[Benefits of nursing care service in the assisted reproduction clinic to self-cycle-management and self-efficiency of infertility patients].

PubMed

Li, Xiao-Qin; Sun, Chao-Feng; Guo, Mei

2017-06-01

To investigate the benefits of nursing care service in the assisted reproduction clinic to self-cycle-management and self-efficiency of the outpatients with infertility. We randomly divided 600 females preliminarily diagnosed with infertility into a control and an experimental group, 288 in the former and 285 in the latter group excluding those whose husbands had azoospermia. For the women patients of the experimental group, we conducted nursing care intervention concerning related knowledge, skills, diet, excise, medication, and psychology, by one-to-one consultation, individualized or group communication, establishing files, telephone follow-up, and wechat guidance. After 3 months of intervention, we compared the compliance of medical visits, effectiveness of cycle management, sense of self-efficiency, satisfaction, and anxiety score between the two groups of patients. In comparison with the controls, the patients of the experimental group showed significantly better knowledge about assisted reproduction and higher effectiveness of self-cycle-management, self-efficiency, and satisfaction (P <0.05), but a markedly lower degree of anxiety (P <0.05). Nursing care service in the assisted reproduction clinic can improve the compliance of medical visits, effectiveness of self-cycle-management, self-efficiency, and satisfaction and reduce the anxiety of the patients.

Activity-based funding for National Health Service hospitals in England: managers' experience and expectations.

PubMed

Sussex, Jonathan; Farrar, Shelley

2009-05-01

Activity-based funding of hospital services has been introduced progressively since 2003 in the National Health Service (NHS) in England, under the name 'Payment by Results' (PbR). It represents a major change from previous funding arrangements based on annual "block" payments for large bundles of services. We interviewed senior local NHS managers about their experience and expectations of the impact of PbR. A high degree of 'NHS solidarity' was apparent, and competition between NHS hospitals was muted. PbR has been introduced against a background of numerous other efficiency incentives, and managers did not detect a further PbR-specific boost to efficiency. No impact on care quality, either positive or negative, is yet evident.

Chip-set for quality of service support in passive optical networks

NASA Astrophysics Data System (ADS)

Ringoot, Edwin; Hoebeke, Rudy; Slabbinck, B. Hans; Verhaert, Michel

1998-10-01

In this paper the design of a chip-set for QoS provisioning in ATM-based Passive Optical Networks is discussed. The implementation of a general-purpose switch chip on the Optical Network Unit is presented, with focus on the design of the cell scheduling and buffer management logic. The cell scheduling logic supports `colored' grants, priority jumping and weighted round-robin scheduling. The switch chip offers powerful buffer management capabilities enabling the efficient support of GFR and UBR services. Multicast forwarding is also supported. In addition, the architecture of a MAC controller chip developed for a SuperPON access network is introduced. In particular, the permit scheduling logic and its implementation on the Optical Line Termination will be discussed. The chip-set enables the efficient support of services with different service requirements on the SuperPON. The permit scheduling logic built into the MAC controller chip in combination with the cell scheduling and buffer management capabilities of the switch chip can be used by network operators to offer guaranteed service performance to delay sensitive services, and to efficiently and fairly distribute any spare capacity to delay insensitive services.

LED Provides Effective and Efficient Parking Area Lighting at the NAVFAC Engineering Service Center

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

2010-08-12

U.S. Department of Energy (DOE) Federal Energy Management Program (FEMP) emerging technology case study showcasing LED lighting to improve energy efficiency in parking areas at the NAVFAC Engineering Services Center.

41 CFR 101-39.105 - Discontinuance or curtailment of service.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., AND MOTOR VEHICLES 39-INTERAGENCY FLEET MANAGEMENT SYSTEMS 39.1-Establishment, Modification, and Discontinuance of Interagency Fleet Management Systems § 101-39.105 Discontinuance or curtailment of service. (a... efficiencies are realized from the operation of any fleet management system, the Administrator, GSA, will...

Data Envelopment Analysis (DEA) Model in Operation Management

NASA Astrophysics Data System (ADS)

Malik, Meilisa; Efendi, Syahril; Zarlis, Muhammad

2018-01-01

Quality management is an effective system in operation management to develops, maintains, and improves quality from groups of companies that allow marketing, production, and service at the most economycal level as well as ensuring customer satisfication. Many companies are practicing quality management to improve their bussiness performance. One of performance measurement is through measurement of efficiency. One of the tools can be used to assess efficiency of companies performance is Data Envelopment Analysis (DEA). The aim of this paper is using Data Envelopment Analysis (DEA) model to assess efficiency of quality management. In this paper will be explained CCR, BCC, and SBM models to assess efficiency of quality management.

Process Reengineering for Quality Improvement in ICU Based on Taylor's Management Theory.

PubMed

Tao, Ziqi

2015-06-01

Using methods including questionnaire-based surveys and control analysis, we analyzed the improvements in the efficiency of ICU rescue, service quality, and patients' satisfaction, in Xuzhou Central Hospital after the implementation of fine management, with an attempt to further introduce the concept of fine management and implement the brand construction. Originating in Taylor's "Theory of Scientific Management" (1982), fine management uses programmed, standardized, digitalized, and informational approaches to ensure each unit of an organization is running with great accuracy, high efficiency, strong coordination, and at sustained duration (Wang et al., Fine Management, 2007). The nature of fine management is a process that breaks up the strategy and goal, and executes it. Strategic planning takes place at every part of the process. Fine management demonstrates that everybody has a role to play in the management process, every area must be examined through the management process, and everything has to be managed (Zhang et al., The Experience of Hospital Nursing Precise Management, 2006). In other words, this kind of management theory demands all people to be involved in the entire process (Liu and Chen, Med Inf, 2007). As public hospital reform is becoming more widespread, it becomes imperative to "build a unified and efficient public hospital management system" and "improve the quality of medical services" (Guidelines on the Pilot Reform of Public Hospitals, 2010). The execution of fine management is of importance in optimizing the medical process, improving medical services and building a prestigious hospital brand.

75 FR 39678 - Meeting of Energy Services Companies and the Federal Energy Management Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-12

... DEPARTMENT OF ENERGY Meeting of Energy Services Companies and the Federal Energy Management... Management Program (FEMP) within the Office of Energy Efficiency and Renewable Energy on the use of high-end... conducted in an informal, conference style. Each participant will be allowed to make a prepared general...

Rapid Building Assessment Project

DTIC Science & Technology

2014-05-01

ongoing management of commercial energy efficiency. No other company offers all of these proven services on a seamless, integrated Software -as-a- Service ...FirstFuel has added a suite of additional Software -as-a- Service analytics capabilities to support the entire energy efficiency lifecycle, including...the client side. In this document, we refer to the service side software as “BUILDER” and the client software as “BuilderRED,” following the Army

Below-cost timber sales and the political marketplace

NASA Astrophysics Data System (ADS)

Cortner, Hanna J.; Schweitzer, Dennis L.

1993-01-01

Political pressures exist to increase the economic efficiency of timber management and production on the national forests managed by the USDA Forest Service. There is growing belief both outside and within the Forest Service that current levels of timber production, and most particularly uneconomic timber production, should be reduced. Many argue that eliminating uneconomic timber management programs will both save money and reduce environmental degradation. This article traces the political evolution of the focus on economic efficiency in timber production and explores the political-institutional factors that are shaping the current policy debate. The below-cost issue is less about economic efficiency than it is about political advantage and alternative political visions of the societal role of the nation's national forests now and in the future.

[Efficiency indicators to contribute to sustainability of health services in Spain].

PubMed

García, E I; Mira Solves, J J; Guilabert Mora, M

2014-01-01

Identifying a minimum set of efficiency indicators calculated from current information sources. Interventions adopted from the analysis of these indicators could contribute to health services sustainability. We applied the discussion group technique. A total of 23 quality coordinators from around the country and the representatives of the regional quality societies in SECA (Spanish Society for Quality in Healthcare) participated. Ten efficiency indicators useful for integrated management areas were identified and accepted, 5 in the area of primary care and 5 for hospital management. The efficiency indicators agreed upon could contribute to the sustainability of the health system without this affecting the quality of care. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

Relationship Between Forage Allowance and Grazing Efficiency in the Great Plains: Implications for Managing Rangelands for Both Livestock Production and Desired Ecosystem Goods and Services

USDA-ARS?s Scientific Manuscript database

Emergence of desired ecosystem goods and services from rangelands as a societal benefit and a potential income source for land managers has implications regarding the management of plant communities traditionally used primarily for livestock production. Contemporary decision-making on rangelands in ...

[Research of regional medical consumables reagent logistics system in the modern hospital].

PubMed

Wu, Jingjiong; Zhang, Yanwen; Luo, Xiaochen; Zhang, Qing; Zhu, Jianxin

2013-09-01

To explore the modern hospital and regional medical consumable reagents logistics system management. The characteristics of regional logistics, through cooperation between medical institutions within the region, and organize a wide range of special logistics activities, to make reasonable of the regional medical consumable reagents logistics. To set the regional management system, dynamic management systems, supply chain information management system, after-sales service system and assessment system. By the research of existing medical market and medical resources, to establish the regional medical supplies reagents directory and the initial data. The emphasis is centralized dispatch of medical supplies reagents, to introduce qualified logistics company for dispatching, to improve the modern hospital management efficiency, to costs down. Regional medical center and regional community health service centers constitute a regional logistics network, the introduction of medical consumable reagents logistics services, fully embodies integrity level, relevance, purpose, environmental adaptability of characteristics by the medical consumable reagents regional logistics distribution. Modern logistics distribution systems can increase the area of medical consumables reagent management efficiency and reduce costs.

An efficient architecture for the integration of sensor and actuator networks into the future internet

NASA Astrophysics Data System (ADS)

Schneider, J.; Klein, A.; Mannweiler, C.; Schotten, H. D.

2011-08-01

In the future, sensors will enable a large variety of new services in different domains. Important application areas are service adaptations in fixed and mobile environments, ambient assisted living, home automation, traffic management, as well as management of smart grids. All these applications will share a common property, the usage of networked sensors and actuators. To ensure an efficient deployment of such sensor-actuator networks, concepts and frameworks for managing and distributing sensor data as well as for triggering actuators need to be developed. In this paper, we present an architecture for integrating sensors and actuators into the future Internet. In our concept, all sensors and actuators are connected via gateways to the Internet, that will be used as comprehensive transport medium. Additionally, an entity is needed for registering all sensors and actuators, and managing sensor data requests. We decided to use a hierarchical structure, comparable to the Domain Name Service. This approach realizes a cost-efficient architecture disposing of "plug and play" capabilities and accounting for privacy issues.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Elia, Valerio; Gnoni, Maria Grazia, E-mail: mariagrazia.gnoni@unisalento.it; Tornese, Fabiana

Highlights: • Pay-As-You-Throw (PAYT) schemes are becoming widespread in several countries. • Economic, organizational and technological issues have to be integrated in an efficient PAYT model design. • Efficiency refers to a PAYT system which support high citizen participation rates as well as economic sustainability. • Different steps and constraints have to be evaluated from collection services to type technologies. • An holistic approach is discussed to support PAYT systems diffusion. - Abstract: Pay-As-You-Throw (PAYT) strategies are becoming widely applied in solid waste management systems; the main purpose is to support a more sustainable – from economic, environmental and socialmore » points of view – management of waste flows. Adopting PAYT charging models increases the complexity level of the waste management service as new organizational issues have to be evaluated compared to flat charging models. In addition, innovative technological solutions could also be adopted to increase the overall efficiency of the service. Unit pricing, user identification and waste measurement represent the three most important processes to be defined in a PAYT system. The paper proposes a holistic framework to support an effective design and management process. The framework defines most critical processes and effective organizational and technological solutions for supporting waste managers as well as researchers.« less

GNSS-based emergency management system

NASA Astrophysics Data System (ADS)

Wu, Yuhang; Chen, Xiuwan; Ma, Lei

2009-06-01

Public safety and public service is a particularly challenging task. The questions of how to use the limited resources efficiently, how to improve the Government's emergency rapid response and ability of risk resistance, and how to provide a more efficient emergency service for the public, have increasingly become the focus to strengthen urban management. Emergency Response Management System is a highly efficient and powerful command system dealing with natural and social disasters, by using all aspects of the force being gathered in a short period of time, sudden events can be handled efficiently, and further development of the incident can be controlled. In this paper, based on the analysis of development status of the emergency management system at home and abroad, and the key technologies of the emergency management system based on GNSS, research and development on emergency command system based on GNSS has been done. Meanwhile, test in Sichuan earthquake has also been carried out. Practice in Sichuan province earthquake relief work has proved that the emergency management command system based on GNSS can play the advantage function and exert the maximum potential, and can play the role of "lifeline" in the critical moment.

Airtankers and wildfire management in the US Forest Service: examining data availability and exploring usage and cost trends

Treesearch

Matthew P. Thompson; David E. Calkin; Jason Herynk; Charles W. McHugh; Karen C. Short

2012-01-01

Evaluating the effectiveness and efficiency of fixed- and rotary-wing aircraft is a crucial component of strategic wildfire management and planning. In this manuscript, we focus on the economics of fire and aviation management within the US Forest Service. Substantial uncertainties challenge comprehensive analysis of airtanker use, prompting calls from federal...

The Daniel Boone Success Story: A Food Service Turnaround.

ERIC Educational Resources Information Center

Miller, Toula

1991-01-01

Changes in the marketing and management of a Pennsylvania food service program made it more attractive to students. An increase in student participation and operational efficiency yielded profitability in food service operations. (MLF)

Pedestrian Levels of Service (LOS) at Muir Woods National Monument (California): An introduction to multi-modal LOS for parks and protected areas

Treesearch

Peter R. Pettengill; Robert E. Manning; William Valliere; Laura E. Anderson

2010-01-01

Historically, transportation planning and management have been guided largely by principles of efficiency. Specifically, the Transportation Research Board has utilized a levels of service (LOS) framework to assess quality of service in terms of traffic congestion, speed and travel time, and maximum road capacity. In the field of park and outdoor recreation management,...

A Secure and Efficient Audit Mechanism for Dynamic Shared Data in Cloud Storage

PubMed Central

2014-01-01

With popularization of cloud services, multiple users easily share and update their data through cloud storage. For data integrity and consistency in the cloud storage, the audit mechanisms were proposed. However, existing approaches have some security vulnerabilities and require a lot of computational overheads. This paper proposes a secure and efficient audit mechanism for dynamic shared data in cloud storage. The proposed scheme prevents a malicious cloud service provider from deceiving an auditor. Moreover, it devises a new index table management method and reduces the auditing cost by employing less complex operations. We prove the resistance against some attacks and show less computation cost and shorter time for auditing when compared with conventional approaches. The results present that the proposed scheme is secure and efficient for cloud storage services managing dynamic shared data. PMID:24959630

A secure and efficient audit mechanism for dynamic shared data in cloud storage.

PubMed

Kwon, Ohmin; Koo, Dongyoung; Shin, Yongjoo; Yoon, Hyunsoo

2014-01-01

With popularization of cloud services, multiple users easily share and update their data through cloud storage. For data integrity and consistency in the cloud storage, the audit mechanisms were proposed. However, existing approaches have some security vulnerabilities and require a lot of computational overheads. This paper proposes a secure and efficient audit mechanism for dynamic shared data in cloud storage. The proposed scheme prevents a malicious cloud service provider from deceiving an auditor. Moreover, it devises a new index table management method and reduces the auditing cost by employing less complex operations. We prove the resistance against some attacks and show less computation cost and shorter time for auditing when compared with conventional approaches. The results present that the proposed scheme is secure and efficient for cloud storage services managing dynamic shared data.

42 CFR 51c.305 - Grant evaluation and award.

Code of Federal Regulations, 2012 CFR

2012-10-01

... potential of the center for the development of new and effective methods for health services delivery and... emphasize direct health services, efficiency of operations and sound financial management. ... Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR COMMUNITY...

42 CFR 51c.305 - Grant evaluation and award.

Code of Federal Regulations, 2014 CFR

2014-10-01

... potential of the center for the development of new and effective methods for health services delivery and... emphasize direct health services, efficiency of operations and sound financial management. ... Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR COMMUNITY...

42 CFR 51c.305 - Grant evaluation and award.

Code of Federal Regulations, 2013 CFR

2013-10-01

... potential of the center for the development of new and effective methods for health services delivery and... emphasize direct health services, efficiency of operations and sound financial management. ... Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR COMMUNITY...

Graph Databases for Large-Scale Healthcare Systems: A Framework for Efficient Data Management and Data Services

DOE Office of Scientific and Technical Information (OSTI.GOV)

Park, Yubin; Shankar, Mallikarjun; Park, Byung H.

Designing a database system for both efficient data management and data services has been one of the enduring challenges in the healthcare domain. In many healthcare systems, data services and data management are often viewed as two orthogonal tasks; data services refer to retrieval and analytic queries such as search, joins, statistical data extraction, and simple data mining algorithms, while data management refers to building error-tolerant and non-redundant database systems. The gap between service and management has resulted in rigid database systems and schemas that do not support effective analytics. We compose a rich graph structure from an abstracted healthcaremore » RDBMS to illustrate how we can fill this gap in practice. We show how a healthcare graph can be automatically constructed from a normalized relational database using the proposed 3NF Equivalent Graph (3EG) transformation.We discuss a set of real world graph queries such as finding self-referrals, shared providers, and collaborative filtering, and evaluate their performance over a relational database and its 3EG-transformed graph. Experimental results show that the graph representation serves as multiple de-normalized tables, thus reducing complexity in a database and enhancing data accessibility of users. Based on this finding, we propose an ensemble framework of databases for healthcare applications.« less

Techniques for Increasing the Efficiency of Automation Systems in School Library Media Centers.

ERIC Educational Resources Information Center

Caffarella, Edward P.

1996-01-01

Discusses methods of managing queues (waiting lines) to optimize the use of student computer stations in school library media centers and to make searches more efficient and effective. The three major factors in queue management are arrival interval of the patrons, service time, and number of stations. (Author/LRW)

A survey of innovative contracting for quality jobs and ecosystem management.

Treesearch

Cassandra Moseley

2002-01-01

This survey identifies and defines innovative contracting mechanisms developed in the Forest Service Pacific Northwest Region and northern California. A survey of nine case studies reveals that several new mechanisms have facilitated ecosystem management, quality jobs, and administrative efficiencies, but at times innovation was hampered by Forest Service institutional...

Technical Efficiency and Primary Education in South Africa: Evidence from Sub-National Level Analyses

ERIC Educational Resources Information Center

Boateng, Nana Adowaa

2014-01-01

The paper examines the extent to which sub-national public officials are efficient in delivering basic education services and argues that technical inefficiencies, especially in the management of public funds for education, could potentially contribute to poor education service delivery in South Africa. A conceptual framework is proposed to show…

Investigating emergency room service quality using lean manufacturing.

PubMed

Abdelhadi, Abdelhakim

2015-01-01

The purpose of this paper is to investigate a lean manufacturing metric called Takt time as a benchmark evaluation measure to evaluate a public hospital's service quality. Lean manufacturing is an established managerial philosophy with a proven track record in industry. A lean metric called Takt time is applied as a measure to compare the relative efficiency between two emergency departments (EDs) belonging to the same public hospital. Outcomes guide managers to improve patient services and increase hospital performances. The patient treatment lead time within the hospital's two EDs (one department serves male and the other female patients) are the study's focus. A lean metric called Takt time is used to find the service's relative efficiency. Findings show that the lean manufacturing metric called Takt time can be used as an effective way to measure service efficiency by analyzing relative efficiency and identifies bottlenecks in different departments providing the same services. The paper presents a new procedure to compare relative efficiency between two EDs. It can be applied to any healthcare facility.

School Management Information Systems in Primary Schools

ERIC Educational Resources Information Center

Demir, Kamile

2006-01-01

Developments in information technologies have been impacting upon educational organizations. Principals have been using management information systems to improve the efficiency of administrative services. The aim of this research is to explore principals' perceptions about management information systems and how school management information…

Contracts and management services site support program plan WBS 6.10.14

DOE Office of Scientific and Technical Information (OSTI.GOV)

Knoll, J.M. Jr.

