Design of a model for improving emergency room performance using a colored Petri net
Emergency rooms are one of the most complex and vital areas of healthcare institutions, which have presented overcrowding, long waiting, and length of stay times, affecting the timeliness, responsiveness, and quality of service. This research aimed to design a detailed patient flow model to improve...
- Autores:
-
Caicedo-Rolón, Alvaro Jr
Guerrero Gomez, Gustavo
Moreno Gamboa, Faustino
Caicedo Rolon, Alvaro Jr
- Tipo de recurso:
- Article of journal
- Fecha de publicación:
- 2024
- Institución:
- Universidad Francisco de Paula Santander
- Repositorio:
- Repositorio Digital UFPS
- Idioma:
- eng
- OAI Identifier:
- oai:repositorio.ufps.edu.co:ufps/9177
- Acceso en línea:
- https://repositorio.ufps.edu.co/handle/ufps/9177
- Palabra clave:
- Healthcare
Simulation
Decision-making
Management
Hospital
Logistics
Emergency
Overcrowding
Modeling
timeliness
- Rights
- openAccess
- License
- This work is licensed under a Creative Commons Attribution 4.0 International License.
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Design of a model for improving emergency room performance using a colored Petri net |
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Design of a model for improving emergency room performance using a colored Petri net |
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Design of a model for improving emergency room performance using a colored Petri net Healthcare Simulation Decision-making Management Hospital Logistics Emergency Overcrowding Modeling timeliness |
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Design of a model for improving emergency room performance using a colored Petri net |
| title_full |
Design of a model for improving emergency room performance using a colored Petri net |
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Design of a model for improving emergency room performance using a colored Petri net |
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Design of a model for improving emergency room performance using a colored Petri net |
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Design of a model for improving emergency room performance using a colored Petri net |
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Caicedo-Rolón, Alvaro Jr Guerrero Gomez, Gustavo Moreno Gamboa, Faustino Caicedo Rolon, Alvaro Jr |
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Caicedo-Rolón, Alvaro Jr Guerrero Gomez, Gustavo Moreno Gamboa, Faustino Caicedo Rolon, Alvaro Jr |
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Healthcare Simulation Decision-making Management Hospital Logistics Emergency Overcrowding Modeling timeliness |
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Healthcare Simulation Decision-making Management Hospital Logistics Emergency Overcrowding Modeling timeliness |
| description |
Emergency rooms are one of the most complex and vital areas of healthcare institutions, which have presented overcrowding, long waiting, and length of stay times, affecting the timeliness, responsiveness, and quality of service. This research aimed to design a detailed patient flow model to improve emergency room performance using the hierarchical timed colored Petri nets. Then, the model was simulated to evaluate scenarios considering tactical decisions such as physician staff planning, operational decisions such as adjusting work schedules, and strategic decisions such as increasing observation beds. The best scenario would reduce the average waiting times for triage II patients by 17.30 % and 47.57 %, and triage III by 33.49 % and 43.49 % for medical consultation in the office or the minor surgery room, respectively. In addition, the waiting time in observation and the rate of patients left without being seen by a physician would be reduced by 92.45 % and 74.67 %, respectively. These results improve the quality and timeliness of the service and avoid putting the patient's health and life at risk. The designed model included more attributes for patients concerning the place of medical care in the emergency room, the number of visits to the physician, and the physician who will care for the patient. Moreover, the simulation model includes observation beds as a limited resource blocking new patient admission. Finally, this model is a tool to support emergency room managers in making short, medium, and long-term decisions to address problems such as overcrowding, long waiting and length of stay times, and high rates of patients left without being seen by a physician |
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2024 |
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2024-01-31 |
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2025-03-06T14:27:25Z |
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2025-03-06T14:27:25Z |
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1 (2024) |
