BACKGROUND: IN CHILE, THE USE OF COSTING SYSTEMS IN THE PUBLIC SECTOR IS LIMITED. THE MINISTRY OF HEALTH REQUIRES HOSPITALS TO MANAGE THEMSELVES WITH THE AIM OF DECENTRALIZING HEALTH CARE SERVICES AND INCREASING THEIR QUALITY. HOWEVER, SELF-MANAGEMENT WITH A LACK OF ACCOUNTING INFORMATION IS ALMOST IMPOSSIBLE. ON THE OTHER HAND, NUTRITION DEPARTMENT COSTS HAVE BARELY BEEN STUDIED BEFORE, AND THERE ARE NO STUDIES SPECIFICALLY FOR ACTIVITY BASED COSTING (ABC) SYSTEMS. ABC FOCUSES ON THE PROCESS AND TRACES HEALTH CARE ACTIVITIES TO GAIN A MORE ACCURATE MEASUREMENT OF THE OBJECT COSTS AND THE FINANCIAL PERFORMANCE OF AN ORGANIZATION. METHOD: THIS PAPER USES ABC IN A NUTRITION UNIT OF A PUBLIC HOSPITAL OF HIGH COMPLEXITY TO DETERMINE COSTS ASSOCIATED WITH THE DIFFERENT MEALS FOR INPATIENTS. THE PAPER ALSO PROVIDES AN ACTIVITY BASED MANAGEMENT (ABM) ANALYSIS FOR THIS UNIT. RESULTS: THE RESULTS SHOW POSITIVE EFFECTS ON THE REDUCTION OF COSTS FOR THE NUTRITION DEPARTMENT AFTER IMPLEMENTING ABC/ABM. THEREFORE, THERE ARE OPPORTUNITIES TO IMPROVE THE PROFITABILITY OF THE AREA AND THE RESULTS COULD ALSO BE REPLICATED TO OTHER AREAS IN THE HOSPITAL. ABC SHED LIGHT ON THE AMOUNT OF NUTRITIONIST TIME DEVOTED TO COMPLETING PAPERWORK, AND AS A RESULT, SYSTEM CHANGES WERE INTRODUCED TO REDUCE THIS BURDEN AND ALLOW THEM TO FOCUS ON MORE RELEVANT ACTIVITIES. ADDITIONAL EFFICIENCIES WERE ACHIEVED THROUGH THE ELIMINATION OF NON-VALUE ADDING ACTIVITIES AND AUTOMATION OF REPORTS. ABC REDUCED THE COST OF THE NUTRITION DEPARTMENT AND COULD PRODUCE SIMILAR RESULTS IN OTHER AREAS OF THE HOSPITAL. CONCLUSIONS: THIS IS A PRACTICAL APPLICATION OF A FINANCIAL MANAGEMENT TOOL, ABC, WHICH WOULD BE USEFUL FOR HOSPITAL MANAGERS TO REDUCE COSTS AND IMPROVE THE MANAGEMENT OF THE UNIT. THIS PAPER TAKES ABC AND EXAMINES ITS USE IN AN AREA, WHICH HAS HAD LITTLE EXPOSURE TO THE BENEFITS OF THIS TOOL.

