National emission standards for hazardous air pollutants for ethylene oxide commercial sterilization and fumigation operations--EPA. Interim final rule.

Today's action suspends the National Emission Standards for Hazardous Air Pollutants for Ethylene Oxide Commercial Sterilization and Fumigation Operations (EO NESHAP) requirements for chamber exhaust and aeration room vents. The suspension allows affected sources subject to the EO NESHAP to defer compliance with the NESHAP requirements for chamber exhaust and aeration room vents for one year until December 6, 1999. This suspension does not affect the requirement for sources subject to the EO NESHAP to comply with provisions for sterilizer vents by December 6, 1998. This action does not change the level of the standards or the intent of the NESHAP promulgated in 1994.

The legal aspects of production documentation/product liability and the abolition of crown immunity. Part 1. Production documentation.

The Manager of the SSD finds himself in the present day at a time of revolutionary change. One of the most immediate concerns is the preparation for competitive tendering: he may be organizing an in-house tender as well as setting up the specifications for the tenders. He may at the same time be concerned for his own future. He also knows that, next year, no fault liability, as a result of the Consumer Protection Act 1987, will be implemented. Already he is anxious at the possibility of court action as a result of negligence in re-using single use disposable items and he knows that no fault liability will lead to far greater problems.

The legal aspects of production documentation/product liability and the abolition of Crown immunity.

The principle of fault liability, enshrined in the Donaghue v Stevenson case, will be revolutionized when the provisions on Product Liability contained in the Consumer Protection Act 1987 comes into force in March 1988. These provisions were passed in order to implement the Directive of the Council of European Communities 25th July 1985 on liability for defective products and the provisions are to be construed accordingly (No 85/374/EEC). Section 2 provides that, 'Where any damage is caused wholly or partly by a defect in a product, every person to whom subsection (2) applies shall be liable for the damage. This section is the crux of the no fault product liability principle.

Evaluation of the Plazlyte Sterilization System at the Richmond Hospital, Richmond, B.C.

Ethylene oxide mixed with chlorofluorocarbons has been the sterilant of choice for heat- and pressure-sensitive instruments and equipment in most Canadian and U.S. healthcare facilities. A pending July 1, 1994 ban on CFCs in British Columbia propelled the Greater Vancouver Regional Hospital District (GVRHD) to seek out any new available technologies to replace EtO sterilization. AbTox Plazlyte Sterilization System, which employs a proprietary, low-temperature gas plasma in conjunction with vaporized peracetic acid chemistry to provide terminal sterilization of instruments and devices, appeared very promising. A task force was formed at the Richmond Hospital to develop and implement a clinical isolate test protocol of the system. Following the three-month trial, the results showed the system to be effective in sterilizing all clinical isolates and compatible with the materials tested. There has also been improved product throughput. The Richmond Hospital now uses one Plazlyte sterilizer to process all items formerly processed using EtO.

The impact of Title V regulations on hospitals and health care facilities.

The Clean Air Act, enacted in 1970, failed to provide for an enforceable regulatory scheme at any level of government. In late 1990, Congress passed the Clean Air Act Amendments, of which Title V is the focal point. This amendment includes the Operating Permit Program, which states that all "major sources" are required to obtain Title V operating permits on or before November 15, 1995. Under Title V, the burden of demonstrating compliance will now fall directly to the facility itself. This document both summarizes and highlights the requirements of the Operating Permit Program and presents guidelines for preparing to file a Title V Operator Permit application.

Mejorando la cadena de suministro en un hospital mediante la gestión Lean / Improving a hospital's supply chain through lean management

Objetivos. La gestión del suministro constituye un área en la que los hospitales tienen importantes oportunidades de mejora. Este trabajo pretende analizar cómo la aplicación de los principios de Lean puede mejorar los costes logísticos y la satisfacción de los usuarios. Métodos. Análisis de los resultados de una experiencia de reorganización del sistema logístico de un hospital basada en algunos principios Lean. Para el cálculo de los costes logísticos se ha utilizado el método del coste completo o full costing de contabilidad analítica de gestión. La satisfacción del usuario se evaluó mediante encuesta anónima. El tratamiento de los datos de la encuesta incluyó análisis factorial y el modelo de análisis de la varianza ANOVA. Resultados. Los datos obtenidos mostraron una mejora en la gestión de logística tras la implantación de Lean, con reducción de costes y mejora del nivel de satisfacción del usuario interno. Se ha observado que el personal sanitario percibe y valora el servicio logístico de manera global, sin diferenciar los aspectos del servicio, detectándose diferencias en cuanto al grado de satisfacción percibida por distintos grupos de usuarios. Conclusiones. La experiencia analizada ha permitido comprobar la aplicabilidad e idoneidad de los principios Lean para mejorar los costes e incrementar la satisfacción de los usuarios de servicios logísticos hospitalarios (AU)

Objectives: Supply management is an area where hospitals have significant opportunities for improvement. The main objective of this paper has been to analyze how the application of Lean principles can improve logistics costs and user satisfaction. In connection with satisfaction, it also aimed to examine which aspects of the service define it and check for differences between different groups of users. Methods: The results of an experience to reorganize the hospital logistic system based on some Lean principles have been studied. This is therefore a case study, which combine different methods of data collection. The logistics cost calculation was carried out using the full costing method. To measure satisfaction of healthcare personnel, the internal logistics service users, an anonymous survey was conducted. Processing of the data obtained from the survey have included exploratory analysis, factor analysis and ANOVAs. Results: The data have showed an improvement in logistics management after the implementation of Lean principles. Logistics costs were reduced and the satisfaction level of the internal users with the new logistics system was increased. Some differences in the degree of satisfaction by different groups of users were also detected, although they did not seem to distinguish between different aspects of logistic service. Conclusions: The analyzed experience shows the applicability and suitability of Lean principles to improve logistics operational costs and increase user satisfaction (AU)