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Caicedo-Rolon, A. J., Guerrero-Gomez, G., & Moreno-Gamboa, F. (2024). Design of a model for improving emergency room performance using a colored Petri net. EUREKA: Physics and Engineering, (1), 154-166. https://doi.org/10.21303/2461-4262.2024.002979 |
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Eureka physics and engineering |
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Harju maakond, Estonia |
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Caicedo-Rolón, Alvaro JrGuerrero Gomez, GustavoMoreno Gamboa, FaustinoCaicedo Rolon, Alvaro Jrvirtual::1547-12025-03-06T14:27:25Z2025-03-06T14:27:25Z2024-01-31https://repositorio.ufps.edu.co/handle/ufps/917710.21303/2461-4262.2024.002979Emergency rooms are one of the most complex and vital areas of healthcare institutions, which have presented overcrowding, long waiting, and length of stay times, affecting the timeliness, responsiveness, and quality of service. This research aimed to design a detailed patient flow model to improve emergency room performance using the hierarchical timed colored Petri nets. Then, the model was simulated to evaluate scenarios considering tactical decisions such as physician staff planning, operational decisions such as adjusting work schedules, and strategic decisions such as increasing observation beds. The best scenario would reduce the average waiting times for triage II patients by 17.30 % and 47.57 %, and triage III by 33.49 % and 43.49 % for medical consultation in the office or the minor surgery room, respectively. In addition, the waiting time in observation and the rate of patients left without being seen by a physician would be reduced by 92.45 % and 74.67 %, respectively. These results improve the quality and timeliness of the service and avoid putting the patient's health and life at risk. The designed model included more attributes for patients concerning the place of medical care in the emergency room, the number of visits to the physician, and the physician who will care for the patient. Moreover, the simulation model includes observation beds as a limited resource blocking new patient admission. Finally, this model is a tool to support emergency room managers in making short, medium, and long-term decisions to address problems such as overcrowding, long waiting and length of stay times, and high rates of patients left without being seen by a physician13 Páginasapplication/pdfengEureka physics and engineeringHarju maakond, EstoniaThis work is licensed under a Creative Commons Attribution 4.0 International License.https://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessAtribución 4.0 Internacional (CC BY 4.0)http://purl.org/coar/access_right/c_abf2https://journal.eu-jr.eu/engineering/article/view/2979Design of a model for improving emergency room performance using a colored Petri netArtículo de revistahttp://purl.org/coar/resource_type/c_6501http://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/version/c_970fb48d4fbd8a85Vol. No.1 (2024)1661 (2024)154Caicedo-Rolon, A. J., Guerrero-Gomez, G., & Moreno-Gamboa, F. (2024). Design of a model for improving emergency room performance using a colored Petri net. EUREKA: Physics and Engineering, (1), 154-166. https://doi.org/10.21303/2461-4262.2024.002979HealthcareSimulationDecision-makingManagementHospitalLogisticsEmergencyOvercrowdingModelingtimelinessDerni, O., Boufera, F., Khelfi, M. F. (2019). Coloured Petri net for modelling and improving emergency department based on the simulation model. International Journal of Simulation and Process Modelling, 14 (1), 72. https://doi.org/10.1504/ijspm.2019.097717Salimifard, K., Hosseini, S., Moradi, M. (2013). Improving Emergency Department Processes Using Coloured Petri Nets. Joint Proceedings of the International Workshop on Petri Nets and Software Engineering (PNSE'13) and the International Workshop on Modeling and Business Environments (ModBE'13) co-located with the 34th International Conference on Application and Theory of Petri Nets and Concurrency Petri Nets 2013. Vol. 989. Milano, 335–349. Available at: https://ceur-ws.org/Vol-989/paper02b.pdfCaicedo, A., Rivera, L. (2021). Caracterización de los servicios de urgencias de una ciudad fronteriza colombiana. Emergencia, 33, 239–241. Available at: https://revistaemergencias.org/wp-content/uploads/2023/08/Emergencias-2021_33_3_239-241.pdfAboueljinane, L., Frichi, Y. (2022). A simulation optimization approach to investigate resource planning and coordination mechanisms in emergency systems. Simulation Modelling Practice and Theory, 119, 102586. https://doi.org/10.1016/j.simpat.2022.102586MSPS, M. de S. y P. S. (2019). Observatorio nacional de Calidad en Salud, Indicadores de calidad resolución 0256/16.Ashour, O. M., Okudan Kremer, G. E. (2014). Dynamic patient grouping and prioritization: a new approach to emergency department flow improvement. Health Care Management Science, 19 (2), 192–205. https://doi.org/10.1007/s10729-014-9311-1Ajami, S., Ketabi, S., Yarmohammadian, M., Bagherian, H. (2012). Wait Time in Emergency Department (ED) Processes. Medical Archives, 66 (1), 53. https://doi.org/10.5455/medarh.2012.66.53-57Luscombe, R., Kozan, E. (2016). Dynamic resource allocation to improve emergency department efficiency in real time. European Journal of Operational Research, 255 (2), 593–603. https://doi.org/10.1016/j.ejor.2016.05.039Ibrahim, I. M., Liong, C.