project management implementation for healthcare ... · project management implementation for...

Project Management implementation for healthcare activities organization

GIUSEPPE CONVERSO, RICCARDO DE CARLINI, LIBERATINA C. SANTILLO

Department of Materials Engineering and Operations Management University of Naples Federico II

Piazzale Tecchio, 80, 80125 Naples ITALY

GIOVANNI IMPROTA Dipartimento di Scienze Mediche Preventive

University of Naples Federico II Via Pansini, 5, 80131 Naples

ITALY [email protected]; [email protected]; [email protected]; [email protected]

Abstract: - In recent decades the following changes of the health care system characterized by the introduction of new technologies in the field of molecular biology and information, the transformation of society with the change the doctor-patient relationship, and finally the evolution of health care with the waves no longer seen as a resource and as an expense. The healthcare organization has the need to improve the quality of health services provided through the implementation of the innovation process, which affects both the design of new medical processes that update the current ones. The use of Project Management methodology allows to make choices according to scientific criteria, resulting in improved benefits consistent with available resources. The right of the citizen is guaranteed according to the available financial resources and depends critically on the ability to organize, manage and monitor effective and efficient allocation of biomedical systems. The optimal allocation of biomedical facilities using the Project Management principles will consider the following steps: formulated the general aim is to optimally allocate the system of interest, then to address to the general objectives or to assess the evidence regarding the safety parameters, the ethical, legal and social, technical and technological parameters, organizational aspects, the economic parameters. It is necessary to assign a value from 1 to 10, evaluating the adequacy of each parameter in the considered case. In this way the parameters identified are "listed" in order to determine the suitability to a particular case in terms of security parameters, ethical, legal, social, economical organized, technical and technological. The adequacy of the above parameters following the installation of the system evaluated in otherwise you may decide to repeat the assessment for another area, or choose another type of equipment. Key-Words: - Project Management, health technology, healthcare organization services

1 Introduction In the last decades of project management technologies have been developed in healthcare. This type of management, strongly oriented to results, solves problems existing today in health care organizations and depend on the crisis of production processes, crisis management systems and the new vision of work organization, which aims at enhancing the function and performance. The Project Management is interested in:

• To give a realistic view of the project throughout the life cycle in Empower all stakeholders on specific objectives;

• Highlight critical situations and propose viable alternatives in a timely manner;

• Draw a forecast of the future development of the project;

• Propose and impose rules common to all actors involved;

• Ensure consistency between the objectives assigned partial and the general design.

The project takes into account the following parameters: the purpose / quality, time and cost/ resources. The time constraint is the amount of time required to complete the project. The cost/resources constraint is the available budget for the project and the set of available resources. The order/quality

Advances in Computer Science

ISBN: 978-1-61804-126-5 436

constraint is what must be bone to achieve the results expected from the project both in terms of requirements of quality standard/ performance. These three constraints are related each other. In addition to these variables we must consider the risk. Risk is defined as a potential cause of project failure, an event that is able to object to the achievement of project objectives. The presence of risks with negative impacts can be addressed by the project manager by intervening in the project planning and increasing the time and / or resources. A risk can also be classified as positive: it may be associated with a potential opportunity. Management of a project is divided into three distinct phases:

- PLANNING; - PROGRAMMING; - CONTROL.

The planning phase of the project must ensure the success of the project, as it identifies the best possible area of intervention of the project, goals and resources. The purpose is to verify the viability and the conditions of the project. The programming phase of the project aims to organize project activities and resources. In this phase it has the determination of the overall costs. The problems identification depend on the gained experience. At the problem identification stage must necessarily be followed by an assessment of the actual risk, impact assessment and the likelihood of the individual problem. Once all the potential problems identified, assessed their weight to the objectives of the project and identify the causes responsible for each area of expertise will be required to highlight the problem of preventive actions that reduce the risk of occurrence of the problem. Despite the introduction of preventive action, hardly the risk of occurrence of the problem may be cancelled. For this reason it is useful to estimate actions ready to come into play in the case of occurrence of the real problem, therefore do not appear in the initial programming, but will be introduced subsequently.

• Analysis of available resources: a first analysis of resource requirements is performed in the planning phase of the project, with the purpose of expressing an opinion on the feasibility of the project and estimate the total cost. During programming the resource analysis has instead a direct impact in determining the start and end dates of each activity. Using a pattern of non-critical activities are in fact a search for the more balanced distribution of key

resources, namely those resources whose acquisition involves a certain amount in addition to a price more than proportionately (labor).