1994-09-01

Contracts and Management Services is recognized as the central focal point for programs having company or sitewide application in pursuit of the Hanford Missions`s financial and operational objectives. Contracts and Management Services actively pursues cost savings and operational efficiencies through: Management Standards by ensuring all employees have an accessible, integrated system of clear, complete, accurate, timely, and useful management control policies and procedures; Contract Reform by restructuring the contract, organization, and cost accounting systems to refocus Hanford contract activities on output products; Systems and Operations Evaluation by directing the Cost Reduction program, Great Ideas, and Span of Management activities; Programmore » Administration by enforcing conditions of Accountability (whether DEAR-based or FAR-based) for WHC, BCSR, ICF KH, and BHI; Contract Performance activities; chairing the WHC Cost Reduction Review Board; and analyzing companywide Performance Measures; Data Standards and Administration by establishing and directing the company data management program; giving direction to the major RL programs and mission areas for implementation of cost-effective and efficient data management practices; directing all operations, application, and interfaces contained within the Hanford PeopleCore System; directing accomplishment and delivery of TPA data management milestones; and directing the sitewide data management processes for Data Standards and the Data Directory.« less

Construction and Application of a Refined Hospital Management Chain.

PubMed

Lihua, Yi

2016-01-01

Large scale development was quite common in the later period of hospital industrialization in China. Today, Chinese hospital management faces such problems as service inefficiency, high human resources cost, and low rate of capital use. This study analyzes the refined management chain of Wuxi No.2 People's Hospital. This consists of six gears namely, "organizational structure, clinical practice, outpatient service, medical technology, and nursing care and logistics." The gears are based on "flat management system targets, chief of medical staff, centralized outpatient service, intensified medical examinations, vertical nursing management and socialized logistics." The core concepts of refined hospital management are optimizing flow process, reducing waste, improving efficiency, saving costs, and taking good care of patients as most important. Keywords: Hospital, Refined, Management chain

Fundamentals of service lines and the necessity of physician leaders.

PubMed

Jain, Anshu K; Thompson, Jon M; Kelley, Scott M; Schwartz, Richard W

2006-06-01

In the demanding and unpredictable environment of the health care industry, hospitals and health systems continue to search for ways to improve the efficiency and quality of care provision and, thus, thrive. Service line organization in health care, a concept that was popularized in the past, has recently experienced a resurgence, spanning the gamut from small community hospitals to large academic medical centers. The modern service line has transformed into an organizational tool that provides hospitals and health systems with a novel approach to achieve the goals of efficient and effective care. Physician leaders can play an integral role in the management of service lines, using a combination of management skills and clinical expertise to provide the oversight and direction necessary for assuring excellence in clinical care and value in its delivery. This article presents an overview of service line structure, implementation, implications, and the role of the physician-leader.

Study on Providing Professors with Efficient Service Based on Time Management Strategy

ERIC Educational Resources Information Center

Li, Chunlin; Liu, Mengchao; Wang, Yining

2016-01-01

Time management is the study to use time scientifically by deploying skills, techniques and means, and maximizing time value to help individuals or organizations efficiently complete tasks and achieve goals. University professor as a body is an important force in teaching and research. In order to ensure high-quality teaching, productive research,…

[Evaluation of financial performance of health services: reflections of operational policies in the hospital sector].

PubMed

Bonacim, Carlos Alberto Grespan; de Araujo, Adriana Maria Procópio

2011-01-01

Discussions about management manners and procedures has been relevant among organization managers in the health services. The health services economic evaluation approaches this theme and is taking an important role around the world, demanding the manager new challenges concerning the continuous search of activities efficiency and efficacy. The objective is to describe the consequences of operational changes in the economic-financial indicators of a Public Hospital. The methodology applied included besides the literature research, a case study in the "Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto--USP". The values found confirm the context of the hospital. One concludes that the average costs present similar behaviors with trend to stabilization, thus confirming improvements in efficiency. The importance of the rendering of accounts for the society related to the use of public resources and how this study can help in this way.

Traffic Management in ATM Networks Over Satellite Links

NASA Technical Reports Server (NTRS)

Goyal, Rohit; Jain, Raj; Goyal, Mukul; Fahmy, Sonia; Vandalore, Bobby; vonDeak, Thomas

1999-01-01

This report presents a survey of the traffic management Issues in the design and implementation of satellite Asynchronous Transfer Mode (ATM) networks. The report focuses on the efficient transport of Transmission Control Protocol (TCP) traffic over satellite ATM. First, a reference satellite ATM network architecture is presented along with an overview of the service categories available in ATM networks. A delay model for satellite networks and the major components of delay and delay variation are described. A survey of design options for TCP over Unspecified Bit Rate (UBR), Guaranteed Frame Rate (GFR) and Available Bit Rate (ABR) services in ATM is presented. The main focus is on traffic management issues. Several recommendations on the design options for efficiently carrying data services over satellite ATM networks are presented. Most of the results are based on experiments performed on Geosynchronous (GEO) latencies. Some results for Low Earth Orbits (LEO) and Medium Earth Orbit (MEO) latencies are also provided.

7 CFR 37.5 - Order of furnishing service.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD CONTAINER... are received, insofar as consistent with good management, efficiency, and economy. ...

Faster response time, effective use of resources : integrating transportation systems and emergency management systems.

DOT National Transportation Integrated Search

1999-01-01

When emergency services agencies share : facilities and traffic monitoring resources : with transportation management agencies, : the efficiency and speed of incident : response are measurably improved.

Content-based management service for medical videos.

PubMed

Mendi, Engin; Bayrak, Coskun; Cecen, Songul; Ermisoglu, Emre

2013-01-01

Development of health information technology has had a dramatic impact to improve the efficiency and quality of medical care. Developing interoperable health information systems for healthcare providers has the potential to improve the quality and equitability of patient-centered healthcare. In this article, we describe an automated content-based medical video analysis and management service that provides convenience and ease in accessing the relevant medical video content without sequential scanning. The system facilitates effective temporal video segmentation and content-based visual information retrieval that enable a more reliable understanding of medical video content. The system is implemented as a Web- and mobile-based service and has the potential to offer a knowledge-sharing platform for the purpose of efficient medical video content access.

NaradaBrokering as Middleware Fabric for Grid-based Remote Visualization Services

NASA Astrophysics Data System (ADS)

Pallickara, S.; Erlebacher, G.; Yuen, D.; Fox, G.; Pierce, M.

2003-12-01

Remote Visualization Services (RVS) have tended to rely on approaches based on the client server paradigm. The simplicity in these approaches is offset by problems such as single-point-of-failures, scaling and availability. Furthermore, as the complexity, scale and scope of the services hosted on this paradigm increase, this approach becomes increasingly unsuitable. We propose a scheme based on top of a distributed brokering infrastructure, NaradaBrokering, which comprises a distributed network of broker nodes. These broker nodes are organized in a cluster-based architecture that can scale to very large sizes. The broker network is resilient to broker failures and efficiently routes interactions to entities that expressed an interest in them. In our approach to RVS, services advertise their capabilities to the broker network, which manages these service advertisements. Among the services considered within our system are those that perform graphic transformations, mediate access to specialized datasets and finally those that manage the execution of specified tasks. There could be multiple instances of each of these services and the system ensures that load for a given service is distributed efficiently over these service instances. Among the features provided in our approach are efficient discovery of services and asynchronous interactions between services and service requestors (which could themselves be other services). Entities need not be online during the execution of the service request. The system also ensures that entities can be notified about task executions, partial results and failures that might have taken place during service execution. The system also facilitates specification of task overrides, distribution of execution results to alternate devices (which were not used to originally request service execution) and to multiple users. These RVS services could of course be either OGSA (Open Grid Services Architecture) based Grid services or traditional Web services. The brokering infrastructure will manage the service advertisements and the invocation of these services. This scheme ensures that the fundamental Grid computing concept is met - provide computing capabilities of those that are willing to provide it to those that seek the same. {[1]} The NaradaBrokering Project: http://www.naradabrokering.org

5 CFR 250.201 - Coverage and purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

....201 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PERSONNEL MANAGEMENT IN AGENCIES Strategic Human Capital Management § 250.201 Coverage and purpose. The Chief Human... effective and efficient operation of Government. As a part of OPM's overall leadership responsibilities in...

76 FR 57947 - Senior Executive Service Performance Review Board Membership

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-19

... AND EFFICIENCY Senior Executive Service Performance Review Board Membership AGENCY: Council of the... of Personnel Management, each agency is required to establish one or more Senior Executive Service... appraisal of a senior executive's performance by the supervisor, along with any recommendations to the...

Rethinking Lean Service

NASA Astrophysics Data System (ADS)

Seddon, John; O'Donovan, Brendan; Zokaei, Keivan

Ever since Levitt's influential Harvard Business Review article 'Production-Line Approach to Service' was published in 1972, it has been common for services to be treated like production lines in both the academic literature and more widely in management practice. The belief that achieving economies of scale will reduce unit costs is a common feature of management decision-making. As technological advancement has produced ever more sophisticated IT and telephony, it has become increasingly easier for firms to standardise and off-shore services. The development of the 'lean' literature has only helped to emphasise the same underlying management assumptions: by managing cost and workers' activity, organisational performance is expected to improve. This chapter argues that through misinterpretation of the core paradigm 'lean' has become subsumed into the 'business as usual' of conventional service management. As a result, 'lean' has become synonymous with 'process efficiency' and the opportunity for significant performance improvement - as exemplified by Toyota - has been missed.

Managing the NHS market.

PubMed Central

Ham, C.; Maynard, A.

1994-01-01

The purpose of the present NHS reforms is to introduce a managed market; developing some of the incentives for greater efficiency that are often found in markets while still being able to regulate proceedings to prevent market failures. If government intervenes too much there will be no incentive to improve efficiency and streamline operations: too little intervention may result in some areas having inadequate health service cover or monopoly powers abusing their position. Effective management of the NHS market requires eight core elements: openness of information, control of labour and capital markets, regulation of mergers and takeovers, arbitrating in disputes, protection of unprofitable functions such as research and development, overseeing national provision of health services, protection of basic principles of the NHS, and handling of closures and redundancy. Management of the market would best be performed by the NHS management executive and health authority purchasers acting within a framework set by politicians. Images p846-a p847-a PMID:8167496

Use Cases for Combining Web Services with ArcPython Tools for Enabling Quality Control of Land Remote Sensing Data Products.

NASA Astrophysics Data System (ADS)

Krehbiel, C.; Maiersperger, T.; Friesz, A.; Harriman, L.; Quenzer, R.; Impecoven, K.

2016-12-01

Three major obstacles facing big Earth data users include data storage, management, and analysis. As the amount of satellite remote sensing data increases, so does the need for better data storage and management strategies to exploit the plethora of data now available. Standard GIS tools can help big Earth data users whom interact with and analyze increasingly large and diverse datasets. In this presentation we highlight how NASA's Land Processes Distributed Active Archive Center (LP DAAC) is tackling these big Earth data challenges. We provide a real life use case example to describe three tools and services provided by the LP DAAC to more efficiently exploit big Earth data in a GIS environment. First, we describe the Open-source Project for a Network Data Access Protocol (OPeNDAP), which calls to specific data, minimizing the amount of data that a user downloads and improves the efficiency of data downloading and processing. Next, we cover the LP DAAC's Application for Extracting and Exploring Analysis Ready Samples (AppEEARS), a web application interface for extracting and analyzing land remote sensing data. From there, we review an ArcPython toolbox that was developed to provide quality control services to land remote sensing data products. Locating and extracting specific subsets of larger big Earth datasets improves data storage and management efficiency for the end user, and quality control services provides a straightforward interpretation of big Earth data. These tools and services are beneficial to the GIS user community in terms of standardizing workflows and improving data storage, management, and analysis tactics.

Perspectives: parity--prelude to a fifth cycle of reform.

PubMed

Goldman, Howard H

2002-09-01

Based on 2000 Carl Taube Lecture at the NIMH Mental Health Economics Meeting. This perspective article examines the relationship between a policy of parity in financing mental health services and the future of reform in service delivery. Applying theories of static and dynamic efficiency to an understanding of parity and the evolution of mental health services, drawing upon Burton Weisbrod s concept of the health care quadrilemma . Each of four cycles of reform in mental health services have contended with issues of static and dynamic efficiency. Each cycle was associated with static efficiency in the management and financing of services, and each was associated with a set of new treatment technologies intended to improve dynamic efficiency. Each reform proved ultimately unsuccessful primarily because of the failure of the treatment technologies to prevent future patient chronicity or to achieve sustained recovery. Recent advances in treatment technology and management of care can permit an unprecedented level of efficiency consistent with a policy of improved access to mainstream health and social welfare resources, including insurance coverage. This policy of so-called financing parity can improve current mental health service delivery, but it may also portend a future fifth cycle of reform. If new technologies continue to advance as full technologies - simple to deliver and producing true recovery - and mainstream resources are made available, then the specialty mental health services may contract dramatically in favor of effective care and treatment of mental illness in primary care and other mainstream settings. Predicting the future of health care is speculative, but it may be easier using the Weisbrod formulation to understand the process of mental health reform. Over-reliance on administrative techniques for building static efficiency and false optimism about dynamic efficiency from new technology have stymied previous reforms. All the same, a fifth cycle of reform could succeed, if the right conditions are met and mainstream resources are available.

SOLVE II: A Technique to Improve Efficiency and Solve Problems in Hardwood Sawmills

Treesearch

Edward L. Adams; Daniel E. Dunmire

1977-01-01

The squeeze between rising costs and product values is getting tighter for sawmill managers. So, they are taking a closer took at the efficiency of their sawmills by making a complete analysis of their milling situation. Such an analysis requires considerable time and expense. To aid the manager with this task, the USDA Forest Service's Northeastern Forest...

Project UCARE : Uniform Commuter Assistance Reporting and Evaluation for transportation demand management programs.

DOT National Transportation Integrated Search

2013-09-01

Moving Ahead for Progress in the 21st Century Act (MAP-21) places emphasis upon results and better management of programs for effective and efficient service delivery. With an increased focus on measuring performance, the transportation demand manage...

Three-year financial analysis of pharmacy services at an independent community pharmacy.

PubMed

Doucette, William R; McDonough, Randal P; Mormann, Megan M; Vaschevici, Renata; Urmie, Julie M; Patterson, Brandon J

2012-01-01

To assess the financial performance of pharmacy services including vaccinations, cholesterol screenings, medication therapy management (MTM), adherence management services, employee health fairs, and compounding services provided by an independent community pharmacy. Three years (2008-10) of pharmacy records were examined to determine the total revenue and costs of each service. Costs included products, materials, labor, marketing, overhead, equipment, reference materials, and fax/phone usage. Costs were allocated to each service using accepted principles (e.g., time for labor). Depending on the service, the total revenue was calculated by multiplying the frequency of the service by the revenue per patient or by adding the total revenue received. A sensitivity analysis was conducted for the adherence management services to account for average dispensing net profit. 7 of 11 pharmacy services showed a net profit each year. Those services include influenza and herpes zoster immunization services, MTM, two adherence management services, employee health fairs, and prescription compounding services. The services that realized a net loss included the pneumococcal immunization service, cholesterol screenings, and two adherence management services. The sensitivity analysis showed that all adherence services had a net gain when average dispensing net profit was included. Most of the pharmacist services had an annual positive net gain. It seems likely that these services can be sustained. Further cost management, such as reducing labor costs, could improve the viability of services with net losses. However, even with greater efficiency, external factors such as competition and reimbursement challenge the sustainability of these services.

X Marks the Spot: Creating and Managing a Single Service Point to Improve Customer Service and Maximize Resources

ERIC Educational Resources Information Center

Venner, Mary Ann; Keshmiripour, Seti

2016-01-01

This article will describe how merging service points in an academic library is an opportunity to improve customer service and utilize staffing resources more efficiently. Combining service points provides libraries with the ability to create a more positive library experience for patrons by minimizing the ping-pong effect for assistance. The…

Assessing the relative efficiency of water companies in the English and Welsh water industry: a metafrontier approach.

PubMed

Molinos-Senante, María; Maziotis, Alexandros; Sala-Garrido, Ramon

2015-11-01

The assessment of relative efficiency of water companies is essential for managers and authorities. This is evident in the UK water sector where there are companies with different services such as water and sewerage companies (WaSCs) and water-only companies (WoCs). Therefore, it is a critical limitation to estimate a common production frontier for both types of companies, as it might lead to biased efficiency estimates. In this paper, a robust and reliable methodology, the metafrontier model, is applied to compare the efficiency of water companies providing different services. The results illustrate the superior performance of WaSCs compared to WoCs. It also confirms the presence of economies of scope in the UK water industry. The methodology and results of this study are of great interest for both regulators and water utility managers to make informed decisions.

48 CFR 31.205-13 - Employee morale, health, welfare, food service, and dormitory costs and credits.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., except for the costs of employees' participation in company sponsored sports teams or employee... demonstrate that unusual circumstances exist such that even with efficient management, operating the services...

48 CFR 31.205-13 - Employee morale, health, welfare, food service, and dormitory costs and credits.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., except for the costs of employees' participation in company sponsored sports teams or employee... demonstrate that unusual circumstances exist such that even with efficient management, operating the services...

48 CFR 31.205-13 - Employee morale, health, welfare, food service, and dormitory costs and credits.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., except for the costs of employees' participation in company sponsored sports teams or employee... demonstrate that unusual circumstances exist such that even with efficient management, operating the services...

48 CFR 31.205-13 - Employee morale, health, welfare, food service, and dormitory costs and credits.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., except for the costs of employees' participation in company sponsored sports teams or employee... demonstrate that unusual circumstances exist such that even with efficient management, operating the services...

48 CFR 31.205-13 - Employee morale, health, welfare, food service, and dormitory costs and credits.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., except for the costs of employees' participation in company sponsored sports teams or employee... demonstrate that unusual circumstances exist such that even with efficient management, operating the services...

31 CFR 206.1 - Scope and application.

Code of Federal Regulations, 2011 CFR

2011-07-01

..., AND OPERATION OF THE CASH MANAGEMENT IMPROVEMENTS FUND § 206.1 Scope and application. (a) This subpart.... (b) Policies and guidelines are prescribed for promoting efficient, effective cash management through... that result from noncompliance. Authority is also granted to the Service, under the Cash Management...

Changing Services and Space at an Academic Library

ERIC Educational Resources Information Center

Bradigan, Pamela S.; Rodman, Ruey L.

2006-01-01

This paper focuses on how an academic library managed changes in services and space to meet customer needs for streamlined services, increasing efficiency for students, faculty and staff in finding, analyzing, sharing, and producing knowledge. The Ohio State University's John A. Prior Health Sciences Library (PHSL) has merged its circulation and…

39 CFR 3010.61 - Contents of exigent requests.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Postal Service, under best practices of honest, efficient and economical management, to maintain and continue the development of postal services of the kind and quality adapted to the needs of the United...) Such other information as the Postal Service believes will assist the Commission to issue a timely...

Improving disease management in the United Kingdom: what can be learned from U.S. experience?

PubMed

Florin, Dominique; Lewis, Richard; Rosen, Rebecca

2004-10-01

Chronic diseases are a large and growing burden for health services. The British National Health Service is set up in a way that has many advantages in the management of chronic diseases, but lessons from U.S. managed care plans show that several changes could be implemented to improve the efficiency and effectiveness of care for patients with chronic conditions. These include the introduction of limited market competition; financial incentives, particularly across primary and secondary care; increased patient self-help; and improved clinician-manager relationships.

Health resources management and physician control in a San Francisco, California, hospital.

PubMed Central

Rosenstein, A. H.; Stier, M. M.

1991-01-01

The continued escalation in health care spending has caused money to become an increasingly limited resource, which may eventually affect the ability of health professionals to provide complete health care services. Health care payers have stressed efficiency and the appropriateness of health care measures and are putting greater financial pressures on health professionals by making them more accountable for services provided. Hospitals and physicians must take a more active role in monitoring health care delivery and work together to improve performance efficiency. Efficiency can be gained through a comprehensive program that emphasizes high-quality care and the effective use of health care resources. The Health Resource Management Program is a model for carrying out this function that integrates data analysis and physician input and education. Images PMID:2006564

Measuring technical efficiency of output quality in intensive care units.

PubMed

Junoy, J P

1997-01-01

Presents some examples of the implications derived from imposing the objective of maximizing social welfare, subject to limited resources, on ethical care patients management in respect of quality performance of health services. Conventional knowledge of health economics points out that critically ill patients are responsible for increased use of technological resources and that they receive a high proportion of health care resources. Attempts to answer, from the point of view of microeconomics, the question: how do we measure comparative efficiency in the management of intensive care units? Analyses this question through data from an international empirical study using micro-economic measures of productive efficiency in public services (data envelopment analysis). Results show a 28.8 per cent level of technical inefficiency processing data from 25 intensive care units in the USA.

Improving outpatient phlebotomy service efficiency and patient experience using discrete-event simulation.

