Construction safety and digital design: a review

As digital technologies become widely used in designing buildings and infrastructure, questions arise about their impacts on construction safety. This review explores relationships between construction safety and digital design practices with the aim of fostering and directing further research. It surveys state-of-the-art research on databases, virtual reality, geographic information systems, 4D CAD, building information modeling and sensing technologies, finding various digital tools for addressing safety issues in the construction phase, but few tools to support design for construction safety. It also considers a literature on safety critical, digital and design practices that raises a general concern about ‘mindlessness’ in the use of technologies, and has implications for the emerging research agenda around construction safety and digital design. Bringing these strands of literature together suggests new kinds of interventions, such as the development of tools and processes for using digital models to promote mindfulness through multi-party collaboration on safet

Paving the Way to Simpler: Experiencing from Maximizing Enrollment States in Streamlining Eligibility and Enrollment

Since 2009, the eight states (Alabama, Illinois, Louisiana, Massachusetts, New York, Utah, Virginia, and Wisconsin) participating in the Robert Wood Johnson Foundation's Maximizing Enrollment program have worked to streamline and simplify enrollment systems, policies, and processes for children and those eligible for health coverage in 2014. The participating states aimed to reduce enrollment barriers for consumers and administrative burdens in processing applications and renewals for staff by making improvements and simplifications at every step of the enrollment process. Although the states began their work before the enactment of the Affordable Care Act (ACA), their efforts positioned them well for implementation in 2014, and offer experiences and lessons that other states may find useful in their efforts to improve efficiency, lower costs, and promote responsible stewardship of limited public resources

Artificial intelligence and UK national security: Policy considerations

RUSI was commissioned by GCHQ to conduct an independent research study into the use of artificial intelligence (AI) for national security purposes. The aim of this project is to establish an independent evidence base to inform future policy development regarding national security uses of AI. The findings are based on in-depth consultation with stakeholders from across the UK national security community, law enforcement agencies, private sector companies, academic and legal experts, and civil society representatives. This was complemented by a targeted review of existing literature on the topic of AI and national security. The research has found that AI offers numerous opportunities for the UK national security community to improve efficiency and effectiveness of existing processes. AI methods can rapidly derive insights from large, disparate datasets and identify connections that would otherwise go unnoticed by human operators. However, in the context of national security and the powers given to UK intelligence agencies, use of AI could give rise to additional privacy and human rights considerations which would need to be assessed within the existing legal and regulatory framework. For this reason, enhanced policy and guidance is needed to ensure the privacy and human rights implications of national security uses of AI are reviewed on an ongoing basis as new analysis methods are applied to data

Study protocol: The Adherence and Intensification of Medications (AIM) study - a cluster randomized controlled effectiveness study

Abstract Background Many patients with diabetes have poor blood pressure (BP) control. Pharmacological therapy is the cornerstone of effective BP treatment, yet there are high rates both of poor medication adherence and failure to intensify medications. Successful medication management requires an effective partnership between providers who initiate and increase doses of effective medications and patients who adhere to the regimen. Methods In this cluster-randomized controlled effectiveness study, primary care teams within sites were randomized to a program led by a clinical pharmacist trained in motivational interviewing-based behavioral counseling approaches and authorized to make BP medication changes or to usual care. This study involved the collection of data during a 14-month intervention period in three Department of Veterans Affairs facilities and two Kaiser Permanente Northern California facilities. The clinical pharmacist was supported by clinical information systems that enabled proactive identification of, and outreach to, eligible patients identified on the basis of poor BP control and either medication refill gaps or lack of recent medication intensification. The primary outcome is the relative change in systolic blood pressure (SBP) measurements over time. Secondary outcomes are changes in Hemoglobin A1c, low-density lipoprotein cholesterol (LDL), medication adherence determined from pharmacy refill data, and medication intensification rates. Discussion Integration of the three intervention elements - proactive identification, adherence counseling and medication intensification - is essential to achieve optimal levels of control for high-risk patients. Testing the effectiveness of this intervention at the team level allows us to study the program as it would typically be implemented within a clinic setting, including how it integrates with other elements of care. Trial Registration The ClinicalTrials.gov registration number is NCT00495794.http://deepblue.lib.umich.edu/bitstream/2027.42/78258/1/1745-6215-11-95.xmlhttp://deepblue.lib.umich.edu/bitstream/2027.42/78258/2/1745-6215-11-95.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/78258/3/1745-6215-11-95-S1.DOCPeer Reviewe

Managing at the Speed of Light: Improving Mission-Support Performance

The House and Senate Energy and Water Development Appropriations Subcommittees requested this study to help DOE's three major mission-support organizations improve their operations to better meet the current and future needs of the department. The passage of the Recovery Act only increased the importance of having DOE's mission-support offices working in the most effective, efficient, and timely manner as possible. While following rules and regulations is essential, the foremost task of the mission-support offices is to support the department's mission, i.e., the programs that DOE is implementing, whether in Washington D.C. or in the field. As a result, the Panel offered specific recommendations to strengthen the mission-focus and improve the management of each of the following support functions based on five "management mandates":- Strategic Vision- Leadership- Mission and Customer Service Orientation- Tactical Implementation- Agility/AdaptabilityKey FindingsThe Panel made several recommendations in each of the functional areas examined and some overarching recommendations for the corporate management of the mission-support offices that they believed would result in significant improvements to DOE's mission-support operations. The Panel believed that adopting these recommendations will not only make DOE a better functioning organization, but that most of them are essential if DOE is to put its very large allocation of Recovery Act funding to its intended uses as quickly as possible

