The prevalent theory of construction is a hindrance for innovation

It is argued that construction innovation is significantly hindered by the prevalent theory of construction, which is implicit and deficient. There are three main mechanisms through which this hindrance is being caused. Firstly, because production theories in general, as well as construction theories specifically, have been implicit, it has not been possible to transfer such radical managerial innovation as mass production or lean production from manufacturing to construction. Direct application of these production templates in construction has been limited due to different context in construction in correspondence to manufacturing. On the other hand, without explicit theories, it has not been possible to access core ideas of concepts and methods of these templates, and to recreate them in construction environment. In consequence, theory and practice of construction has not progressed as in manufacturing. Secondly, it is argued that the underlying, even if implicit, theoretical model of construction is the transformation model of production. There are two first principles in the transformation model. First, the total transformation can be achieved only by realising all parts of it. Thus, we decompose the total transformation into parts, finally into tasks, ensure that all inputs are available and assign these tasks to operatives or workstations. Second, minimising the cost of each task, i.e. each decomposed transformation, minimises the cost of production. It is argued that these principles, in which uncertainty and time are abstracted away, are counterproductive, and lead to myopic control and inflated variability. Practical examples show that these deficiencies and related practical constraints hinder the top-down implementation of innovations. Thirdly, empirical research shows that also bottom-up innovation - systematic learning and problem solving - is hindered by this deficient theory. Thus, the advancement of construction innovation requires that a new, explicit and valid theory of construction is created, and business models and control methods based on it are developed

Improving supply chain management in construction: what can be learned from the aerospace industry?

In order to provide for controllable delivery, reliable lead times and efficient customer response, lean manufacturing and platform assembly practices play an important role in supply chains in the aerospace industry. The adoption of lean manufacturing practices ensures an efficient delivery of products to the market. Benefits from the development of platform strategies are a more reliable materials supply and an improved logistics control. The aerospace industry is characterized by a small number of major global players and many small ones. A major part of the design and production has been contracted out to suppliers. In this paper the basic similarities and differences between the construction and aerospace industry and supply chains are analysed. A comparative study of aerospace and construction supply chains is presented to indicate and discuss the applicability of supply chain management concepts to construction, and the improvement potential of these concepts regarding supply chain management in construction. It is concluded that in particular the practice of platform assembly is a fruitful concept to be applied in the construction industry

A Fourth Party Energy Provider for the Construction Value Chain: Identifying Needs and Establishing Requirements

Today’s building and energy management market is heterogeneous and complex. Most of the players in the construction market are not in possession of the managerial capability to fully control the dynamics that affect their energy costs in terms of energy sourcing and energy management. Moreover, construction industry needs to rely on a stronger technical and commercial expertise. On one hand, there is a need of an in-depth and extensive level of technical know-how that most of facility managers, property developers and building owners at private and public level scarcely hold. On the other hand, this industry is characterized by a fragmentation within the single tiers of the value chain. In this context, the paper aims at proposing a new vision of the building value chain towards a collaborative network led by a new player, namely the Fourth Party Energy Provider, acting as the “one-stop contracting and managing” operator, integrating resources, capabilities, best available technologies and practices for providing energy-efficient building solutions

Optimising integrated stroke care in regional networks:A nationwide self-assessment study in 2012, 2015 and 2019

Background: To help enhance the quality of integrated stroke care delivery, regional stroke services networks in the Netherlands participated in a self-assessment study in 2012, 2015 and 2019. Methods: Coordinators of the regional stroke services networks filled out an online self-assessment questionnaire in 2012, 2015 and 2019. The questionnaire, which was based on the Development Model for Integrated Care, consisted of 97 questions in nine clusters (themes). Cluster scores were calculated as proportions of the activities implemented. Associations between clusters and features of stroke services were assessed by regression analysis. Results: The response rate varied from 93.1% (2012) to 85.5% (2019). Over the years, the regional stroke services networks increased in ‘size’: the median number of organisations involved and the volume of patients per network increased (7 and 499 in 2019, compared to 5 and 364 in 2012). At the same time, fewer coordinators were appointed for more than 1 day a week in 2019 (35.1%) compared to 2012 (45.9%). Between 2012 and 2019, there were statistically significantly more elements implemented in four out of nine clusters: ‘Transparent entrepreneurship’ (MD = 18.0% F(1) = 10.693, p = 0.001), ‘Roles and tasks’ (MD = 14.0% F(1) = 9.255, p = 0.003), ‘Patient-centeredness’ (MD = 12.9% F(1) = 9.255, p = 0.003), and ‘Commitment’ (MD = 11.2%, F(1) = 4.982, p = 0.028). A statistically significant positive correlation was found for all clusters between implementation of activities and age of the network. In addition, the number of involved organisations is associated with better execution of implemented activities for ‘Transparent entrepreneurship’, ‘Result-focused learning’ and ‘Quality of care’. Conversely, there are small but negative associations between the volume of patients and implementation rates for ‘Interprofessional teamwork’ and ‘Patient-centredness’. Conclusion: This long-term analyses of stroke service development in the Netherlands, showed that between 2012 and 2019, integrated care activities within the regional stroke networks increased. Experience in collaboration between organisations within a network benefits the uptake of integrated care activities

Meeting the governance challenges of integrated health and social care

Background Many countries are experimenting with novel ways of organising and delivering more integrated health and social care. Governance is relatively neglected as a focus of attention in this context but addressing governance challenges is key for successful collaboration. Methods Cross-country case analysis involving document review and semi-structured interviews with 27 local, regional and national level stakeholders in Italy, the Netherlands and Scotland. We used the Transparency, Accountability, Participation, Integrity and Capability (TAPIC) framework to structure our analytical enquiry to explore factors that influence the governance arrangements in each system. Results Governance arrangements ranged from informal agreements in the Netherlands to mandated integration in Scotland. Novel service models were generally participative involving a wide range of stakeholders, including the public, although integration was seen to be driven, largely, from a health perspective. In Italy and Scotland some reversion to ‘command & control’ was reported in response to the imperatives of the Covid-19 pandemic. Policies, budgets, auditing and reporting systems that are clearly aligned at all levels were seen to help with implementing innovations in service organisation. Where alignment was lacking, cooperation and integration was suboptimal, regardless of whether governance arrangements were statutory or not. There was wide recognition of the importance of buy-in. Enablers of greater engagement included visible leadership, time and long-standing working relationships. Lack of suitable indicators and openness to data sharing to measure integration hindered working relationships and thus the successful delivery of integrated services. Conclusions Our study provides important insights into how to more effectively and efficiently govern service delivery structures within care systems. We will discuss approaches to governance that help support more resilient integrated care systems. Key messages • Different governance arrangements face common challenges to greater integration of care. Enablers include strong leadership, inclusivity and openness to work across traditional boundaries. • Meeting the governance challenges of integrated health and social care requires clear lines of accountability, aligned policies, budgets and reporting systems

Briefing: Towards exploring profession-specific BIM challenges in the UK

Building information modelling (BIM) has been proposed as an enabler for greater efficiency and effectiveness within the UK construction industry, providing digital management of construction data throughout the project life cycle. The potential benefits of BIM have been widely discussed in published literature but relatively less attention has been paid to the discipline/profession-specific challenges of wider industry adoption. Further studies, such as the authors' ongoing research, could help to remedy this