-Y., Bakar, S. A., Ahmad, N., Najmuddin, A. F. (2017). Minimizing patient waiting time in emergency department of public hospital using simulation optimization approach. AIP Conference Proceedings. https://doi.org/10.1063/1.4980949M. de S. y P. S. MSPS (2015). Resolución 5596 del 2015. Por la cual se definen los criterios técnicos para el Sistema de Selección y Clasificación de pacientes en los servicios de urgencias ‘Triage’.Kuo, Y.-H., Rado, O., Lupia, B., Leung, J. M. Y., Graham, C. A. (2014). Improving the efficiency of a hospital emergency department: a simulation study with indirectly imputed service-time distributions. Flexible Services and Manufacturing Journal, 28 (1-2), 120–147. https://doi.org/10.1007/s10696-014-9198-7Diefenbach, M., Kozan, E. (2011). Effects of bed configurations at a hospital emergency department. Journal of Simulation, 5 (1), 44–57. https://doi.org/10.1057/jos.2010.1Sinreich, D., Jabali, O., Dellaert, N. P. (2012). Reducing emergency department waiting times by adjusting work shifts considering patient visits to multiple care providers. IIE Transactions, 44 (3), 163–180. https://doi.org/10.1080/0740817x.2011.609875Ershadi, M. M., Shafaeizadeh, A. (2021). Simulation-based improvement and modification for performances of hospitals: a case study. International Journal of Simulation and Process Modelling, 16 (2), 90. https://doi.org/10.1504/ijspm.2021.115857Doudareva, E., Carter, M. (2021). Using Discrete Event Simulation to Improve Performance At Two Canadian Emergency Departments. 2021 Winter Simulation Conference (WSC). https://doi.org/10.1109/wsc52266.2021.9715411Bedoya-Valencia, L., Kirac, E. (2016). Evaluating alternative resource allocation in an emergency department using discrete event simulation. SIMULATION, 92 (12), 1041–1051. https://doi.org/10.1177/0037549716673150Zhao, Y., Peng, Q., Strome, T., Weldon, E., Zhang, M., Chochinov, A. (2015). Bottleneck detection for improvement of Emergency Department efficiency. Business Process Management Journal, 21 (3), 564–585. https://doi.org/10.1108/bpmj-06-2014-0060Cocke, S., Guinn, D., MacBlane, E., Walshak, S., Willenbrock, N., White, K. P. et al. (2016). UVA emergency department patient flow simulation and analysis. 2016 IEEE Systems and Information Engineering Design Symposium (SIEDS). https://doi.org/10.1109/sieds.2016.7489282Daldoul, D., Nouaouri, I., Bouchriha, H., Allaoui, H. (2015). Optimization on human and material resources in Emergency Department. 2015 International Conference on Industrial Engineering and Systems Management (IESM). https://doi.org/10.1109/iesm.2015.7380224Hoot, N. R., LeBlanc, L. J., Jones, I., Levin, S. R., Zhou, C., Gadd, C. S., Aronsky, D. (2008). Forecasting Emergency Department Crowding: A Discrete Event Simulation. Annals of Emergency Medicine, 52 (2), 116–125. https://doi.org/10.1016/j.annemergmed.2007.12.011Lee, S. (2014). The role of hospital selection in ambulance logistics. IIE Transactions on Healthcare Systems Engineering, 4 (2), 105–117. https://doi.org/10.1080/19488300.2014.914608Castanheira-Pinto, A., Gonçalves, B., Lima, R. M., Dinis-Carvalho, J. (2021). Data Modelling and Validation of An Emergency Department Simulation Model—A Lean Healthcare Approach. Industrial Engineering and Operations Management, 1–11. https://doi.org/10.1007/978-3-030-78570-3_1Hosseini, S. M., Mohammadi, K., Yaghoubi, M. (2022). Optimization of Service Process in Emergency Department Using Discrete Event Simulation and Machine Learning Algorithm. Arch. Acad. Emerg. Med., 10 (1), e44.Guasch Petit, A., Piera Eroles, M. A., Casanovas Garcia, J., Figueras Jové, J. (2003). Modelado y simulación : aplicación a procesos logísticos de fabricación y servicios. https://doi.org/10.5821/ebook-9788498802351Banks, J., Carson, J. (1984). Discrete-event system simulation. New Yersey: Prentice Hall, INC.van der Aalst, W. M. P., Stahl, C. (2011). Modeling Business Processes. The MIT Press. https://doi.org/10.7551/mitpress/8811.001.0001Barad, M. (2003). Tutorial and Survey Articles: An introduction to Petri Nets. International Journal of General Systems, 32 (6), 565–582. https://doi.org/10.1080/03081070310001623366Jensen, K., Kristensen, L. M. (2009). Coloured Petri Nets. Springer Berlin Heidelberg. https://doi.org/10.1007/b95112Ceballos-Acevedo, T. M., Velásquez-Restrepo, P. A., Jaén-Posada, J. S. (2014). Duración de la estancia hospitalaria. Metodologías para su intervención. 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 incorporada en las Obras Colectivas.