CONTEXT: AN EMERGENCY DEPARTMENT (ED) IN A HOSPITAL PROVIDES 24-HOUR CARE FOR THE INJURED/SEVERELY ILL PATIENTS. EDS ARE ESSENTIAL IN ANY HEALTH CARE SYSTEM. HOWEVER, THEY FACE MANY CHALLENGES TO PROVIDE TIMELY TREATMENT SUCH AS SHORTAGE OF SPECIALISTS, INADEQUATE INFRASTRUCTURE, AND UNAVAILABILITY OF HOSPITAL BEDS, AMONG OTHERS. THESE CHALLENGES ARE WORLDWIDE AND UNDERMINE THE EFFECTIVENESS OF OPERATIONS AND QUALITY OF SERVICES THROUGHOUT THE HOSPITAL. METHODS: THIS STUDY AIMS TO IMPROVE THE PERFORMANCE OF EDS USING KEY PERFORMANCE INDICATORS (KPIS). THE KPIS WILL HELP DECISION MAKERS TO MONITOR AND MANAGE THE PERFORMANCE OF EDS SYSTEMATICALLY. BASED ON AN IN-DEPTH FIELD STUDY, EXPERT OPINIONS, AND LITERATURE REVIEW, WE PROPOSE 5 CATEGORIES OF KPIS REGARDING CAPACITY FOR, TEMPORALITY OF, QUALITY OF, OUTCOMES OF, AND ECONOMICS OF EMERGENCY CARE. THE KPIS ARE APPLICABLE TO THE BASIC STAGES OF EMERGENCY CARE. THE ACHIEVEMENT OF THE KPIS IN EACH STAGE WILL BE A FUNCTION OF (1) HOW THE KPIS ARE USED, (2) RESOURCES FOR ACHIEVING THE KPIS, AND (3) MANAGEMENT OF THE RESOURCES. THE UNIFIED SYSTEMIC FRAMEWORK TO MANAGE EDS IS PRESENTED AS AN ONTOLOGY THAT ARTICULATES THE VERY LARGE NUMBER OF POTENTIAL WAYS OF ED PERFORMANCE MANAGEMENT. RESULTS: SEVENTY-FIVE KPIS WERE DEFINED FOR MONITORING PURPOSES. THE KPIS AND THE PROPOSED FRAMEWORK WERE VALIDATED AND APPLIED IN 2 EDS AT A PUBLIC CHILDREN'S HOSPITAL AND A MEDIUM SIZE CLINIC IN CHILE. CONCLUSIONS: BASED ON THE STUDY, WE PROPOSE TO STANDARDIZE THE ESSENTIAL INFORMATION NECESSARY TO ASSESS THE PERFORMANCE OF EDS IN CHILE USING KPIS FOR THEIR CONTINUOUS IMPROVEMENT.

THE CONSTRUCTION INDUSTRY HAS A SERIES OF OWN PRACTICES AND METHODS; WHICH SPECIFICALLY DEPENDS ON EITHER THE NATURE OF CONSTRUCTION WORKS OR THE ACTIONS OF THE ACTORS INVOLVED IN CONSTRUCTION ACTIVITIES. THIS MAKES EVIDENT THE NEED OF HAVING TOOLS THAT FACILITATE THE CONSTRUCTION MANAGEMENT OF PROJECTS, ONE OF THEM: THE SIMULATION OF CONSTRUCTION PROCESSES. THUS, THIS PAPER PRESENTS A CONCEPTUALIZATION OF CONSTRUCTIVE OPERATIONS, AS A START POINT FOR THE DEVELOPMENT OF A LIBRARY OF OBJECTS FOR THE SIMULATION OF CONSTRUCTION PROCESSES IN BUILDINGS. TO DO IT, FIELDWORK WAS CONDUCTED TO GATHER INFORMATION ABOUT PROCESSES AND RESOURCES, WHICH WERE THEN MODELED BY USING UNIFIED MODELING LANGUAGE (UML). TO VALIDATE THE CONCEPTUALIZATION MADE, SOME OF THE MODELS CREATED WERE SIMULATED BY USING DISCRETE EVENT SIMULATION.

THREE-DIMENSIONAL CONCRETE PRINTING IS A TECHNIQUE THAT HAS BEEN GROWING CONSTANTLY, PRESENTING ADVANTAGES SUCH AS REDUCED COMPLETION TIMES AND A DECREASED ENVIRONMENTAL IMPACT BY ELIMINATING THE USE OF FORMWORKS. TO CARRY OUT THE PROCESS, THE PRINTING PATH OF THE EXTRUDED MATERIAL AND THE MOVEMENT OF A ROBOT MUST BE PROGRAMMED. THUS, THE PRESENT RESEARCH SIMULATED THESE 3D CONCRETE PRINTING PROCESSES IN A SMALL 2-FLOOR BUILDING OF 309.06 M2 AND THEN IN A 12-FLOOR BUILDING OF 10,920 M2. TO ANALYZE THE 3D PRINTING PROCESS, DISCRETE-EVENT SIMULATION WAS USED WHILE CONSIDERING DIFFERENT VARIABLES SUCH AS EXTRUSION SPEED AND THE LOCATIONS OF A ROBOT MOUNTED ON TRACKS. THE RESULTS SHOW THAT WHEN COMPARING THE TIME TAKEN FOR A CONVENTIONAL CONSTRUCTION SYSTEM TO CONSTRUCT CONCRETE WALLS AND THE MAXIMUM DURATION FOR 3D-PRINTED WALLS, THIS METHOD IS 45% FASTER THAN TRADITIONAL CONSTRUCTION FOR A SMALL BUILDING, BUT FOR A BIG BUILDING, THERE IS A DIFFERENCE OF 40% IN FAVOR OF CONVENTIONAL CONSTRUCTION; HOWEVER, THIS WAS WHEN USING ONLY 1 ROBOT FOR THE WHOLE BUILDING. AFTER RUNNING THE SAME ANALYSES BUT USING 3 ROBOTS INSTEAD OF 1, THE TOTAL 3D CONCRETE PRINTING TIME FOR THE BIG BUILDING WAS 80% FASTER IN FAVOR OF THE 3D CONCRETE PRINTING PROCESS.