PubMed

Yip, Kenneth; Pang, Suk-King; Chan, Kui-Tim; Chan, Chi-Kuen; Lee, Tsz-Leung

2016-08-08

Purpose - The purpose of this paper is to present a simulation modeling application to reconfigure the outpatient phlebotomy service of an acute regional and teaching hospital in Hong Kong, with an aim to improve service efficiency, shorten patient queuing time and enhance workforce utilization. Design/methodology/approach - The system was modeled as an inhomogeneous Poisson process and a discrete-event simulation model was developed to simulate the current setting, and to evaluate how various performance metrics would change if switched from a decentralized to a centralized model. Variations were then made to the model to test different workforce arrangements for the centralized service, so that managers could decide on the service's final configuration via an evidence-based and data-driven approach. Findings - This paper provides empirical insights about the relationship between staffing arrangement and system performance via a detailed scenario analysis. One particular staffing scenario was chosen by manages as it was considered to strike the best balance between performance and workforce scheduled. The resulting centralized phlebotomy service was successfully commissioned. Practical implications - This paper demonstrates how analytics could be used for operational planning at the hospital level. The authors show that a transparent and evidence-based scenario analysis, made available through analytics and simulation, greatly facilitates management and clinical stakeholders to arrive at the ideal service configuration. Originality/value - The authors provide a robust method in evaluating the relationship between workforce investment, queuing reduction and workforce utilization, which is crucial for managers when deciding the delivery model for any outpatient-related service.

Modifying physician behavior to improve cost-efficiency in safety-net ambulatory settings.

PubMed

Borkowski, Nancy; Gumus, Gulcin; Deckard, Gloria J

2013-01-01

Change interventions in one form or another are viewed as important tools to reduce variation in medical services, reduce costs, and improve quality of care. With the current focus on efficient resource use, the successful design and implementation of change strategies are of utmost importance for health care managers. We present a case study in which macro and micro level change strategies were used to modify primary care physicians' practice patterns of prescribing diagnostic services in a safety-net's ambulatory clinics. The findings suggest that health care managers using evidence-based strategies can create a practice environment that reduces barriers and facilitates change.

Evaluation of a patient centered e-nursing and caring system.

PubMed

Tsai, Lai-Yin; Shan, Huang; Mei-Bei, Lin

2006-01-01

This study aims to develop an electronic nursing and caring system to manage patients' information and provide patients with safe and efficient services. By transmitting data among wireless cards, optical network, and mainframe computer, nursing care will be delivered more systematically and patients' safety centered caring will be delivered more efficiently and effectively. With this system, manual record keeping time was cut down, and relevant nursing and caring information was linked up. With the development of an electronic nursing system, nurses were able to make the best use of the Internet resources, integrate information management systematically and improve quality of nursing and caring service.

Efficiency and factors influencing efficiency of Community Health Strategy in providing Maternal and Child Health services in Mwingi District, Kenya: an expert opinion perspective

PubMed Central

Nzioki, Japheth Mativo; Onyango, Rosebella Ogutu; Ombaka, James Herbert

2015-01-01

Introduction Community Health Strategy (CHS) is a new Primary Health Care (PHC) model in Kenya, designed to provide PHC services in Kenya. In 2011, CHS was initiated in Mwingi district as one of the components of APHIA plus kamili program. The objectives of this study was to evaluate the efficiency of the CHS in providing MCH services in Mwingi district and to establish the factors influencing efficiency of the CHS in providing MCH services in the district. Methods This was a qualitative study. Fifteen Key informants were sampled from key stakeholders. Sampling was done using purposive and maximum variation sampling methods. Semi-structured in-depth interviews were used for data collection. Data was managed and analyzed using NVIVO. Framework analysis and quasi statistics were used in data analysis. Results Expert opinion data indicated that the CHS was efficient in providing MCH services. Factors influencing efficiency of the CHS in provision of MCH services were: challenges facing Community Health Workers (CHWs), Social cultural and economic factors influencing MCH in the district, and motivation among CHWs. Conclusion Though CHS was found to be efficient in providing MCH services, this was an expert opinion perspective, a quantitative Cost Effectiveness Analysis (CEA) to confirm these findings is recommended. To improve efficiency of the CHS in the district, challenges facing CHWs and Social cultural and economic factors that influence efficiency of the CHS in the district need to be addressed. PMID:26090046

Timber net value and physical output changes following wildfire in the northern Rocky Mountains: estimates for specific fire situations

Treesearch

Patrick J. Flowers; Patricia B. Shinkle; Daria A. Cain; Thomas J. Mills

1985-01-01

In the last decade, the fire management program of the Forest Service, U.S. Department of Agriculture, has come under closer scrutiny because of ever-rising program costs. The Forest Service has responded by conducting several studies analyzing the economic efficiency of its fire management program. Some components of the analytical models have been difficult to...

Keeping it wild in the National Park Service: A user guide to integrating wilderness character into park planning, management, and monitoring

Treesearch

Peter Landres; Suzy Stutzman; Wade Vagias; Carol Cook; Christina Mills; Tim Devine; Sandee Dingman; Adrienne Lindholm; Miki Stuebe; Melissa Memory; Ruth Scott; Michael Bilecki; Ray O' Neil; Chris Holbeck; Frank Turina; Michael Haynie; Sarah Craighead; Chip Jenkins; Jeremy Curtis; Karen Trevino

2014-01-01

This User Guide was developed to help National Park Service (NPS) staff effectively and efficiently fulfill the mandate from the 1964 Wilderness Act and NPS policy to "preserve wilderness character" now and into the future. This mandate applies to all congressionally designated wilderness and other park lands that are, by policy, managed as wilderness,...

Total centralisation and optimisation of an oncology management suite via Citrix®

NASA Astrophysics Data System (ADS)

James, C.; Frantzis, J.; Ripps, L.; Fenton, P.

2014-03-01

The management of patient information and treatment planning is traditionally an intra-departmental requirement of a radiation oncology service. Epworth Radiation Oncology systems must support the transient nature of Visiting Medical Officers (VMOs). This unique work practice created challenges when implementing the vision of a completely paperless solution that allows for a responsive and efficient service delivery. ARIA® and EclipseTM (Varian Medical Systems, Palo Alto, CA, USA) have been deployed across four dedicated Citrix® (Citrix Systems, Santa Clara, CA, USA) servers allowing VMOs to access these applications remotely. A range of paperless solutions were developed within ARIA® to facilitate clinical and organisational management whilst optimising efficient work practices. The IT infrastructure and paperless workflow has enabled VMOs to securely access the VarianTM (Varian Medical Systems, Palo Alto, CA, USA) oncology software and experience full functionality from any location on multiple devices. This has enhanced access to patient information and improved the responsiveness of the service. Epworth HealthCare has developed a unique solution to enable remote access to a centralised oncology management suite, while maintaining a secure and paperless working environment.

A Study on the Effect on Scheduling and Management of Surgeries with the Introduction of Excellent Medical Information.

PubMed

Mei, Tsai Ching

2016-01-01

The services of OR play an important role in the medical business for department of surgery. The most important issue for OR is about the scheduling and management of surgeries. Good surgery schedule could elevate the utilization efficiency of OR. Therefore, the introduction of excellent medical information can both dramatically elevate the work efficiency of health care employees and reduce workload to reach win-win benefits in both management and performance.

Providing Personalized Energy Management and Awareness Services for Energy Efficiency in Smart Buildings.

PubMed

Fotopoulou, Eleni; Zafeiropoulos, Anastasios; Terroso-Sáenz, Fernando; Şimşek, Umutcan; González-Vidal, Aurora; Tsiolis, George; Gouvas, Panagiotis; Liapis, Paris; Fensel, Anna; Skarmeta, Antonio

2017-09-07

Considering that the largest part of end-use energy consumption worldwide is associated with the buildings sector, there is an inherent need for the conceptualization, specification, implementation, and instantiation of novel solutions in smart buildings, able to achieve significant reductions in energy consumption through the adoption of energy efficient techniques and the active engagement of the occupants. Towards the design of such solutions, the identification of the main energy consuming factors, trends, and patterns, along with the appropriate modeling and understanding of the occupants' behavior and the potential for the adoption of environmentally-friendly lifestyle changes have to be realized. In the current article, an innovative energy-aware information technology (IT) ecosystem is presented, aiming to support the design and development of novel personalized energy management and awareness services that can lead to occupants' behavioral change towards actions that can have a positive impact on energy efficiency. Novel information and communication technologies (ICT) are exploited towards this direction, related mainly to the evolution of the Internet of Things (IoT), data modeling, management and fusion, big data analytics, and personalized recommendation mechanisms. The combination of such technologies has resulted in an open and extensible architectural approach able to exploit in a homogeneous, efficient and scalable way the vast amount of energy, environmental, and behavioral data collected in energy efficiency campaigns and lead to the design of energy management and awareness services targeted to the occupants' lifestyles. The overall layered architectural approach is detailed, including design and instantiation aspects based on the selection of set of available technologies and tools. Initial results from the usage of the proposed energy aware IT ecosystem in a pilot site at the University of Murcia are presented along with a set of identified open issues for future research.

Providing Personalized Energy Management and Awareness Services for Energy Efficiency in Smart Buildings

PubMed Central

Fotopoulou, Eleni; Tsiolis, George; Gouvas, Panagiotis; Liapis, Paris; Fensel, Anna; Skarmeta, Antonio

2017-01-01

Considering that the largest part of end-use energy consumption worldwide is associated with the buildings sector, there is an inherent need for the conceptualization, specification, implementation, and instantiation of novel solutions in smart buildings, able to achieve significant reductions in energy consumption through the adoption of energy efficient techniques and the active engagement of the occupants. Towards the design of such solutions, the identification of the main energy consuming factors, trends, and patterns, along with the appropriate modeling and understanding of the occupants’ behavior and the potential for the adoption of environmentally-friendly lifestyle changes have to be realized. In the current article, an innovative energy-aware information technology (IT) ecosystem is presented, aiming to support the design and development of novel personalized energy management and awareness services that can lead to occupants’ behavioral change towards actions that can have a positive impact on energy efficiency. Novel information and communication technologies (ICT) are exploited towards this direction, related mainly to the evolution of the Internet of Things (IoT), data modeling, management and fusion, big data analytics, and personalized recommendation mechanisms. The combination of such technologies has resulted in an open and extensible architectural approach able to exploit in a homogeneous, efficient and scalable way the vast amount of energy, environmental, and behavioral data collected in energy efficiency campaigns and lead to the design of energy management and awareness services targeted to the occupants’ lifestyles. The overall layered architectural approach is detailed, including design and instantiation aspects based on the selection of set of available technologies and tools. Initial results from the usage of the proposed energy aware IT ecosystem in a pilot site at the University of Murcia are presented along with a set of identified open issues for future research. PMID:28880227

[Nursing motivation leadership].

PubMed

Chen, Ia-Ling; Hung, Chich-Hsiu

2007-02-01

The concept of "patients treated as guests" is emphasized in today's medical service and patient-center nursing care. However, with rapid changes in health insurance and hospital accreditation systems as well as increasing consumer awareness, the nurse manager must both efficiently relieve the working pressure of nurses and motivate them. However, it would be an extreme challenge for nurse managers to build a team in which each member works in a self-fulfilling work environment and achieves a high quality of care. This article presents several theories and techniques that relate to motivation strategies. These strategies can serve as a guide and a reference for nurse managers to inspire teamwork and raise morale. It can be expected that increasing nurse satisfaction, performance, and care quality will decrease turnover and desertion rates. Hopefully, this article will assist nurse managers to become better leaders and to achieve success in providing efficient services and good of nursing care quality.

Toward multidomain integrated network management for ATM and SDH networks

NASA Astrophysics Data System (ADS)

Galis, Alex; Gantenbein, Dieter; Covaci, Stefan; Bianza, Carlo; Karayannis, Fotis; Mykoniatis, George

1996-12-01

ACTS Project AC080 MISA has embarked upon the task of realizing and validating via European field trials integrated end-to-end management of hybrid SDH and ATM networks in the framework of open network provision. This paper reflects the initial work of the project and gives an overview of the proposed MISA system architecture and initial design. We describe our understanding of the underlying enterprise model in the network management context, including the concept of the MISA Global Broadband Connectivity Management service. It supports Integrated Broadband Communication by defining an end-to-end broadband connection service in a multi-domain business environment. Its implementation by the MISA consortium within trials across Europe aims for an efficient management of network resources of the SDH and ATM infrastructure, considering optimum end-to-end quality of service and the needs of a number of telecommunication actors: customers, value-added service providers, and network providers.

Bundled-rate legislation for Medicare reimbursement for dialysis services: implications for anemia management with ESAs.

PubMed

Charytan, Chaim

2010-12-01

With the incidence of ESRD on the rise, there is a continuing need to control anemia-related treatment costs in dialysis patients receiving reimbursement through Medicare. Currently, erythropoiesis-stimulating agents (ESAs) are billed separately from dialysis services, potentially creating little financial incentive for more efficient use. The Medicare Improvement for Patients and Providers Act, passed by the U.S. Congress in July 2008, includes provisions intended to address this concern. Under this act, dialysis services will be reimbursed using a fully bundled, comprehensive payment system that includes all services currently covered in the basic composite rate, as well as certain separately billable items, including ESAs. A base rate of $229.63 per treatment has been assigned, to be individualized using case-mix adjusters. The implications of this new system for anemia management with ESAs continue to be elucidated. With fixed compensation for ESAs, management strategies that maximize efficiencies and, thereby, optimize cost savings will be favored. Select strategies may include switching from intravenous (IV) to subcutaneous routes, lowering Hb targets and ESA doses in hyporesponsive patients, increasing administration of IV iron, increasing use of home dialysis, and optimizing ESA dosing intervals. Once-monthly ESA therapy has potential advantages under this new system as an alternative to more frequently administered ESAs and may help achieve quality metrics in a cost-efficient manner.

Integrating emergency services in an urban health system.

PubMed

Radloff, D; Blouin, A S; Larsen, L; Kripp, M E

2000-03-01

When planning for growth and management efficiency across urban health systems, economic and market factors present significant service line challenges and opportunities. This article describes the evolutionary integration of emergency services in St John Health System, a large, religious-sponsored health care system located in Detroit, Michigan. Critical business elements, including the System's vision, mission, and economic context, are defined as the framework for site-specific and System-wide planning. The impact of managed care and market changes prompted St John's clinicians and executives to explore how integrating emergency services could create a competitive market advantage.

Multidisciplinary management--an opportunity for service integration.

PubMed

Cameron, M

1997-01-01

The management team of the future will enter an environment requiring facilitation, participation, clinical, and empowerment skills. Those individuals who possess a clinical orientation as well as business expertise will be sought to manage multidisciplinary units. The rapid changes in the health-care environment have forced organizations to restructure their operations. To achieve quality care, customer satisfaction, cost-effectiveness, and efficiency, service integration across the organization will be required. As we approach the 21st century, this standard will evolve until "all levels are managing patient care." Some of the restructuring trends occurring in the health-care industry have been collaboration service integration, management consolidation, and job elimination. The emphasis for the multidisciplinary manager of the future will include integrating the professional and clinical services, managing information, building community partnerships, promoting physician collaboration, and managing the change process. A model organization in the next century will move toward a people-oriented system with inclusion and empowerment initiatives. Service integration will affect all organizations, but the disciplines within the Clinical Support System will be the most affected. Future opportunities of leadership will exist for pathologists, nurses, or medical technologists as the professional silos of managers and clinicians continue to crumble.

[The conceptual bases for an entrepreneurial management of local health systems].

PubMed

Yepes, F J; Durán-Arenas, L

1994-01-01

Health management has become a fashion and it is now common to talk about strategic or service management, or of total quality management applied to health systems. However, all these elements of business management are being translated to health systems without a previous analysis on the implicit health model and the rationality of the prevalent production functions, which can lead to a higher level of efficiency but with an inadequate use of resources. This paper suggests the importance of integrating the advances in management and health sciences and proposes what are considered to be the conceptual basis for the design of a management tool geared to conduct local health systems with effectiveness, efficiency, quality and equity.

Faster response time : effective use of resources : integrating transportation systems and emergency management systems

DOT National Transportation Integrated Search

1999-01-01

This brochure discusses how coordinating the efforts of emergency dispatchers with transportation management agencies can improve efficiency and response times. It is noted that when emergency services agencies share facilities and traffic monitoring...

41 CFR 102-118.385 - What must a waiver request include?

Code of Federal Regulations, 2010 CFR

2010-07-01

... Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION TRANSPORTATION 118-TRANSPORTATION PAYMENT AND AUDIT Prepayment Audits of Transportation Services Waivers from Mandatory Prepayment Audit... a prepayment audit increases costs over a postpayment audit, decreases efficiency, involves a...

Enhancing DSN Operations Efficiency with the Discrepancy Reporting Management System (DRMS)

NASA Technical Reports Server (NTRS)

Chatillon, Mark; Lin, James; Cooper, Tonja M.

2003-01-01

The DRMS is the Discrepancy Reporting Management System used by the Deep Space Network (DSN). It uses a web interface and is a management tool designed to track and manage: data outage incidents during spacecraft tracks against equipment and software known as DRs (discrepancy Reports), to record "out of pass" incident logs against equipment and software in a Station Log, to record instances where equipment has be restarted or reset as Reset records, and to electronically record equipment readiness status across the DSN. Tracking and managing these items increases DSN operational efficiency by providing: the ability to establish the operational history of equipment items, data on the quality of service provided to the DSN customers, the ability to measure service performance, early insight into processes, procedures and interfaces that may need updating or changing, and the capability to trace a data outage to a software or hardware change. The items listed above help the DSN to focus resources on areas of most need.

Incident Management in Academic Information System using ITIL Framework

NASA Astrophysics Data System (ADS)

Palilingan, V. R.; Batmetan, J. R.

2018-02-01

Incident management is very important in order to ensure the continuity of a system. Information systems require incident management to ensure information systems can provide maximum service according to the service provided. Many of the problems that arise in academic information systems come from incidents that are not properly handled. The objective of this study aims to find the appropriate way of incident management. The incident can be managed so it will not be a big problem. This research uses the ITIL framework to solve incident problems. The technique used in this study is a technique adopted and developed from the service operations section of the ITIL framework. The results of this research found that 84.5% of incidents appearing in academic information systems can be handled quickly and appropriately. 15.5% incidents can be escalated so as to not cause any new problems. The model of incident management applied to make academic information system can run quickly in providing academic service in a good and efficient. The incident management model implemented in this research is able to manage resources appropriately so as to quickly and easily manage incidents.

Enterprise Systems in a Service Science Context

NASA Astrophysics Data System (ADS)

Nilsson, Anders G.

By enterprise systems we here refer to large integrated standard application packages that fully cover the provision of information required in a company. They are made up of extensive administrative solutions for management accounting, human resource management, production, logistics and sales control. Most of the enterprise systems on the market have traditionally been designed with a focus on manufacturing companies, but during the past years the supply of various enterprise systems for service-oriented business organizations has gradually increased. This fact raises the issue to study enterprise systems from a service management perspective. Service science is an emerging discipline that studies value creation through services from technical, behavioural and social perspectives. Within service science it is therefore possible to use and apply a wide spectrum of engineering tools for development of business services in organizations. In this sense, enterprise systems represent an efficient tool for service innovations. The research interest in this chapter is focussed on how we can study enterprise systems in a service science context.

Real-time GIS data model and sensor web service platform for environmental data management.

PubMed

Gong, Jianya; Geng, Jing; Chen, Zeqiang

2015-01-09

Effective environmental data management is meaningful for human health. In the past, environmental data management involved developing a specific environmental data management system, but this method often lacks real-time data retrieving and sharing/interoperating capability. With the development of information technology, a Geospatial Service Web method is proposed that can be employed for environmental data management. The purpose of this study is to determine a method to realize environmental data management under the Geospatial Service Web framework. A real-time GIS (Geographic Information System) data model and a Sensor Web service platform to realize environmental data management under the Geospatial Service Web framework are proposed in this study. The real-time GIS data model manages real-time data. The Sensor Web service platform is applied to support the realization of the real-time GIS data model based on the Sensor Web technologies. To support the realization of the proposed real-time GIS data model, a Sensor Web service platform is implemented. Real-time environmental data, such as meteorological data, air quality data, soil moisture data, soil temperature data, and landslide data, are managed in the Sensor Web service platform. In addition, two use cases of real-time air quality monitoring and real-time soil moisture monitoring based on the real-time GIS data model in the Sensor Web service platform are realized and demonstrated. The total time efficiency of the two experiments is 3.7 s and 9.2 s. The experimental results show that the method integrating real-time GIS data model and Sensor Web Service Platform is an effective way to manage environmental data under the Geospatial Service Web framework.

