Specialist tissue viability services: a priority or a luxury?

During the 1980s, the number of tissue viability nurses (TVNs) rose steadily in the UK, in response to mismanagement of patients with wounds (Fletcher, 1995). Since this time, and in response to the quality agenda, the necessity of promoting a tissue viability service (TVS) that is able to meet the needs of a changing population, while being cost effective and offering interventions based on research and evidence, has grown. The drive to reduce avoidable harm in healthcare and to make efficiency savings is continuing, with TVS being one of the key areas to deliver these targets. However, across the UK we have a wide range of role descriptions and job titles, yet little clarification as to the qualifications and skills required to deliver a successful TVS. Infection control specialist nurses have a clear identity with concise role descriptions representing a range of pay bands. Arguably, this is because they are aligned with a medical specialty, whereas TV is not. The introduction of ‘Any Qualified Provider’ (Department of Health, 2011) has witnessed some services, including management of leg ulceration, being delivered by non-NHS providers at a reduced cost. So is TVS in danger of becoming more of a ‘nice thing’ rather than a priority

SLA Management in Intent-Driven Service Management Systems: A Taxonomy and Future Directions

Traditionally, network and system administrators are responsible for designing, configuring, and resolving the Internet service requests. Human-driven system configuration and management are proving unsatisfactory due to the recent interest in time-sensitive applications with stringent quality of service (QoS). Aiming to transition from the traditional human-driven to zero-touch service management in the field of networks and computing, intent-driven service management (IDSM) has been proposed as a response to stringent quality of service requirements. In IDSM, users express their service requirements in a declarative manner as intents. IDSM, with the help of closed control-loop operations, perform configurations and deployments, autonomously to meet service request requirements. The result is a faster deployment of Internet services and reduction in configuration errors caused by manual operations, which in turn reduces the service-level agreement (SLA) violations. In the early stages of development, IDSM systems require attention from industry as well as academia. In an attempt to fill the gaps in current research, we conducted a systematic literature review of SLA management in IDSM systems. As an outcome, we have identified four IDSM intent management activities and proposed a taxonomy for each activity. Analysis of all studies and future research directions, are presented in the conclusions.Comment: Extended version of the preprint submitted at ACM Computing Surveys (CSUR

Targeting Perioperative Performance Aligned to Hospital Strategy via Digital Transformation

This study examines the digital transformation of a U.S. hospital’s perioperative process, which yields targeted performance alignment to strategy. Based on a 184-month longitudinal study of a large 1,157 registered-bed academic medical center, the observed effects are viewed through a lens of information technology (IT) impact on core capabilities and core strategy. The results offer a framework that supports patient-centric improvement and targets alignment of perioperative sub-process efforts to overall hospital strategy. This research identifies existing limitations, potential capabilities, and subsequent contextual understanding to minimize perioperative process complexity, target and measure improvement, and ultimately yield process management and hospital strategy alignment. Dynamic activities of analysis, evaluation, and synthesis applied to specific perioperative patient-centric data, collected within integrated hospital information systems, provide the organizational resource for management and control. Conclusions include theoretical and practical implications as well as study limitations

Towards an integrated perspective on fleet asset management: engineering and governance considerations

The traditional engineering perspective on asset management concentrates on the operational performance the assets. This perspective aims at managing assets through their life-cycle, from technical specification, to acquisition, operation including maintenance, and disposal. However, the engineering perspective often takes for granted organizational-level factors. For example, a focus on performance at the asset level may lead to ignore performance measures at the business unit level. The governance perspective on asset management usually concentrates on organizational factors, and measures performance in financial terms. In doing so, the governance perspective tends to ignore the engineering considerations required for optimal asset performance. These two perspectives often take each other for granted. However experience demonstrates that an exclusive focus on one or the other may lead to sub-optimal performance. For example, the two perspectives have different time frames: engineering considers the long term asset life-cycle whereas the organizational time frame is based on a yearly financial calendar. Asset fleets provide a relevant and important context to investigate the interaction between engineering and governance views on asset management as fleets have distributed system characteristics. In this project we investigate how engineering and governance perspectives can be reconciled and integrated to enable optimal asset and organizational performance in the context of asset fleets

Design, Development and Evaluation of 5G-Enabled Vehicular Services:The 5G-HEART Perspective

The ongoing transition towards 5G technology expedites the emergence of a variety of mobile applications that pertain to different vertical industries. Delivering on the key commitment of 5G, these diverse service streams, along with their distinct requirements, should be facilitated under the same unified network infrastructure. Consequently, in order to unleash the benefits brought by 5G technology, a holistic approach towards the requirement analysis and the design, development, and evaluation of multiple concurrent vertical services should be followed. In this paper, we focus on the Transport vertical industry, and we study four novel vehicular service categories, each one consisting of one or more related specific scenarios, within the framework of the “5G Health, Aquaculture and Transport (5G-HEART)” 5G PPP ICT-19 (Phase 3) project. In contrast to the majority of the literature, we provide a holistic overview of the overall life-cycle management required for the realization of the examined vehicular use cases. This comprises the definition and analysis of the network Key Performance Indicators (KPIs) resulting from high-level user requirements and their interpretation in terms of the underlying network infrastructure tasked with meeting their conflicting or converging needs. Our approach is complemented by the experimental investigation of the real unified 5G pilot’s characteristics that enable the delivery of the considered vehicular services and the initial trialling results that verify the effectiveness and feasibility of the presented theoretical analysis