What does it take to make integrated care work? A ‘cookbook’ for large-scale deployment of coordinated care and telehealth

The Advancing Care Coordination & Telehealth Deployment (ACT) Programme is the first to explore the organisational and structural processes needed to successfully implement care coordination and telehealth (CC&TH) services on a large scale. A number of insights and conclusions were identified by the ACT programme. These will prove useful and valuable in supporting the large-scale deployment of CC&TH. Targeted at populations of chronic patients and elderly people, these insights and conclusions are a useful benchmark for implementing and exchanging best practices across the EU. Examples are: Perceptions between managers, frontline staff and patients do not always match; Organisational structure does influence the views and experiences of patients: a dedicated contact person is considered both important and helpful; Successful patient adherence happens when staff are engaged; There is a willingness by patients to participate in healthcare programmes; Patients overestimate their level of knowledge and adherence behaviour; The responsibility for adherence must be shared between patients and health care providers; Awareness of the adherence concept is an important factor for adherence promotion; The ability to track the use of resources is a useful feature of a stratification strategy, however, current regional case finding tools are difficult to benchmark and evaluate; Data availability and homogeneity are the biggest challenges when evaluating the performance of the programmes

Sustainable Strategic Urban Planning: Methodology for Urban Renovation At District Level

Sustainable urban renovation is characterized by multiple factors (e.g. technical, socio-economic, environmental and ethical perspectives), different spatial scales and a number of administrative structures that should address the evaluation of alternative scenarios or solutions. This defines a complex decision problem that includes different stakeholders where several aspects need to be considered simultaneously. In spite of the knowledge and experiences during the recent years, there is a need of methods that lead the decision-making processes. In response, a methodology based on the global idea and implications of working towards a more sustainable and energy efficient cities as a holistic procedure for urban renovation at district level is proposed in the European Smart City project CITyFiED. The methodology has the energy efficiency as main pillar and the local authorities as client. It is composed of seven phases that ensures an effective dialogue among all the stakeholders, aiming to understand the objectives and needs of the city to define a set of Strategies for Sustainable Urban Renovation and their integration within the Strategic Urban Planning of the cities.This project has received funding from the European Union’s Seventh Programme for research, technological development and demonstration under grant agreement N° 609129. The authors would like to thank the rest of the partners of the CITyFiED project for their help and support

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

A review of clinical decision-making: Models and current research

Aims and objectives: The aim of this paper was to review the current literature with respect to clinical decision-making models and the educational application of models to clinical practice. This was achieved by exploring the function and related research of the three available models of clinical decision making: information processing model, the intuitive-humanist model and the clinical decision making model. Background: Clinical decision-making is a unique process that involves the interplay between knowledge of pre-existing pathological conditions, explicit patient information, nursing care and experiential learning. Historically, two models of clinical decision making are recognised from the literature; the information processing model and the intuitive-humanist model. The usefulness and application of both models has been examined in relation the provision of nursing care and care related outcomes. More recently a third model of clinical decision making has been proposed. This new multidimensional model contains elements of the information processing model but also examines patient specific elements that are necessary for cue and pattern recognition. Design: Literature review Methods: Evaluation of the literature generated from MEDLINE, CINAHL, OVID, PUBMED and EBESCO systems and the Internet from 1980 – November 2005

Increasing resilience of ATM networks using traffic monitoring and automated anomaly analysis

Systematic network monitoring can be the cornerstone for the dependable operation of safety-critical distributed systems. In this paper, we present our vision for informed anomaly detection through network monitoring and resilience measurements to increase the operators' visibility of ATM communication networks. We raise the question of how to determine the optimal level of automation in this safety-critical context, and we present a novel passive network monitoring system that can reveal network utilisation trends and traffic patterns in diverse timescales. Using network measurements, we derive resilience metrics and visualisations to enhance the operators' knowledge of the network and traffic behaviour, and allow for network planning and provisioning based on informed what-if analysis

The PACTUM model: product analysis of cost and time using mathematics

Establishing a mathematical supply-chain model is a proposition that has received attention due to its inherent benefits of evolving global supply-chain efficiencies. This paper discusses the prevailing relationships found within apparel supply-chain environments, and contemplates the complex issues indicated for constituting a mathematical model. Principal results identified within the data suggest, that the multifarious nature of global supply-chain activities require a degree of simplification in order to fully dilate the necessary factors which affect, each sub-section of the chain. Subsequently, the research findings allowed the division of supply-chain components into sub-sections, which amassed a coherent method of product development activity. Concurrently, the supply-chain model was found to allow systematic mathematical formulae analysis, of cost and time, within the multiple contexts of each sub-section encountered. The paper indicates the supply-chain model structure, the mathematics, and considers how product analysis of cost and time can improve the comprehension of product lifecycle management

Requirements analysis for decision-support system design: evidence from the automotive industry

The purpose of this paper is to outline the requirements analysis that was carried out to support the development of a system that allows engineers to view real-time data integrated from multiple silos such as Product Lifecycle Management (PLM) and Warranty systems, in a single and visual environment. The outcome of this study provides a clear understanding of how engineers working in different phases of the product-lifecycle could utilise such information to improve the decision making process and as a result design better products. This study uses data collected via in-depth semi-structured interviews and workshops that includes people working in various roles within the automotive sector. In order to demonstrate the applicability this approach, SysML diagrams are also provided

Building information modelling (BIM) implementation and remote construction projects: issues, challenges, and critiques.

The construction industry has been facing a paradigm shift to (i) increase productivity, efficiency, infrastructure value; quality and sustainability (ii) reduce lifecycle costs, lead times and duplications via effective collaboration and communication of stakeholders in construction projects. This paradigm shift is becoming more critical with remote construction projects, which reveals unique and even more complicated challenging problems in relation to communication and management due to the remoteness of the construction sites. On the other hand, Building Informational Modelling (BIM) is offered by some as the panacea to addressing the interdisciplinary inefficiencies in construction projects. Although in many cases the adoption of BIM has numerous potential benefits, it also raises interesting challenges with regards to how BIM integrates the business processes of individual practices. This paper aims to show how BIM adoption for an architectural company helps to mitigate the management and communication problems in remote construction project. The paper adopts a case study methodology, which is a UK Knowledge Transfer Partnership (KTP) project of BIM adoption between the University of Salford, UK and John McCall Architects (JMA), in which the BIM use between the architectural company and the main contractor for a remote construction project is elaborated and justified. Research showed that the key management and communication problems such as poor quality of construction works, unavailability of materials, and ineffective planning and scheduling can largely be mitigated by adopting BIM at the design stage