7 CFR 4284.504 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... startup, expansion or operational improvement of a cooperative to promote development in rural areas of services and products, processes that can be used in the marketing of products, or enterprises that create... advisory services. Operational improvement includes making the cooperative more efficient or better managed...

Efficiency of antenatal care and childbirth services in selected primary health care facilities in rural Tanzania: a cross-sectional study.

PubMed

Saronga, Happiness P; Duysburgh, Els; Massawe, Siriel; Dalaba, Maxwell A; Savadogo, Germain; Tonchev, Pencho; Dong, Hengjin; Sauerborn, Rainer; Loukanova, Svetla

2014-02-28

Cost studies are paramount for demonstrating how resources have been spent and identifying opportunities for more efficient use of resources. The main objective of this study was to assess the actual dimension and distribution of the costs of providing antenatal care (ANC) and childbirth services in selected rural primary health care facilities in Tanzania. In addition, the study analyzed determining factors of service provision efficiency in order to inform health policy and planning. This was a retrospective quantitative cross-sectional study conducted in 11 health centers and dispensaries in Lindi and Mtwara rural districts. Cost analysis was carried out using step down cost accounting technique. Unit costs reflected efficiency of service provision. Multivariate regression analysis on the drivers of observed relative efficiency in service provision between the study facilities was conducted. Reported personnel workload was also described. The health facilities spent on average 7 USD per capita in 2009. As expected, fewer resources were spent for service provision at dispensaries than at health centers. Personnel costs contributed a high approximate 44% to total costs. ANC and childbirth consumed approximately 11% and 12% of total costs; and 8% and 10% of reported service provision time respectively. On average, unit costs were rather high, 16 USD per ANC visit and 79.4 USD per childbirth. The unit costs showed variation in relative efficiency in providing the services between the health facilities. The results showed that efficiency in ANC depended on the number of staff, structural quality of care, process quality of care and perceived quality of care. Population-staff ratio and structural quality of basic emergency obstetric care services highly influenced childbirth efficiency. Differences in the efficiency of service provision present an opportunity for efficiency improvement. Taking into consideration client heterogeneity, quality improvements are possible and necessary. This will stimulate utilization of ANC and childbirth services in resource-constrained health facilities. Efficiency analyses through simple techniques such as measurement of unit costs should be made standard in health care provision, health managers can then use the performance results to gauge progress and reward efficiency through performance based incentives.

A means to an end: a web-based client management system in palliative care.

PubMed

O'Connor, Margaret; Erwin, Trudy; Dawson, Linda

2009-03-01

Home-based palliative care (hospice) services require comprehensive and fully integrated information systems to develop and manage the various aspects of their business, incorporating client data and management information. These systems assist in maintaining the quality of client care as well as improved management efficiencies. This article reports on a large not-for-profit home-based palliative care service in Australia, which embarked on a project to develop an electronic data management system specifically designed to meet the needs of the palliative care sector. This web-based client information management system represents a joint venture between the organization and a commercial company and has been a very successful project.

An Analysis of Medical Imaging Costs in Military Treatment Facilities

DTIC Science & Technology

2014-09-01

authority to completely control the medical systems of each service, the DHA 7 was given management responsibility for specific shared services , functions...efficient health operations through enhanced enterprise-wide shared services . • Deliver more comprehensive primary care and integrated health...of shared services that will fall under central control: • facility planning • medical logistics • health information technology • Tricare health

Enabling Healthcare IT Governance: Human Task Management Service for Administering Emergency Department's Resources for Efficient Patient Flow.

PubMed

Rodriguez, Salvador; Aziz, Ayesha; Chatwin, Chris

2014-01-01

The use of Health Information Technology (HIT) to improve healthcare service delivery is constantly increasing due to research advances in medical science and information systems. Having a fully automated process solution for a Healthcare Organization (HCO) requires a combination of organizational strategies along with a selection of technologies that facilitate the goal of improving clinical outcomes. HCOs, requires dynamic management of care capability to realize the full potential of HIT. Business Process Management (BPM) is being increasingly adopted to streamline the healthcare service delivery and management processes. Emergency Departments (EDs) provide a case in point, which require multidisciplinary resources and services to deliver effective clinical outcomes. Managed care involves the coordination of a range of services in an ED. Although fully automated processes in emergency care provide a cutting edge example of service delivery, there are many situations that require human interactions with the computerized systems; e.g. Medication Approvals, care transfer, acute patient care. This requires a coordination mechanism for all the resources, computer and human, to work side by side to provide the best care. To ensure evidence-based medical practice in ED, we have designed a Human Task Management service to model the process of coordination of ED resources based on the UK's NICE Clinical guideline for managing the care of acutely ill patients. This functionality is implemented using Java Business process Management (jBPM).

Hong Kong Hospital Authority resource efficiency evaluation: Via a novel DEA-Malmquist model and Tobit regression model.

PubMed

Guo, Hainan; Zhao, Yang; Niu, Tie; Tsui, Kwok-Leung

2017-01-01

The Hospital Authority (HA) is a statutory body managing all the public hospitals and institutes in Hong Kong (HK). In recent decades, Hong Kong Hospital Authority (HKHA) has been making efforts to improve the healthcare services, but there still exist some problems like unfair resource allocation and poor management, as reported by the Hong Kong medical legislative committee. One critical consequence of these problems is low healthcare efficiency of hospitals, leading to low satisfaction among patients. Moreover, HKHA also suffers from the conflict between limited resource and growing demand. An effective evaluation of HA is important for resource planning and healthcare decision making. In this paper, we propose a two-phase method to evaluate HA efficiency for reducing healthcare expenditure and improving healthcare service. Specifically, in Phase I, we measure the HKHA efficiency changes from 2000 to 2013 by applying a novel DEA-Malmquist index with undesirable factors. In Phase II, we further explore the impact of some exogenous factors (e.g., population density) on HKHA efficiency by Tobit regression model. Empirical results show that there are significant differences between the efficiencies of different hospitals and clusters. In particular, it is found that the public hospital serving in a richer district has a relatively lower efficiency. To a certain extent, this reflects the socioeconomic reality in HK that people with better economic condition prefers receiving higher quality service from the private hospitals.

Hong Kong Hospital Authority resource efficiency evaluation: Via a novel DEA-Malmquist model and Tobit regression model

PubMed Central

Guo, Hainan; Zhao, Yang; Niu, Tie; Tsui, Kwok-Leung

2017-01-01

The Hospital Authority (HA) is a statutory body managing all the public hospitals and institutes in Hong Kong (HK). In recent decades, Hong Kong Hospital Authority (HKHA) has been making efforts to improve the healthcare services, but there still exist some problems like unfair resource allocation and poor management, as reported by the Hong Kong medical legislative committee. One critical consequence of these problems is low healthcare efficiency of hospitals, leading to low satisfaction among patients. Moreover, HKHA also suffers from the conflict between limited resource and growing demand. An effective evaluation of HA is important for resource planning and healthcare decision making. In this paper, we propose a two-phase method to evaluate HA efficiency for reducing healthcare expenditure and improving healthcare service. Specifically, in Phase I, we measure the HKHA efficiency changes from 2000 to 2013 by applying a novel DEA-Malmquist index with undesirable factors. In Phase II, we further explore the impact of some exogenous factors (e.g., population density) on HKHA efficiency by Tobit regression model. Empirical results show that there are significant differences between the efficiencies of different hospitals and clusters. In particular, it is found that the public hospital serving in a richer district has a relatively lower efficiency. To a certain extent, this reflects the socioeconomic reality in HK that people with better economic condition prefers receiving higher quality service from the private hospitals. PMID:28886087

University and Polytechnic Objectives, Resource Allocation and Performance Indices in the Central Services. Program on Institutional Management in Higher Education.

ERIC Educational Resources Information Center

Norris, Graeme, Ed.

Research progress by member institutions is reviewed with regard to university administration, computing, committees, libraries, and student welfare. Consideration is given to effectiveness and efficiency, management information, management by objectives, periodic review of objectives, strategy, and analytic resource allocation. Two research…

Energy services in the information age: The convergence of energy, communications, and information technologies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Centolella, P.A.

1998-07-01

Most of the economic efficiency benefits of electric restructuring--consumer choice based on price and risk preferences, efficient capacity utilization, capacity expansion that reflects marketability, and innovative products--depend upon consumer access to information and opportunities to respond to time- and location-specific prices and customized products. Information and communications technologies from back-room data management centers to intelligent consumer gateways will play an essential role in marketing energy services in a retail access environment. This paper describes the role of information and communications technology in electric industry restructuring and retailing of energy services. It includes a survey of economic analyses on the likelymore » variability in competitive generation prices and consumer responses if such prices are effectively communicated. The paper describes the potential benefits and cost savings associated with flexible consumer responses to price variability. It identifies consumer loads and preferences. Finally, the paper describes the building blocks of information systems being developed to facilitate price-responsive energy management and provide a range of other energy services. Intelligent gateways, analytical tools for facility load prediction and optimizing energy management responses, and electronic commerce applications are discussed.« less

Managing a highly important service.

PubMed

Simpson, Murray

2014-10-01

As facilities managers take more responsibility for the hospital laundries, Murray Simpson, chief executive of the TSA (Textile Services Association), the trade association for the laundry, dry cleaning, and textile rental industries in the UK, highlights the major issues that need to be addressed--ranging from effective stock control, to making sure nurses' uniforms are washed at sufficiently high temperatures to prevent them harbouring bacteria, to ensure that Government targets on hygiene and efficiency are met.

What is the Right RFID for Your Process?

DTIC Science & Technology

2006-04-30

chain efficiency at the US Department of Defense (DoD) and at major retailers such as Wal-Mart, Tesco and others has prompted these organizations...areas of expertise include global operations, supply- chain management, sustainable technologies, product stewardship, reverse logistics and...time MBA programs. Areas of Apte’s research interests include managing service operations, supply- chain management, technology management, and

Spatial service delivery system for smart licensing & enforcement management

NASA Astrophysics Data System (ADS)

Wahap, N. A.; Ismail, N. M.; Nor, N. M.; Ahmad, N.; Omar, M. F.; Termizi, A. A. A.; Zainal, D.; Noordin, N. M.; Mansor, S.

2016-06-01

Spatial information has introduced a new sense of urgency for a better understanding of the public needs in term of what, when and where they need services and through which devices, platform or physical locations they need them. The objective of this project is to value- add existing license management process for business premises which comes under the responsibility of Local Authority (PBT). Manipulation of geospatial and tracing technology via mobile platform allows enforcement officers to work in real-time, use a standardized system, improve service delivery, and optimize operation management. This paper will augment the scope and capabilities of proposed concept namely, Smart Licensing/Enforcement Management (SLEm). It will review the current licensing and enforcement practice of selected PBT in comparison to the enhanced method. As a result, the new enhanced system is expected to offer a total solution for licensing/enforcement management whilst increasing efficiency and transparency for smart city management and governance.

45 CFR 205.36 - State plan requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., of an automated statewide management information system designed effectively and efficiently, to assist management in the administration of an approved AFDC State plan. The submission process to amend... aid or services is changed. (c) To electronically refer and exchange information with programs under...

Diagnostic laboratory for bleeding disorders ensures efficient management of haemorrhagic disorders.

PubMed

Riddell, A; Chuansumrit, A; El-Ekiaby, M; Nair, S C

2016-07-01

Haemorrhagic disorders like Postpartum haemorrhage and Dengue haemorrhagic fever are life threatening and requires an active and efficient transfusion service that could provide the most appropriate blood product which could be effective in managing them. This would essentially require prompt identification of the coagulopathy so that the best available product can be given to the bleeding patient to correct the identified haemostatic defect which will help control the bleeding. This would only be possible if the transfusion service has a laboratory to correctly detect the haemostatic defect and that too with an accuracy and precision which is ensured by a good laboratory quality assurance practices. These same processes are necessary for the transfusion services to ensure the quality of the blood products manufactured by them and that it contains adequate amounts of haemostasis factors which will be good to be effective in the management of haemorrhagic disorders. These issues are discussed in detail individually in the management of postpartum haemorrhage and Dengue haemorrhagic fever including when these can help in the use of rFVIIa in Dengue haemorrhagic fever. The requirements to ensure good-quality blood products are made available for the management of these disorders and the same have also been described. © 2016 John Wiley & Sons Ltd.

Ambulatory surgery centers best practices for the 90s.

PubMed

Hoover, J A

1994-05-01

Outpatient surgery will be the driving force in the continued growth of ambulatory care in the 1990s. Providing efficient, high-quality ambulatory surgical services should therefore be a priority among healthcare providers. Arthur Andersen conducted a survey to discover best practices in ambulatory surgical service. General success characteristics of best performers were business-focused relationships with physicians, the use of clinical protocols, patient convenience, cost management, strong leadership, teamwork, streamlined processes and efficient design. Other important factors included scheduling to maximize OR room use; achieving surgical efficiencies through reduced case pack assembly errors and equipment availability; a focus on cost capture rather than charge capture; sound materiel management practices, such as standardization and vendor teaming; and the appropriate use of automated systems. It is important to evaluate whether the best practices are applicable to your environment and what specific changes to your current processes would be necessary to adopt them.

Market leadership by example: Government sector energy efficiency in developing countries

DOE Office of Scientific and Technical Information (OSTI.GOV)

Van Wie McGrory, Laura; Harris, Jeffrey; Breceda, Miguel

2002-05-20

Government facilities and services are often the largest energy users and major purchasers of energy-using equipment within a country. In developing as well as industrial countries, government ''leadership by example'' can be a powerful force to shift the market toward energy efficiency, complementing other elements of a national energy efficiency strategy. Benefits from more efficient energy management in government facilities and operations include lower government energy bills, reduced greenhouse gas emissions, less demand on electric utility systems, and in many cases reduced dependence on imported oil. Even more significantly, the government sector's buying power and example to others can generatemore » broader demand for energy-efficient products and services, creating entry markets for domestic suppliers and stimulating competition in providing high-efficiency products and services. Despite these benefits, with the exception of a few countries government sector actions have often lagged behind other energy efficiency policies. This is especially true in developing countries and transition economies - even though energy used by public agencies in these countries may represent at least as large a share of total energy use as the public sector in industrial economies. This paper summarizes work in progress to inventory current programs and policies for government sector energy efficiency in developing countries, and describes successful case studies from Mexico's implementation of energy management in the public sector. We show how these policies in Mexico, begun at the federal level, have more recently been extended to state and local agencies, and consider the applicability of this model to other developing countries.« less

Cost & efficiency evaluation of a publicly financed & publicly delivered referral transport service model in three districts of Haryana State, India.

PubMed

Prinja, Shankar; Manchanda, Neha; Aggarwal, Arun Kumar; Kaur, Manmeet; Jeet, Gursimer; Kumar, Rajesh

2013-12-01

Various models of referral transport services have been introduced in different States in India with an aim to reduce maternal and infant mortality. Most of the research on referral transport has focussed on coverage, quality and timeliness of the service with not much information on cost and efficiency. This study was undertaken to analyze the cost of a publicly financed and managed referral transport service model in three districts of Haryana State, and to assess its cost and technical efficiency. Data on all resources spent for delivering referral transport service, during 2010, were collected from three districts of Haryana State. Costs incurred at State level were apportioned using appropriate methods. Data Envelopment Analysis (DEA) technique was used to assess the technical efficiency of ambulances. To estimate the efficient scale of operation for ambulance service, the average cost was regressed on kilometres travelled for each ambulance station using a quadratic regression equation. The cost of referral transport per year varied from [symbol: see text] 5.2 million in Narnaul to [symbol: see text] 9.8 million in Ambala. Salaries (36-50%) constituted the major cost. Referral transport was found to be operating at an average efficiency level of 76.8 per cent. Operating an ambulance with a patient load of 137 per month was found to reduce unit costs from an average [symbol: see text] 15.5 per km to [symbol: see text] 9.57 per km. Our results showed that the publicly delivered referral transport services in Haryana were operating at an efficient level. Increasing the demand for referral transport services among the target population represents an opportunity for further improving the efficiency of the underutilized ambulances.

Cost & efficiency evaluation of a publicly financed & publicly delivered referral transport service model in three districts of Haryana State, India

PubMed Central

Prinja, Shankar; Manchanda, Neha; Aggarwal, Arun Kumar; Kaur, Manmeet; Jeet, Gursimer; Kumar, Rajesh

2013-01-01

Background & objectives: Various models of referral transport services have been introduced in different States in India with an aim to reduce maternal and infant mortality. Most of the research on referral transport has focussed on coverage, quality and timeliness of the service with not much information on cost and efficiency. This study was undertaken to analyze the cost of a publicly financed and managed referral transport service model in three districts of Haryana State, and to assess its cost and technical efficiency. Methods: Data on all resources spent for delivering referral transport service, during 2010, were collected from three districts of Haryana State. Costs incurred at State level were apportioned using appropriate methods. Data Envelopment Analysis (DEA) technique was used to assess the technical efficiency of ambulances. To estimate the efficient scale of operation for ambulance service, the average cost was regressed on kilometres travelled for each ambulance station using a quadratic regression equation. Results: The cost of referral transport per year varied from ₹5.2 million in Narnaul to ₹9.8 million in Ambala. Salaries (36-50%) constituted the major cost. Referral transport was found to be operating at an average efficiency level of 76.8 per cent. Operating an ambulance with a patient load of 137 per month was found to reduce unit costs from an average ₹ 15.5 per km to ₹ 9.57 per km. Interpretation & conclusions: Our results showed that the publicly delivered referral transport services in Haryana were operating at an efficient level. Increasing the demand for referral transport services among the target population represents an opportunity for further improving the efficiency of the underutilized ambulances. PMID:24521648

Agreement between physicians' and nurses' clinical decisions for the management of the fracture liaison service (4iFLS): the Lucky Bone™ program.

PubMed

Senay, A; Delisle, J; Raynauld, J P; Morin, S N; Fernandes, J C

2016-04-01

We determined if nurses can manage osteoporotic fractures in a fracture liaison service by asking a rheumatologist and an internist to assess their clinical decisions. Experts agreed on more than 94 % of all nurses' actions for 525 fragility fracture patients, showing that their management is efficient and safe. A major care gap exists in the investigation of bone fragility and initiation of treatment for individuals who have sustained a fragility fracture. The implementation of a fracture liaison service (FLS) managed by nurses could be the key in resolving this problem. The aim of this project was to obtain agreement between physicians' and nurses' clinical decisions and evaluate if the algorithm of care is efficient and reliable for the management of a FLS. Clinical decisions of nurses for 525 subjects in a fracture liaison service between 2010 and 2013 were assessed by two independent physicians with expertise in osteoporosis treatment. Nurses succeeded in identifying all patients at risk and needed to refer 27 % of patients to an MD. Thereby, they managed autonomously 73 % of fragility fracture patients. No needless referrals were made according to assessing physicians. Agreement between each evaluator and nurses was of >97 %. Physicians' decisions were the same in >96 %, and Gwet AC11 coefficient was of >0.960 (almost perfect level of agreement). All major comorbidities were adequately managed. High agreement between nurses' and physicians' clinical decisions indicate that the independent management by nurses of a fracture liaison service is safe and should strongly be recommended in the care of patients with a fragility fracture. This kind of intervention could help resolve the existing care gap in bone fragility care as well as the societal economic burden associated with prevention and treatment of fragility fractures.

Focus on Efficient Management.

ERIC Educational Resources Information Center

Kentucky State Dept. of Education, Frankfort. Office of Resource Management.

Compiled as a workshop handbook, this guide presents information to help food service program administrators comply with federal regulations and evaluate and upgrade their operations. Part I discusses requirements of the National School Lunch Program, focusing on the "offer versus serve" method of service enacted in 1976 to reduce waste.…

Food Service Equipment. Third Edition.

ERIC Educational Resources Information Center

Jernigan, Anna Katherine; Ross, Lynne Nannen

This book provides information that will help in purchasing the kind of food service equipment most useful in any given facility. Hence, it should be of value to architects, contractors, administrators, dietitians, managers, and others involved in remodeling a facility, replacing equipment, and/or improving the efficiency of food service…

Perspectives: Community Education and Services in the 1980's.

ERIC Educational Resources Information Center

Cosand, Joseph P.

