High performance VLSI telemetry data systems

NASA's deployment of major space complexes such as Space Station Freedom (SSF) and the Earth Observing System (EOS) will demand increased functionality and performance from ground based telemetry acquisition systems well above current system capabilities. Adaptation of space telemetry data transport and processing standards such as those specified by the Consultative Committee for Space Data Systems (CCSDS) standards and those required for commercial ground distribution of telemetry data, will drive these functional and performance requirements. In addition, budget limitations will force the requirement for higher modularity, flexibility, and interchangeability at lower cost in new ground telemetry data system elements. At NASA's Goddard Space Flight Center (GSFC), the design and development of generic ground telemetry data system elements, over the last five years, has resulted in significant solutions to these problems. This solution, referred to as the functional components approach includes both hardware and software components ready for end user application. The hardware functional components consist of modern data flow architectures utilizing Application Specific Integrated Circuits (ASIC's) developed specifically to support NASA's telemetry data systems needs and designed to meet a range of data rate requirements up to 300 Mbps. Real-time operating system software components support both embedded local software intelligence, and overall system control, status, processing, and interface requirements. These components, hardware and software, form the superstructure upon which project specific elements are added to complete a telemetry ground data system installation. This paper describes the functional components approach, some specific component examples, and a project example of the evolution from VLSI component, to basic board level functional component, to integrated telemetry data system

Advanced Process Monitoring for Industry 4.0

This book reports recent advances on Process Monitoring (PM) to cope with the many challenges raised by the new production systems, sensors and “extreme data” conditions that emerged with Industry 4.0. Concepts such as digital-twins and deep learning are brought to the PM arena, pushing forward the capabilities of existing methodologies to handle more complex scenarios. The evolution of classical paradigms such as Latent Variable modeling, Six Sigma and FMEA are also covered. Applications span a wide range of domains such as microelectronics, semiconductors, chemicals, materials, agriculture, as well as the monitoring of rotating equipment, combustion systems and membrane separation processes

NHS arm’s length bodies and health regulation in England: who regulates the regulators?

This research uses mixed methods to critically analyse health regulation systems in England, in a macro and micro sense. The qualitative side of the research involves interviews with key staff members from four NHS Trusts and two Clinical Commissioning Groups. These semi-structured interviews offer unique specific insights from the key actors, from varying perspectives in the process. The quantitative element of the research focuses on trends and correlations of the data sets used by particular arm’s length bodies operating in the policy area. Specific arm’s length bodies operating in the health policy arena, which are assessed in the research, include the Care Quality Commission, Monitor and Dr Foster Intelligence. The findings and conclusions centre on the deficiencies that are present in the current regulatory regime, what is occurring in this area, and why this is occurring. Following the Grounded Theory Approach, the research develops inductive theory, from the data, culminating in a “Feedback Loop Theory of Regulation”. Key words: NHS, regulation, mixed methods, arm’s length bodies, feedback loop theory, grounded theory, Care Quality Commission, Monitor, and Dr Foster Intelligence

La réduction des méfaits au Canada : les enjeux et les limites de la conceptualisation actuelle

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal

Performance management within the NHS

A performance measurement (PM) system should exemplify an organisation’s activities, so it can learn and adapt based on its assessment (Otley, 1999; Adler, 2011; Agostino & Arnaboldi, 2012). This paper investigates ‘to what extent NHS performance can be measured’ in the confines of the Accident and Emergency (A&E) department, at East Lancashire Hospitals NHS Trust. The NHS constitution stipulates ‘95% of patients should be seen and discharged within 4-hours’; hence, this is widely regarded as the ‘key metric’ of A&E performance (The King's Fund, 2016; NHS England, 2013). Since 2013, performance across all areas of health and social care in England, is externally regulated by the Care Quality Commission (CQC, 2015). In 2015/16 ELHT’s emergency services treated over 185,000 patients, placing it in the top-twenty busiest units in the country. Unfortunately, its 4-hour target for the same period was 92.5% and its emergency services were classified as ‘requiring improvement’ by the CQC (HSCIC, 2016; CQC, 2014). Literature relating to performance was critically reviewed, alongside theories of organisational effectiveness (OE). The CQC’s performance regulatory framework was appraised against theoretical models and considered to support PM from an ‘internal process’ perspective (of OE). Conversely, A&E was deemed to align with an ‘open systems’ model i.e. its individuals, groups, processes and interactions are interconnected with the rest of the hospital and the external environment (Stacey & Mowles, 2016). After evaluating various models of ‘open systems’, key components of A&E performance were aggregated and conceptualised into an appropriate framework. Subsequently, research was undertaken in the practical setting to identify areas for improvement. A critical realist research philosophy was applied to a case study design, which incorporated self-completion questionnaires, semi-structured interviews and secondary data collection methods. Research identified some good practices, particularly in relation to A&E’s internal processes i.e. policies and procedures. Other areas included improvements in competency training and medical device technologies. Staff’s professionalism and sense of purpose to providing exceptional care was also very strong. This mood was offset by a sense of disengagement from the organisation that echoed through the factors of the conceptual framework, leading to the following recommendations: r einforce vision and values to A&E staff; create a bespoke A&E mission statement; review A&E leadership structure and training programme; budget training for senior A&E clinical staff; r oll-out of e-Rostering training; u pdate of job descriptions against workplace demands; review of appraisal process; upgrade of IT systems. An area for further research was uncovered relating to producing a standardised ‘A&E coefficient’, which captures all elements of open systems performance, allowing fair comparison for A&E departments across the country

