Investigation of the Impact of Micro-Structuring on the Bonding Performance of Beechwood (Fagus Sylvatica L.)

Although glueing softwood is well mastered by the industry, predicting and controlling bond quality for hardwood is still challenging after years of research. Parameters such as the adhesive type, resin–hardener ratio, and the penetration behaviour of the wood are determinants for the bond quality. The aim of this work was to assess to what extent the glueing behaviour of beechwood can be improved by using structural planing. The different surfacing methods were characterised by their roughness. The bond strength of the micro-structured surfaces was determined according to EN 302-1, and the delamination resistance was tested as indicated by EN 302-2 for type I adhesives. Micro-structured surfaces were compared with different surfaces (generated by surfacing methods such as dull/sharp planing and sanding). In dry test conditions, all surfacing methods gave satisfying results. In the wet stage, the bond strength on the finer micro-structured surface slightly outperformed the coarse structure surface. For the delamination resistance, a clear improvement could be observed for melamine-formaldehyde-bonded specimens since, when using the recommended amount of adhesive, micro-structured surfaces fulfilled the requirements. Nevertheless, structural planing cannot lead to a reduction in the applied grammage since no sample with a smaller amount fulfilled EN 302-2 requirements even by observing the recommended closed assembly waiting time. Adhesion area enlargement of the micro-structuring is minor. The good delamination performance without waiting time (CAT) is not caused by surface enlargement, since finer micro-structured surface with negligible area increase and delivered even better delamination resistance. Subsurface analysis should be carried out to thoroughly investigate this phenomenon.

MAD Dispersion Measure Makes Extremal Queue Analysis Simple

A notorious problem in queueing theory is to compute the worst possible performance of the GI/G/1 queue under mean-dispersion constraints for the interarrival- and service-time distributions. We address this extremal queue problem by measuring dispersion in terms of mean absolute deviation (MAD) instead of the more conventional variance, making available methods for distribution-free analysis. Combined with random walk theory, we obtain explicit expressions for the extremal interarrival- and service-time distributions and, hence, the best possible upper bounds for all moments of the waiting time. We also obtain tight lower bounds that, together with the upper bounds, provide robust performance intervals. We show that all bounds are computationally tractable and remain sharp also when the mean and MAD are not known precisely but are estimated based on available data instead. Summary of Contribution: Queueing theory is a classic OR topic with a central role for the GI/G/1 queue. Although this queueing system is conceptually simple, it is notoriously hard to determine the worst-case expected waiting time when only knowing the first two moments of the interarrival- and service-time distributions. In this setting, the exact form of the extremal distribution can only be determined numerically as the solution to a nonconvex nonlinear optimization problem. Our paper demonstrates that using mean absolute deviation (MAD) instead of variance alleviates the computational intractability of the extremal GI/G/1 queue problem, enabling us to state the worst-case distributions explicitly.

Relationship Between Waiting Time on Patient Satisfaction at Baloi Permai Batam Puskesmas Year 2021

Background: Medical records are an important part in assisting the implementation of service delivery to patients in hospitals. This research aimsMethods: Quantitative with survey research, a quantitative approach is used to find out how effective the relationship between waiting time and patient satisfaction is at the Baloi Permai Health Center.Results: The results of the chi square statistical test showed that the p-value of 0.001 was less than 0.050, so it can be said that there is a significant relationship between waiting time and patient satisfaction. The odds ratio for the relationship between waiting time and patient satisfaction is 7.263 with 95% CI between 2.143- 24.614. Patients with long waiting times are 7,263 or 7 times more likely to have a low level of satisfaction compared to patients whose waiting times are not too long.Conclusions: Based on the results of the study, it can be concluded that there is an effect of patient waiting time on outpatient satisfaction. The staff of the Baloi Perma Batam outpatient unit should further improve services, especially for waiting time for outpatients. Based on the results of the study, it can be concluded that there is an effect of patient waiting time on outpatient satisfaction. The staff of the Baloi Perma Batam outpatient unit should further improve services, especially for waiting time for outpatients.