QUALITY IMPROVEMENT IS AN IMPORTANT COMPONENT OF HOSPITAL OPERATIONS. AIM: TO PRIORITISE CLINICAL QUALITY AND SAFETY PROBLEMS IN CHILEAN HOSPITALS ACCORDING TO THEIR SEVERITY, FREQUENCY, AND DETECTABILITY. MATERIAL AND METHODS: THE STUDY WAS CONDUCTED BETWEEN DECEMBER 2018 AND JUNE 2019. TO IDENTIFY QUALITY AND SAFETY PROBLEMS, AN EXPLORATORY STUDY WAS CONDUCTED USING AN ONLINE SURVEY AIMED TO THOSE RESPONSIBLE FOR CLINICAL QUALITY AND SAFETY IN CHILEAN HOSPITALS. THE SURVEY WAS SENT TO 94 HOSPITALS AND COMPLETED BY QUALITY MANAGEMENT PERSONNEL AT 34 HOSPITALS, YIELDING A TOTAL OF 25 VALID SURVEYS FOR ANALYSIS. BASED ON THE INFORMATION GATHERED, A RISK PRIORITY SCORE WAS COMPUTED TO RANK THE PROBLEMS SURVEYED. FOCUS GROUPS WERE HELD TO FIND THE ROOT CAUSES OF THE QUALITY AND SAFETY PROBLEM WITH THE HIGHEST RISK PRIORITY SCORE. RESULTS: THE THREE HIGHEST RISK PRIORITIES WERE:1 INEFFECTIVE INTERPROFESSIONAL COMMUNICATION,2 LACK OF LEADERSHIP FOR ADDRESSING FREQUENTLY RECURRING SAFETY ISSUES, AND3 ANTIMICROBIAL RESISTANCE DUE TO INAPPROPRIATE USE OF ANTIBIOTICS. FOR THE COMMUNICATION PROBLEM, THE FOCUS GROUP FOUND TWO MAIN ROOT CAUSES: THOSE DUE TO PERSONNEL AND THOSE RELATING TO THE HOSPITALS THEMSELVES. CONCLUSIONS: HOSPITALS CAN SYSTEMATICALLY USE THE PROPOSED APPROACH TO CATEGORIZE THEIR MAIN CLINICAL QUALITY AND SAFETY PROBLEMS, ANALYZE THEIR CAUSES, AND THEN DESIGN SOLUTIONS.

PLANNING AND SCHEDULING TOOLS USED BY CONSTRUCTION PROFESSIONALS NOWADAYS NOT ALWAYS CONSIDER THE EFFECT OF VARIABILITY IN THE CONSTRUCTION PROCESS; THEY DO NOT CONSIDER EXPLICITLY THE EFFECT OF CHANGES IN ACTIVITY DURATIONS ALONG THE PRODUCTION CHAIN. DISCRETE EVENT SIMULATION APPROACH IS A RELEVANT EXCEPTION THAT DESERVES PARTICULAR ATTENTION FROM THE CONSTRUCTION INDUSTRY. THE PRESENT RESEARCH PROPOSES A DISCRETE EVENT SIMULATION MODEL APPLIED TO A SIMPLIFIED CONSTRUCTION PROCESS SCHEDULE. THIS MODEL CONSIDERED MAIN CONSTRUCTION ACTIVITIES DIVIDED IN: FOUNDATIONS, STRUCTURE AND ROOFING. THE MODEL CAN BE EXTENDED AND EASILY APPLIED TO OTHER CONSTRUCTION ACTIVITIES. INPUT PARAMETERS FOR THE MODEL WERE OBTAINED DIRECTLY FROM ON-SITE FIELD EXPERIENCE AND A BETA UNIMODAL DISTRIBUTION ASSIGNED. ON A FIRST STAGE, PERT SCHEDULING METHODOLOGY WAS USED FOR THE MODEL, WHICH WAS LATER COMPARED WITH DISCRETE EVENT SIMULATION. RESULTS DID NOT PROVIDE EVIDENCE OF SIGNIFICANT STATISTICAL DIFFERENCES BETWEEN DIFFERENT PROBABILITY DISTRIBUTION USED WITH RESPECT TO THE MEAN PROJECT DURATION OBTAINED USING PERT SCHEDULING AS COMPARED TO THE DISCRETE EVENT SIMULATION MODEL. THIS PROVIDES CONCLUSIONS ABOUT TOTAL PROJECT DURATION AND VALIDATION OF THE PROBABILITY DISTRIBUTION TYPES CONSIDERED IN THE PRESENT RESEARCH.