• Economic evaluation of the project. In the planning phase is usually the first economic evaluation of necessary resources. In the programming phase the economic evaluation of comparison becomes continuous work in progress. This objective and obtained through a daily timing of the economic budget that allows you to manage with easily the progress of the project costs. In the programming phase the economic evaluation of comparison becomes continuous work in progress. This objective and obtained through a daily timing of the economic budget that allows you to manage easily the progress of the project costs.

By monitoring progress is a continuous monitoring of operating parameters aim (quality), time and cost project. The purpose of control and the identification of possible deviations from the objectives of the program in order to take immediate corrective action. The time control estimation is based on:

v Assessment of the weight of each elementary activities;

v physical activity estimation. Cost control is the third parameter to be monitored during implementation of the program. In this case the comparison between actual costs and cost budgets can’t ignore the contemporary assessment of the time variable.

2 Health Technology and Project Management

For health technology is set of all tools equipment, drugs and procedure used in delivery of health services, also including the organizational and support systems through which health care is provided. It’s useful to classify the biomedical technologies as depending on the type of technologies the rules concerning them are different. The classification separates the biomedical technologies in two areas:

1. Diagnostic area; 2. Therapeutic area / rehabilitation.

The diagnostic area in turn includes the following sectors:

• Functional assessment; • The bio-imaging;


ISBN: 978-1-61804-126-5 437

• Clinical diagnostic.

The area of therapeutic /rehabilitation includes: • Surgery; • Interventional low invasiveness; • Artificial organs/ prosthetic appliances; • Rehabilitation/ support; • Artificial organs and prostheses.

The projects are created to solve problems or exploit opportunities. In the health sector projects arise for the following reasons:

a. Operating results unsatisfactory; b. Need to meet health needs; c. Creation of a development opportunity.

In the health field of project management methodologies have been introduced only recently and allowed to profoundly transform the institutional, managerial and organizational entire health system, responding comprehensively to the following objectives:

Ø Respect for human dignity; Ø Need for health and wellness health; Ø Fairness in access; Ø Appropriateness and adequacy of quality

performances; Ø Economical use of resources and

elimination of diseconomies.

A company health is seen as both a production system both as a social institution in which the contractor (General Manager) has the responsibility to put up their own business in the most suitable according to the instructions issued by the National Health Plan and laws imposed by the market. The governors were asked a complex effort that involves not only efficiency, but also the effectiveness of medical processes for customer satisfaction. For a company health benefits linked to the 'introduction of the Project Management cover the following points:

Ø Increased Visibility in National and International Level: The Project Management is used in most areas, so that any organization can manage its projects and share results;

Ø Standardization of Results: Using the methodologies and tools for Project Management Project management is standardized;

Ø Strong Focus on Objectives: The project is the foundation for achieving the objectives

within the limitation of time, cost and agreed quality;

Ø Creating a Culture of Project Management in the Health Sector: Project Management using the methods of creating a true within the health sector.

Programming using the project management within a healthcare organization consists of the following phases:

1) Phase analysis of the situation; 2) Definition phase of the objectives; 3) Formulation phase of the action plan; 4) Verification phase.

The strategy of a 'company is the ability to maintain its competitive advantage over its competitors. To develop a competitive advantage companies must be able to align its internal resources to the environment in which it operates and must be able to design. To pursue its strategy the company from a health care need (need for public health), problem (emergency/inappropriateness), opportunity (to remodel the offer/reallocate resources/integrate hospital and territory), a constraint (optimize supply/demand/need in relation to economic and financial reasons). The strategic analysis in the health sector is carried out through systematic evaluation of the following parameters:

v macro-environment, is to evaluate the evolution of health legislation, national and regional health plans, the real context;

v Competitive Environment (ASL, AO) v Competitive analysis and segmentation

of demand (competition / cooperation, hospital/territory management employee / contracted, health / society).

The success factors for planning and design in the health sector are the following:

ü Cash flow positive, growth in revenues and profits;

ü Future, acquire new customers and / or distributors;

ü Customer satisfaction, the customer is satisfied?

ü Quality, as is the quality of the product or service?

ü Development of the product or service, what's new that will increase business with existing customers and attract new ones?

ü Intellectual capital, increase what is profitable;


ISBN: 978-1-61804-126-5 438

ü The strategic relationships, new sources of business, product and external revenue;

ü Ability to attraction and retention, the ability to extend the word of mouth;

ü Sustainability. 4 Application of Project Management concepts to healthcare activities organization For the preparation of a project must:

1. Analyze problems; 2. Analyze the goals and outcomes to be

achieved; 3. Analyze the strategies and draw up the

strategic plan of action to achieve the objectives.