b.	Distribuir copias o fonogramas de las Obras, exhibirlas públicamente, ejecutarlas públicamente y/o ponerlas a disposición pública, incluyéndolas como incorporadas en Obras Colectivas, según corresponda.

c.	Distribuir copias de las Obras Derivadas que se generen, exhibirlas públicamente, ejecutarlas públicamente y/o ponerlas a disposición pública.
Los derechos mencionados anteriormente pueden ser ejercidos en todos los medios y formatos, actualmente conocidos o que se inventen en el futuro. Los derechos antes mencionados incluyen el derecho a realizar dichas modificaciones en la medida que sean técnicamente necesarias para ejercer los derechos en otro medio o formatos, pero de otra manera usted no está autorizado para realizar obras derivadas. Todos los derechos no otorgados expresamente por el Licenciante quedan por este medio reservados, incluyendo pero sin limitarse a aquellos que se mencionan en las secciones 4(d) y 4(e).

4. Restricciones.
La licencia otorgada en la anterior Sección 3 está expresamente sujeta y limitada por las siguientes restricciones:

a.	Usted puede distribuir, exhibir públicamente, ejecutar públicamente, o poner a disposición pública la Obra sólo bajo las condiciones de esta Licencia, y Usted debe incluir una copia de esta licencia o del Identificador Universal de Recursos de la misma con cada copia de la Obra que distribuya, exhiba públicamente, ejecute públicamente o ponga a disposición pública. No es posible ofrecer o imponer ninguna condición sobre la Obra que altere o limite las condiciones de esta Licencia o el ejercicio de los derechos de los destinatarios otorgados en este documento. No es posible sublicenciar la Obra. Usted debe mantener intactos todos los avisos que hagan referencia a esta Licencia y a la cláusula de limitación de garantías. Usted no puede distribuir, exhibir públicamente, ejecutar públicamente, o poner a disposición pública la Obra con alguna medida tecnológica que controle el acceso o la utilización de ella de una forma que sea inconsistente con las condiciones de esta Licencia. Lo anterior se aplica a la Obra incorporada a una Obra Colectiva, pero esto no exige que la Obra Colectiva aparte de la obra misma quede sujeta a las condiciones de esta Licencia. Si Usted crea una Obra Colectiva, previo aviso de cualquier Licenciante debe, en la medida de lo posible, eliminar de la Obra Colectiva cualquier referencia a dicho Licenciante o al Autor Original, según lo solicitado por el Licenciante y conforme lo exige la cláusula 4(c).

b.	Usted no puede ejercer ninguno de los derechos que le han sido otorgados en la Sección 3 precedente de modo que estén principalmente destinados o directamente dirigidos a conseguir un provecho comercial o una compensación monetaria privada. El intercambio de la Obra por otras obras protegidas por derechos de autor, ya sea a través de un sistema para compartir archivos digitales (digital file-sharing) o de cualquier otra manera no será considerado como estar destinado principalmente o dirigido directamente a conseguir un provecho comercial o una compensación monetaria privada, siempre que no se realice un pago mediante una compensación monetaria en relación con el intercambio de obras protegidas por el derecho de autor.