Understanding, recognising and preventing dehydration in older residents living in care homes: a mixed methods study

Abstract Aim To recognise and understand how to prevent water-loss dehydration occurring in older people living in care homes. Background Water-loss dehydration is common and linked to poor drinking, but prevention is likely to be multi-faceted. Methods Three independent studies investigating hydration care in older care home residents were conducted and the findings integrated (mixed methods, convergent parallel design): Diagnostic accuracy of clinical signs and symptoms of dehydration. Systematic review investigating effectiveness of interventions and associations of modifiable environmental factors on improving fluid intake and/or hydration status. Qualitative study involving residents, families and care-staff in focus groups, exploring challenges and facilitators in hydration care. Results In the diagnostic accuracy study, 188 residents (mean age 85 years, 66% women) were recruited from 56 care homes. Clinical signs and symptoms were ineffective in identifying older people with dehydration. The 23 included studies in the systematic review addressed a range of strategies at carer, institutional and societal (‘macro’) levels to improve fluid intake and hydration status, but high risk of bias in many studies meant findings were inconclusive. Three themes emerged from the qualitative study: ‘meanings and experiences of drinking’, ‘caring roles’, and ‘tensions and barriers to successful drinking’. Integrated findings identified residents’ and families’ contributions to residents’ hydration care and preventing dehydration requires a multi-faceted approach. The researcher-led quantitative studies of the systematic review indicated how macro factors may impact on hydration care (along with institutional and carer-led factors). Findings from the diagnostic accuracy should inform national guidelines at the macro level. The qualitative study provided experiential perspectives and insights into relational care between each care level and how these have positive and negative impacts on residents’ drinking. Conclusion Fluid intake is a physiological necessity to prevent dehydration. Supporting care home residents to drink involves multi-levels of care and is a social experience. (300 words) Medline medical subject headings (MeSH): aged; beverages; dehydration; diagnostic tests, routine; drinking; geriatrics; long-term care; osmolar concentration; qualitative research; residential facilities; review, systematic

Towards achieving interorganisational collaboration between health-care providers:a realist evidence synthesis

Background Interorganisational collaboration is currently being promoted to improve the performance of NHS providers. However, up to now, there has, to the best of our knowledge, been no systematic attempt to assess the effect of different approaches to collaboration or to understand the mechanisms through which interorganisational collaborations can work in particular contexts. Objectives Our objectives were to (1) explore the main strands of the literature about interorganisational collaboration and to identify the main theoretical and conceptual frameworks, (2) assess the empirical evidence with regard to how different interorganisational collaborations may (or may not) lead to improved performance and outcomes, (3) understand and learn from NHS evidence users and other stakeholders about how and where interorganisational collaborations can best be used to support turnaround processes, (4) develop a typology of interorganisational collaboration that considers different types and scales of collaboration appropriate to NHS provider contexts and (5) generate evidence-informed practical guidance for NHS providers, policy-makers and others with responsibility for implementing and assessing interorganisational collaboration arrangements. Design A realist synthesis was carried out to develop, test and refine theories about how interorganisational collaborations work, for whom and in what circumstances. Data sources Data sources were gathered from peer-reviewed and grey literature, realist interviews with 34 stakeholders and a focus group with patient and public representatives. Review methods Initial theories and ideas were gathered from scoping reviews that were gleaned and refined through a realist review of the literature. A range of stakeholder interviews and a focus group sought to further refine understandings of what works, for whom and in what circumstances with regard to high-performing interorganisational collaborations. Results A realist review and synthesis identified key mechanisms, such as trust, faith, confidence and risk tolerance, within the functioning of effective interorganisational collaborations. A stakeholder analysis refined this understanding and, in addition, developed a new programme theory of collaborative performance, with mechanisms related to cultural efficacy, organisational efficiency and technological effectiveness. A series of translatable tools, including a diagnostic survey and a collaboration maturity index, were also developed. Limitations The breadth of interorganisational collaboration arrangements included made it difficult to make specific recommendations for individual interorganisational collaboration types. The stakeholder analysis focused exclusively on England, UK, where the COVID-19 pandemic posed challenges for fieldwork. Conclusions Implementing successful interorganisational collaborations is a difficult, complex task that requires significant time, resource and energy to achieve the collaborative functioning that generates performance improvements. A delicate balance of building trust, instilling faith and maintaining confidence is required for high-performing interorganisational collaborations to flourish. Future work Future research should further refine our theory by incorporating other workforce and user perspectives. Research into digital platforms for interorganisational collaborations and outcome measurement are advocated, along with place-based and cross-sectoral partnerships, as well as regulatory models for overseeing interorganisational collaborations. Study registration The study is registered as PROSPERO CRD42019149009. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 11, No. 6. See the NIHR Journals Library website for further project information

NASA Space Engineering Research Center Symposium on VLSI Design

The NASA Space Engineering Research Center (SERC) is proud to offer, at its second symposium on VLSI design, presentations by an outstanding set of individuals from national laboratories and the electronics industry. These featured speakers share insights into next generation advances that will serve as a basis for future VLSI design. Questions of reliability in the space environment along with new directions in CAD and design are addressed by the featured speakers

An exploratory study of the views of stakeholders about the role of regulation in social care service provision in Scotland.

