Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit

Background The intensive care unit (ICU) staffing model affects clinical outcomes of critically ill patients. However, the benefits of a closed unit model have not been extensively compared to those of a mandatory critical care consultation model. Methods This retrospective before-after study included patients admitted to the medical ICU. Anthropometric data, admission reason, Acute Physiology and Chronic Health Evaluation II score, Eastern Cooperative Oncology Group grade, survival status, length of stay (LOS) in the ICU, duration of mechanical ventilator care, and occurrence of ventilator-associated pneumonia (VAP) were recorded. The staffing model of the medical ICU was changed from a mandatory critical care consultation model to a closed unit model in September 2017, and indices before and after the conversion were compared. Results A total of 1,526 patients were included in the analysis. The mean age was 64.5 years, and 954 (62.5%) patients were men. The mean LOS in the ICU among survivors was shorter in the closed unit model than in the mandatory critical care consultation model by multiple regression analysis (5.5 vs. 6.7 days; p = 0.005). Central venous catheter insertion (38.5% vs. 51.9%; p < 0.001) and VAP (3.5% vs. 8.6%; p < 0.001) were less frequent in the closed unit model group than in the mandatory critical care consultation model group. After adjusting for confounders, the closed unit model group had decreased ICU mortality (adjusted odds ratio 0.65; p < 0.001) and shortened LOS in the ICU compared to the mandatory critical care consultation model group. Conclusion The closed unit model was superior to the mandatory critical care consultation model in terms of ICU mortality and LOS among ICU survivors.

Pendampingan Penyusunan Pedoman Staffing Model Untuk Meningkatkan Efisiensi Usaha Pada PT. Asuransi Bangun Askrida Bandung

This community service activity was carried out in Kelurahan, Cijagra, Lengkong District, Bandung City, 40253 with the target of PT. Askrida Insurance Bandung. Based on interviews and observations, the problems faced by partners today are the amount of premium rates that are difficult to compete with similar companies, poor work governance that requires employees to work overtime every day and the slow delivery of services to customers. This program has the following objectives: 1) improving the welfare of the community through the improvement of healthy financial institutions, especially insurance 2) improving the skills and professionalism of the community 3) increasing business efficiency for partners so that they are able to compete and serve the community better. This activity uses two approaches, namely the training and mentoring approach. The training approach includes: 1) job analysis training; 2) training on work load analysis (work load analysis); and 3) skills training for the preparation of staffing model guidelines. While the mentoring methods include: 1) assistance in conducting job analysis; 2) workload analysis assistance; 3) assistance in the preparation of staffing model guidelines. The results of this community service activity have an impact on clients to be able to organize their employees well, so as to improve business efficiency and serve the community better.

Construction of maintenance staffing model for managing sports venues in comprehensive sports games: A research based on the practice of the 7th military world games

The operation and maintenance of sports venues is the basis of ensuring the orderly organization of various events in large-scale comprehensive sports games. Due to the lack of evaluation methods and an index system, it was difficult to predict the input of operating and managing sports venues in large-scale comprehensive sports games. Excessive manpower is often put to guarantee the smooth operation work, causing the problem of waste on all resources. Based on the practice of the operational work for specified sports fields during the 7th World Army Games, this paper establishes a staffing allocation model for the maintenance and operation of sports venues. On the premise of building up a clear maintenance scope, a clarified organization structure and working procedure, the maintenance index of 15 specified venues is evaluated with analytic hierarchy process (AHP), and a set of allocation criteria of the operation team is put forward. The maintenance coefficients of studied venues range from 0.08 to 0.91, and the venues with highest coefficients are the main stadium, the naval pentathlon venues and the soccer field, etc.