c.	Si usted distribuye, exhibe públicamente, ejecuta públicamente o ejecuta públicamente en forma digital la Obra o cualquier Obra Derivada u Obra Colectiva, Usted debe mantener intacta toda la información de derecho de autor de la Obra y proporcionar, de forma razonable según el medio o manera que Usted esté utilizando: (i) el nombre del Autor Original si está provisto (o seudónimo, si fuere aplicable), y/o (ii) el nombre de la parte o las partes que el Autor Original y/o el Licenciante hubieren designado para la atribución (v.g., un instituto patrocinador, editorial, publicación) en la información de los derechos de autor del Licenciante, términos de servicios o de otras formas razonables; el título de la Obra si está provisto; en la medida de lo razonablemente factible y, si está provisto, el Identificador Uniforme de Recursos (Uniform Resource Identifier) que el Licenciante especifica para ser asociado con la Obra, salvo que tal URI no se refiera a la nota sobre los derechos de autor o a la información sobre el licenciamiento de la Obra; y en el caso de una Obra Derivada, atribuir el crédito identificando el uso de la Obra en la Obra Derivada (v.g., "Traducción Francesa de la Obra del Autor Original," o "Guión Cinematográfico basado en la Obra original del Autor Original"). Tal crédito puede ser implementado de cualquier forma razonable; en el caso, sin embargo, de Obras Derivadas u Obras Colectivas, tal crédito aparecerá, como mínimo, donde aparece el crédito de cualquier otro autor comparable y de una manera, al menos, tan destacada como el crédito de otro autor comparable.

d.	Para evitar toda confusión, el Licenciante aclara que, cuando la obra es una composición musical:

i.	Regalías por interpretación y ejecución bajo licencias generales. El Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública o la ejecución pública digital de la obra y de recolectar, sea individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, SAYCO), las regalías por la ejecución pública o por la ejecución pública digital de la obra (por ejemplo Webcast) licenciada bajo licencias generales, si la interpretación o ejecución de la obra está primordialmente orientada por o dirigida a la obtención de una ventaja comercial o una compensación monetaria privada.

ii.	Regalías por Fonogramas. El Licenciante se reserva el derecho exclusivo de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, los consagrados por la SAYCO), una agencia de derechos musicales o algún agente designado, las regalías por cualquier fonograma que Usted cree a partir de la obra (“versión cover”) y distribuya, en los términos del régimen de derechos de autor, si la creación o distribución de esa versión cover está primordialmente destinada o dirigida a obtener una ventaja comercial o una compensación monetaria privada.

e.	Gestión de Derechos de Autor sobre Interpretaciones y Ejecuciones Digitales (WebCasting). Para evitar toda confusión, el Licenciante aclara que, cuando la obra sea un fonograma, el Licenciante se reserva el derecho exclusivo de autorizar la ejecución pública digital de la obra (por ejemplo, webcast) y de recolectar, individualmente o a través de una sociedad de gestión colectiva de derechos de autor y derechos conexos (por ejemplo, ACINPRO), las regalías por la ejecución pública digital de la obra (por ejemplo, webcast), sujeta a las disposiciones aplicables del régimen de Derecho de Autor, si esta ejecución pública digital está primordialmente dirigida a obtener una ventaja comercial o una compensación monetaria privada.

5. Representaciones, Garantías y Limitaciones de Responsabilidad.
A MENOS QUE LAS PARTES LO ACORDARAN DE OTRA FORMA POR ESCRITO, EL LICENCIANTE OFRECE LA OBRA (EN EL ESTADO EN EL QUE SE ENCUENTRA) “TAL CUAL”, SIN BRINDAR GARANTÍAS DE CLASE ALGUNA RESPECTO DE LA OBRA, YA SEA EXPRESA, IMPLÍCITA, LEGAL O CUALQUIERA OTRA, INCLUYENDO, SIN LIMITARSE A ELLAS, GARANTÍAS DE TITULARIDAD, COMERCIABILIDAD, ADAPTABILIDAD O ADECUACIÓN A PROPÓSITO DETERMINADO, AUSENCIA DE INFRACCIÓN, DE AUSENCIA DE DEFECTOS LATENTES O DE OTRO TIPO, O LA PRESENCIA O AUSENCIA DE ERRORES, SEAN O NO DESCUBRIBLES (PUEDAN O NO SER ESTOS DESCUBIERTOS). ALGUNAS JURISDICCIONES NO PERMITEN LA EXCLUSIÓN DE GARANTÍAS IMPLÍCITAS, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.

