دانلود رایگان مقاله انگلیسی سیستم برنامه ریزی منابع سازمانی در نگهداری درمانگاه ها - نشریه الزویر

abstract

The intensive use of community clinics in recent years has emphasized the importance of non-core activities in facilities supporting patient care. This study poses the following hypotheses: The maintenance and performance of clinics can be monitored with accuracy and reliability by following key performance indicators (KPIs) based on criteria for performance and life cycle costs, and implementation of such principles can contribute both to cost savings and improved performance. A performance-based model was developed for clinic facilities by integrating eight KPIs into an enterprise resource planning (ERP) system for the maintenance of public clinic facilities. The ERP system has an inference engine designed to establish maintenance policy by deductive inference of the clinic's profile and inductive reasoning generated by the KPIs. Implementation of the model in a sample of 42 clinics resulted in increased efficiency (+25%).

6. Conclusions

This manuscript presents a theoretical scientific infrastructure based on a framework of KPIs that was used to develop a 3-module ERP system for the maintenance of clinic facilities. This depends on a framework of KPIs selected and adapted specifically for clinic facilities. These were chosen to enable an evaluation of the following:

• Analysis of the clinic's performance

• Maintenance efficiency analysis

• Derivation of maintenance policy of the systems at the clinic facility.

The proposed ERP system is generic because it is based on three principles of reasoning: (a) performance benchmarking, (b) adjustment of the maintenance expenditures in accordance with the effects of age and other service conditions, such as patient density, and (c) benchmarking of maintenance efficiency. The system was validated by the application of the above principles in a two-phase pilot study, which showed an improvement of 25% in efficiency with regard to the allocation and application of resources for clinic maintenance. As 70% of the maintenance resources were labor resources, the better cost-effectiveness was expressed in similar savings in labor. The performance of the clinics improved as well. Through the use of the proposed KPIs and LCC principles, it is also possible to benchmark the asset's performance in relation to other clinics or facilities (inter-organizational benchmarking) and to benchmark the clinic's systems in order to compare the efficiency of the various maintenance crews (intra-organizational benchmarking).

Statistical analysis demonstrated not only enhanced performance but also a 48% reduction in the variability of the performance of the clinics and a 16% decrease in normalized annual maintenance expenditure (NAME). The latter indicates that the performance of the maintenance regime can be significantly improved by using the proposed ERP system, thus allowing a public organization to predict and more precisely define the expenditure on clinic maintenance.