Developments in hospital management: a proposal for a new hospital management model for Malta

The management of hospitals has changed considerably over the last two decades. The business processes and patient treatment regimes are unrecognisable from those of ten years ago. Health care in general faces unprecedented challenges internationally as the demand for more medical treatment and services increases together with a parallel emphasis on quality and cost containment1. Furthermore external factors such as the 'greying' population and growing patients' expectations increase the burden upon hospital management and staff to provide a quality hospital service. Hospitals are expensive enterprises. Huge investments go into the construction and equipping of hospitals. In the UK the cost of building a hospital is £1000 /square metre2, whilst in Malta new construction costs around Lm430 /square metre. Medical equipment accounts for an additional 20%. Furthermore hospitals invariably take the lion's share of health care expenditure, averaging around 8% of GDP in Western Europe3 . It is therefore incumbent upon the authorities to ensure that the populace gets an appropriate return on its investment. This paper reviews developments in hospital care and management, including the increasing importance of focusing care and management decisions around the patient. It will explore the role clinicians should play in management, itself still a topic of controversy. The role of information technology and its indissoluble link with the proper administration of resources will also be critically appraised. These will be reviewed in the local context where a model for the future management of Malta's hospitals is proposed.peer-reviewe

Product ecodesign and materials: current status and future prospects

The aim of this paper is to discuss the current status of ecodesign in the industry and its future implications for materials. There is today more and more focus on the environmental impacts of products during their whole life cycle. In particular, ecodesign aims at integrating environmental aspects during the product's design process as any other criterion, in order to reduce the life cycle impacts. Although a lot of product environmental impact assessment and Design for Environment tools already exist, environmental aspects are unfortunately rarely routinely integrated into product development process in the industry. This is mainly due to the fact that current ecodesign tools are little adapted to designers' practices, requirements and competencies. After the sequential and DfX paradigms, design of products is today maturing into Integrated Design, where multiple points of views and expertise have to be considered at the same time to progressively define the product

Towards a flexible service integration through separation of business rules

Driven by dynamic market demands, enterprises are continuously exploring collaborations with others to add value to their services and seize new market opportunities. Achieving enterprise collaboration is facilitated by Enterprise Application Integration and Business-to-Business approaches that employ architectural paradigms like Service Oriented Architecture and incorporate technological advancements in networking and computing. However, flexibility remains a major challenge related to enterprise collaboration. How can changes in demands and opportunities be reflected in collaboration solutions with minimum time and effort and with maximum reuse of existing applications? This paper proposes an approach towards a more flexible integration of enterprise applications in the context of service mediation. We achieve this by combining goal-based, model-driven and serviceoriented approaches. In particular, we pay special attention to the separation of business rules from the business process of the integration solution. Specifying the requirements as goal models, we separate those parts which are more likely to evolve over time in terms of business rules. These business rules are then made executable by exposing them as Web services and incorporating them into the design of the business process.\ud Thus, should the business rules change, the business process remains unaffected. Finally, this paper also provides an evaluation of the flexibility of our solution in relation to the current work in business process flexibility research

Satisfaction in performing arts: the role of value?

Purpose – The aim of this paper is to report on the structure and relationships between value and satisfaction in a cultural performing arts setting to identify the structure of satisfaction in the performing arts context. Design/methodology/approach – This paper examines customer attitudes to value, show experience quality and peripheral service quality in a high arts setting by using a questionnaire. The pool of questions used the most recent scale measures for constructs in the area of services, in particular experiential services. The data are tested using AMOS 5.0 structural equation modelling. Findings – This paper reports that value mediates the relationship of show experience quality and peripheral service quality to satisfaction and the direct link of these pathways to satisfaction was not significant. This research supports the notion that customers determine service satisfaction based on attribute performance of the show and peripheral service aspects, and derive value from this. Practical implications – This research informs cultural organisation managers of the importance of delivering high levels of service quality and show experience in order to offer a value for money experience. This paper identifies the importance of understanding the heterogeneous and complex nature of customer-derived value. Originality/value – This paper examines a service sector that receives little attention. Cultural organisations operate as non-profit organisations and are accountable for scarce fund allocation. Government support has decreased and corporate sponsorship is scarce and competitive. This paper offers assistance to organisations in the quest to balance the economic issues and constraints by creating value and satisfaction and balancing service quality and show delivery