A problem is a bad situation, while a goal is a positive situation in the future. The formulation of the problem is through the use of the technique of "brainstorming" (storm of ideas), which consists in externalizing ideas which could theoretically lead to the solution of the problem proposed. Briefly, the method of brainstorming is: given a problem each member freely proposes solutions for every type (even or odd, apparently with little sense) with none of them is minimally discarded. The criticism and possible selection takes place only at a later time, when the brainstorming session is over. With a brainstorming group expressed the highest number of causes, which are grouped into categories, and written on the board. The various causes are assigned priority indexes and choose those with the highest indices. The ideas generated from the brainstorming session are grouped into a cause and effect diagram. With this method you can get a complete picture of the causes of a phenomenon with the goal of determining the most appropriate corrective action. The analysis of the objectives is to transform the current situation in a positive negative obtained with the problem tree. Technically just turn every negative current condition (problem) in a positive condition future (goal), thereby obtaining the objective tree. The operation is very simple, but it is equally easy, if you are not familiar with the mechanism, lie in the error to revise the negative condition (problem) as the solution of the problem (task), instead of writing it as a positive condition in the future (goal). The identification strategy is to identify areas of intervention in which the project must be applied as the determination of the tree of objectives can be conducted on a larger sphere. The

logical framework to account for proper preparation of a project is as follows:

• GENERAL OBJECTIVES: are the interests of a more general, with respect to the objectives of the project;

• SPECIFIC OBJECTIVE: are the goals that characterize exclusively to the project;

• RESULTS: what is material and not get through the course of the project;

• ACTIVITY: are the activities and steps needed to produce the expected results and the achievement of project objectives.

The logical framework of the general project management applied to the case study becomes the following: v Overall Objective: To determine the

methods necessary to achieve optimal allocation of biomedical equipment

v Specific objective: the security parameters are evaluated, the ethical, legal and social parameters, organizational, technical and technological and economic parameters.

v Activities: we must consider the specific parameters listed in the preceding paragraph.

v Result: we associate with different parameter values from 1 to 10 to indicate their suitability.

We analyze in detail the elements that constitute the parameters listed above. With regard to the Safety must assess the following parameters S1, S2, S3, S4, S5, S6, S7, S8, S9, S10, S11: S1: Overall results of the visual inspection includes the evaluation of the local installation if it is eligible according to technical specifications and requirements of current legislation, the assessment of the plant if it has damage, deterioration, oxidation and corrosion , the surfaces of the plant if they are intact, safety devices if they are not tampered with, or short-circuited, the ventilation in the room if the vents are free from any obstacle that impedes the flow of air, locking systems and security alarm if they are present in the room, though no damage and are easily accessible. S2: compliance with safety standards include assessing the standards and guidelines of both electrical and mechanical on both acoustic powers:

1. Electrical and mechanical devices • According to the Directive

MDD/93/42/EEC medical devices are divided into four classes depending on the vulnerability of the human body to which they are applied, the potential risks associated with their use, conditions of use


ISBN: 978-1-61804-126-5 439

and their intrinsic characteristics. To certify compliance with this directive on the CE mark is applied;

• EC 601-1 (CEI 62-5) relating to minimum risk being put on the patient and the operator.

According to leakage currents, the device can be: TYPE B, suitable for direct application on the patient; TYPE BF, with the patient applied part isolated from the ground; TYPE CF, suitable for direct application to the patient's heart; Depending on the type of protection against contact, the device can be: CLASS I, the unit is grounded through a protective conductor; CLASS II, the device has a housing with double insulation.

• Standard EC-EMC (89/336/EEC) aimed at ensuring the free movement of equipment and create an acceptable electromagnetic environment. In other words, we must ensure that electromagnetic disturbances produced by electrical equipment do not affect the proper operation of other equipment that must function as established by providing them with an adequate level of immunity against electromagnetic disturbances.

