, količina različitih
tipova otpada u određenom razdoblju, radni sati i troškovi. Uključeni su i intervjui s medicinskim
osobljem koji su potom transkribirani i obrađeni direktnom analizom sadržaja s ciljem
dobivanja dubinskih kvalitativnih podataka. Provedeni su modeliranje i dubinska računalna analiza
podataka u svrhu pronalaženja parametara koji bi mogli rezultirati optimizacijom jedinice.
To je bila prilika i za obavljanje računalne podatkovne analize parametara u okvirima laboratorija.
Nakon precizne analize identificirali smo ključne parametre koji konstantno utječu na
sustav, a čije bi modeliranje moglo rezultirati optimizacijom sustava u cjelini. Označili smo ih
kao tvrde i meke. Dobiveni rezultati potvrdili su našu početnu hipotezu. Tijekom istraživanja
otkrivena je važnost mentalnog stanja djelatnika i odnosa među kolegama, koji pozitivno ili
negativno utječu na obavljanje radnih zadataka. Obzirom da oni nisu cilj istraživanja od samog
početka, smatramo da bi o toj konkretnoj temi trebalo provesti dodatna istraživanja. Uvođenje
LCA u zdravstvo jedan je od elemenata Strategije Europa 2020 – “Roadmap to a Resource
Efficient Europe”. Stalna oskudica resursa, materijala i naglasak na postupcima uštede troškova u društvenoj sferi dovode nas do pokušaja pronalaženja učinkovitih načina optimizacije
ekonomskih i okolišnih učinaka zdravstvene zaštite. Identificirani parametri mogli bi u predloženim
okvirima rezultirati stvaranjem novih modela i tehnika u svrhu konačne optimizacije
jedinica. Metodologija procjene životnog ciklusa trebala bi se uspješno primjenjivati u analizi
jedinica sustava zdravstvene zaštite (npr. odjela, laboratorija, bolnica, ambulanti i operacijskih
sala), proučavanja životnog ciklusa pojedinačnih procesa, učinkovitost zdravstvenih djelatnika,
kao i u analizi uspješnosti zdravstvenog sustava određene regije ili čitave države. Osim toga,
rastuća društvena odgovornost, društvena odgovornost tvrtki i upravljanje životnim ciklusom
biti će pokretači razvoja i široke primjene takvih metoda u procesima i aktivnostima zdravstvenih
ustanova širom svijeta. Stoga bi bilo od iznimne važnosti razviti i primijeniti učinkovit
model optimiziranja sustava u zdravstvu utemeljen na relevantnim, značajnim, pouzdanim rezultatima,
prema načelima pažljivog korištenja resursa, poboljšanja oporavka pacijenata i
ekonomsku učinkovitost jedinica. Sektori javnog zdravstva i zdravstvene zaštite mogli bi na taj
način postati održivi i pouzdani socijalni partneri s visokom razinom odgovornosti što bi djelatnike
učinilo predanijima i motiviranijima, a pacijente zadovoljnijima.
Keywords
Humans
Health Care Sector
Economic Development
Laboratories
Hospitals
General
Public Health
Croatia
Life Cycle Stages
Keywords (croatian)
Ljudi
Zdravstveni sektor
Ekonomski razvoj
Laboratoriji
Bolnice
općenito
Javno zdravstvo
Hrvatska
Faze životnog ciklusa
Language english URN:NBN urn:nbn:hr:105:678228 Study programme Title: Biomedicine and Health Sciences Catalog URL https://katalog.nsk.hr/F/19IT7Y755V1NXQJPHCLYSQGPF6BLAPPF179HQ7FAXXMYBYGMV5-48224?func=find-e&request=Process+optimization+of+hospital+units+using+life-cycle+assessment+methods&find_scan_code=FIND_NAS&adjacent=N&local_base=MF_WEB&x=13&y=17&filter_code_1=WLN&filter_request_1=&filter_code_2=WYR&filter_request_2=&filter_code_3=WYR&filter_request_3=&filter_code_4=WFM&filter_request_4= Type of resource Text Extent 100 str. File origin Born digital Access conditions Open access Terms of use Created on 2021-04-12 08:58:05
