Quality and Cost Analysis of Nurse Staffing, Discharge Preparation, and Postdischarge Utilization

Objectives. To determine the impact of unit-level nurse staffing on quality of discharge teaching, patient perception of discharge readiness, and postdischarge readmission and emergency department (ED) visits, and cost-benefit of adjustments to unit nurse staffing. Data Sources. Patient questionnaires, electronic medical records, and administrative data for 1,892 medical–surgical patients from 16 nursing units within four acute care hospitals between January and July 2008. Design. Nested panel data with hospital and unit-level fixed effects and patient and unit-level control variables. Data Collection/Extraction. Registered nurse (RN) staffing was recorded monthly in hours-per-patient-day. Patient questionnaires were completed before discharge. Thirty-day readmission and ED use with reimbursement data were obtained by cross-hospital electronic searches. Principal Findings. Higher RN nonovertime staffing decreased odds of readmission (OR=0.56); higher RN overtime staffing increased odds of ED visit (OR=1.70). RN nonovertime staffing reduced ED visits indirectly, via a sequential path through discharge teaching quality and discharge readiness. Cost analysis projected total savings from 1 SD increase in RN nonovertime staffing and decrease in RN overtime of U.S.$11.64 million and U.S.$544,000 annually for the 16 study units. Conclusions. Postdischarge utilization costs could potentially be reduced by investment in nursing care hours to better prepare patients before hospital discharge

How can SMEs benefit from big data? Challenges and a path forward

Big data is big news, and large companies in all sectors are making significant advances in their customer relations, product selection and development and consequent profitability through using this valuable commodity. Small and medium enterprises (SMEs) have proved themselves to be slow adopters of the new technology of big data analytics and are in danger of being left behind. In Europe, SMEs are a vital part of the economy, and the challenges they encounter need to be addressed as a matter of urgency. This paper identifies barriers to SME uptake of big data analytics and recognises their complex challenge to all stakeholders, including national and international policy makers, IT, business management and data science communities. The paper proposes a big data maturity model for SMEs as a first step towards an SME roadmap to data analytics. It considers the ‘state-of-the-art’ of IT with respect to usability and usefulness for SMEs and discusses how SMEs can overcome the barriers preventing them from adopting existing solutions. The paper then considers management perspectives and the role of maturity models in enhancing and structuring the adoption of data analytics in an organisation. The history of total quality management is reviewed to inform the core aspects of implanting a new paradigm. The paper concludes with recommendations to help SMEs develop their big data capability and enable them to continue as the engines of European industrial and business success. Copyright © 2016 John Wiley & Sons, Ltd.Peer ReviewedPostprint (author's final draft

Systems Engineering Cost/Risk Analysis Capability Roadmap Progress Review

A viewgraph presentation on the cost/risk analysis capability of systems engineering is shown

Analyze the Air Force Methods for Facility Sustainment and Restoration

The Department of Defense (DoD) is improving the procedures for identifying, advocating, allocating funding, and accomplishing facility requirements to improve the readiness capability to support the mission. The purposes of this research were to fully explore the methodologies employed by the Air Force (AF) and try to capitalize on industry standard practices to improve the AF methods. Industry has conducted extensive research devoted to the development of predictive models to estimate facility maintenance or sustainment requirements. The DoD and the AF have already implemented the facility sustainment model (FSM) to predict facility sustainment requirements; now however, they are struggling with a justifiable methodology for predicting facility repair or restoration requirements. This research used statistical stepwise regression with historical AF facility requirement cost data for the last five years, in an attempt to develop a predictive model. The analysis results were not significant and did not result in an accurate predictive model, but the methodology and background research did produce some positive results. Observations regarding AF facility requirement reporting tools were identified and recommendations for improved integration were made in the research

Estimating components of ICT expenditure: a model-based approach with applicability to short time-series

This paper develops a microeconomic model-based approach to forecast national information and communications technology expenditure that is helpful when only very short time-series are available. The model specification incorporates parameters for network effects and national e-readiness. Finally, the model allows for observed non-homotheticity and ‘noise’ found in sample data, with the latter attributed to country-specific influences.ICT forecasts; short time-series; microeconomic modeling

Assessing Information System Integration Using Combination of the Readiness and Success Models

Information system integration (ISI) is one of the development concerns for organizations to enhance business competitiveness. However, the implementations still present its failures. Despite the ISI may successful technically; but it still seems to be unsuccessful because of the human and management issues. The issues may relate to the readiness constructs of ISI. This study was aimed to know the status of the readiness and success of ISI and to assess the influential factors of the integration in the sampled institution. About 160 samples were purposely involved by considering their key informant characteristics. The data were analyzed using the partial least squares-structural equation modeling (PLS-SEM) method. The findings revealed only the user satisfaction variable that mediated the positive effects of the readiness variables towards variable of the system integration success. Besides, the findings may practically helpful for stakeholders in the sampled institution, but it may also theoretically useful for researchers in regard to the readiness and success issues of ISI

The Eye in the Sky - Freight Rate Effects of Tanker Supply

We show how the evolution of crude oil tanker freight rates depends on the employment status and geographical position of the fleet of very large crude oil carriers (VLCCs). We provide a novel measure of short-term capacity in the voyage charter market which is a proxy for the percentage of vessels available for orders. We find that our capacity measure explains parts of the freight rate evolution at weekly horizons, where traditional supply measures are uninformative. The fact that freight rates directly influence shipowners’ profitability and charterers’ expenditures makes our measure particularly relevant for these groups of market participants