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The Paper deals with the management of the operating block in its many activities. By a new approach and with innovative machinery specific several problems were thus studied and overcome, such as the control of hospital infections, the operations of washing and sterilization of surgical instruments, the planning of interventions, the tracking of drugs and medical devices entering the operating block, the management of stocks, the bed management, the monitoring of environmental parameters for patient comfort and safety, the monitoring of machines and the interlocking of doors, etc. Furthermore, it is proposed a wide use of the analytical tools to support decision making, extended to the most modern Cyber-Physical Systems and Digital Twin, alongside Machine Learning and Artificial Intelligence algorithms. Concluding with the new services that can be offered following the digital transformation 4.0 process of the operating block. Using the tools made available by the most advanced Engineering, an operating block was redesigned, safer for patients and medical staff and more efficient from a conduction point of view. This is done using an administration model that was first conceptualized, designed and then implemented adopting what is made available by Industry 4.0, as well as a series of Management Engineering methodologies aimed at an optimized government of complex systems. Through the data collected by appropriate sensors and translated by the software into usable information, there is an optimal use of the available resources, furthermore, the activities for which improvements can be made with the benefit of patients and structures are identified.

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