Strategic emergency department design: An approach to capacity planning in healthcare provision in overcrowded emergency rooms

Healthcare professionals and the public have increasing concerns about the ability of emergency departments to meet current demands. Increased demand for emergency services, mainly caused by a growing number of minor and moderate injuries has reached crisis proportions, especially in the United Kingdom. Numerous efforts have been made to explore the complex causes because it is becoming more and more important to provide adequate healthcare within tight budgets. Optimisation of patient pathways in the emergency department is therefore an important factor

GISualization: visualized integration of multiple types of data for knowledge co-production

Urban planning deals with multiple layers of information stemming from concurrent activities and stakeholders intervening in urban development. For a better management of complexity more comprehensiveness and data integration are needed. This study develops an adaptive and iterative mixed-method approach for knowledge production in urban transformation processes. Specific research questions relate to data integration from different sources and facilitation of co-production of knowledge beyond triangulation. A new multi-layer framework, GISualization, has been developed in the context of a research project exploring compact city qualities. The framework is structured through five data layers, representing different methods for data collection and different grades of complexity, richness and interpretation: basic statistics; advanced statistics; exogenous quali-quantitative descriptions; exogenous qualitative descriptions; and endogenous qualitative descriptions. Thus, data stem from both quantitative and qualitative sources. Our study has proven that GISualization is a methodological framework that enables analysis and visualization of complex data in a rich format. The approach is closely related to analytical eclecticism and abductivity. It embodies a collaborative communication platform that provides a language to navigate between heterogeneous data, information and methods. The GISualization framework opens up for broader stakeholder involvement and community participation extending research into the domain of transdisciplinary knowledge production

Tuple-based semantic and structural mapping for a sustainable interoperability

Abstract. Enterprises are demanded to collaborate and establish partnerships to reach global business and markets. However, due to the different sources of models and semantics, organizations are experiencing difficulties exchanging vital information electronically and seamlessly, even when they operate in related business environments. This situation is even worst in the advent of the evolution of the enterprise systems and applications, whose dynamics result in increasing the interoperability problem due to the continuous need for model adjustments and semantics harmonization. To contribute for a long term stable interoperable enterprise operating environment, the authors propose the integration of traceability functionalities in information systems as a way to support such sustainability. Either data, semantic, and structural mappings between partner enterprises in the complex network should be modelled as tuples and stored in a knowledge base for communication support with reasoning capabilities, thus allowing to trace, monitor and support the stability maintenance of a system's interoperable state

Applying critical systems thinking to social prescribing: a relational model of stakeholder “buy-in”

Background Social prescribing (SP) allows health professionals to refer primary care patients toward health and wellbeing interventions and activities in the local community. Now widely implemented across the UK and adopted in other nations, questions arise concerning the modelling of present and future schemes, including challenges to full engagement encountered by stakeholders, which lie beyond the scope of traditional evaluations. Critical Systems Thinking (CST) allows for holistic analysis of fields where multiple stakeholders hold diverse interests and unequal power. Methods We use CST to (a) critically examine a developing rural social prescribing scheme from multiple stakeholder perspectives and (b) present a relational model for local social prescribing schemes. Our fieldwork included 24 in-depth interviews, regular planning meetings with key stakeholders, and discussions with those involved with national and international SP landscaping. A modified grounded theory approach was used for the analysis, and to consider the core elements of social prescribing sustainability. Results Our study confirms that local social prescribing schemes must operate with numerous stakeholder interests in mind, seeking to address real life social complexity and offer integrated solutions to multifaceted issues. Three main areas are discussed: holistic vision and boundary judgments; barriers and facilitators; relational issues and “emotional buy in”. Problems for staff include selecting suitable clients, feedback and technological issues and funding and evaluation pressures. Barriers for clients include health, transport and expense issues, also lack of prior information and GP involvement. Emotional “buy-in” emerged as essential for all stakeholders, but hard to sustain. Based on our findings we propose a positive relational model comprising shared vision, confidence and commitment; motivation and encouragement, support and wellbeing focus, collaborative relationships, communication and feedback, access to information /resources, learning in and from action, with emotional “buy-in” at its heart. Conclusion Those implementing social prescribing in different localities inevitably face hard choices about what and whom to include. Research on the sustainability of social prescribing remains limited, studies are required to ascertain which “holistic” models of social prescribing work best for which communities, who are the main beneficiaries of these approaches and how “buy-in” is best sustained