119,794 research outputs found

    Gender, health and disease

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    The real SAP® Business one cost : a case study of ERP adoption in an SME

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    This paper reports on a UK based service management Small and Medium-sized Enterprise (SME) that invested into SAP® Business One. The action research case study highlights the real cost and difficulties faced in moving to the one single SAP system and the process that was followed in order to identify third-party vendors that can integrate or customise SAP® Business One. This paper highlights the additional costs required to ensure a ‘fit-for-purpose’ solution to close the gap between strategic needs and the existing SAP Business One solution. The gap itself is illustrated by highlighting 10 key functionalities expected by the given service management SME. The actual implementation cost of the Enterprise Resource Planning (ERP) was found to be approximately double the initial SAP costs. The real costs involve time for, among other things, process reengineering, strategic decision making, software add-ons, staff-training, project-management and software maintenance

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    Stroke mimic diagnoses presenting to a hyperacute stroke unit.

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    Stroke services have been centralised in several countries in recent years. Diagnosing acute stroke is challenging and a high proportion of patients admitted to stroke units are diagnosed as a non-stroke condition (stroke mimics). This study aims to describe the stroke mimic patient group, including their impact on stroke services. We analysed routine clinical data from 2,305 consecutive admissions to a stroke unit at St George's Hospital, London. Mimic groupings were derived from 335 individual codes into 17 groupings. From 2,305 admissions, 555 stroke mimic diagnoses were identified (24.2%) and 72% of stroke mimics had at least one stroke risk factor. Common mimic diagnoses were headache, seizure and syncope. Medically unexplained symptoms and decompensation of underlying conditions were also common. Median length of stay was 1 day; a diagnosis of dementia (p=0.028) or needing MRI (p=0.006) was associated with a longer stay. Despite emergency department assessment by specialist clinicians and computed tomography brain, one in four suspected stroke patients admitted to hospital had a non-stroke diagnosis. Stroke mimics represent a heterogeneous patient group with significant impacts on stroke services. Co-location of stroke and acute neurology services may offer advantages where service reorganisation is being considered
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