NOWADAYS THE BUSINESS WORLD IS CHARACTERIZED BY VERTIGINOUS CHANGES MAKING WORK ENVIRONMENTS MORE COMPLEX AND UNCERTAIN. THIS SCENARIO REQUIRES PROFESSIONALS WITH PRACTICAL EXPERIENCE. WHILE STUDENTS AND NEW GRADUATES OFTEN GAIN PRACTICAL EXPERIENCE THROUGH INTERNSHIPS OR PART-TIME JOBS, UNIVERSITIES CAN PLAY AN ACTIVE ROLE IN DEVELOPING THE REQUIRED STUDENT SKILLS. WITHIN THIS CONTEXT, INSTRUCTION AIMED TO PROMOTE LEARNING BASED SOLELY ON MEMORIZATION AS A MECHANISM TO ENSURE COGNITIVE SUFFICIENCY IS CERTAINLY OUTDATED. SIMULATION-BASED TRAINING (SBT), AN ACTIVE LEARNING METHODOLOGY, IS THE APPROACH USED IN THIS STUDY. BOTH SURVEYS AND FOCUS GROUPS WERE PERFORMED TO ASSESS THE IMPACT OF SBT ON THE STUDENTS? LEARNING PROCESS TO UNDERSTAND HOW PRODUCTIVE PROCESSES AFFECT BUSINESS PROFITABILITY. THE SAMPLE INCLUDED STUDENTS FROM TWO COHORTS ATTENDING A BUSINESS SCHOOL. OUR RESULTS SHOW THAT THIS TECHNIQUE IS USEFUL IN BRINGING STUDENTS A STEP CLOSER TO UNDERSTANDING HOW A COMPANY WORKS WHILE INTERACTING IN A CONTROLLED ENVIRONMENT.

SEWAGE TREATMENT PLANTS (STPS) SANITIZE WASTEWATER SO THAT IT CAN BE DISCHARGED INTO NATURAL WATERCOURSES. AS A RE-SULT OF THIS TREATMENT, BIOSOLIDS OR SLUDGE ARE GENERATED. SLUDGE DISPOSAL IS A POTENTIAL SOURCE OF SOIL AND WATER POLLUTION, AND ITS MANAGEMENT CAN ACCOUNT FOR UP TO 50% OF THE OPERATION-AL COSTS OF WASTEWATER TREATMENT FACILITIES. ON THE OTHER HAND, THE MANAGEMENT OF OTHER SOURCES OF ORGANIC WASTES SUCH AS FRUIT AND VEGETABLE WASTE (FVW) REPRESENT A CHALLENGE AND AN OPPORTUNITY, DUE TO THEIR HIGH VOLUMES AND POTENTIAL EN-ERGY VALORIZATION THOUGH BIOLOGICAL AND THERMAL PROCESSES. IN THIS ARTICLE, WE REVIEW THE MAIN REPORTS REGARDING ANAEROBIC CO-DIGESTION OF SEWAGE SLUDGE WITH FVW AND SIMILAR RESIDUES. ONLY PILOT AND FULL-SCALE EXPERIENCES WERE INCLUDED IN OUR SEARCH, IN AN ATTEMPT TO PROVIDE A REALISTIC ASSESSMENT OF THE DEGREE OF TECHNOL-OGY ADOPTION IN INDUSTRIAL PLANTS. ADDITIONALLY, WE REVIEW THE CUR-RENT CHILEAN, EUROPEAN AND AMERICAN REGULATIONS REGARDING ?NAL DISPOSAL OR ELIMINATION OF SLUDGE, WITH EMPHASIS ON THOSE THAT INVOLVE WASTE ENERGY VALORIZATION, SUCH AS INCINERATION IN CEMENT PLANTS.