UPAYA PENERAPAN METODE LEAN THINKING PADA PROSES PELAYANAN FARMASI RAWAT JALAN

Pharmacy services in a hospital are an inaccessible part of the hospital services as a whole. The accumulation of prescriptions in the pharmacy will cause the prescription process to be long and long, which has an impact on customer waiting times, which of course will have a major impact on customer satisfaction. From the standard time set as Quality Indicators at Bali Jimbaran Hospital, namely: drug processing at the outpatient pharmacy of Bali Jimbaran Hospital is 60 minutes of concocted drugs, 30 minutes of non-concocted drugs. The purpose of this research is to identify activities starting from the input, process and results generated through the Lean approach. The method used is an observational action process research, using lean methods to photograph the outpatient pharmacy service process flow through document review, direct interviews, interviews. The result of the research is an improvement in waiting time, it can be seen that the NVA activities can be eliminated by 66% and VA activities show an increase of 44%. With the many activities that are VA and the elimination of NVA activities, it will accelerate the process of outpatient pharmacy services at the Bali Jimbaran Hospital and improve customer satisfaction, which can be seen from the decrease in customer complaints against outpatient pharmacy services by up to 50%, which was previously 80%. Keywords: Lean, Pharmacist, Waiting time, Value Added, Non-Value Added

Reducing Waiting Time in the General Pediatric Clinic at Al Wakra Hospital, Qatar

Background: Waiting times for clinic appointments constitute a key indicator of an outpatient department performance for access to care and patient satisfaction. This is particularly relevant for pediatric population. The Ministry of Public Health in Qatar set a waiting time of 28 days for patients to get new appointment in General Outpatient Department (GOPD). The current average waiting time to get a new appointment in the general pediatric clinic (GPC) at AWH is 57 days. Aim: Decrease the average waiting time to get a new clinic appointment from 57 days to 28 days by the end of December 2018, and to meet the national targets set by the Ministry of Public Health. Methodology: This is a Quality Improvement (QI) project using the Model for Improvement (MFI). The MFI framework is designed to support organizations answering fundamental questions before agreeing on drivers for change. The implementation of change was be facilitated by the Plan-Do-Study-Act (PDSA) cycles methodology. The QI project team performed a root cause analysis using the Ishikawa diagram and identified the key contributing factors to the long waiting times to get a new appointment. Twenty-seven PDSA cycle ramps were designed with support of predictive tool to test innovative changes in current operational processes in an attempt to improve waiting time in the general pediatric clinic at Al Wakra Hospital. Results: The monthly average number of referrals for GPC increased by 200% between the pre and post implementation periods. The average triage waiting time improved from 6 to 2.6 days in 2018 and the average become 1 day in 2019. Post-implementation the average waiting time for patients to get new appointment improved from 57 days to 28 days in 2018 and the average waiting time improved to 16 days in 2019. Conclusion: The quality improvement project for the AWH general pediatric clinic demonstrates significant improvement in waiting times for new appointments, the recommendation for the hospital leadership would be to rollout the improvement methodology to other clinics that suffer from similar challenges.

Bus Travel Time Reliability Incorporating Stop Waiting Time and In-vehicle Travel Time with AVL Data

Improving bus operation quality can attract more commuters to use bus transit, and therefore reduces the share of car and alleviates traffic congestion. One important index of bus operation quality is the bus travel time reliability, which in this paper is defined to be the probability when the sum of bus stop waiting time and in-vehicle travel time is less than a certain threshold. We formulate the bus travel time reliability by the convolution of independent events’ probabilities, and elaborate the calculation method using Automatic Vehicle Location (AVL) data. Next, the No.63 Bus Line in Harbin City is used to test the applicability of the proposed method, and analyze the influence factors of the bus travel time reliability. The numerical results show that factors such as weather, workday, departure time, travel distance, and the distance from the boarding stop to the bus departure station will significantly affect the travel time reliability. At last, some general conclusions and future research are summarized.