2. Acoustic powers: • Standard IEC 61157 Electroacoustics /

ultrasound. S3: Periodic review of safety parameters include regular assessment of safety parameters by a company. S4: Presence of the manuals is to verify if the user manuals are readily available and the operators. S5: Adequacy of the manuals is to verify if the user manuals are adequate S6: Presence of the service manual consists of checking if the manuals are readily available and the operators S7: Adequacy of the service manual consists of checking if the manuals are adequate S8: Presence alarms appropriate and easily manageable includes the evaluation of an alarm both in terms of comprehensibility and safety. S9: Any precautions for the safety and critical elements relating to the apparatus includes evaluating the manual of the precautions to be followed to ensure the security, in particular defines

the technical specifications of interventions and change aspects of installation, and indications / instructions on the installation. With regard to the critical elements must always take account of the manual, in which are written the operating conditions of the equipment to be kept in mind. S10: Information and training of appropriate personnel regarding the mode of treatment of adverse events is to verify implementation of training activities and information about the possible adverse events for all those who use biomedical equipment. S11: Terms of use includes the plant and environmental assessment requirements of all applicable laws:

o Earthquake Protection; o Fire protection; o Hearing protection; o Electrical safety and electrical continuity; o Safety anti-accident; o Hygiene in the workplace; o Protection of ionizing radiation; o Removal of architectural barriers; o Disposal of waste; o microclimatic conditions o Compliance with the smoking ban o gas distribution systems o Explosive Materials o health and biomedical equipment; o Maintenance of buildings and facilities

Furthermore the analysis of environmental conditions than the equipment:

- Temperature +10 ° C +40 ° C; - Humidity 30-75%; - Pressure 700-1060hPa.

To the Ethical Aspects, Legal and Social is necessary to evaluate the parameters L1, L2, L3, L4, L5. L1: Respect for human and animal life consists in the verification of the Legislative Decree No. 116 of 27/01/92 on the ethical principle of respect for human and animal life. Since 1993 have been authorized by the Ministry, several research projects. A rundown of a regulation governing animal experiments and was set up an ethics committee, which draws on the advice of experts in the field of animal experimentation from the academic world who help those inside the company. L2: Compliance with European directives and binding standards on biomedical equipment consist of the establishment of specific regulations on the use of health technologies, which includes the


ISBN: 978-1-61804-126-5 440

responsibility of the manufacturer about the marketing of this technology, health care and the responsibility of the health professional in 'use the same or in the evaluation of possible risks to the patient. L3: Level of noise pollution is to check on the plant during the operation of any production of noise L4: Level of electromagnetic pollution consists in checking the EMC directive EN 60601-1-2 class concerning the possible audio interference during operation. L5: Level of radioactive pollution is to check on the plant during the operation of any production of radioactive pollution.

For organizational aspects need to assess the parameters O1, O2, O3, O4, O5, O6, O7, O8, O9, O10, O11

O1: Total Number of repairs is the evaluation of the total number of interventions (defined as repairs and corrective maintenance) over the life of the equipment. O2: Number of repairs in the last 12 months is the evaluation of the total number of operations performed on the equipment (defined as repairs and corrective maintenance) over a period of 12 months. O3: Time is the evaluation of unavailability of days of downtime recorded on an annual basis. The average time of unavailability is the time between the fault and the effective repair.

O4: time of actual use of the equipment in relation to time in which the equipment is actually usable is the evaluation of the actual time of use, given by the ratio between the actual time of use of the equipment in question and the time in which the equipment may be used, which can be up to 24 hours if the equipment does not require specialized personnel, this time of use, it can also not coincide with the physical use of the equipment, but correspond to the time in which the equipment must remain available.

O5: Criticality of use means the use of critical evaluation of existing concerning the risks associated with electrical safety, set out in S9 and projected use of the equipment in combination with other active devices. O6: Usability biomedical equipment is to check the device to perform its intended function and interpret the signals provided by the device.

O7: Availability to the operational needs in practice and according to which the equipment was

purchased is to assess whether the equipment in question satisfies or not the needs of operational functions which the equipment was purchased, it is important to evaluate appropriateness.

O8: Availability of alternative technologies for the same purpose is to assess the presence of similar technologies, through the analysis of the market once the identification of similar technologies, alternative or change the technology itself to make it sustainable. Taking into account the technological evolution continues to grow, to make an appropriate choice must make appropriate assessments about costs, effectiveness, efficiency and scientific.

O9: Education and training of appropriate personnel is to verify whether activities were carried out education and training of personnel.

O10: Level of qualification of the personnel using consists in evaluating the level of qualifying personnel

O11: Proper communication with patients is to verify the existence of an information, education and communication, involving the patient.

For the economic aspects is necessary to evaluate the following parameters E1, E2, E3, E4, E5.

E1: Timing of depreciation is to assess the cost of the asset basis over the years of useful life, it falls in determining the income of the individual exercises. The relative cost of the property claimed is divided into many shares as there are periods in which the machinery will be used.