1981-01-01

Looks at goals and rewards associated with community education and services. Points to areas where community colleges are vulnerable to criticism of self-interest at the community's expense: management efficiency, duplication of effort, mission, and productivity and accountability. Underscores the importance of cooperation between community…

IT-strategy and major aspects of quality management on the market of goods and services

NASA Astrophysics Data System (ADS)

Khafizov, I. I.; Galimov, A. N.

2017-09-01

The article deals with the basic provisions of the formation of IT-strategies and interaction with management quality. Formation of the IT-strategy in a volatile, changing marketing environment is a prerequisite for efficient operation of the company.

IoT-based smart garbage system for efficient food waste management.

PubMed

Hong, Insung; Park, Sunghoi; Lee, Beomseok; Lee, Jaekeun; Jeong, Daebeom; Park, Sehyun

2014-01-01

Owing to a paradigm shift toward Internet of Things (IoT), researches into IoT services have been conducted in a wide range of fields. As a major application field of IoT, waste management has become one such issue. The absence of efficient waste management has caused serious environmental problems and cost issues. Therefore, in this paper, an IoT-based smart garbage system (SGS) is proposed to reduce the amount of food waste. In an SGS, battery-based smart garbage bins (SGBs) exchange information with each other using wireless mesh networks, and a router and server collect and analyze the information for service provisioning. Furthermore, the SGS includes various IoT techniques considering user convenience and increases the battery lifetime through two types of energy-efficient operations of the SGBs: stand-alone operation and cooperation-based operation. The proposed SGS had been operated as a pilot project in Gangnam district, Seoul, Republic of Korea, for a one-year period. The experiment showed that the average amount of food waste could be reduced by 33%.

IoT-Based Smart Garbage System for Efficient Food Waste Management

PubMed Central

Lee, Jaekeun

2014-01-01

Owing to a paradigm shift toward Internet of Things (IoT), researches into IoT services have been conducted in a wide range of fields. As a major application field of IoT, waste management has become one such issue. The absence of efficient waste management has caused serious environmental problems and cost issues. Therefore, in this paper, an IoT-based smart garbage system (SGS) is proposed to reduce the amount of food waste. In an SGS, battery-based smart garbage bins (SGBs) exchange information with each other using wireless mesh networks, and a router and server collect and analyze the information for service provisioning. Furthermore, the SGS includes various IoT techniques considering user convenience and increases the battery lifetime through two types of energy-efficient operations of the SGBs: stand-alone operation and cooperation-based operation. The proposed SGS had been operated as a pilot project in Gangnam district, Seoul, Republic of Korea, for a one-year period. The experiment showed that the average amount of food waste could be reduced by 33%. PMID:25258730

Concept for a Satellite-Based Advanced Air Traffic Management System : Volume 8. Operational Logic Flow Diagrams for a Generic Advanced Air Traffic Management system

DOT National Transportation Integrated Search

1974-02-01

The volume presents a description of the services a generic Advanced Air Traffic Management System (AATMS) should provide to the useres of the system to facilitate the safe, efficient flow of traffic. It provides a definition of the functions which t...

Discrete event simulation modelling of patient service management with Arena

NASA Astrophysics Data System (ADS)

Guseva, Elena; Varfolomeyeva, Tatyana; Efimova, Irina; Movchan, Irina

2018-05-01

This paper describes the simulation modeling methodology aimed to aid in solving the practical problems of the research and analysing the complex systems. The paper gives the review of a simulation platform sand example of simulation model development with Arena 15.0 (Rockwell Automation).The provided example of the simulation model for the patient service management helps to evaluate the workload of the clinic doctors, determine the number of the general practitioners, surgeons, traumatologists and other specialized doctors required for the patient service and develop recommendations to ensure timely delivery of medical care and improve the efficiency of the clinic operation.

Integrating policy-based management and SLA performance monitoring

NASA Astrophysics Data System (ADS)

Liu, Tzong-Jye; Lin, Chin-Yi; Chang, Shu-Hsin; Yen, Meng-Tzu

2001-10-01

Policy-based management system provides the configuration capability for the system administrators to focus on the requirements of customers. The service level agreement performance monitoring mechanism helps system administrators to verify the correctness of policies. However, it is difficult for a device to process the policies directly because the policies are the management concept. This paper proposes a mechanism to decompose a policy into rules that can be efficiently processed by a device. Thus, the device may process the rule and collect the performance statistics information efficiently; and the policy-based management system may collect these performance statistics information and report the service-level agreement performance monitoring information to the system administrator. The proposed policy-based management system achieves both the policy configuration and service-level agreement performance monitoring requirements. A policy consists of a condition part and an action part. The condition part is a Boolean expression of a source host IP group, a destination host IP group, etc. The action part is the parameters of services. We say that an address group is compact if it only consists of a range of IP address that can be denoted by a pair of IP address and corresponding IP mask. If the condition part of a policy only consists of the compact address group, we say that the policy is a rule. Since a device can efficiently process a compact address and a system administrator prefers to define a range of IP address, the policy-based management system has to translate policy into rules and supplements the gaps between policy and rules. The proposed policy-based management system builds the relationships between VPN and policies, policy and rules. Since the system administrator wants to monitor the system performance information of VPNs and policies, the proposed policy-based management system downloads the relationships among VPNs, policies and rules to the SNMP agents. The SNMP agents build the management information base (MIB) of all VPNs, policies and rules according to the relationships obtained from the management server. Thus, the proposed policy-based management system may get all performance monitoring information of VPNs and policies from agents. The proposed policy-based manager achieves two goals: a) provide a management environment for the system administrator to configure their network only considering the policy requirement issues and b) let the device have only to process the packet and then collect the required performance information. These two things make the proposed management system satisfy both the user and device requirements.

Renewing Occupational Cultures--Bridging Boundaries in Learning Spaces

ERIC Educational Resources Information Center

Kalliola, Satu; Nakari, Risto

2007-01-01

Professional bureaucracies of the Finnish municipal services are challenged by many modernization pressures manifested currently in the form of New Public Management. Along with efficiency demands the new emphasis is on the provision of client-oriented services by the means of multi-professional teamwork crossing the traditional sector boundaries.…

Faculty Compensation Systems: Impact on the Quality of Higher Education. ERIC Digest.

ERIC Educational Resources Information Center

Sutton, Terry P.; Bergerson, Peter J.

Faculty compensation is a critical management tool for increasing faculty productivity, improving cost efficiency, and enhancing an institution's public image. Factors that determine faculty compensation include academic rank, faculty productivity, discipline market pay, ability to obtain external grants, seniority or length of service, service in…

Evaluating the use of operational management techniques for capacity improvements on shared-use rail corridors : final report.

DOT National Transportation Integrated Search

2016-01-01

The majority of intercity passenger and commuter rail services in the United States (U.S.) operate on the shared-use corridors with : freight rail services. These types of operations tend to be challenging for efficient capacity utilization and relia...

5 CFR 295.101 - Scope and purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

....101 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS TESTIMONY BY OPM... you submit a demand or request to an employee of the U.S. Office of Personnel Management (OPM) to... efficiency in its programs and operations; (2) Minimize the possibility of involving OPM in controversial...

41 CFR 51-4.4 - Subcontracting.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Subcontracting. 51-4.4 Section 51-4.4 Public Contracts and Property Management Other Provisions Relating to Public Contracts... both with efficient performance in furnishing commodities or services under the JWOD Act and maximizing...

Construction and Application of a Refined Hospital Management Chain.

PubMed

Yi, Lihua; Hao, Aimin; Hu, Minmin; Huang, Pei; Yuan, Huikang; Xing, Ming

2015-05-01

Gaining large scale success was quite common in the later period of industrialization for hospitals in China. Today, Chinese hospital management face such problems as service inefficiency, high human resources cost, and low rate of capital use. This study analyzes the refined management chain of the Wuxi No. 2 People's Hospital. This consists of six gears namely "organizational structure, clinical practice, outpatient service, medical technology, and nursing care and logistics" used to achieve maximum scale and benefits. The gears are based on "flat management system targets, chief of medical staff, centralized outpatient service, intensified medical examinations, vertical nursing management and socialized logistics". The hospital took innovative measures. The "one doctor-one patient-one clinic" was well accepted; "one dispensary" shorten the waiting time by 20 min. The 168 rear service hot line "made patients' lives easier; and a red wrist ribbon" for seriously ill patient was implemented to prioritize medical treatment. The core concepts of refined hospital management are optimizing flow process, reducing waste, improving efficiency, saving costs, and taking good care of patients as most important.

The Particle Physics Data Grid. Final Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Livny, Miron

2002-08-16

The main objective of the Particle Physics Data Grid (PPDG) project has been to implement and evaluate distributed (Grid-enabled) data access and management technology for current and future particle and nuclear physics experiments. The specific goals of PPDG have been to design, implement, and deploy a Grid-based software infrastructure capable of supporting the data generation, processing and analysis needs common to the physics experiments represented by the participants, and to adapt experiment-specific software to operate in the Grid environment and to exploit this infrastructure. To accomplish these goals, the PPDG focused on the implementation and deployment of several critical services:more » reliable and efficient file replication service, high-speed data transfer services, multisite file caching and staging service, and reliable and recoverable job management services. The focus of the activity was the job management services and the interplay between these services and distributed data access in a Grid environment. Software was developed to study the interaction between HENP applications and distributed data storage fabric. One key conclusion was the need for a reliable and recoverable tool for managing large collections of interdependent jobs. An attached document provides an overview of the current status of the Directed Acyclic Graph Manager (DAGMan) with its main features and capabilities.« less

A multi-service data management platform for scientific oceanographic products

NASA Astrophysics Data System (ADS)

D'Anca, Alessandro; Conte, Laura; Nassisi, Paola; Palazzo, Cosimo; Lecci, Rita; Cretì, Sergio; Mancini, Marco; Nuzzo, Alessandra; Mirto, Maria; Mannarini, Gianandrea; Coppini, Giovanni; Fiore, Sandro; Aloisio, Giovanni

2017-02-01

An efficient, secure and interoperable data platform solution has been developed in the TESSA project to provide fast navigation and access to the data stored in the data archive, as well as a standard-based metadata management support. The platform mainly targets scientific users and the situational sea awareness high-level services such as the decision support systems (DSS). These datasets are accessible through the following three main components: the Data Access Service (DAS), the Metadata Service and the Complex Data Analysis Module (CDAM). The DAS allows access to data stored in the archive by providing interfaces for different protocols and services for downloading, variables selection, data subsetting or map generation. Metadata Service is the heart of the information system of the TESSA products and completes the overall infrastructure for data and metadata management. This component enables data search and discovery and addresses interoperability by exploiting widely adopted standards for geospatial data. Finally, the CDAM represents the back-end of the TESSA DSS by performing on-demand complex data analysis tasks.

Evaluation of the Consolidation of Real Property Maintenance Activities (RPMA) in the U.S. Army Engineer Activity, Capital Area (USAEA, CA). Volume 2. Evaluation

DTIC Science & Technology

1990-03-01

MANAGEMENT ................................... 62 Scope of Current Operations 62 Evolution of the Original RMD Plan 66 Financial Management Support Operations...Scope of Current Operations 76 Evolution of SMD From IPG Plan 78 SMD Support to RPMA 81 Efficiency of Supply Service 85 7 PROCUREMENT AND CONTRACTING...RPMA are to be realized. This chapter investigates these controls in terms of scope, evolution , operations (a functional assessment), and efficiency

The changing role of the medical technologist from technologist to information specialist.

PubMed

Miller, W G

2000-01-01

Pathology laboratory services are dependent on the laboratory information system (LIS) to organize the work, manage the operation, and communicate the results for effective laboratory medicine. For maximum efficiency, staffing for the LIS should be an integral component of laboratory operations and is facilitated by a two-tier structure. A core LIS staff provides system support and continuous services. A group of bench medical technologists have multitasking responsibilities, including LIS support for a specific laboratory work area. The two components form a team that uses staff efficiently to provide ongoing operational services and flexibility for problem solving and new functionality implementation.

Top-down and bottom-up approaches to greenhouse gas inventory methods—a comparison between national- and forest-scale reporting methods

Treesearch

David Nicholls; Frank Barnes; Felicia Acrea; Chinling Chen; Lara Y. Buluç; Michele M. Parker

2015-01-01

Federal agencies are mandated to measure, manage, and reduce greenhouse gas (GHG) emissions. The General Services Administration (GSA) Carbon Footprint Tool (CFT) is an online tool built to utilize measured GHG inventories to help Forest Service units streamline reporting and make informed decisions about operational efficiency. In fiscal year 2013, the Forest Service...

Balancing the balanced scorecard for a New Zealand mental health service.

PubMed

Coop, Colleen F

2006-05-01

Given the high prevalence of mental disorders, there is a need to evaluate mental health services to ensure they are efficient, effective, responsive and accessible. One method that is being used is the "balanced scorecard" which uses performance indicators in four quadrants to assess various dimensions of service provision. This case study describes the steps taken by a New Zealand mental health service to improve service management through greater use of key performance indicators in relation to preset targets using this approach.

Product policy - the main component of the marketing mix in the Romanian health services.

PubMed

Coculescu, B I; Purcarea, V L; Coculescu, E C

2016-01-01

The objectives of the reforms in the EU healthcare systems are based on the implementation of the marketing concept in the health systems, which are, among other things: • efficient management of the financial resources and control costs of the rendered health services; • increased satisfaction of the clients of health care services; • broad accessibility to health services; • effective implementation of modern technologies; • rational stimulation of medical services consumption; • achievement of a fair and neutral competition between the public/ private providers and health insurance companies; • introduction of performance criteria in order to increase the incomes of the medical staff and hierarchy in hospitals; • implementation of modern management methods in health services management; • decentralization of the public healthcare system. Product policy in the medical system of healthcare - the most important component of the marketing mix - is the attitude that addresses a medical organization to the volume, structure, and diversity of services subject to their own activities in relation to the requirements of the services market and the competitive actions of other medical institutions.

Product policy - the main component of the marketing mix in the Romanian health services

PubMed Central

Coculescu, BI; Purcarea, VL; Coculescu, EC

2016-01-01

The objectives of the reforms in the EU healthcare systems are based on the implementation of the marketing concept in the health systems, which are, among other things: • efficient management of the financial resources and control costs of the rendered health services; • increased satisfaction of the clients of health care services; • broad accessibility to health services; • effective implementation of modern technologies; • rational stimulation of medical services consumption; • achievement of a fair and neutral competition between the public/ private providers and health insurance companies; • introduction of performance criteria in order to increase the incomes of the medical staff and hierarchy in hospitals; • implementation of modern management methods in health services management; • decentralization of the public healthcare system. Product policy in the medical system of healthcare - the most important component of the marketing mix - is the attitude that addresses a medical organization to the volume, structure, and diversity of services subject to their own activities in relation to the requirements of the services market and the competitive actions of other medical institutions. PMID:27974913

Disabilities Information Flow: A Disabilities Information Management System

ERIC Educational Resources Information Center

Ling, Bin; Allison, Colin; Nicholl, J. Ross; Moodley, Luke; Roberts, Dave

2006-01-01

The Disabilities Information Flow (DIF) project at the University of St Andrews has sought to provide a means of efficiently managing all student disabilities information within the institution and provide appropriate role-based service interfaces for all staff who need to routinely interact with this information. This paper describes the software…

Compliance Issues in Higher Education

ERIC Educational Resources Information Center

Benedek, Petra

2016-01-01

Efficiency in the 1980's, quality in the 1990's, compliance in the 2010's - private sector management techniques and mechanisms find their way to public services. This paper facilitates the understanding of how compliance management controls can improve operations and prevent or detect failure or wrong doing. The last few years' empirical research…

Applying operations management in client-oriented and cost-efficient provision of care, welfare and housing services

PubMed Central

de Blok, Carolien; Meijboom, Bert; Luijkx, Katrien; Schols, Jos

2008-01-01

Purpose In all Western countries, ageing populations cause the demand for elderly care services to increase dramatically. In addition, elderly clients are getting more demanding about the services they require to fulfil their widely varying and multiple needs. Besides, cost reductions have been the focus of governmental policies and organisational practices for many years. Health care providers increasingly see operations management as a promising approach to align both client-orientation and cost-efficiency in their day-to-day practices. Theory The paper starts from operations management literature on front office—back office design and modular production. Organisations have several options for deciding which activities need to be performed by FO, BO, or the client himself, and in deciding which employees need to perform these activities. By applying modular production, organisations can differentiate care and related services to a high degree without major cost increases. Method A literature review will be presented leading to a theoretical framework. This formed the basis for explorative case studies in the elderly care sector. Results and conclusions It will be argued how insights provided with the framework may enhance a client-orientation in integrated care delivery without major cost increases. Although case studies need to be interpreted with caution, interesting implications for organisational structures and inter-organisational cooperation can be seen. We will discuss how combined supply of care services can be made transparent to enhance choice options in service products, and what is required at the level of professionals for providing care and service packages based on client demand.

77 FR 21161 - National Forest System Land Management Planning

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-09

... ecosystem services and multiple uses. The planning rule is designed to ensure that plans provide for the... adaptive and science-based, engages the public, and is designed to be efficient, effective, and within the..., the new rule is designed to make planning more efficient and effective. Purpose and Need for the New...

78 FR 68441 - Information Collection Being Submitted for Review and Approval to the Office of Management and...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-14

... disclosure requirement. Obligation to Respond: Required to obtain or retain benefits. Statutory authority for...-222 MHz and (220 MHz service). In establishing this licensing plan, FCC's goal is to establish a flexible regulatory framework that allows for efficient licensing of the 220 MHz service, eliminates...

Human Factors of Queuing: A Library Circulation Model.

ERIC Educational Resources Information Center

Mansfield, Jerry W.

1981-01-01

Classical queuing theories and their accompanying service facilities totally disregard the human factors in the name of efficiency. As library managers we need to be more responsive to human needs in the design of service points and make every effort to minimize queuing and queue frustration. Five references are listed. (Author/RAA)

Combining Economic and Conjoint Analysis to Determine Optimal Academic Services

ERIC Educational Resources Information Center

Howard, Mona Whitley; Sobol, Marion G.

2004-01-01

In today's era of global competition, organizations must manage their functions and activities in a manner such that they are responsive to customers' needs and can provide excellence in service to the customer while also being efficient and cost conscious. These issues are extremely common in corporate organizations, but such concerns are equally…

Health-care district management information system plan: Review of operations analysis activities during calendar year 1975 and plan for continued research and analysis activities

NASA Technical Reports Server (NTRS)

Nielson, G. J.; Stevenson, W. G.

1976-01-01

Operations research activities developed to identify the information required to manage both the efficiency and effectiveness of the Veterans Administration (VA) health services as these services relate to individual patient care are reported. The clinical concerns and management functions that determine this information requirement are discussed conceptually. Investigations of existing VA data for useful management information are recorded, and a diagnostic index is provided. The age-specific characteristics of diseases and lengths of stay are explored, and recommendations for future analysis activities are articulated. The effect of the introduction of new technology to health care is also discussed.

The effectiveness and efficiency of disease management programs for patients with chronic diseases.

PubMed

Hisashige, Akinori

2012-11-26

Disease management (DM) approach is increasingly advocated as a means of improving effectiveness and efficiency of healthcare for chronic diseases. To evaluate the evidence on effectiveness and efficiency of DM, evidence synthesis was carried out. To locate eligible meta-analyses and systematic reviews, we searched Medline, EMBASE, the Cochrane Library, SCI-EXPANDED, SSCI, A&HCI, DARE, HTA and NHS EED from 1995 to 2010. Two reviewers independently extracted data and assessed a study quality. Twenty-eight meta-analyses and systematic reviews were included for synthesizing evidence. The proportion of articles which observed improvement with a reasonable amount of evidence was the highest at process (69%), followed by health services (63%), QOL (57%), health outcomes (51%), satisfaction (50%), costs (38%) and so on. As to mortality, statistically significant results were observed only in coronary heart disease. Important components in DM, such as a multidisciplinary approach, were identified. The evidence synthesized shows considerable evidence in the effectiveness and efficiency of DM programs in process, health services, QOL and so on. The question is no longer whether DM programs work, but rather which type or component of DM programs works best and efficiently in the context of each healthcare system or country.

Occupational health management: an audit tool.

PubMed

Shelmerdine, L; Williams, N

2003-03-01

Organizations must manage occupational health risks in the workplace and the UK Health & Safety Executive (HSE) has published guidance on successful health and safety management. This paper describes a method of using the published guidance to audit the management of occupational health and safety, first at an organizational level and, secondly, to audit an occupational health service provider's role in the management of health risks. The paper outlines the legal framework in the UK for health risk management and describes the development and use of a tool for qualitative auditing of the efficiency, effectiveness and reliability of occupational health service provision within an organization. The audit tool is presented as a question set and the paper concludes with discussion of the strengths and weaknesses of using this tool, and recommendations on its use.

