Search results

The goal was to improve the quality of the hospitalization process and the management of patients, allowing the reduction of costs and the minimization of the preoperative Length of Hospital Stay (LOS).

The methodology used to improve the quality of the hospitalization process and patient management was Lean Thinking. Therefore, the Lean tools (Value stream map and Ishikawa diagram) were used to identify waste and inefficiencies, improving the process with the implementation of corrective actions. The data was collected through personal observations, patient interviews, brainstorming and from printed medical records of 151 patients undergoing oral cancer surgery in the period from 2006 to 2018.

The authors identified, through Value Stream Map, waste and inefficiencies during preoperative activities, consequently influencing preoperative LOS, considered the best performance indicator. The main causes were identified through the Ishikawa diagram, allowing reflection on possible solutions. The main corrective action was the introduction of the pre-hospitalization service. A comparative statistical analysis showed the significance of the solutions implemented. The average preoperative LOS decreased from 4.90 to 3.80 days (−22.40%) with a p-value of 0.001.

The methodology allowed to highlight the improvement of the patient hospitalization process with the introduction of the pre-hospitalization service. Therefore, by adopting the culture of continuous improvement, the flow of hospitalization was redrawn. The benefits of the solutions implemented are addressed to the patient in terms of lower LOS and greater service satisfaction and to the hospital for lower patient management costs and improved process quality. This article will be useful for those who need examples on how to apply Lean tools in healthcare.

Head and neck cancers are multi-factorial diseases that can affect many sides of people's life and are due to a lot of risk factors. According to their characteristics, the treatment can be surgical, use of radiation or chemotherapy. The use of a surgical treatment can lead to surgical infections that are a main theme in medicine. At the University hospital of Naples “Federico II”, two antibiotics were employed to tackle the issue of the infections and they are compared in this paper to find which one implies the lowest length of hospital stay (LOS) and the reduction of infections.

The Six Sigma methodology and its problem-solving strategy DMAIC (define, measure, analyse, improve, control), already employed in the healthcare sector, were used as a tool of a health technology assessment between two drugs. In this paper the DMAIC roadmap is used to compare the Ceftriaxone (administered to a group of 48 patients) and the association of Cefazolin plus Clindamycin (administered to a group of 45 patients).

The results show that the LOS of patients treated with Ceftriaxone is lower than those who were treated with the association of Cefazolin plus Clindamycin, the difference is about 41%. Moreover, a lower number of complications and infections was found in patients who received Ceftriaxone. Finally, a greater number of antibiotic shifts was needed by patients treated with Cefazolin plus Clindamycin.

While the paper enhances clearly the advantages for patients' outcomes regarding the LOS and the number of complications, it did not analyse the costs of the two antibiotics.

Employing the Ceftriaxone would allow the Department of Maxillofacial Surgery to obtain lower LOS and a limited number of complications/infections for recovered patients, consequently reducing the hospitalization costs.

There is a double value in this paper: first of all, the comparison between the two antibiotics gives an answer to one of the main issues in medicine that is the reduction of hospital-acquired infections; secondly, the Six Sigma through its DMAIC cycle can be employed also to compare two biomedical technologies as a tool of health technology assessment studies.

Banks in emerging markets such as Brazil provide a wide range of services to companies to facilitate the export process. The objective of the present study was to analyze, from the perspective of Brazilian export companies, the relationships between banking intellectual capital (human and organizational), banking agility, banking technologies and company size in banking service provision.

A sample of 318 Brazilian export companies was surveyed with questionnaires. The research model was tested using structural equation modeling, namely the partial least squares (PLS-SEM) technique and SmartPLS.

Banking intellectual capital affects banking service provision, banking agility mediates the relationship between intellectual capitals and banking service provision and technology does not moderate the relationship between agility and banking service provision. The size of the company does not moderate the relationship between intellectual capital and banking service provision.

This work indicates that intellectual capital and the banking agility strategy are critical in the provision of banking service provision for exports.

This work illustrates the effect of banks' intangible resources on the provision of banking services from the perspective of Brazilian export companies.

The purpose of this study is to analyse the brand communication on social media (SM) made by two- and three-starred restaurants and the customer reaction in terms of engagement effects during a crisis. The research highlights the connections between brand communication and engagement dynamics on Instagram by looking for differences in the strategies of two and three-starred restaurants and by highlighting the changes in the background engagement drivers.

Using data collected from 5,666 Instagram posts by 34 Italian Michelin-starred restaurants, the authors analysed the crisis-driven changes in online communication and customer engagement comparing three phases of the COVID-19 pandemic by applying a linear regression model with fixed effects.

Michelin-starred restaurants changed their strategies of brand communication to overcome the effects of the crisis. The findings highlight the importance of SM as a tool to stay in touch with consumers and the pivotal role of customers in engagement, especially during a pandemic.

To the best of the authors’ knowledge, this is among the first studies to investigate the changes in brand communication and the effects on customer engagement during a pandemic, with a focus on Instagram. It contributes to understanding the role of platform and the main drivers of engagement on Instagram, as well as suggesting how managers can improve brand value using SM.