Applications of lean thinking: a briefing document

This report has been put together by the Health and Care Infrastructure Research and Innovation Centre (HaCIRIC) at the University of Salford for the Department of Health. The need for the report grew out of two main simple questions, o Is Lean applicable in sectors other than manufacturing? o Can the service delivery sector learn from the success of lean in manufacturing and realise the benefits of its implementation?The aim of the report is to list together examples of lean thinking as it is evidenced in the public and private service sector. Following a review of various sources a catalogue of evidence is put together in an organised manner which demonstrates that Lean principles and techniques, when applied rigorously and throughout an entire organization/unit, they can have a positive impact on productivity, cost, quality, and timely delivery of services

Digital twins: Understanding the added value of integrated models for through-life engineering services

Digital twins are digital representations of physical products or systems that consist of multiple models from various domains describing them on multiple scales. By means of communication, digital twins change and evolve together with their physical counterparts throughout their lifecycle. Domain-specific partial models that make up the digital twin, such as the CAD model or the degradation model, are usually well known and provide accurate descriptions of certain parts of the physical asset. However, in complex systems, the value of integrating the partial models increases because it facilitates the study of their complex behaviours which only emerge from the interactions between various parts of the system. The paper proposes that the partial models of the digital twin share a common model space that integrates them through a definition of their interrelations and acts as a bridge between the digital twin and the physical asset. The approach is illustrated in a case of a mechatronic product - a differential drive mobile robot developed as a testbed for digital twin research. It is demonstrated how the integrated models add value to different stages of the lifecycle, allowing for evaluation of performance in the design stage and real-time reflection with the physical asset during its operation

BCAS: A Web-enabled and GIS-based Decision Support System for the Diagnosis and Treatment of Breast Cancer

For decades, geographical variations in cancer rates have been observed but the precise determinants of such geographic differences in breast cancer development are unclear. Various statistical models have been proposed. Applications of these models, however, require that the data be assembled from a variety of sources, converted into the statistical models’ parameters and delivered effectively to researchers and policy makers. A web-enabled and GIS-based system can be developed to provide the needed functionality. This article overviews the conceptual web-enabled and GIS-based system (BCAS), illustrates the system’s use in diagnosing and treating breast cancer and examines the potential benefits and implications for breast cancer research and practice

Technologie en innovatie in Vlaanderen: Prioriteiten.

Vlaanderen;

Exploring the role of Modelling, Simulation, and Visualisation (MSV) in innovating healthcare environmental design

There exists a global and national need for improved understanding of how innovative solutions can be developed and applied to the therapeutic design of new hospitals. This necessity is growing as National Health Service (NHS) infrastructures face challenges of: overcrowding; thermal energy use and comfort; lighting; hygiene and Health Care Acquired Infection (HCAI); and ventilation. These issues emphasise considerable need for change in the way hospitals are designed in order to become built environments that promote health, and enhance patient wellbeing, staff performance, operational efficiency and medical outcomes. This paper reviewed current literature and tools relating to advances in MSV technology, particularly in: 3 Dimensional (3D) Computer Aided Design (CAD); Building Information Modelling (BIM); Parametric Modelling and Environmental Simulation; Construction Simulation; Virtual Reality (VR); and Facility Planning and Design Simulation. Their applicability to healthcare environmental design was reviewed to identify: examples of good practice; evidence based solutions and current trends; and conceptualise a Virtual Health Promoting Environment (VHE) that integrates MSV tools for optimised building performance. It was discovered that MSV has an important role to play in facilitating innovation and stimulating change from traditional healthcare design approaches to new approaches that support healthcare environmental design aimed at increase in the evidence base and optimisation of performance within multiple environmental parameters

Addendum to Informatics for Health 2017: Advancing both science and practice

This article presents presentation and poster abstracts that were mistakenly omitted from the original publication

Use of COTS functional analysis software as an IVHM design tool for detection and isolation of UAV fuel system faults

