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This paper presents sensitivity and resilience analyses for a trigeneration system designed for a hospital. The following information is utilized to formulate an integer linear programming model: (1) energy service demands of the hospital, (2) technical and economical characteristics of the potential technologies for installation, (3) prices of the available utilities interchanged, and (4) financial parameters of the project. The solution of the model, minimizing the annual total cost, provides the optimal configuration of the system (technologies installed and number of pieces of equipment) and the optimal operation mode (operational load of equipment, interchange of utilities with the environment, convenience of wasting cogenerated heat, etc.) at each temporal interval defining the demand. The broad range of technical, economic, and institutional uncertainties throughout the life cycle of energy supply systems for buildings makes it necessary to delve more deeply into the fundamental properties of resilient systems: feasibility, flexibility and robustness. The resilience of the obtained solution is tested by varying, within reasonable limits, selected parameters: energy demand, amortization and maintenance factor, natural gas price, self-consumption of electricity, and time-of-delivery feed-in tariffs.

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Objetivo Utilizar técnicas de clustering para caracterizar a los proveedores de servicios de mantenimiento de una institución de salud. Métodos El estudio analiza el inventario del equipamiento perteneciente a 7 áreas pilotos (264 equipos médicos). Se aplican técnicas de clustering usando 26 variables. Entre las más significativas: el tiempo de respuesta (RT), la duración de las intervenciones (DR), la disponibilidad y el tiempo de cambio de estado (TAT). Resultados La obsolescencia del equipo biomédico en promedio es de 0,78. Se identifican 4 grupos de proveedores de servicios. Grupos (1 y 3): Mejor desempeño, menores valores de TAT, RT y DR; cuyos proveedores son: O, L, C, B, I, S, H, F, G; representan el 56 por ciento del total; con valores de TAT entre: 1,4 días

Objective Using clustering techniques for characterising companies providing health institutions with maintenance services. Methods The study analysed seven pilot areas' equipment inventory (264 medical devices). Clustering techniques were applied using 26 variables. Response time (RT), operation duration (OD), availability and turnaround time (TAT) were amongst the most significant ones. Results Average biomedical equipment obsolescence value was 0.78. Four service provider clusters were identified: clusters 1 and 3 had better performance, lower TAT, RT and DR values (56 percent of the providers coded O, L, C, B, I, S, H, F and G, had 1 to 4 day TAT values:

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OBJECTIVE: Using clustering techniques for characterising companies providing health institutions with maintenance services. METHODS: The study analysed seven pilot areas' equipment inventory (264 medical devices). Clustering techniques were applied using 26 variables. Response time (RT), operation duration (OD), availability and turnaround time (TAT) were amongst the most significant ones. RESULTS: Average biomedical equipment obsolescence value was 0.78. Four service provider clusters were identified: clusters 1 and 3 had better performance, lower TAT, RT and DR values (56 % of the providers coded O, L, C, B, I, S, H, F and G, had 1 to 4 day TAT values:

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"Accomplishing in-house CT maintenance can be a lengthy process," warns the author speaking from his own experience at the Department of Veterans Affairs Medical Center, Philadelphia, Pennsylvania. However, Mr. Brown insists that the payoff can be substantial in terms of significant cost savings and decreased downtime. His step-by-step advice and documentation are structured to help managers interested in investigating this option.

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Reparaciones en techos de las salas 1 y 2 de cirugía y de la Dirección del Hospital Perrando, modelo observado dirigido por obras públicas y modelo teórico donde se pretende demostrar que los costos hubieran sido menoressi la obra se hubiera hecho con la dirección de obras públicas pero con trabajadores contratados por la misma

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Reparaciones en techos de las salas 1 y 2 de cirugía y de la Dirección del Hospital Perrando, modelo observado dirigido por obras públicas y modelo teórico donde se pretende demostrar que los costos hubieran sido menoressi la obra se hubiera hecho con la dirección de obras públicas pero con trabajadores contratados por la misma

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