Healthcare various

A wealth of different techniques and approaches are available in the quest for safer healthcare, variously supported by theory, evidence and common sense, and it can be very difficult to discern underlying themes and direaions. Underlying the plethora of approaches however, we can distinguish two broad approaches. These two visions of safety are seldom explicitly articulated, but are ever present themes in debates and discussions about patient safety. 

Different approaches to metrics have been described by noted authors for various parts of the chemical enterprise and examples of their applications in practice have been provided. The main focus has been on chemical processes but the breadth and interconnections chemistry has with other technology sectors (e.g., energy, electronics, healthcare, food, consumer products) means that many aspects of the book will be relevant to those related sectors as well. 

The number of new NIR fluorophores that can be used in biological systems has grown substantially in recent years as a consequence of extensive research efforts to improve the properties of available dyes. A brief overview of the various types of long-wavelength (above 600 nm) fluorophores including phycobiliproteins, BODIPY, and Alexa Fluor dyes (Life Technologies), Cy dyes (GE Healthcare),... 

Organic fluorescent dyes with the appropriate spectral properties also can be paired with lanthanide chelates in FRET systems. For instance, many rhodamine dyes and the cyanine dye Cy5 have ideal excitation wavelengths for receiving energy from a nearby europium chelate. The LeadSeeker assay system from GE Healthcare incorporates various Cy5-labeled antibodies for developing specific analyte assays. In addition, if using a terbium chelate as the donor, then a Cy3 fluorescent dye can be used in assays as the acceptor. 

Medical devices and pharmaceuticals are two closely related communities. Their materials of concern are agents intended as therapeutics or as components of devices to be used in healthcare, where the production worker or healthcare provider (doctor, nurse, or pharmacist) may have a significant chance of exposure, but the major concern is for those patients who receive or use the drug or device. Various centers of the Food and Drug Administration (FDA) are the primary U.S. regulators. 

References [52-54] do not include any data directly comparing squaraine rotaxanes with common cyanine dyes such as Cy5 (GE Healthcare) and Alexa 647 (Life Technologies). Nevertheless, from the available data it can be concluded that squaraine rotaxanes are remarkably resistant to chemical and photochemical degradation, and likely to be very useful as a versatile fluorescent scaffold for constructing various types of highly stable, red and near infrared (NIR) imaging probes and labels. 

Tablets 0.75 and 1.5 mg estropipate (Rx) Various, Ogen (Pharmacia), 0rtho-Est Vs/omen First Healthcare)...

Solution Sodium chloride Various, Pretz Moisturizing, Pretz Irrigation (Parnell), Afrin Saline (Schering-Plough Healthcare), Simply Saline (Blairex)... 

Various, Duradrin (Barr), Midrin (Women First Healthcare), Migratine (Major)... 

Explanations and details of these terms can be obtained in various books and pamphlets, for instance, Allen (1980) and Liversey (1983). No one parameter is self-sufficient, and alone gives a complete view of the financial status of a project or product. Therefore a number of parameters are usually calculated, and used in conjunction. They serve to give indications of how to minimise the period over which capital needs to be committed to a specific project, to show changes in the cost-structure of the process with time, and to reduce the time taken to convert the material, labour and overhead resources (the working capital) into cash in the form of profits from sales. That is, to make the cash-flow as favourable as possible. Each comparer will have different criteria as to what constitutes an acceptable financial risk when evaluating a project. Obviously healthcare product/pharmaceutical companies have quite different criteria to companies manufacturing bulk chemicals. 

Compliance is defined as adherence to the recommended treatment plan of a healthcare professional. Typically, it is partial at best, in that medications prescribed are taken less often than recommended, irregularly, and, at times, excessively. There are various reasons for noncompliance, which can be categorized as follows ... 

Various approaches to self-regulation have heen taken hy different physicians organizations. However, a review of these approaches reveals general themes. In most cases, the primary justification for having a direct relationship between the pharmaceutical industry and individual physicians seems to he based on the premise that an advancement of patient healthcare will occur through increased education and research. This assumes that the information provided to the physician is impartial and also disregards the capacity of physicians to keep themselves up to date about advances in drug therapy by way of medical and other academic journals. 

Detlev Ruland is a principal at McKinsey based in Dusseldorf. He is a member of the Business Technology office and co-leads its global IT performance management practice. He has worked in various fields of IT in the process, pharmaceuticals, healthcare, and energy industries, focusing on IT-enabled operations and performance transformations. He studied mathematics and computer science at RWTH Aachen and holds a PhD in natural sciences. 

The resultant fabrics are unique in that they have many functional property improvements thermal adaptability due to the phase change nature of the bound polyol, durable press or resiliency, soil release, reduction of static charge, antimicrobial activity, enhanced hydrophilicity and improved flex life, and resistance to pilling. Because of the different molecular weights of polyols, resins, acid catalysts, and fabric constructions, there are numerous modified fabrics that can be produced with sets of improved attributes. Each fabric must be carefully evaluated for optimum curing conditions and formulations to produce the desired product. Several licenses have been granted for this process. Various types of apparel, healthcare items, and industrial fabrics are currently evaluated for commercial production [381,382]. 

The Joint Commission on Accreditation of Healthcare Organizations requires that all patients receive a pain assessment and appropriate pain-relief measures. Various pain scales are available to measure pain in preverbal and verbal children nurses should administer... 

Pharmaceutical and healthcare companies may also find it beneficial to tailor particular sets of procedures to different types of systems. This may help ownership and adoption since different types of systems are usually supported by QA/laboratory, engineering, and IT departmental functions. From a technical standpoint, too, it is very difficult to make a single set of procedures easy to use while providing a practical level of detail to address the various technical characteristics of different types of computer systems. One size does not readily fit all. As a consequence, typically there might be four sets of validation procedures ... 

The various validation approaches promoted within the pharmaceutical and healthcare industries by GxP regulators and industry groups adopt the same basic approach ... 

These factors should be assessed for each supplier being considered, so that the best balance of business fit and compliance can be achieved. An example supplier evaluation matrix is provided in Figure 7.4. Of course, identifying a clear winner in the selection process is seldom clear-cut, and the winner rarely meets all the selection criteria. Some pharmaceutical and healthcare companies weigh the importance of various factors and for the outcome compare the sum totals for each supplier. A summary of the supplier selection process applied to larger systems should be retained for possible subsequent inspection. ... 

More sophisticated FMEAs examine the level of concern over various hazards in terms of GxP criticality. Figure 8.9 describes how to determine three levels of concern low, medium, and high. The decision tree presented considers only the impact on drug product quality. Some pharmaceutical and healthcare companies may want to include operator safety, business impact, and even the GAMP categories of software affected in their determination of these levels of concern. ... 

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