This paper presents a new approach to the development of health management solutions which can be applied to both new and legacy platforms during the conceptual design phase. The approach involves the qualitative functional modelling of a system in order to perform an Integrated Vehicle Health Management (IVHM) design – the placement of sensors and the diagnostic rules to be used in interrogating their output. The qualitative functional analysis was chosen as a route for early assessment of failures in complex systems. Functional models of system components are required for capturing the available system knowledge used during various stages of system and IVHM design. MADe™ (Maintenance Aware Design environment), a COTS software tool developed by PHM Technology, was used for the health management design. A model has been built incorporating the failure diagrams of five failure modes for five different components of a UAV fuel system. Thus an inherent health management solution for the system and the optimised sensor set solution have been defined. The automatically generated sensor set solution also contains a diagnostic rule set, which was validated on the fuel rig for different operation modes taking into account the predicted fault detection/isolation and ambiguity group coefficients. It was concluded that when using functional modelling, the IVHM design and the actual system design cannot be done in isolation. The functional approach requires permanent input from the system designer and reliability engineers in order to construct a functional model that will qualitatively represent the real system. In other words, the physical insight should not be isolated from the failure phenomena and the diagnostic analysis tools should be able to adequately capture the experience bases. This approach has been verified on a laboratory bench top test rig which can simulate a range of possible fuel system faults. The rig is fully instrumented in order to allow benchmarking of various sensing solution for fault detection/isolation that were identified using functional analysis

Twelve tips for rapidly migrating to online learning during the COVID-19 pandemic

The COVID-19 pandemic has resulted in a massive adaptation in health professions education, with a shift from in-person learning activities to a sudden heavy reliance on internet-mediated education. Some health professions schools will have already had considerable educational technology and cultural infrastructure in place, making such a shift more of a different emphasis in provision. For others, this shift will have been a considerable dislocation for both educators and learners in the provision of education. To aid educators make this shift effectively, this 12 Tips article presents a compendium of key principles and practical recommendations that apply to the modalities that make up online learning. The emphasis is on design features that can be rapidly implemented and optimised for the current pandemic. Where applicable, we have pointed out how these short-term shifts can also be beneficial for the long-term integration of educational technology into the organisations' infrastructure. The need for adaptability on the part of educators and learners is an important over-arching theme. By demonstrating these core values of the health professions school in a time of crisis, the manner in which the shift to online learning is carried out sends its own important message to novice health professionals who are in the process of developing their professional identities as learners and as clinicians

Towards More Nuanced Patient Management: Decomposing Readmission Risk with Survival Models

Unplanned hospital readmissions are costly and associated with poorer patient outcomes. Overall readmission rates have also come to be used as performance metrics in reimbursement in healthcare policy, further motivating hospitals to identify and manage high-risk patients. Many models predicting readmission risk have been developed to facilitate the equitable measurement of readmission rates and to support hospital decision-makers in prioritising patients for interventions. However, these models consider the overall risk of readmission and are often restricted to a single time point. This work aims to develop the use of survival models to better support hospital decision-makers in managing readmission risk. First, semi-parametric statistical and nonparametric machine learning models are applied to adult patients admitted via the emergency department at Gold Coast University Hospital (n = 46,659) and Robina Hospital (n = 23,976) in Queensland, Australia. Overall model performance is assessed based on discrimination and calibration, as measured by time-dependent concordance and D-calibration. Second, a framework based on iterative hypothesis development and model fitting is proposed for decomposing readmission risk into persistent, patient-specific baselines and transient, care-related components using a sum of exponential hazards structure. Third, criteria for patient prioritisation based on the duration and magnitude of care-related risk components are developed. The extensibility of the framework and subsequent prioritisation criteria are considered for alternative populations, such as outpatient admissions and specific diagnosis groups, and different modelling techniques. Time-to-event models have rarely been applied for readmission modelling but can provide a rich description of the evolution of readmission risk post-discharge and support more nuanced patient management decisions than simple classification models