A survey of health care models that encompass multiple departments

In this survey we review quantitative health care models to illustrate the extent to which they encompass multiple hospital departments. The paper provides general overviews of the relationships that exists between major hospital departments and describes how these relationships are accounted for by researchers. We find the atomistic view of hospitals often taken by researchers is partially due to the ambiguity of patient care trajectories. To this end clinical pathways literature is reviewed to illustrate its potential for clarifying patient flows and for providing a holistic hospital perspective

Managing healthcare performance in analytical framework

Purpose – The purpose of the paper is to develop an integrated framework for performance management of healthcare services. Design/methodology/approach – This study develops a performance management framework for healthcare services using a combined analytic hierarchy process (AHP) and logical framework (LOGFRAME). The framework is then applied to the intensive care units of three different hospitals in developing nations. Numerous focus group discussions were undertaken, involving experts from the specific area under investigation. Findings – The study reveals that a combination of outcome, structure and process-based critical success factors and a combined AHP and LOGFRAME-based performance management framework helps manage performance of healthcare services. Practical implications – The proposed framework could be practiced in hospital-based healthcare services. Originality/value – The conventional approaches to healthcare performance management are either outcome-based or process-based, which cannot reveal improvement measures appropriately in order to assure superior performance. Additionally, they lack planning, implementing and evaluating improvement projects that are identified from performance measurement. This study presents an integrated approach to performance measurement and implementing framework of improvement projects

Toward sustainable stormwater management : overcoming barriers to green infrastructure

Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 2010.Cataloged from PDF version of thesis.Includes bibliographical references (p. 79-83).With their high concentrations of impervious surface, urban areas generate stormwater runoff that overwhelms existing infrastructure causing flooding, sewer overflows, water pollution, and habitat degradation. Under pressure to find cost-effective, environmentally sustainable, and socially responsible solutions to stormwater management, cities are looking to green infrastructure. The term "green infrastructure," when used for stormwater management, denotes design techniques, such as raingardens, green roofs, permeable pavement, street trees, and rain barrels, that infiltrate, evapotranspirate, capture, and reuse stormwater onsite. With the added benefits of improving air quality, land values, wildlife habitat, urban heat island, and urban aesthetics, some decision-makers view green infrastructure as a silver bullet solution to address climate change, water quality, and other urban issues. As cities move to create neighborhood- and citywide-scale green infrastructure plans, my thesis explores the common barriers that cities face when implementing green infrastructure, as well as tactics that have been used to overcome those barriers. The realities of implementation indicate that cities seeking to scale up green infrastructure should plan on expanding public participation and awareness-raising, strengthening interdepartmental coordination and partnerships within the community, building the technical capacity of the public and the government, and developing innovative ways to continuously engage and motivate individuals.by Sarah A. Hammitt.M.C.P

Institutions for Climate Adaptation: An Inventory of Institutions in the Netherlands that are Relevant for Climate Change

One of the goals of project IC12, a research project of the Climate changes Spatial Planning programme, is to assess if the formal institutions operating in the Netherlands are improving or hampering adaptive capacity. In order to answer the research question, the most important documents referring to those institutions need to be evaluated. This document presents an initial inventory of these adaptation institutions – i.e. policy plans, laws and directives, reports and other documents that seemed relevant to the question at hand

Organizational influences on innovation to improve quality in health care

With medical evidence constantly advancing, the health care system faces pressure to generate, apply and integrate innovations to improve the quality of patient care. This dissertation examines how organizational characteristics influence these processes. The first study, a systematic review, investigates how organizational features influence the translation of basic research findings to clinical applications. Results showed a dearth of peer-reviewed literature on this topic, despite a proliferation of efforts to accelerate translational research by manipulating organizational structures and processes. Few studies effectively linked structures, processes and outcomes and no organizational feature was associated conclusively with translation of research into clinical practice. The second study draws on in-depth qualitative interviews (82 participants at 10 hospitals) to understand how hospitals that reduced readmission rates had applied innovations in clinical practice and organizational context. High performing and low performing hospitals had both implemented similar clinical practice changes in their efforts to reduce readmissions; however, high performing hospitals reported greater investment in creating an organizational context to facilitate readmissions. This included more extensive efforts to improve collaboration within the hospital, greater coordination between the hospital and outside providers, deeper engagement in learning and problem solving related to readmissions, and greater senior leadership support. The third study draws on an expanded set of interviews from the same data collection (90 participants at 10 hospitals) to investigate mechanisms through which innovations become integrated into hospital routines. Despite a well-developed literature on the initial implementation of new practices, we have limited knowledge about the mechanisms by which integration occurs. Results showed that when an innovation was integrated successfully, a small number of key staff held the innovation in place for as long as a year while more permanent integrating mechanisms began to work. Innovations that proved intrinsically rewarding to staff integrated through shifts in attitudes and norms over time. Innovations that did not provide direct benefits to staff were integrated through changed incentives or automation. Together, these studies illuminate opportunities for hospitals to improve patient care by managing the organizational context in which innovations are deployed. Understanding how organizational context affects translation requires further research.2017-10-02T00:00:00

Urban and Regional Cooperation and Development

This is an open access book. This book, first of all, introduces the new unveiled Guangdong-Macao Intensive Cooperation Zone with details as a special mode of the regional collaborative development that is committed to be mutually beneficial to both sides with different political and economic systems. China's central authorities have recently issued a masterplan for constructing the Guangdong-Macao Intensive Cooperation Zone at Hengqin Island in September 2021. As China's first and last European colony and one of China’s two special administrative regions (SARs), Macao has developed the gambling industry seven times larger than that of Las Vegas. However, the problem of the homogeneous industrial structure and the urgent need to promote sustainable economic growth by regional cooperation have been important theoretical and practical issues discussed by scholars and policy-makers. The Guangdong-Macao Intensive Cooperation Zone (ICZ) is managed under special customs supervision between two boarder lines and expected to diversify Macao’s economy. Then, this book dissects the theory of regional synergistic development and its applications in a number of international comparative and cross-interdisciplinary case studies worldwide. Finally, from the perspective of land use, transportation connection, and social service, this book thoroughly explores the challenges and strategies to implement the new cooperation model within the framework of one country, two systems, two customs, and two currencies to achieve a win–win situation using updated first-hand data collected by literature review, case study, field survey, spatial analysis, and interview

Treatment and valorization plants in materials recovery supply chain

Aim of industrial symbiosis is to create synergies between industries in order to exchange resources (by-products, water and energy) through geographic proximity and collaboration [1]. By optimizing resource flows in a “whole-system approach”, a minimization of dangerous emissions and of supply needs can be achieved. Resources exchanges are established to facilitate recycling and re-use of industrial waste using a commercial vehicle. Several paths can be identified in order to establish an industrial symbiosis network (Figure 1, left), in relation (i) to the life cycle phase (raw material, component, product) and (ii) to the nature (material, water, energy) of the resource flows to be exchanged. Sometimes by-products and/or waste of an industrial process have to be treated and valorized in order to become the raw materials for others. In particular, two main treatment processes can be identified: refurbishment/upgrade for re-use (Figure 1, center) and recycling for material recovery (Figure 1, right). A brief overview of technological and economic aspects is given, together with their relevance to industrial symbiosis