E2: Cost of acquisition of equipment related to the year of purchase is equal to:

Cost of purchase (year of purchase) = (cost of equipment) + (ancillary costs)

The assessment of this parameter is obtained by adjusting the purchase cost of purchase as a function of the year so as to obtain the purchase cost of re-evaluated: Cost of purchase (purchase year) * (coefficient of revaluation) = purchase cost revalued R (relative valuation) = purchase cost revalued / current average cost of purchase

E3: fixed cost (by year) consists of the evaluation of the parameter R obtained in the following way:


ISBN: 978-1-61804-126-5 441

R (relative valuation) = Fixed Cost detected / fixed cost reference

E4: Variable costs (by year) is the evaluation of the R factor obtained as:

R (relative valuation) = measured variable costs / variable costs of reference

E5:Annual revenue is the evaluation of the R factor obtained as:

R (relative valuation) = Annual Revenue / Revenue annual reference

For technical and technological aspects is necessary to evaluate the following parameters T1, T2, T3, T4, T5. T1: to comply with manufacturing specifications consists in 'put marks on the plant and ensure compliance so that the suitability of the design and proper construction / sale and indicate the procedures to use and maintain. So that proper testing and maintenance equipment to maintain over time allow the features and specifications for performance and safety that had been declared at the time of sale by the manufacturer. T2: Performance level is the evaluation of the amount of useful work produced in relation to time and available resources.

T3: State of Origination is the evaluation of the degree of ancient plant

T4: Status and Conservation of Use T5: Spare parts available on the market consists of the evaluation of market-find parts or equipmentlease, follow our instructions faithfully, otherwise you have to resubmit 4 Conclusion The context of the Italian health system, today's increasingly complex and dynamic, linking the competitive success of a company health, public or private, to its actual ability to innovate. The simple logic of the application of quality is no longer a sufficient condition for the successful organization, because we must continually improve the health service delivered through the implementation of the innovation process, which affects both the design of new medical processes that upgrading existing ones. The current structure of hospital organizations requires all professionals who work within them with the responsibilities of management, the

acquisition of methodological skills in design, suitable for a gradual transition between jobs "for homework" to a work "projects and goals." The project management fits organically into this modern vision. A project is fundamentally characterized by the fact that the end result to be achieved is unique and that dedicated resources are temporary and that is available for the duration of the project. One of the problems within the health care is the allocation of biomedical systems. The project management methodologies include the following procedure: to evaluate the parameters of safety, the ethical, legal and social, economic, technical and technological, and organizational, to assign a value from 1 to 10, evaluate each single parameter in this case. Once the parameters are "listed" in order to decide if requirements are met in terms of safety in the area where you intend to install the system if ventilation systems are adequate, security systems and alarm are present, fire alarm etc. are easily accessible, in terms of ethical, legal and social standards are met on human and animal life, noise pollution and electromagnetic radiation, in terms of organization on the plant if they comply with, maintenance, etc., in economic terms to assess the costs of acquiring the equipment, the payback period, fixed costs, variable costs and revenues, and finally in terms of technology and technical assessment of the level of performance, the conformity of the manufacturing specifications. If these requirements are met we proceed with the installation of the system in the assessed area, otherwise the target area does not comply with the installation of the system and it is possible to repeat the assessment for another area or choose a different type of system. References: [1] Revetria R, Mosca R, Cassettari L, Guizzi G,

Romano E, Santillo L.C. Advanced Modeling Methodology based on System Dynamics in Healthcare, Applied Mathematics in Electrical and Computer Engineering, Proceedings WSEAS, Harvard Cambridge, USA, January 25-27, 2012, pp. 127-132.

[2] Joosten T., Bongers I., Janssen R. Application of lean thinking to health care: issues and observations International Journal Quality Health Care October, 21 (5), 2009, pp 341-347

[3] Banta D, The development of health technology assessment, Health Policy, Volume 63, 2, 2003, pp 121-132.

[4] Atkinson R., Project Management: Cost, time and quality, two best guesses and a phenomen, its time to accept other success criteria,


ISBN: 978-1-61804-126-5 442

International Journal of Project Management, volume 17, 6, 1999, pp 337-342.

[5] Holimchayachotikul, P., Leksakul, K., Guizzi, G., Robust design for etching process parameters of hard disk drive slider fabrication using data mining and multi response optimization, 2011, WSEAS Transactions on Systems and Control, 6 (1), pp. 15-24.