Performance management of social work and social care services, complemented by effective regulation, is viewed as key to improving delivery and providing public assurance about care quality, and the value of listening to stakeholders as contributors to the knowledge base has long been recognised. The evidence base as it relates to stakeholders’ experiences of regulation, however, has not been comprehensively explored. Many studies seek the views of stakeholders in the development of individual services, yet fewer studies seek their views in shaping regulatory methodology. The rationale for this research was to contribute to a knowledge base from evidence using an empirical approach and to contribute to better understanding of regulation from the perspectives of stakeholders. The research was undertaken using an explanatory sequential mixed methods design. For the quantitative phase, a descriptive analysis of data held by the regulator in relation to the evaluations of care services, improvement in evaluations over a specified period of time and the impact of complaints, requirements or enforcements on this performance was undertaken. Data in relation to inspection satisfaction questionnaires was also descriptively analysed. Findings from the quantitative phase informed the qualitative phase. The qualitative phase began with a co-productive approach involving ten individuals: both regulatory staff and inspection volunteers. Themes arising from their responses, complemented by the findings from previous research phases, then informed the design of individual interviews with six service providers. A thematic analysis was undertaken for both parts of the qualitative phase. The research demonstrated some contradictory views between regulators and those being regulated. Regulators described building positive relationships with services within a model of responsive regulation. Service providers experienced a bureaucratic process with a compliance focus and relationships in which the power imbalance and a lack of knowledge often led to feelings of anxiety and fear. In the current environment in which high quality care is expected by both public and government alike, despite the impact of austerity measures, this research recommends that further dialogue needs to take place to ensure the impact and outcomes from regulation are better understood and explicitly articulated

DMAIC 4.0 - innovating the Lean Six Sigma methodology with Industry 4.0 technologies

Lean Six Sigma (LSS) is a continuous improvement methodology that emerged around 2000 (George and George, 2002; Snee, 2010). It combines the strengths of two methodologies, Lean and Six Sigma, into an effective process and quality improvement framework. Although many organisations have successfully applied LSS over the past two decades, over 60% of Lean and Six Sigma implementations have failed (Albliwi et al., 2014; Sony et al., 2020c), and, accordingly, a significant number of improvement projects. Consequently, researchers have investigated the reasons behind these failures and revealed numerous failure factors, criticisms, impediments, and barriers that jeopardise the success of LSS initiatives. These reasons, also recognised as LSS limitations, represent the problem addressed in this research. On the other hand, the Industry 4.0 (I4.0) era, entailing machine connectivity, big data technologies and artificial intelligence, offers new opportunities for data-driven quality improvement strategies such as LSS. Therefore, this study explored how I4.0 technologies can enhance the traditional LSS methodology by following a Design Science Research (DSR) approach. The aim was to design a solution integrating I4.0 data-driven tools into the traditional DMAIC framework to enhance the success and effectiveness of LSS projects. DMAIC stands for Define, Measure, Analyse, Improve, and Control, representing project phases executed in a prescribed order. The designed solution is a DMAIC 4.0 framework that should help organisations overcome the limitations of LSS by exploiting modern technologies and techniques. This study adopts the DSR process described by Peffers et al. (2007), combined with qualitative methods suggested by Offermann et al. (2009). There are three main phases: (1) Problem Identification, (2) Solution Design and (3) Evaluation. Expert interviews were conducted in phase 1 to confirm the problem and underpin its relevance. The design built in phase 2 is based on existing knowledge and field experience. In phase 3, the researcher successfully evaluated the framework’s utility and effectiveness within a German manufacturing organisation through action research. Additionally, a Delphi study demonstrated that the design presented is relevant and applicable to various industries. Upon Delphi panel feedback, a roadmap was created to guide organisations in implementing the new framework. To the authors’ knowledge, this is the first DMAIC 4.0 framework presented in the academic literature thus far. Knowledge and novel contributions were generated through the design and evaluation process. The validated framework includes 42 LSS tasks enhanced by I4.0 technologies. It incorporates knowledge from extant research related to LSS, DMAIC and I4.0. Furthermore, it focuses on tools and tasks and is more detailed than previously presented frameworks integrating I4.0 with LSS. Unlike conceptual frameworks, it is empirically validated, which should motivate LSS practitioners to innovate their projects. Clearly, there is still room for expansion as there are many more tools in both areas, LSS and I4.0. Researchers and practitioners can customise and apply the framework in various contexts to establish a new standard for DMAIC