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Publicações

Publicações por Nazaré Rego

2014

A hybrid approach for integrated healthcare cooperative purchasing and supply chain configuration

Autores
Rego, N; Claro, J; de Sousa, JP;

Publicação
HEALTH CARE MANAGEMENT SCIENCE

Abstract
This paper presents an innovative and flexible approach for recommending the number, size and composition of purchasing groups, for a set of hospitals willing to cooperate, while minimising their shared supply chain costs. This approach makes the financial impact of the various cooperation alternatives transparent to the group and the individual participants, opening way to a negotiation process concerning the allocation of the cooperation costs and gains. The approach was developed around a hybrid Variable Neighbourhood Search (VNS)/Tabu Search metaheuristic, resulting in a flexible tool that can be applied to purchasing groups with different characteristics, namely different operative and market circumstances, and to supply chains with different topologies and atypical cost characteristics. Preliminary computational results show the potential of the approach in solving a broad range of problems.

2020

Customized risk assessment in military shipbuilding

Autores
Crispim, J; Fernandes, J; Rego, N;

Publicação
RELIABILITY ENGINEERING & SYSTEM SAFETY

Abstract
This paper describes a customized risk assessment framework to be applied in military shipbuilding projects. The framework incorporates the Delphi method with visual diagrams, Bayesian Networks (BN) and the expression of expert opinions through linguistic variables. Noisy-OR and Leak Canonical models are used to determine the conditional probabilities of the BN model. The approach can easily be adapted for other shipbuilding construction projects. The visual diagrams that support the Delphi questionnaire favor the comprehensive visualization of the interdependencies between risks, causes, risks and causes, and risks and effects. The applicability of the framework is illustrated through the assessment of risk of two real military shipbuilding projects. This assessment includes a sensitivity analysis that is useful to prioritize mitigation actions. In the two cases studies, the risks with higher probability of occurrence were failures or errors in production, of the contracted, in the requirements, and in planning. The results of the sensitivity analysis showed that a set of mitigation actions directed at relatively easily controllable causes would have achieved important reductions in risk probabilities.

2021

Supply chain flows and stocks as entry points for cyber-risks

Autores
Gomes, N; Rego, N; Claro, J;

Publicação
INTERNATIONAL CONFERENCE ON ENTERPRISE INFORMATION SYSTEMS / INTERNATIONAL CONFERENCE ON PROJECT MANAGEMENT / INTERNATIONAL CONFERENCE ON HEALTH AND SOCIAL CARE INFORMATION SYSTEMS AND TECHNOLOGIES 2020 (CENTERIS/PROJMAN/HCIST 2020)

Abstract
As supply chains become more digital to reach new levels of global competitiveness, caveats from this decision arise. Cyber-risks are one of these potential setbacks, affecting supply chains directly and indirectly, and propagating via supply chain flows and stocks information, material, and financial. This study applied a systematic literature review to determine how the supply chain's flows and stocks serve as points of entry to cyber-risks. Cyber-risks arise from different sources (i.e., direct attacks, built-in problems, low-quality issues), impacting supply chains' flows and stocks (material and information). There is a relation between the type of supply chain and which flow, or stock facilitates access to the supply chain. Finally, we provide a distinction between two concepts related to Supply Chain Risk Management and cyber-risks. This research is useful to 1) enterprise decision-makers, as the description of potential cyber-risks' points of entry delivers hints on where to focus managerial efforts; 2) developers of Supply Chain Management (SCM) Information and Communication Technology (ICT) systems, since discussing potential points of entry build awareness about probable exploitation points, thus improving ICT systems' resiliency, and 3) scholars, as the depiction of the state-of-the-art may serve as a common departing point for future research. (C) 2021 The Authors. Published by Elsevier B.V.

2019

Project risk management practices: the organizational maturity influence

Autores
Crispim, J; Silva, LH; Rego, N;