Principles in Patterns (PiP) : Evaluation of Impact on Business Processes

The innovation and development work conducted under the auspices of the Principles in Patterns (PiP) project is intended to explore and develop new technology-supported approaches to curriculum design, approval and review. An integral component of this innovation is the use of business process analysis and process change techniques - and their instantiation within the C-CAP system (Class and Course Approval Pilot) - in order to improve the efficacy of curriculum approval processes. Improvements to approval process responsiveness and overall process efficacy can assist institutions in better reviewing or updating curriculum designs to enhance pedagogy. Such improvements also assume a greater significance in a globalised HE environment, in which institutions must adapt or create curricula quickly in order to better reflect rapidly changing academic contexts, as well as better responding to the demands of employment marketplaces and the expectations of professional bodies. This is increasingly an issue for disciplines within the sciences and engineering, where new skills or knowledge need to be rapidly embedded in curricula as a response to emerging technological or environmental developments. All of the aforementioned must also be achieved while simultaneously maintaining high standards of academic quality, thus adding a further layer of complexity to the way in which HE institutions engage in "responsive curriculum design" and approval. This strand of the PiP evaluation therefore entails an analysis of the business process techniques used by PiP, their efficacy, and the impact of process changes on the curriculum approval process, as instantiated by C-CAP. More generally the evaluation is a contribution towards a wider understanding of technology-supported process improvement initiatives within curriculum approval and their potential to render such processes more transparent, efficient and effective. Partly owing to limitations in the data required to facilitate comparative analyses, this evaluation adopts a mixed approach, making use of qualitative and quantitative methods as well as theoretical techniques. These approaches combined enable a comparative evaluation of the curriculum approval process under the "new state" (i.e. using C-CAP) and under the "previous state". This report summarises the methodology used to enable comparative evaluation and presents an analysis and discussion of the results. As the report will explain, the impact of C-CAP and its ability to support improvements in process and document management has resulted in the resolution of numerous process failings. C-CAP has also demonstrated potential for improvements in approval process cycle time, process reliability, process visibility, process automation, process parallelism and a reduction in transition delays within the approval process, thus contributing to considerable process efficiencies; although it is acknowledged that enhancements and redesign may be required to take advantage of C-CAP's potential. Other aspects pertaining to C-CAP's impact on process change, improvements to document management and the curation of curriculum designs will also be discussed

Project Controls and Management Systems : current practice and how it has changed over the past decade

Project Controls and Management System (PCMS) refers to an ecosystem of processes, tools and personnel required for the proper planning and execution of capital projects throughout the different phases of design, procurement, construction and startup. This can be divided into different focus areas (functions) that would include Estimating, Planning, Scheduling, Cost Control, Change Management, Progressing, and Forecasting. Various trends such as globalization, contractor specialization and information technology developments have impacted the way PCMS are implemented and made it the subject of extensive research over the past years to investigate how to best utilize those trends. Replicating the research methodology used in a 2011 report published by the Construction Research Institute (CII), this work aims to investigate the current status of PCMS implementation and how it has changed over the past decade. It was concluded that while the original PCMS principles are still valid, adoption has drastically changed in terms of efficiency for the majority of the functions. The research also identifies areas of potential concerns and provides recommendations for further improvement.Civil, Architectural, and Environmental Engineerin

IT process architectures for enterprises development: A survey from a maturity model perspective

During the last years much has been published about IT governance. Close to the success of many governance efforts are the business frameworks, quality models, and technology standards that help enterprises improve processes, customer service, quality of products, and control. In this paper we i) survey existing frameworks, namely ITIL, ASL and BiSL, ii) find relations with the IT Governance framework CobiT to determine if the maturity model of CobiT can be used by ITIL, ASL and BiSL, and (iii) provide an integrated vista of IT processes viewed from a maturity model perspective. This perspective can help us understand the importance of maturity models for increasing the efficiency of IT processes for enterprises development and business-IT alignment

Complex Care Management Program Overview

This report includes brief updates on various forms of complex care management including: Aetna - Medicare Advantage Embedded Case Management ProgramBrigham and Women's Hospital - Care Management ProgramIndependent Health - Care PartnersIntermountain Healthcare and Oregon Health and Science University - Care Management PlusJohns Hopkins University - Hospital at HomeMount Sinai Medical Center -- New York - Mount Sinai Visiting Doctors Program/ Chelsea-Village House Calls ProgramsPartners in Care Foundation - HomeMeds ProgramPrinceton HealthCare System - Partnerships for PIECEQuality Improvement for Complex Chronic Conditions - CarePartner ProgramSenior Services - Project Enhance/EnhanceWellnessSenior Whole Health - Complex Care Management ProgramSumma Health/Ohio Department of Aging - PASSPORT Medicaid Waiver ProgramSutter Health - Sutter Care Coordination ProgramUniversity of Washington School of Medicine - TEAMcar

Committed to Safety: Ten Case Studies on Reducing Harm to Patients

Presents case studies of healthcare organizations, clinical teams, and learning collaborations to illustrate successful innovations for improving patient safety nationwide. Includes actions taken, results achieved, lessons learned, and recommendations