Contract Service for School Maintenance

ERIC Educational Resources Information Center

Modern Schools, 1976

1976-01-01

Preventive maintenance can extend useful equipment life in a school building and keep systems running more efficiently. Points to consider before selecting a comprehensive energy management package are listed. (Author/MLF)

Multilingual Services Accounting Act

THOMAS, 112th Congress

Rep. Foxx, Virginia [R-NC-5

2011-05-04

House - 05/13/2011 Referred to the Subcommittee on Government Organization, Efficiency, and Financial Management . (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Trust and Privacy Solutions Based on Holistic Service Requirements.

PubMed

Sánchez Alcón, José Antonio; López, Lourdes; Martínez, José-Fernán; Rubio Cifuentes, Gregorio

2015-12-24

The products and services designed for Smart Cities provide the necessary tools to improve the management of modern cities in a more efficient way. These tools need to gather citizens' information about their activity, preferences, habits, etc. opening up the possibility of tracking them. Thus, privacy and security policies must be developed in order to satisfy and manage the legislative heterogeneity surrounding the services provided and comply with the laws of the country where they are provided. This paper presents one of the possible solutions to manage this heterogeneity, bearing in mind these types of networks, such as Wireless Sensor Networks, have important resource limitations. A knowledge and ontology management system is proposed to facilitate the collaboration between the business, legal and technological areas. This will ease the implementation of adequate specific security and privacy policies for a given service. All these security and privacy policies are based on the information provided by the deployed platforms and by expert system processing.

Trust and Privacy Solutions Based on Holistic Service Requirements

PubMed Central

Sánchez Alcón, José Antonio; López, Lourdes; Martínez, José-Fernán; Rubio Cifuentes, Gregorio

2015-01-01

The products and services designed for Smart Cities provide the necessary tools to improve the management of modern cities in a more efficient way. These tools need to gather citizens’ information about their activity, preferences, habits, etc. opening up the possibility of tracking them. Thus, privacy and security policies must be developed in order to satisfy and manage the legislative heterogeneity surrounding the services provided and comply with the laws of the country where they are provided. This paper presents one of the possible solutions to manage this heterogeneity, bearing in mind these types of networks, such as Wireless Sensor Networks, have important resource limitations. A knowledge and ontology management system is proposed to facilitate the collaboration between the business, legal and technological areas. This will ease the implementation of adequate specific security and privacy policies for a given service. All these security and privacy policies are based on the information provided by the deployed platforms and by expert system processing. PMID:26712752

Space station as a vital focus for advancing the technologies of automation and robotics

NASA Technical Reports Server (NTRS)

Varsi, Giulio; Herman, Daniel H.

1988-01-01

A major guideline for the design of the U.S. Space Station is that the Space Station address a wide variety of functions. These functions include the servicing of unmanned assets in space, the support of commercial labs in space and the efficient management of the Space Station itself; the largest space asset. The technologies of Automation and Robotics have the promise to help in reducing Space Station operating costs and to achieve a highly efficient use of the human in space. The use of advanced automation and artificial intelligence techniques, such as expert systems, in Space Station subsystems for activity planning and failure mode management will enable us to reduce dependency on a mission control center and could ultimately result in breaking the umbilical link from Earth to the Space Station. The application of robotic technologies with advanced perception capability and hierarchical intelligent control to servicing system will enable the servicing of assets either in space or in situ with a high degree of human efficiency. The results of studies leading toward the formulation of an automation and robotics plan for Space Station development are presented.

Pharmaceutical care in community pharmacies: practice and research in the US.

PubMed

Christensen, Dale B; Farris, Karen B

2006-01-01

To describe the state of community pharmacy, including patient care services, in the US. Chain pharmacies, including traditional chains, mass merchandisers, and supermarkets, comprise more than 50% of community pharmacies in the US. Dispensing of drugs remains the primary focus, yet the incidence of patients being counseled on medications appears to be increasing. More than 25% of independent community pharmacy owners report providing some patient clinical care services, such as medication counseling and chronic disease management. Most insurance programs pay pharmacists only for dispensing services, yet there are a growing number of public and private initiatives that reimburse pharmacists for cognitive services. Clinical care opportunities exist in the new Medicare prescription drug benefit plan, as it requires medication therapy management services for specific enrollees. The private market approach to healthcare delivery in the US, including pharmacy services, precludes national and statewide strategies to change the basic business model. To date, most pharmacies remain focused on dispensing prescriptions. With lower dispensing fees and higher operating costs, community pharmacies are focused on increasing productivity and efficiency through technology and technicians. Pharmacists remain challenged to establish the value of their nondispensing-related pharmaceutical care services in the private sector. As the cost of suboptimal drug therapy becomes more evident, medication therapy management may become a required pharmacy benefit in private drug insurance plans. Pharmacy school curricula, as well as national and state pharmacy associations, continually work to train and promote community pharmacists for these roles. Practice research is driven primarily by interested academics and, to a lesser degree, by pharmacy associations. Efficient dispensing of prescriptions is the primary focus of community pharmacies in the US. Some well designed practice-based research has been conducted, but there is no national research agenda or infrastructure. Reimbursement for cognitive services remains an infrequent, but growing, activity.

Intelligent community management system based on the devicenet fieldbus

NASA Astrophysics Data System (ADS)

Wang, Yulan; Wang, Jianxiong; Liu, Jiwen

2013-03-01

With the rapid development of the national economy and the improvement of people's living standards, people are making higher demands on the living environment. And the estate management content, management efficiency and service quality have been higher required. This paper in-depth analyzes about the intelligent community of the structure and composition. According to the users' requirements and related specifications, it achieves the district management systems, which includes Basic Information Management: the management level of housing, household information management, administrator-level management, password management, etc. Service Management: standard property costs, property charges collecting, the history of arrears and other property expenses. Security Management: household gas, water, electricity and security and other security management, security management district and other public places. Systems Management: backup database, restore database, log management. This article also carries out on the Intelligent Community System analysis, proposes an architecture which is based on B / S technology system. And it has achieved a global network device management with friendly, easy to use, unified human - machine interface.

Strengthening pharmaceutical systems for palliative care services in resource limited settings: piloting a mHealth application across a rural and urban setting in Uganda.

PubMed

Namisango, Eve; Ntege, Chris; Luyirika, Emmanuel B K; Kiyange, Fatia; Allsop, Matthew J

2016-02-19

Medicine availability is improving in sub-Saharan Africa for palliative care services. There is a need to develop strong and sustainable pharmaceutical systems to enhance the proper management of palliative care medicines, some of which are controlled. One approach to addressing these needs is the use of mobile technology to support data capture, storage and retrieval. Utilizing mobile technology in healthcare (mHealth) has recently been highlighted as an approach to enhancing palliative care services but development is at an early stage. An electronic application was implemented as part of palliative care services at two settings in Uganda; a rural hospital and an urban hospice. Measures of the completeness of data capture, time efficiency of activities and medicines stock and waste management were taken pre- and post-implementation to identify changes to practice arising from the introduction of the application. Improvements in all measures were identified at both sites. The application supported the registration and management of 455 patients and a total of 565 consultations. Improvements in both time efficiency and medicines management were noted. Time taken to collect and report pharmaceuticals data was reduced from 7 days to 30 min and 10 days to 1 h at the urban hospice and rural hospital respectively. Stock expiration reduced from 3 to 0.5% at the urban hospice and from 58 to 0% at the rural hospital. Additional observations relating to the use of the application across the two sites are reported. A mHealth approach adopted in this study was shown to improve existing processes for patient record management, pharmacy forecasting and supply planning, procurement, and distribution of essential health commodities for palliative care services. An important next step will be to identify where and how such mHealth approaches can be implemented more widely to improve pharmaceutical systems for palliative care services in resource limited settings.

Kitchen Appliance Upgrades Improve Water Efficiency at DOD Exchange Facilities: Best Management Practice Case Study #11: Commercial Kitchen Equipment (Brochure)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

2011-09-01

The Exchange, formerly the Army and Air Force Exchange Service (AAFES), is a joint military activity and the U.S. Department of Defense?s (DOD) oldest and largest retailer. The Exchange is taking a leadership role in water efficiency improvements in their commercial kitchens by integrating water efficiency concepts into the organization?s overall sustainability plan and objectives.

[Influence of contractual medical association on inpatient service performance].

PubMed

Wu, Zhi-jun; Jian, Wei-yan

2015-06-18

To study the influence of contractual medical association on inpatient service performance. The data came from "Database of Inpatient Record" administered by Department of Medical Insurance. Using diagnosis related groups (DRG) as the tool of risk-adjustment, the third-tier general hospitals and second-tier general hospitals in medical alliance as the intervention group, and the average level of the same grade local hospitals as the control group, the influence of medical alliance on inpatient service performance was evaluated. The difference in difference (DID) method was used for the data analysis. The assessing indicators included the number of DRG group, case mix index (CMI), the total weight, cost efficiency index and time efficiency index. After the establishment of medical association, compared with the average level of the same grade local hospitals, in the third-tier general hospitals of medical alliance, the growth rate of the total weight had declined, and cost efficiency index had increased, while in the second-tier general hospitals of medical alliance, the CMI value had declined, and the cost efficiency index had increased. Contractual medical association played a role of triage patients, and improved the service levels and management efficiency of the second-tier general hospitals.

PaaS for web applications with OpenShift Origin

NASA Astrophysics Data System (ADS)

Lossent, A.; Rodriguez Peon, A.; Wagner, A.

2017-10-01

The CERN Web Frameworks team has deployed OpenShift Origin to facilitate deployment of web applications and to improving efficiency in terms of computing resource usage. OpenShift leverages Docker containers and Kubernetes orchestration to provide a Platform-as-a-service solution oriented for web applications. We will review use cases and how OpenShift was integrated with other services such as source control, web site management and authentication services.

Making decisions in complex landscapes: Headwater stream management across multiple federal agencies

USGS Publications Warehouse

Katz, Rachel; Grant, Evan H. Campbell; Runge, Michael C.; Connery, Bruce; Crockett, Marquette; Herland, Libby; Johnson, Sheela; Kirk, Dawn; Wofford, Jeb; Bennett, Rick; Nislow, Keith; Norris, Marian; Hocking, Daniel; Letcher, Benjamin; Roy, Allison

2014-01-01

Headwater stream ecosystems are vulnerable to numerous threats associated with climate and land use change. In the northeastern US, many headwater stream species (e.g., brook trout and stream salamanders) are of special conservation concern and may be vulnerable to climate change influences, such as changes in stream temperature and streamflow. Federal land management agencies (e.g., US Fish and Wildlife Service, National Park Service, USDA Forest Service, Bureau of Land Management and Department of Defense) are required to adopt policies that respond to climate change and may have longer-term institutional support to enforce such policies compared to state, local, non-governmental, or private land managers. However, federal agencies largely make management decisions in regards to headwater stream ecosystems independently. This fragmentation of management resources and responsibilities across the landscape may significantly impede the efficiency and effectiveness of conservation actions, and higher degrees of collaboration may be required to achieve conservation goals. This project seeks to provide an example of cooperative landscape decision-making to address the conservation of headwater stream ecosystems. We identified shared and contrasting objectives of each federal agency and potential collaboration opportunities that may increase efficient and effective management of headwater stream ecosystems in two northeastern US watersheds. These workshops provided useful insights into the adaptive capacity of federal institutions to address threats to headwater stream ecosystems. Our ultimate goal is to provide a decision-making framework and analysis that addresses large-scale conservation threats across multiple stakeholders, as a demonstration of cooperative landscape conservation for aquatic ecosystems. Additionally, we aim to provide new scientific knowledge and a regional perspective to resource managers to help inform local management decisions.

Frail elderly patients. New model for integrated service delivery.

PubMed Central

Hébert, Rejean; Durand, Pierre J.; Dubuc, Nicole; Tourigny, André

2003-01-01

PROBLEM BEING ADDRESSED: Given the complex needs of frail older people and the multiplicity of care providers and services, care for this clientele lacks continuity. OBJECTIVE OF PROGRAM: Integrated service delivery (ISD) systems have been developed to improve continuity and increase the efficacy and efficiency of services. PROGRAM DESCRIPTION: The Program of Research to Integrate Services for the Maintenance of Autonomy (PRISMA) is an innovative ISD model based on coordination. It includes coordination between decision makers and managers of different organizations and services; a single entry point; a case-management process; individualized service plans; a single assessment instrument based on clients' functional autonomy, coupled with a case-mix classification system; and a computerized clinical chart for communicating between institutions and professionals for client monitoring. CONCLUSION: Preliminary results on the efficacy of this model showed a decreased incidence of functional decline, a decreased burden for caregivers, and a smaller proportion of older people wishing to enter institutions. PMID:12943358

Critical Zone services as environmental assessment criteria in intensively managed landscapes

NASA Astrophysics Data System (ADS)

Richardson, Meredith; Kumar, Praveen

2017-06-01

The Critical Zone (CZ) includes the biophysical processes occurring from the top of the vegetation canopy to the weathering zone below the groundwater table. CZ services provide a measure for the goods and benefits derived from CZ processes. In intensively managed landscapes, cropland is altered through anthropogenic energy inputs to derive more productivity, as agricultural products, than would be possible under natural conditions. However, the actual costs of alterations to CZ functions within landscape profiles are unknown. Through comparisons of corn feed and corn-based ethanol, we show that valuation of these CZ services in monetary terms provides a more concrete tool for characterizing seemingly abstract environmental damages from agricultural production systems. Multiple models are combined to simulate the movement of nutrients throughout the soil system, enabling the measurement of agricultural anthropogenic impacts to the CZ's regulating services. Results indicate water quality and atmospheric stabilizing services, measured by soil carbon storage, carbon respiration, and nitrate leaching, among others, can cost more than double that of emissions estimated in previous studies. Energy efficiency in addition to environmental impact is assessed to demonstrate how the inclusion of CZ services is necessary in accounting for the entire life cycle of agricultural production systems. These results conclude that feed production systems are more energy efficient and less environmentally costly than corn-based ethanol.

A management-control system to assist with the development, contracting, and monitoring of new services for older people: you can always get what you want (with apologies to the Rolling Stones).

PubMed

Jacobs, Stephen

2007-10-01

Implementing community services can be a very complex process where people end up "not seeing the wood for the trees" and then accepting a compromise nobody wants. Neither agency theory nor stewardship theory is particularly robust when explaining the reality that funders and managers of community health service for older people face in managing contracts. There are particular difficulties with goal divergence between policy directives and implementation practices, which result from goals not being well understood and performance requirements being ambiguously defined and infrequently monitored. This leads to accountability issues for public managers, and raises efficiency and effectiveness issues. This paper provides an interim report on a project developing a management-control system to provide a process for health planners and funders to use when developing and contracting services. A major focus is inviting stakeholders into a process of communication that ensures that they have shared understandings of where they want to get to, and what has to be done to get there.

Hybrid scheduling mechanisms for Next-generation Passive Optical Networks based on network coding

NASA Astrophysics Data System (ADS)

Zhao, Jijun; Bai, Wei; Liu, Xin; Feng, Nan; Maier, Martin

2014-10-01

Network coding (NC) integrated into Passive Optical Networks (PONs) is regarded as a promising solution to achieve higher throughput and energy efficiency. To efficiently support multimedia traffic under this new transmission mode, novel NC-based hybrid scheduling mechanisms for Next-generation PONs (NG-PONs) including energy management, time slot management, resource allocation, and Quality-of-Service (QoS) scheduling are proposed in this paper. First, we design an energy-saving scheme that is based on Bidirectional Centric Scheduling (BCS) to reduce the energy consumption of both the Optical Line Terminal (OLT) and Optical Network Units (ONUs). Next, we propose an intra-ONU scheduling and an inter-ONU scheduling scheme, which takes NC into account to support service differentiation and QoS assurance. The presented simulation results show that BCS achieves higher energy efficiency under low traffic loads, clearly outperforming the alternative NC-based Upstream Centric Scheduling (UCS) scheme. Furthermore, BCS is shown to provide better QoS assurance.

Europe sees mixed results from public-private partnerships for building and managing health care facilities and services.

PubMed

Barlow, James; Roehrich, Jens; Wright, Steve

2013-01-01

Prompted in part by constrained national budgets, European governments are increasingly partnering with the private sector to underwrite the costs of constructing and operating public hospitals and other health care facilities and delivering services. Through such public-private partnerships, governments hope to avoid up-front capital expenditure and to harness private-sector efficiencies, while private-sector partners aim for a return on investment. Our research indicates that to date, experience with these partnerships has been mixed. Early models of these partnerships-for example, in which a private firm builds a hospital and carries out building maintenance, which we term an "accommodation-only" model-arguably have not met expectations for achieving greater efficiencies at lower costs. Newer models described in this article offer greater opportunities for efficiency gains but are administratively harder to set up and manage. Given the shortages in public capital for new infrastructure, it seems likely that the attractiveness of these partnerships to European governments will grow.

End-to-end QoS bounds for RTP-based service subnetworks

NASA Astrophysics Data System (ADS)

Pitts, Jonathan M.; Schormans, John A.

1999-11-01

With the increasing focus on traffic prioritization to support voice-data integration in corporate intranets, practical methods are needed to dimension and manage cost efficient service partitions. This is particularly important for the provisioning of real time, delay sensitive services such as telephony and voice/video conferencing applications. Typically these can be provided over RTP/UDP/IP or ATM DBR/SBR bearers but, irrespective of the specific networking technology, the switches or routers need to implement some form of virtual buffer management with queue scheduling mechanisms to provide partitioning. The key requirement is for operators of such networks to be able to dimension the partitions and virtual buffer sizes for efficient resource utilization, instead of simply over-dimensioning. This paper draws on recent work at Queen Mary, University of London, supported by the UK Engineering and Physical Sciences Research Council, to investigate approximate analytical methods for assessing end to end delay variation bounds in cell based and packet based networks.

Design of System Scheme and Operationmechanism on Agricultural Science &Technology Information Service System `110'

NASA Astrophysics Data System (ADS)

Wu, Yongchang; Hu, Zhiquan; Xiao, Bilin; Li, Quanxin

Agricultural science & technology information service system ‘110’ (ASTISS-110), connected through unitary telephone hotline as well as multipurpose service of the network, television and video etc, is one of the most characteristic content of the Chinese rural informatization. ASTISS-110 is a low cost and high efficiency way to make the agricultural science & technology achievements extension and achieve the combination of science & technology with farmers in the rural area. This paper would primary focus on the ASTISS-110 foundation and system principle. On basis of its main functions and system objectives, we put forward the combination of the ‘Sky- Land-People’ technical solution, and analyze the management operation mechanism from commonweal service, enterprise management and commercialization operation.

Dynamic Online Bandwidth Adjustment Scheme Based on Kalai-Smorodinsky Bargaining Solution

NASA Astrophysics Data System (ADS)

Kim, Sungwook

Virtual Private Network (VPN) is a cost effective method to provide integrated multimedia services. Usually heterogeneous multimedia data can be categorized into different types according to the required Quality of Service (QoS). Therefore, VPN should support the prioritization among different services. In order to support multiple types of services with different QoS requirements, efficient bandwidth management algorithms are important issues. In this paper, I employ the Kalai-Smorodinsky Bargaining Solution (KSBS) for the development of an adaptive bandwidth adjustment algorithm. In addition, to effectively manage the bandwidth in VPNs, the proposed control paradigm is realized in a dynamic online approach, which is practical for real network operations. The simulations show that the proposed scheme can significantly improve the system performances.

Managing and Collecting Student Accounts and Loans: A Desk Reference for Educational Receivables Stewardship

ERIC Educational Resources Information Center

Glezerman, David R.; DeSantis, Dennis

2008-01-01

This handy desk reference will help readers and their institutions develop and maintain a professional environment that will maximize efficiencies and provide the necessary skills to properly manage operations and portfolios while ensuring that students receive fair and equitable service and opportunities. Written for business officers, financial…

Application of Computer Assisted Energy Analysis Seminar (Pittsburgh, Pennsylvania, April 12-14, 1977).

ERIC Educational Resources Information Center

Association of Physical Plant Administrators of Universities and Colleges, Washington, DC.

The intent of this seminar presentation was to demonstrate that with proper care in selecting and managing energy analysis programs, or in choosing commercial services to accomplish the same purposes, universities and colleges may derive significant benefits from efficient and economical use and management of their facilities. The workbook begins…

Cloud GIS Based Watershed Management

NASA Astrophysics Data System (ADS)

Bediroğlu, G.; Colak, H. E.