Talk up or criticize? Customer responses to WOM about competitors during social interactions

Popular metrics such as the Net Promoter Score (NPS) highlights many benefits of word of mouth (WOM) to firms. Is WOM all it is claimed to be? Building on social identity theory, this research develops a conceptual model of WOM exchange in social settings and tests the model with customer surveys of three service sectors. The findings show that the effects of (1) positive and negative WOM (P/NWOM) received about competitors and (2) perceived presence of critical incidents (PPCIs) on P/NWOM given about own service provider are far from intuitive. Responses to PWOM received counter the suggestions in the NPS literature. The findings also indicate that the best firms can hope for when receiving NWOM about competitors is that their customers remain silent. It is recommended that firms communicate a message that is consistent with the nuanced views expressed by friends in social circles, rather than a uniformly superior positioning

Value Creation in Marketing: Can Sales-Turnover turn to be a Competitive Advantage to the Marketer and Customer?

Doing business based on value delivered gives companies the means to get an equitable return for their efforts. Once markers/suppliers truly understand value, they will be able to realize the benefits of measuring and monitoring it for their customers. In this highly competitive circumstance all the firms regardless of the local or multinational tend to focus on value creation in marketing, by any means, in order to make their customers satisfied. Value is usually made with a target to satisfy the ultimate customer, but value creation in sales-turnover also affects the channel members and cost function, as a result impacts on the volume of sales and customer satisfaction as well. This formulation integrates value management, brand management, and relationship management within a customer-centered focus. Companies can decide which driver(s) strengthen for the best payoff. In this paper an effort has been made to develop an integrated value model composed of different strategies with different value concept, which ultimately impact on the sales turnover and thus create a value throughout the marketing functions and achieve its ultimate target. The paper moves step by step, from discussion of the concepts evolved in relation to value creation in marketing, then induction and development of the conceptual value creation model with special focus on the minimization of duration of the Sales-Turnover for competitive advantage vis-à-vis value creation for consumers. Finally, a rigorous theoretical analysis is given with an experimentation of the value model on a company- Abul Khair Co. Ltd.- partially practicing this concept in their marketing functions. This inductive model can be a solid basis for further research of strategic marketing application.

CamFlow: Managed Data-sharing for Cloud Services

A model of cloud services is emerging whereby a few trusted providers manage the underlying hardware and communications whereas many companies build on this infrastructure to offer higher level, cloud-hosted PaaS services and/or SaaS applications. From the start, strong isolation between cloud tenants was seen to be of paramount importance, provided first by virtual machines (VM) and later by containers, which share the operating system (OS) kernel. Increasingly it is the case that applications also require facilities to effect isolation and protection of data managed by those applications. They also require flexible data sharing with other applications, often across the traditional cloud-isolation boundaries; for example, when government provides many related services for its citizens on a common platform. Similar considerations apply to the end-users of applications. But in particular, the incorporation of cloud services within `Internet of Things' architectures is driving the requirements for both protection and cross-application data sharing. These concerns relate to the management of data. Traditional access control is application and principal/role specific, applied at policy enforcement points, after which there is no subsequent control over where data flows; a crucial issue once data has left its owner's control by cloud-hosted applications and within cloud-services. Information Flow Control (IFC), in addition, offers system-wide, end-to-end, flow control based on the properties of the data. We discuss the potential of cloud-deployed IFC for enforcing owners' dataflow policy with regard to protection and sharing, as well as safeguarding against malicious or buggy software. In addition, the audit log associated with IFC provides transparency, giving configurable system-wide visibility over data flows. [...]Comment: 14 pages, 8 figure