Search results

Achieving reliable instrument reprocessing requires finding the right balance among cost, productivity, and safety. However, there have been few attempts to comprehensively examine sterile processing department (SPD) work systems. We considered an SPD as an example of a socio-technical system – where people, tools, technologies, the work environment, and the organization mutually interact – and applied work systems analysis (WSA) to provide a framework for future intervention and improvement.

The study was conducted at two SPD facilities at a 700-bed academic medical center servicing 56 onsite clinics, 31 operating rooms (ORs), and nine ambulatory centers. Process maps, task analyses, abstraction hierarchies, and variance matrices were developed through direct observations of reprocessing work and staff interviews and iteratively refined based on feedback from an expert group composed of eight staff from SPD, infection control, performance improvement, quality and safety, and perioperative services. Performance sampling conducted focused on specific challenges observed, interruptions during case cart preparation, and analysis of tray defect data from administrative databases.

Across five main sterilization tasks (prepare load, perform double-checks, run sterilizers, place trays in cooling, and test the biological indicator), variance analysis identified 16 failures created by 21 performance shaping factors (PSFs), leading to nine different outcome variations. Case cart preparation involved three main tasks: storing trays, picking cases, and prioritizing trays. Variance analysis for case cart preparation identified 11 different failures, 16 different PSFs, and seven different outcomes. Approximately 1% of cases had a tray with a sterilization or case cart preparation defect and 13.5 interruptions per hour were noted during case cart preparation.

While highly dependent upon the individual skills of the sterile processing technicians, making the sterilization process less complex and more visible, managing interruptions during case cart preparation, improving communication with the OR, and improving workspace and technology design could enhance performance in instrument reprocessing.

One of the most satisfactory methods of preserving foods for long periods is the process of canning, in which the food is sealed into a container and then sterilised by heat. Modern canning lines are capable of handling up to 2000 cans per minute, but the geometry of the can and the low thermal conductivity of food place constraints on the maximum heating temperature and type of food that can be canned. ‘Aseptic’ canning processes overcome these constraints by sterilising food in specially designed heat exchangers before it is filled into sterile cans. Such processes allow high sterilising temperatures to be used, resulting in improved product quality.

The paper aims to focus on the individual contribution of water to the lubrication regimes in articular joints because understanding of these regimes is crucial not only for the treatment of diseases like osteoarthritis but also for the development of new implants to have a longer service cycle.

Cartilage specimen and the synovial fluid were both isolated from bovine knee joints that are enclosed by a synovial membrane under sterile conditions of a biosafety Level 2 (BSL2) cabinet. Subchondral bone was removed from the cartilage because it not only creates a stable base to place the specimen on the holder, but it also acts as a primary shock absorber protecting the overlaying cartilage under high-impact loads. A specimen holder specially designed for tests and was attached to the linear oscillation (SRV) test machine. The SRV test machine provides a reciprocating sliding motion between the cartilage samples that are submerged into the selected biological media. The entire system can be mounted on the BSL2 cabinet, sealed with the convoluted gaiter and transported to the SRV machine with a specifically designed handle for the entire system. The process ensures sterile conditions for tests on biological samples that are highly sensitive to the environmental conditions.

A remarkably low coefficient of friction value for distilled water constitutes more evidence to support the assumption of the impact of water in the friction behaviour of the cartilage-against-cartilage contact. As the fluid in articular cartilage (AC) effectively serves as a synovial fluid reserve and 70-80 per cent of its composition is distilled water, it can be stated that the tribotest system mimics the natural working conditions of an actual knee joint adequately.

Time and limited availability of the animal-driven samples led to a focus on certain parameters mentioned in the approach. A planned scan of parameter matrix, such as variation of load and speed, would allow deeper knowledge on the lubrication regimes.

Study of relevant tribological contact in human joints might give ideas on new designs for artificial joints.

Understanding of lubrication regimes is crucial not only for the treatment of diseases like osteoarthritis but also for the development of new implants to adapt motion of related joint.

Exclusion of water and application as the primary lubricant in the test system brings a new perspective to joint lubrication.

In recent years, consumer demand has very much been for fresh quality food at the point of delivery. An explosion in the range of processed foods available in the supermarket chiller cabinet has occurred to meet this demand. Chilled ready meals, pizzas, speciality sausages and other small goods all have to live up to consumer expectations of visual appearance, flavour and eating quality, whilst safely achieving a commercially acceptable shelf‐life. All these products contain one common flavouring ingredient, which can severely limit the time a food item can remain on display in the chiller cabinet – herbs and spices. This paper discusses the various strategies and processes currently in use to reduce the microbial loads of herbs and spices to acceptable levels, including improved agricultural methods product selection, irradiation, heat treatment, flavour extraction through steam distillation, and micro encapsulation.

The long interval between the last abortive attempt to negotiate entry to the European Economic Community and the present time, when, if we read the signs aright, the atmosphere is more favourable, seems to have been a period of reflection for great numbers of people. Nothing has changed politically; “getting into Europe” is the official policy of both Government and Opposition, but many of the so‐called Marketeers are now ready to admit to there being problems. What has emerged, however, in the last year or two is that to the British people, the Common Market is not a political question; there are probably as many against it in both camps; big business remains for it, but the spate of letters in the correspondence columns of newspapers from people who, having had time to think, expressing misgivings, cannot have escaped observation by the policy‐makers. A few politicians confess to having second thoughts, mainly from concern at the price the British public may be called upon to pay.

Presents a discussion on the importance of management information systems in management. It explains the role of information, as an essential tool for managers in planning and decision making. It describes MIS as a well co‐ordinated information system, a database that is to provide management with needed information to plan and make decisions. Modern technology has further made the resort to MIS in management imperative because of the changing circumstances and environment. Also identifies some problems which can hinder effective use of MIS. These are lack of management involvement in the design; poor appreciation of mangement support. Finally, recommends that organizations, both private and public; commercial and non‐commercial should endeavour to set up an MIS unit in their organizations so that adequate information can be put at the disposal of their management.

The purpose of this paper is to shed light on the problematics of learning across knowledge boundaries in organizational settings. The paper specifically explores learning processes that emerge, when a new knowledge domain is introduced into an existing organizational practice with the aim of creating a new combined practice.

A case study was carried out as a “natural experiment” in an engineering consultancy, where emerging initiatives to integrate the newly acquired competencies into the existing practice were explored. A theoretical framework informed by selected perspectives on learning processes and boundary processes was applied on three illustrative vignettes to illuminate learning potentials and shortcomings in boundary processes.

In the engineering consultancy, it was found that while learning did occur in the consultancy organization, it remained discrete in ‘pockets’ of learning; mainly at an individual level, at project level or as domain-specific learning. Learning processes were intertwined with elements of domain-specific interests, power, managerial support, structural conditions, material and epistemic differences between knowledge domains.

The finding in this paper is based on a single case study: hence, the findings' generalizability may be limited.

The paper argues that learning across knowledge domains needs various forms of supporting initiatives and constant readiness to alter or counteract when an initiative's shortcomings appear or undesired learning loops arise.

The paper contributes to understanding the complexity of learning across knowledge boundaries in organizational settings.