2017-11-01

In this study, we generated a Cloud GIS based watershed management system with using Cloud Computing architecture. Cloud GIS is used as SAAS (Software as a Service) and DAAS (Data as a Service). We applied GIS analysis on cloud in terms of testing SAAS and deployed GIS datasets on cloud in terms of DAAS. We used Hybrid cloud computing model in manner of using ready web based mapping services hosted on cloud (World Topology, Satellite Imageries). We uploaded to system after creating geodatabases including Hydrology (Rivers, Lakes), Soil Maps, Climate Maps, Rain Maps, Geology and Land Use. Watershed of study area has been determined on cloud using ready-hosted topology maps. After uploading all the datasets to systems, we have applied various GIS analysis and queries. Results shown that Cloud GIS technology brings velocity and efficiency for watershed management studies. Besides this, system can be easily implemented for similar land analysis and management studies.

Towards Dynamic Service Level Agreement Negotiation:An Approach Based on WS-Agreement

NASA Astrophysics Data System (ADS)

Pichot, Antoine; Wäldrich, Oliver; Ziegler, Wolfgang; Wieder, Philipp

In Grid, e-Science and e-Business environments, Service Level Agreements are often used to establish frameworks for the delivery of services between service providers and the organisations hosting the researchers. While this high level SLAs define the overall quality of the services, it is desirable for the end-user to have dedicated service quality also for individual services like the orchestration of resources necessary for composed services. Grid level scheduling services typically are responsible for the orchestration and co-ordination of resources in the Grid. Co-allocation e.g. requires the Grid level scheduler to co-ordinate resource management systems located in different domains. As the site autonomy has to be respected negotiation is the only way to achieve the intended co-ordination. SLAs emerged as a new way to negotiate and manage usage of resources in the Grid and are already adopted by a number of management systems. Therefore, it is natural to look for ways to adopt SLAs for Grid level scheduling. In order to do this, efficient and flexible protocols are needed, which support dynamic negotiation and creation of SLAs. In this paper we propose and discuss extensions to the WS-Agreement protocol addressing these issues.

The challenge of corporatisation: the experience of Portuguese public hospitals.

PubMed

Rego, Guilhermina; Nunes, Rui; Costa, José

2010-08-01

The inability of traditional state organisations to respond to new economic, technological and social challenges and the associated emerging problems has made it necessary to adopt new methods of health management. As a result, new directions have emerged in the reform of Public Administration together with the introduction of innovative models. The aim is to achieve a type of management that focuses on results as well as on effort and efficiency. We intend to analyse to what extent the adoption of business management models by hospital healthcare units can improve their performance, mainly in terms of standards of efficiency. Data envelopment analysis (DEA) was used to investigate the efficiency of a set of public Portuguese hospitals. The aim was to evaluate the impact of business management in Portuguese public hospitals with regards to efficiency, specifically taking into account the fact that lack of resources and increased health care needs are a present and future reality. From a total of 83 public hospitals, a sample of 59 hospitals was chosen, of which 21 are state-owned hospital enterprises (SA) and 38 are traditional public administration sector hospitals (SPA). This study evaluates hospital performance by calculating two efficiency measures associated with two categories of inputs. The first efficiency measures the costs associated with hospital production lines and the number of beds (representing fixed capacity) as inputs. The annual costs generated by the hospitals in the consumption of capital and work (direct and indirect costs) are used. A second measure of efficiency is calculated separately. This measure includes in the inputs the number of beds as well as the human resources available (number of doctors, number of nurses and other personnel) in each hospital. With regard to output, the variables that best reflect the hospital services rendered were considered: number of inpatient days, patients discharged, outpatient visits, emergencies services, sessions in hospital day care services and the number of surgeries. The results seem to suggest that the introduction of market processes and changes in organisational structure--such as managerial autonomy and corporatisation of public hospitals--have had a positive impact on Portuguese public hospitals. This positive evolution was particularly evident in SA hospitals, but further studies are needed to confirm these preliminary results.

Prioritising Mangrove Ecosystem Services Results in Spatially Variable Management Priorities.

PubMed

Atkinson, Scott C; Jupiter, Stacy D; Adams, Vanessa M; Ingram, J Carter; Narayan, Siddharth; Klein, Carissa J; Possingham, Hugh P

2016-01-01

Incorporating the values of the services that ecosystems provide into decision making is becoming increasingly common in nature conservation and resource management policies, both locally and globally. Yet with limited funds for conservation of threatened species and ecosystems there is a desire to identify priority areas where investment efficiently conserves multiple ecosystem services. We mapped four mangrove ecosystems services (coastal protection, fisheries, biodiversity, and carbon storage) across Fiji. Using a cost-effectiveness analysis, we prioritised mangrove areas for each service, where the effectiveness was a function of the benefits provided to the local communities, and the costs were associated with restricting specific uses of mangroves. We demonstrate that, although priority mangrove areas (top 20%) for each service can be managed at relatively low opportunity costs (ranging from 4.5 to 11.3% of overall opportunity costs), prioritising for a single service yields relatively low co-benefits due to limited geographical overlap with priority areas for other services. None-the-less, prioritisation of mangrove areas provides greater overlap of benefits than if sites were selected randomly for most ecosystem services. We discuss deficiencies in the mapping of ecosystems services in data poor regions and how this may impact upon the equity of managing mangroves for particular services across the urban-rural divide in developing countries. Finally we discuss how our maps may aid decision-makers to direct funding for mangrove management from various sources to localities that best meet funding objectives, as well as how this knowledge can aid in creating a national mangrove zoning scheme.

Prioritising Mangrove Ecosystem Services Results in Spatially Variable Management Priorities

PubMed Central

Atkinson, Scott C.; Jupiter, Stacy D.; Adams, Vanessa M.; Ingram, J. Carter; Narayan, Siddharth; Klein, Carissa J.; Possingham, Hugh P.

2016-01-01

Incorporating the values of the services that ecosystems provide into decision making is becoming increasingly common in nature conservation and resource management policies, both locally and globally. Yet with limited funds for conservation of threatened species and ecosystems there is a desire to identify priority areas where investment efficiently conserves multiple ecosystem services. We mapped four mangrove ecosystems services (coastal protection, fisheries, biodiversity, and carbon storage) across Fiji. Using a cost-effectiveness analysis, we prioritised mangrove areas for each service, where the effectiveness was a function of the benefits provided to the local communities, and the costs were associated with restricting specific uses of mangroves. We demonstrate that, although priority mangrove areas (top 20%) for each service can be managed at relatively low opportunity costs (ranging from 4.5 to 11.3% of overall opportunity costs), prioritising for a single service yields relatively low co-benefits due to limited geographical overlap with priority areas for other services. None-the-less, prioritisation of mangrove areas provides greater overlap of benefits than if sites were selected randomly for most ecosystem services. We discuss deficiencies in the mapping of ecosystems services in data poor regions and how this may impact upon the equity of managing mangroves for particular services across the urban-rural divide in developing countries. Finally we discuss how our maps may aid decision-makers to direct funding for mangrove management from various sources to localities that best meet funding objectives, as well as how this knowledge can aid in creating a national mangrove zoning scheme. PMID:27008421

Moving towards Universal Health Coverage through the Development of Integrated Service Delivery Packages for Primary Health Care in the Solomon Islands

PubMed Central

Whiting, Stephen; Postma, Sjoerd; Jamshaid de Lorenzo, Ayesha; Aumua, Audrey

2016-01-01

The Solomon Islands Government is pursuing integrated care with the goal of improving the quality of health service delivery to rural populations. Under the auspices of Universal Health Coverage, integrated service delivery packages were developed which defined the clinical and public health services that should be provided at different levels of the health system. The process of developing integrated service delivery packages helped to identify key policy decisions the government needed to make in order to improve service quality and efficiency. The integrated service delivery packages have instigated the revision of job descriptions and are feeding into the development of a human resource plan for health. They are also being used to guide infrastructure development and health system planning and should lead to better management of resources. The integrated service delivery packages have become a key tool to operationalise the government’s policy to move towards a more efficient, equitable, quality and sustainable health system. PMID:28321177

Workflow as a Service in the Cloud: Architecture and Scheduling Algorithms.

PubMed

Wang, Jianwu; Korambath, Prakashan; Altintas, Ilkay; Davis, Jim; Crawl, Daniel

2014-01-01

With more and more workflow systems adopting cloud as their execution environment, it becomes increasingly challenging on how to efficiently manage various workflows, virtual machines (VMs) and workflow execution on VM instances. To make the system scalable and easy-to-extend, we design a Workflow as a Service (WFaaS) architecture with independent services. A core part of the architecture is how to efficiently respond continuous workflow requests from users and schedule their executions in the cloud. Based on different targets, we propose four heuristic workflow scheduling algorithms for the WFaaS architecture, and analyze the differences and best usages of the algorithms in terms of performance, cost and the price/performance ratio via experimental studies.

Aviation weather services

NASA Technical Reports Server (NTRS)

Sprinkle, C. H.

1983-01-01

The primary responsibilities of the National Weather Service (NWS) are to: provide warnings of severe weather and flooding for the protection of life and property; provide public forecasts for land and adjacent ocean areas for planning and operation; and provide weather support for: production of food and fiber; management of water resources; production, distribution and use of energy; and efficient and safe air operations.

Building the Community Nexus: A Community Centered Approach to Planning and Design

ERIC Educational Resources Information Center

Bingler, Steven

2011-01-01

Recent research indicates that the goals (of producing management efficiencies to deliver community programs and infrastructure and more graduates) can be better achieved through a holistic model that supports the whole family and child by providing better access to wrap around services. Nexus planning is a process through which these services can…

Soil Disturbance Monitoring in the USDA Forest Service, Pacific Northwest Region

Treesearch

Steven W. Howes

2006-01-01

In order to make reasoned decisions, USDA Forest Service managers must understand how changes in specific indicators of soil quality resulting from project implementation affect long-term forest productivity and watershed health. They must also be able to efficiently and economically assess the degree and extent of such changes across specified areas and adjust...

Partnership between CTSI and business schools can promote best practices for core facilities and resources.

PubMed

Reeves, Lilith; Dunn-Jensen, Linda M; Baldwin, Timothy T; Tatikonda, Mohan V; Cornetta, Kenneth

2013-08-01

Biomedical research enterprises require a large number of core facilities and resources to supply the infrastructure necessary for translational research. Maintaining the financial viability and promoting efficiency in an academic environment can be particularly challenging for medical schools and universities. The Indiana Clinical and Translational Sciences Institute sought to improve core and service programs through a partnership with the Indiana University Kelley School of Business. The program paired teams of Masters of Business Administration students with cores and programs that self-identified the need for assistance in project management, financial management, marketing, or resource efficiency. The projects were developed by CTSI project managers and business school faculty using service-learning principles to ensure learning for students who also received course credit for their participation. With three years of experience, the program demonstrates a successful partnership that improves clinical research infrastructure by promoting business best practices and providing a valued learning experience for business students. © 2013 Wiley Periodicals, Inc.

Outsourcing in the Italian National Health Service: findings from a national survey.

PubMed

Macinati, Manuela S

2008-01-01

Over the last decade, outsourcing has become one of the major issues in health care. Two major concerns are related to public health care outsourcing practice. The first one involves the suitability of the outsourcing strategy in the public sector, principally with reference to the outsourcing of essential clinical services. The second one relates to the actual benefits of the outsourcing practice in health care, in terms of cost reduction and increasing efficiency. This paper aims to contribute to the debate and literature on outsourcing through a national survey carried out in the Italian National Health Service. In order to achieve the research objective, a questionnaire was developed and, after a pilot test, it was mailed to all Italian public providers. The total response rate was around 42%. Results showed that outsourcing is a widespread phenomenon within health care, especially in the ancillary services area. Moreover, results showed many criticalities of the outsourcing practice in the Italian health-care sector. On the one hand, criticalities concerned the reasons for outsourcing, the characteristics of the outsourced services and the management of the relationship with the vendor. With reference to essential clinical service, outsourcing, as currently managed by health-care providers, may potentially weaken their ability to reach its own objectives. On the other hand, criticalities related to respondent-perceived benefits. Despite the overall positive outsourcing experience expressed in the survey, the results on perceived benefits showed that the effects of outsourcing did not always align to managers' expectations, especially in the cost containment and efficiency area.

Memory Management of Multimedia Services in Smart Homes

NASA Astrophysics Data System (ADS)

Kamel, Ibrahim; Muhaureq, Sanaa A.

Nowadays there is a wide spectrum of applications that run in smart home environments. Consequently, home gateway, which is a central component in the smart home, must manage many applications despite limited memory resources. OSGi is a middleware standard for home gateways. OSGi models services as dependent components. Moreover, these applications might differ in their importance. Services collaborate and complement each other to achieve the required results. This paper addresses the following problem: given a home gateway that hosts several applications with different priorities and arbitrary dependencies among them. When the gateway runs out of memory, which application or service will be stopped or kicked out of memory to start a new service. Note that stopping a given service means that all the services that depend on it will be stopped too. Because of the service dependencies, traditional memory management techniques, in the operating system literatures might not be efficient. Our goal is to stop the least important and the least number of services. The paper presents a novel algorithm for home gateway memory management. The proposed algorithm takes into consideration the priority of the application and dependencies between different services, in addition to the amount of memory occupied by each service. We implement the proposed algorithm and performed many experiments to evaluate its performance and execution time. The proposed algorithm is implemented as a part of the OSGi framework (Open Service Gateway initiative). We used best fit and worst fit as yardstick to show the effectiveness of the proposed algorithm.

Cardiac catheterization laboratory management: the fundamentals.

PubMed

Newell, Amy

2012-01-01

Increasingly, imaging administrators are gaining oversight for the cardiac cath lab as part of imaging services. Significant daily challenges include physician and staff demands, as well as patients who in many cases require higher acuity care. Along with strategic program driven responsibilities, the management role is complex. Critical elements that are the major impacts on cath lab management, as well as the overall success of a cardiac and vascular program, include program quality, patient safety, operational efficiency including inventory management, and customer service. It is critically important to have a well-qualified cath lab manager who acts as a leader by example, a mentor and motivator of the team, and an expert in the organization's processes and procedures. Such qualities will result in a streamlined cath lab with outstanding results.

Research on the application of wisdom technology in smart city

NASA Astrophysics Data System (ADS)

Li, Juntao; Ma, Shuai; Gu, Weihua; Chen, Weiyi

2015-12-01

This paper first analyzes the concept of smart technology, the relationship between wisdom technology and smart city, and discusses the practical application of IOT(Internet of things) in smart city to explore a better way to realize smart city; then Introduces the basic concepts of cloud computing and smart city, and explains the relationship between the two; Discusses five advantages of cloud computing that applies to smart city construction: a unified and highly efficient, large-scale infrastructure software and hardware management, service scheduling and resource management, security control and management, energy conservation and management platform layer, and to promote modern practical significance of the development of services, promoting regional social and economic development faster. Finally, a brief description of the wisdom technology and smart city management is presented.

Strategic management of Public Hospitals' medical services.

PubMed

Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua

2016-01-01

Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.

High-Efficiency Food Production in a Renewable Energy Based Micro-Grid Power System

NASA Technical Reports Server (NTRS)

Bubenheim, David; Meiners, Dennis

2016-01-01

Controlled Environment Agriculture (CEA) systems can be used to produce high-quality, desirable food year round, and the fresh produce can positively contribute to the health and well being of residents in communities with difficult supply logistics. While CEA has many positive outcomes for a remote community, the associated high electric demands have prohibited widespread implementation in what is typically already a fully subscribed power generation and distribution system. Recent advances in CEA technologies as well as renewable power generation, storage, and micro-grid management are increasing system efficiency and expanding the possibilities for enhancing community supporting infrastructure without increasing demands for outside supplied fuels. We will present examples of how new lighting, nutrient delivery, and energy management and control systems can enable significant increases in food production efficiency while maintaining high yields in CEA. Examples from Alaskan communities where initial incorporation of renewable power generation, energy storage and grid management techniques have already reduced diesel fuel consumption for electric generation by more than 40% and expanded grid capacity will be presented. We will discuss how renewable power generation, efficient grid management to extract maximum community service per kW, and novel energy storage approaches can expand the food production, water supply, waste treatment, sanitation and other community support services without traditional increases of consumable fuels supplied from outside the community. These capabilities offer communities with a range of choices to enhance their communities. The examples represent a synergy of technology advancement efforts to develop sustainable community support systems for future space-based human habitats and practical implementation of infrastructure components to increase efficiency and enhance health and well being in remote communities today and tomorrow.

High-Efficiency Food Production in a Renewable Energy Based Micro-Grid

NASA Technical Reports Server (NTRS)

Bubenheim, David L.

2017-01-01

Controlled Environment Agriculture (CEA) systems can be used to produce high-quality, desirable food year round, and the fresh produce can positively contribute to the health and well being of residents in communities with difficult supply logistics. While CEA has many positive outcomes for a remote community, the associated high electric demands have prohibited widespread implementation in what is typically already a fully subscribed power generation and distribution system. Recent advances in CEA technologies as well as renewable power generation, storage, and micro-grid management are increasing system efficiency and expanding the possibilities for enhancing community supporting infrastructure without increasing demands for outside supplied fuels. We will present examples of how new lighting, nutrient delivery, and energy management and control systems can enable significant increases in food production efficiency while maintaining high yields in CEA.Examples from Alaskan communities where initial incorporation of renewable power generation, energy storage and grid management techniques have already reduced diesel fuel consumption for electric generation by more than 40 and expanded grid capacity will be presented. We will discuss how renewable power generation, efficient grid management to extract maximum community service per kW, and novel energy storage approaches can expand the food production, water supply, waste treatment, sanitation and other community support services without traditional increases of consumable fuels supplied from outside the community. These capabilities offer communities with a range of choices to enhance their communities. The examples represent a synergy of technology advancement efforts to develop sustainable community support systems for future space-based human habitats and practical implementation of infrastructure components to increase efficiency and enhance health and well-being in remote communities today and tomorrow.

A secure data outsourcing scheme based on Asmuth-Bloom secret sharing

NASA Astrophysics Data System (ADS)

Idris Muhammad, Yusuf; Kaiiali, Mustafa; Habbal, Adib; Wazan, A. S.; Sani Ilyasu, Auwal

2016-11-01

Data outsourcing is an emerging paradigm for data management in which a database is provided as a service by third-party service providers. One of the major benefits of offering database as a service is to provide organisations, which are unable to purchase expensive hardware and software to host their databases, with efficient data storage accessible online at a cheap rate. Despite that, several issues of data confidentiality, integrity, availability and efficient indexing of users' queries at the server side have to be addressed in the data outsourcing paradigm. Service providers have to guarantee that their clients' data are secured against internal (insider) and external attacks. This paper briefly analyses the existing indexing schemes in data outsourcing and highlights their advantages and disadvantages. Then, this paper proposes a secure data outsourcing scheme based on Asmuth-Bloom secret sharing which tries to address the issues in data outsourcing such as data confidentiality, availability and order preservation for efficient indexing.

Intelligent Transportation System Strategic Plan For Las Vegas Valley

DOT National Transportation Integrated Search

1996-11-01

"INTELLIGENT TRANSPORTATION SYSTEMS" (ITS) IS A COLLECTIVE TERM FOR MEASURES TARGETING THE EFFICIENT OPERATIONS AND MANAGEMENT OF TRANSPORTATION FACILITIES AND SERVICES, USUALLY INVOLVING THE USE OF ELECTRONIC EQUIPMENT FOR COLLECTING,. PROCESSING, R...

Better service, greater efficiency : transit management for demand response systems

DOT National Transportation Integrated Search

1999-01-01

This brochure briefly describes different technologies which can enhance demand response transit systems. It covers automated scheduling and dispatching, mobile data terminals, electronic identification cards, automatic vehicle location, and geograph...

Space-assisted irrigation management: an operational perspective

NASA Astrophysics Data System (ADS)

Calera Belmonte, Alfonso; Jochum, Anne M.; Cuesta Garcia, Andres

2004-10-01

Irrigation Advisory Services (IAS) are the natural management instruments to achieve a better efficiency in the use of water for irrigation. IAS help farmers to apply water according to the actual crop water requirements and thus, to optimize production and cost-effectiveness. The project DEMETER (DEMonstration of Earth observation TEchnologies in Routine irrigation advisory services) aims at assessing and demonstrating how the performance and cost-effectiveness of IAS is substantially improved by the incorporation of Earth observation (EO) techniques and Information Society Technology (IT) into their day-to-day operations. EO allows for efficiently monitoring crop water requirements of each field in extended areas. The incorporation of IT in the generation and distribution of information makes that information easily available to IAS and to its associated farmers (the end-users) in a personalized way. This paper describes the methodology and selected results.