Publicação
INTERNATIONAL JOURNAL OF MANAGING PROJECTS IN BUSINESS

Abstract
Purpose The purpose of this paper is to identify patterns of project risk management (PRM) practices' adoption, and provides empirical evidence concerning the importance (and key attributes) of organizational PRM maturity to the use of risk-related practices and project performance. Design/methodology/approach The research involved two phases: interviews with five project managers, and a worldwide survey of project managers that resulted in the analysis of 865 valid questionnaire responses. Cluster analysis was used to classify PRM practices' use, factor analysis to detect the structure of the relationship between the variables measuring PRM practices' use and a multiple regression analysis (with canonical correlation) to further reveal the different degrees to which PRM practices and organizational maturity are associated. Findings The identified patterns of risk practices' adoption indicate that different contexts of organization PRM maturity and project complexity influence practices selection. The PRM practices related with targets (e.g. time-phased budget plan) are the most used, and those related to tools and techniques (e.g. S-curve) are the least used. Additionally, the obtained results confirm that organizational PRM maturity influences risk practices' usage, moderated by project complexity, and organizational PRM maturity influences project performance. Originality/value Empirical methods were used to investigate the relationship between organizational PRM maturity and a large set of PRM practices with project complexity as a moderator. Gaps in the use of PRM practices (i.e. areas where more PRM knowledge and training are needed) were identified. Finally, this work identifies the attributes of organizational maturity with implications in practices' usage and project performance.

2019

Potential of a nurse telephone triage line to direct elderly to appropriate health care settings

Autores
Jacome, M; Rego, N; Veiga, P;

Publicação
JOURNAL OF NURSING MANAGEMENT

Abstract
Aim To explore the potential of a nurse health triage telephone line to advise and guide elderly users' decisions regarding the appropriate health care setting and self-care. Background Ageing is a concern in many countries and poses challenges to health care services. Triage and advice lines can play an important role for the (re)organisation of health care delivery. Discussion has been focused on the capacity of these lines to reduce inappropriate demand for acute and emergency departments. Methods Cross-sectional descriptive analysis. Results Nurses directed elders to a health care service both by downgrading their initial intentions (concurring to the most common objective) and by upgrading them (e.g., directing elders that intended to stay at home to acute and emergency care). The intention to comply with the nurse's disposition was high. Conclusions The line helped to improve the appropriateness of acute and emergency care demand and to reduce the overall demand for care by elders. There is nonetheless space for improvement given the underuse of the line by elders. Implications for Nursing Management Health telephone-based triage and advice should be promoted to increase the match between the needs of elderly patients and health resources, thus improving health equity.

2021

Perceptions of Patients and Physicians on Teleconsultation at Home for Diabetes Mellitus: Survey Study

Autores
Rego, N; Pereira, HS; Crispim, J;

Publicação
JMIR HUMAN FACTORS

Abstract
Background: Diabetes mellitus (DM) is one of the most challenging diseases in the 21st century and is the sixth leading cause of death. Telemedicine has increasingly been implemented in the care of patients with DM. Although teleconsultations at home have shown to be more effective for inducing HbA(1c) reduction than other telemedicine options, before the 2019 coronavirus disease crisis, their use had been lagging behind. Studies on physicians' or patients' perceptions about telemedicine have been performed independently of each other, and very few have focused on teleconsultations. In a time of great pressure for health systems and when an important portion of health care has to be assured at a distance, obtaining insights about teleconsultations at home from the stakeholders directly involved in the health care interaction is particularly important. Objective: The perceptions of patients and physicians about their intentions to use home synchronous teleconsultations for DM care are examined to identify drivers and barriers inherent to programs that involve home teleconsultations. Methods: Two identical questionnaires integrating the technology acceptance model and the unified theory of acceptance and use of technology and assessing the confidence in information and communication technology use of patients and physicians were developed. Responses by patients (n=75) and physicians (n=68) were analyzed using canonical correlation analysis. Results: Associations between predictor constructs (performance, effort, social influence, facilitating conditions, and attitude) and intention to use yielded significant functions, with a canonical R-2 of 0.95 (for physicians) and 0.98 (patients). The main identified barriers to patient intention to use were the expected effort to explain the medical problem, and privacy and confidentiality issues. The major drivers were the facilitation of contact with the physician, which is beneficial to patient disease management and treatment, time savings, and reciprocity concerning physicians' willingness to perform teleconsultations. Responses from physicians revealed an association between intention to use and the expected performance of home teleconsultations. The major barrier to intention to use expressed in physicians' answers was doubts concerning the quality of patient examination. The major drivers were time savings, productivity increases, improvements in patient's health and patient management, National Health System costs reduction, and reciprocity relative to patients' willingness to engage in teleconsultations. Conclusions: To promote the use of home teleconsultations for DM, decision makers should improve patients' health literacy so the physician-patient communication is more effective; explore information and communication technology developments to reduce current limitations of non-face-to-face examinations; ensure patient privacy and data confidentiality; and demonstrate the capabilities of home teleconsultations to physicians.

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