6. Limitación de responsabilidad.
A MENOS QUE LO EXIJA EXPRESAMENTE LA LEY APLICABLE, EL LICENCIANTE NO SERÁ RESPONSABLE ANTE USTED POR DAÑO ALGUNO, SEA POR RESPONSABILIDAD EXTRACONTRACTUAL, PRECONTRACTUAL O CONTRACTUAL, OBJETIVA O SUBJETIVA, SE TRATE DE DAÑOS MORALES O PATRIMONIALES, DIRECTOS O INDIRECTOS, PREVISTOS O IMPREVISTOS PRODUCIDOS POR EL USO DE ESTA LICENCIA O DE LA OBRA, AUN CUANDO EL LICENCIANTE HAYA SIDO ADVERTIDO DE LA POSIBILIDAD DE DICHOS DAÑOS. ALGUNAS LEYES NO PERMITEN LA EXCLUSIÓN DE CIERTA RESPONSABILIDAD, EN CUYO CASO ESTA EXCLUSIÓN PUEDE NO APLICARSE A USTED.

7. Término.

a.	Esta Licencia y los derechos otorgados en virtud de ella terminarán automáticamente si Usted infringe alguna condición establecida en ella. Sin embargo, los individuos o entidades que han recibido Obras Derivadas o Colectivas de Usted de conformidad con esta Licencia, no verán terminadas sus licencias, siempre que estos individuos o entidades sigan cumpliendo íntegramente las condiciones de estas licencias. Las Secciones 1, 2, 5, 6, 7, y 8 subsistirán a cualquier terminación de esta Licencia.

b.	Sujeta a las condiciones y términos anteriores, la licencia otorgada aquí es perpetua (durante el período de vigencia de los derechos de autor de la obra). No obstante lo anterior, el Licenciante se reserva el derecho a publicar y/o estrenar la Obra bajo condiciones de licencia diferentes o a dejar de distribuirla en los términos de esta Licencia en cualquier momento; en el entendido, sin embargo, que esa elección no servirá para revocar esta licencia o que deba ser otorgada , bajo los términos de esta licencia), y esta licencia continuará en pleno vigor y efecto a menos que sea terminada como se expresa atrás. La Licencia revocada continuará siendo plenamente vigente y efectiva si no se le da término en las condiciones indicadas anteriormente.

8. Varios.

a.	Cada vez que Usted distribuya o ponga a disposición pública la Obra o una Obra Colectiva, el Licenciante ofrecerá al destinatario una licencia en los mismos términos y condiciones que la licencia otorgada a Usted bajo esta Licencia.

b.	Si alguna disposición de esta Licencia resulta invalidada o no exigible, según la legislación vigente, esto no afectará ni la validez ni la aplicabilidad del resto de condiciones de esta Licencia y, sin acción adicional por parte de los sujetos de este acuerdo, aquélla se entenderá reformada lo mínimo necesario para hacer que dicha disposición sea válida y exigible.

c.	Ningún término o disposición de esta Licencia se estimará renunciada y ninguna violación de ella será consentida a menos que esa renuncia o consentimiento sea otorgado por escrito y firmado por la parte que renuncie o consienta.

d.	Esta Licencia refleja el acuerdo pleno entre las partes respecto a la Obra aquí licenciada. No hay arreglos, acuerdos o declaraciones respecto a la Obra que no estén especificados en este documento. El Licenciante no se verá limitado por ninguna disposición adicional que pueda surgir en alguna comunicación emanada de Usted. Esta Licencia no puede ser modificada sin el consentimiento mutuo por escrito del Licenciante y Usted.
 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