[6] Holimchayachotikul, P., Derrouiche, R., Leksakul, K., Guizzi, G. B2B supply chain performance enhancement road map using data mining techniques, International conference on System Science and Simulation in Engineering - Proceedings, 2010, pp. 336-341.

[7] Holimchayachotikul, P., Limcharoen, A., Leksakul, K., Guizzi, G., Multi-objective optimization based on robust design for etching process parameters of hard disk drive slider fabrication, Proceedings of the 11th WSEAS International Conference on Automation and Information, ICAI '10, 2010, pp. 166-170.

[8] Guizzi, G., Gallo, M., Zoppoli, P., Condition based maintenance: Simulation and optimization, Proceedings of the 8th WSEAS International Conference on System Science and Simulation in Engineering, ICOSSSE '09, 2009, pp. 319-325.

[9] Gallo, M., Grisi, R., Guizzi, G., Romano, E., A comparison of production policies in remanufacturing systems, Proceedings of the 8th WSEAS International Conference on System Science and Simulation in Engineering, ICOSSSE '09, (2009), pp. 334-339.

[10] Caputo, G., Gallo, M., Guizzi, G., Optimization of production plan through simulation techniques, WSEAS Transactions on Information Science and Applications, 6 (3), 2009, pp. 352-362.

[11] Gallo, M., Guerra, L., Guizzi, G., Hybrid remanufacturing/manufacturing systems: Secondary markets issues and opportunities WSEAS Transactions on Business and Economics, 6 (1), 2009, pp. 31-41.

[12] Murino, T., Naviglio, G., Romano, E., Cost estimation in an aeronautical supply chain SKIMA 2011 - 5th International Conference on Software, Knowledge Information, Industrial Management and Applications, 2011 pp. 126-132.

[13] Murino, T., Romano, E., Santillo, L.C., Supply chain performance sustainability through resilience function Proceedings-Winter Simulation Conference, 2011, pp. 1600-1611.

[14] Gallo, M., Romano, E., Santillo, L.C., A methodological approach to manage WEEE

recovery systems in a push/pull logic Proceedings - Winter Simulation Conference, 2011, art. no. 6147827, pp. 1035-1047.

[15] Gallo, M., Murino, T., Romano, E. The simulation of hybrid logic in reverse logistic network, International conference on System Science and Simulation in Engineering - Proceedings, 2010, pp. 378-384.

[16] Murino, T., Naviglio, G., Romano, E. Optimal size of kanban board in a single stage multi product system WSEAS Transactions on Systems and Control, 5 (6), 2010, pp. 464-473.

[17] Murino, T., Naviglio, G., Romano, E., Zoppoli, P. Single stage multi product kanban system. Optimization and parametric analysis Proceedings of the 8th WSEAS International Conference on System Science and Simulation in Engineering, ICOSSSE '09, 2009, pp. 313-318.

[18] Romano, E., Santillo, L.C., Zoppoli, P., Transformation of a production/assembly washing machine lines into a lean manufacturing system WSEAS Transactions on Systems and Control, 4 (2),2009, pp. 65-76.

[19] Romano, E., Santillo, L.C., Zoppoli, P. A static algorithm to solve the air traffic sequencing problem WSEAS Transactions on Systems, 7 (6), 2008, 682-695.

[20] Briano, E., Caballini, C., Mosca, M., Revetria, R. A system dynamics decision cockpit for a container terminal: The case of Voltri terminal Europe, International Journal of Mathematics and Computers in Simulation, 3 (2), 2009, pp. 55-64

[21] Giribone, P., Oliva, F., Revetria, R., Catania, A., Models for supporting sea transportation evolution: A case study for an international harbor system, WSEAS Transactions on Systems, 6 (4),2007, pp. 668-676

[22] Briano, E., Caballini, C., Giribone, P., Revetria, R. Design of experiment and montecarlo simulation as support for gas turbine power plant availabilty estimation, 12th WSEAS International Conference on Automatic Control, Modelling and Simulation, ACMOS '10,2010, pp. 223-230

[23] Revetria R., Catania A., Cassettari L., Guizzi G., Romano E., Murino T., Improta G., Fujita H., Improving Healthcare Using Cognitive Computing Based Software: An Application in Emergency Situation, Advanced Research in Applied Artificial Intelligence, Lecture Notes in Computer Science, 2012, Volume 7345/2012, 477-490.


ISBN: 978-1-61804-126-5 443

project management implementation for healthcare ... · project management implementation for...

Documents