Measuring efficiency among US federal hospitals.

PubMed

Harrison, Jeffrey P; Meyer, Sean

2014-01-01

This study evaluates the efficiency of federal hospitals, specifically those hospitals administered by the US Department of Veterans Affairs and the US Department of Defense. Hospital executives, health care policymakers, taxpayers, and federal hospital beneficiaries benefit from studies that improve hospital efficiency. This study uses data envelopment analysis to evaluate a panel of 165 federal hospitals in 2007 and 157 of the same hospitals again in 2011. Results indicate that overall efficiency in federal hospitals improved from 81% in 2007 to 86% in 2011. The number of federal hospitals operating on the efficiency frontier decreased slightly from 25 in 2007 to 21 in 2011. The higher efficiency score clearly documents that federal hospitals are becoming more efficient in the management of resources. From a policy perspective, this study highlights the economic importance of encouraging increased efficiency throughout the health care industry. This research examines benchmarking strategies to improve the efficiency of hospital services to federal beneficiaries. Through the use of strategies such as integrated information systems, consolidation of services, transaction-cost economics, and focusing on preventative health care, these organizations have been able to provide quality service while maintaining fiscal responsibility. In addition, the research documented the characteristics of those federal hospitals that were found to be on the Efficiency Frontier. These hospitals serve as benchmarks for less efficient federal hospitals as they develop strategies for improvement.

Heart failure in primary care: co-morbidity and utilization of health care resources.

PubMed

Carmona, Montserrat; García-Olmos, Luis M; García-Sagredo, Pilar; Alberquilla, Ángel; López-Rodríguez, Fernando; Pascual, Mario; Muñoz, Adolfo; Salvador, Carlos H; Monteagudo, José L; Otero-Puime, Ángel

2013-10-01

In order to ensure proper management of primary care (PC) services, the efficiency of the health professionals tasked with such services must be known. Patients with heart failure (HF) are characterized by advanced age, high co-morbidity and high resource utilization. To ascertain PC resource utilization by HF patients and variability in the management of such patients by GPs. Descriptive, cross-sectional study targeting a population attended by 129 GPs over the course of 1 year. All patients with diagnosis of HF in their clinical histories were included, classified using the Adjusted Clinical Group system and then grouped into six resource utilization bands (RUBs). Resource utilization and Efficiency Index were both calculated. One hundred per cent of patients with HF were ranked in RUBs 3, 4 and 5. The highest GP visit rate was 20 and the lowest in excess of 10 visits per year. Prescription drug costs for these patients ranged from €885 to €1422 per patient per year. Health professional efficiency varied notably, even after adjustment for co-morbidity (Efficiency Index Variation Ratio of 28.27 for visits and 404.29 for prescription drug cost). Patients with HF register a high utilization of resources, and there is great variability in the management of such patients by health professionals, which cannot be accounted for by the degree of case complexity.

Is bigger better? An empirical analysis of waste management in New South Wales

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carvalho, Pedro, E-mail: pedrotcc@gmail.com; CESUR – Center for Urban and Regional Systems, Instituto Superior Técnico, University of Lisboa, Av. Rovisco Pais, 1049-001 Lisbon; Marques, Rui Cunha, E-mail: rui.marques@tecnico.ulisboa.pt

Highlights: • We search for the most efficient cost structure for NSW household waste services. • We found that larger services are no longer efficient. • We found an optimal size for the range 12,000–20,000 inhabitants. • We found significant economies of output density for household waste collection. • We found economies of scope in joint provision of unsorted and recycling services. - Abstract: Across the world, rising demand for municipal solid waste services has seen an ongoing increase in the costs of providing these services. Moreover, municipal waste services have typically been provided through natural or legal monopolies, wheremore » few incentives exist to reduce costs. It is thus vital to examine empirically the cost structure of these services in order to develop effective public policies which can make these services more cost efficient. Accordingly, this paper considers economies of size and economies of output density in the municipal waste collection sector in the New South Wales (NSW) local government system in an effort to identify the optimal size of utilities from the perspective of cost efficiency. Our results show that – as presently constituted – NSW municipal waste services are not efficient in terms of costs, thereby demonstrating that ‘bigger is not better.’ The optimal size of waste utilities is estimated to fall in the range 12,000–20,000 inhabitants. However, significant economies of output density for unsorted (residual) municipal waste collection and recycling waste collection were found, which means it is advantageous to increase the amount of waste collected, but maintaining constant the number of customers and the intervention area.« less

A priority system model for sanitation management in food service establishments.

PubMed

Wodi, B E; Mill, R A

1985-12-01

We set out to develop a sanitation management scheme that will enable health regulatory authorities to utilize available personnel more efficiently in the regulation of the food service industry given the current budgetary and manpower constraints. Previous analyses of the Annual Food Service Establishment Sanitation Inspection Summary records from a large County Department of Health for fiscal years 1979, 1980, and 1981 indicated a cut-off point at about two to four visits for a productive follow-up sanitation inspection of food service establishments. Revisits after this point seemed counter-productive. Revisits of up to 13 times in some establishments and a high uninspection rate of others were noted. The above data, the population at risk for each establishment (generated by a prescribed method), and various control criteria were integrated into the model. Application of the model to a sample of 82 food service establishments was successful in ensuring that those operations that pose high risk to patrons are given priority in a sanitation management program while also facilitating the inspection of all food service establishments within a jurisdiction at some point.

A priority system model for sanitation management in food service establishments.

PubMed Central

Wodi, B E; Mill, R A

1985-01-01

We set out to develop a sanitation management scheme that will enable health regulatory authorities to utilize available personnel more efficiently in the regulation of the food service industry given the current budgetary and manpower constraints. Previous analyses of the Annual Food Service Establishment Sanitation Inspection Summary records from a large County Department of Health for fiscal years 1979, 1980, and 1981 indicated a cut-off point at about two to four visits for a productive follow-up sanitation inspection of food service establishments. Revisits after this point seemed counter-productive. Revisits of up to 13 times in some establishments and a high uninspection rate of others were noted. The above data, the population at risk for each establishment (generated by a prescribed method), and various control criteria were integrated into the model. Application of the model to a sample of 82 food service establishments was successful in ensuring that those operations that pose high risk to patrons are given priority in a sanitation management program while also facilitating the inspection of all food service establishments within a jurisdiction at some point. PMID:4061711

Application of a model for the development of a mental health service delivery collaboration between police and the health service.

PubMed

Laing, Robert; Halsey, Rebecca; Donohue, David; Newman, Claire; Cashin, Andrew

2009-05-01

Changing societal trends have revealed an increased prevalence of mental illness and diminished health resources from which to offer services. This has lead to a need to develop new and more efficient police and health service models of practice. Services offered by the police department in the management of mental health crisis in the community are essential in minimising the risk of individuals with mental health problems causing harm to themselves or a member of the public. In addressing the difficulties associated with police playing an important role in the management of mental health crisis in the community, but having little training in mental health issues, this paper discusses a proposed innovation for New South Wales police in Australia through the development of a Crisis Intervention Team model.

An exploration of how nurse prescribing is being used for patients with respiratory conditions across the east of England

PubMed Central

2014-01-01

Background There is a need to reduce symptoms, exacerbations and improve quality of life for patients with respiratory diseases. Across the world, increasing numbers of nurses are adopting the prescribing role and can potentially enhance service provision. Evidence suggests improved quality of care and efficiencies occur when nurses adopt the prescribing role. No evidence is available on the views of nurse prescribers who care for respiratory patients. The aim was to explore how nurse prescribing is being used for patients with respiratory conditions in different care settings across one strategic health authority, and whether this has benefited patients, healthcare professionals and the National Health Service. Methods A qualitative study involving semi-structured interviews with a purposive sample of 40 nurses who prescribed for respiratory patients across the six counties in the East of England Strategic Health Authority. Data were collected in 2011 and subject to thematic analysis. Results Disease management, including treatment and prevention of exacerbations, emergency episodes and minor illness, optimising and co-ordinating care were key aspects of care provided. Findings are reported under three themes: access, adherence and risk management and impact on nurses. Prescribing enabled nurses overcome existing problems in service provision to improve access, efficiency and patient convenience, reducing hospital admissions and length of stay. It also enabled patient centered consultations, which encouraged self-management, improved adherence, helped manage expectations, and reduced inappropriate service use. While participants experienced increased job satisfaction, knowledge and confidence, concerns were raised about increased responsibility, support, governance and future commissioning of services in line with planned major changes to the National Health Service. Conclusions This study provides new knowledge about how nurse prescribers provide care to patients with respiratory diseases. Despite a lack of consensus over the most effective model of respiratory care, prescribing was reported to have improved and extended points of access to treatment, and supported management of complex patients, particularly vulnerable groups. Given the high burden of chronic respiratory disease to patients and families this has important implications that need to be considered by those responsible for commissioning services in the United Kingdom and other countries. PMID:24443796

Assessing the technical efficiency of health posts in rural Guatemala: a data envelopment analysis.

PubMed

Hernández, Alison R; San Sebastián, Miguel

2014-01-01

Strengthening health service delivery to the rural poor is an important means of redressing inequities. Meso-level managers can help enhance efficiency in the utilization of existing resources through the application of practical tools to analyze routinely collected data reflecting inputs and outputs. This study aimed to assess the efficiency and change in productivity of health posts over two years in a rural department of Guatemala. Data envelopment analysis was used to measure health posts' technical efficiency and productivity change for 2008 and 2009. Input/output data were collected from the regional health office of Alta Verapaz for 34 health posts from the 19 districts comprising the health region. Technical efficiency varied widely across health posts, with mean scores of 0.78 (SD=0.24) and 0.75 (SD=0.21) in 2008 and 2009, respectively. Overall, productivity increased by 4%, though 47% of health posts experienced a decline in productivity. Results were combined on a bivariate plot to identify health posts at the high and low extremes of efficiency, which should be followed up to determine how and why their production processes are operating differently. Assessing efficiency using the data that are available at the meso-level can serve as a first step in strengthening performance. Further work is required to support managers in the routine application of efficiency analysis and putting the results to use in guiding efforts to improve service delivery and increase utilization.

Assessing the technical efficiency of health posts in rural Guatemala: a data envelopment analysis

PubMed Central

Hernández, Alison R.; Sebastián, Miguel San

2014-01-01

Introduction Strengthening health service delivery to the rural poor is an important means of redressing inequities. Meso-level managers can help enhance efficiency in the utilization of existing resources through the application of practical tools to analyze routinely collected data reflecting inputs and outputs. This study aimed to assess the efficiency and change in productivity of health posts over two years in a rural department of Guatemala. Methods Data envelopment analysis was used to measure health posts’ technical efficiency and productivity change for 2008 and 2009. Input/output data were collected from the regional health office of Alta Verapaz for 34 health posts from the 19 districts comprising the health region. Results Technical efficiency varied widely across health posts, with mean scores of 0.78 (SD=0.24) and 0.75 (SD=0.21) in 2008 and 2009, respectively. Overall, productivity increased by 4%, though 47% of health posts experienced a decline in productivity. Results were combined on a bivariate plot to identify health posts at the high and low extremes of efficiency, which should be followed up to determine how and why their production processes are operating differently. Conclusions Assessing efficiency using the data that are available at the meso-level can serve as a first step in strengthening performance. Further work is required to support managers in the routine application of efficiency analysis and putting the results to use in guiding efforts to improve service delivery and increase utilization. PMID:24461356

Certification and brand identity for energy efficiency in competitive energy services markets

DOE Office of Scientific and Technical Information (OSTI.GOV)

Prindle, W.R.; Wiser, R.

Resource commitments for energy efficiency from electricity companies are disappearing rapidly as the regulated Integrated Resource Planning and Demand-Side Management paradigms that fostered them give way to competitive power markets in a restructuring electricity industry. While free-market advocates claim that energy efficiency needs will be taken care of by competitive energy service providers, there is no assurance that efficiency will compete effectively with the panoply of other energy-related (and non-energy-related) services that are beginning to appear in early market offerings. This paper reports the results of a feasibility study for a certification and brand identity program for energy efficiency gearedmore » to competitive power markets. Funded by the Energy Foundation, this study involved a survey and personal interviews with stakeholders, plus a workshop to further the discussion. Stakeholders include independent power marketers and energy service companies, utility affiliate power marketers and energy service companies, government agencies, trade associations, non-profit organizations, equipment manufacturers, and consultants. The paper summarizes the study's findings on such key issues as: Whether a brand identity concept has a critical mass of interest and support; how qualification and certification could work in such a program; how a brand identity could be positioned in the market; how an efficiency brand identity could co-brand with renewable power branding programs and other green marketing efforts; and the resources and components needed to make such a program work on a national scale.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Katipamula, Srinivas; Gowri, Krishnan; Hernandez, George

This paper describes one such reference process that can be deployed to provide continuous automated conditioned-based maintenance management for buildings that have BIM, a building automation system (BAS) and a computerized maintenance management software (CMMS) systems. The process can be deployed using an open source transactional network platform, VOLTTRON™, designed for distributed sensing and controls and supports both energy efficiency and grid services.

Does the private sector have a role in Canadian healthcare?

PubMed

McGowan, Tom

2004-01-01

The current system of public pay with primarily public management for essential healthcare services has largely been successful. The Romanow and Kirby reports have made compelling arguments for expanding the definition of essential healthcare services to include, among other things, medications. The problem facing Canadians is that expanding services is not feasible under the current structure, as it is not affordable. The rigid adherence to a 45-year-old definition of system structure is hampering our ability to innovate. In an increasingly unresponsive system, the introduction of private management, through the judicious use of private contracts, can improve efficiency and increase accountability, while maintaining the important principle of public funding.

Are You Ready for Emergency Medical Services in Your Oral and Maxillofacial Surgery Office?

PubMed

Rayner, Clive; Ragan, Michael R

2018-05-01

Efficient responses to emergencies in the oral and maxillofacial surgery office require preparation, communication, and thorough documentation of the event and response. The concept of team anesthesia is showcased with these efforts. Emergency medical services training and response times vary greatly. The oral and maxillofacial surgery office should be prepared to manage the patient for at least 15 minutes after making the call to 911. Patient outcomes are optimized when providers work together to manage and transport the patient. Oral and maxillofacial surgery offices should develop and rehearse emergency plans and coordinate these protocols with local Emergency medical services teams. Copyright © 2018 Elsevier Inc. All rights reserved.

The Effectiveness and Efficiency of Disease Management Programs for Patients with Chronic Diseases

PubMed Central

Hisashige, Akinori

2013-01-01

Objective: Disease management (DM) approach is increasingly advocated as a means of improving effectiveness and efficiency of healthcare for chronic diseases. To evaluate the evidence on effectiveness and efficiency of DM, evidence synthesis was carried out. Methods: To locate eligible meta-analyses and systematic reviews, we searched Medline, EMBASE, the Cochrane Library, SCI-EXPANDED, SSCI, A&HCI, DARE, HTA and NHS EED from 1995 to 2010. Two reviewers independently extracted data and assessed a study quality. Results: Twenty-eight meta-analyses and systematic reviews were included for synthesizing evidence. The proportion of articles which observed improvement with a reasonable amount of evidence was the highest at process (69%), followed by health services (63%), QOL (57%), health outcomes (51%), satisfaction (50%), costs (38%) and so on. As to mortality, statistically significant results were observed only in coronary heart disease. Important components in DM, such as a multidisciplinary approach, were identified. Conclusion: The evidence synthesized shows considerable evidence in the effectiveness and efficiency of DM programs in process, health services, QOL and so on. The question is no longer whether DM programs work, but rather which type or component of DM programs works best and efficiently in the context of each healthcare system or country. PMID:23445693

Total quality management - It works for aerospace information services

NASA Technical Reports Server (NTRS)

Erwin, James; Eberline, Carl; Colquitt, Wanda

1993-01-01

Today we are in the midst of information and 'total quality' revolutions. At the NASA STI Program's Center for AeroSpace Information (CASI), we are focused on using continuous improvements techniques to enrich today's services and products and to ensure that tomorrow's technology supports the TQM-based improvement of future STI program products and services. The Continuous Improvements Program at CASI is the foundation for Total Quality Management in products and services. The focus is customer-driven; its goal, to identify processes and procedures that can be improved and new technologies that can be integrated with the processes to gain efficiencies, provide effectiveness, and promote customer satisfaction. This Program seeks to establish quality through an iterative defect prevention approach that is based on the incorporation of standards and measurements into the processing cycle.

The impact of managed care penetration and hospital quality on efficiency in hospital staffing.

PubMed

Mobley, Lee R; Magnussen, Jon

2002-01-01

The state of California has recently mandated minimum nurse-staffing ratios, raising concerns about possible affects on hospital efficiency. In this study, we examine how market factors and quality were related to staffing levels in California hospitals in 1995 (prior to implementation of the new law). We are particularly interested in the affect of managed care penetration on this aspect of hospital efficiency because the call to legislative action was predicated on fears that hospitals were reducing staffing below optimal levels in response to managed care pressures. We derive a unique measure of excess staffing in hospitals based on a data envelopment analysis (DEA) production function model, which explicitly includes ancillary care among the inputs and outputs. This careful specification of production is important because ancillary care use has risen relative to daily hospital services, with the spread of managed care and advances in medical technology. We find that market share (adjusted for size) and market concentration are the major determinants of excess staffing while managed care penetration is insignificant. We also find that poor quality (outcomes worse than expected) is associated with less efficient staffing. These findings suggest that the larger, more efficient urban hospitals will be penalized more heavily under binding staffing ratios than smaller, less-urban hospitals.

Efficiency Analysis of Integrated Public Hospital Networks in Outpatient Internal Medicine.

PubMed

Ortíz-Barrios, Miguel Angel; Escorcia-Caballero, Juan P; Sánchez-Sánchez, Fabián; De Felice, Fabio; Petrillo, Antonella

2017-09-07

Healthcare systems are evolving towards a complex network of interconnected services due to the increasing costs and the increasing expectations for high service levels. It is evidenced in the literature the importance of implementing management techniques and sophisticated methods to improve the efficiency of healthcare systems, especially in emerging economies. This paper proposes an integrated collaboration model between two public hospitals to reach the reduction of weighted average lead time in outpatient internal medicine department. A strategic framework based on value stream mapping and collaborative practices has been developed in real case study settled in Colombia.

Electronic freight management (EFM) standards strategy

DOT National Transportation Integrated Search

2006-04-01

The EFM initiative is a U.S. Department of Transportation (DOT)-sponsored research effort aimed at improving the operating efficiency, safety, and security of freight movement. The initiative involves conducting a deployment test using Web services t...

Trends in Interactive Information Systems for Earth Observation from Space: Towards a Global, Digital Image Library Service.

ERIC Educational Resources Information Center

Kingwell, Jeff

1996-01-01

Data management systems for earth science information gathered from space are being affected by two related trends: (1) a move from ad hoc systems established for particular projects to a longer lasting national and global infrastructure; and (2) an emphasis on efficient service delivery in an era of diminishing resources for national space…

Wild bees enhance honey bees’ pollination of hybrid sunflower

PubMed Central

Greenleaf, Sarah S.; Kremen, Claire

2006-01-01

Pollinators are required for producing 15–30% of the human food supply, and farmers rely on managed honey bees throughout the world to provide these services. Yet honey bees are not always the most efficient pollinators of all crops and are declining in various parts of the world. Crop pollination shortages are becoming increasingly common. We found that behavioral interactions between wild and honey bees increase the pollination efficiency of honey bees on hybrid sunflower up to 5-fold, effectively doubling honey bee pollination services on the average field. These indirect contributions caused by interspecific interactions between wild and honey bees were more than five times more important than the contributions wild bees make to sunflower pollination directly. Both proximity to natural habitat and crop planting practices were significantly correlated with pollination services provided directly and indirectly by wild bees. Our results suggest that conserving wild habitat at the landscape scale and altering selected farm management techniques could increase hybrid sunflower production. These findings also demonstrate the economic importance of interspecific interactions for ecosystem services and suggest that protecting wild bee populations can help buffer the human food supply from honey bee shortages. PMID:16940358

Wild bees enhance honey bees' pollination of hybrid sunflower.

PubMed

Greenleaf, Sarah S; Kremen, Claire

2006-09-12

Pollinators are required for producing 15-30% of the human food supply, and farmers rely on managed honey bees throughout the world to provide these services. Yet honey bees are not always the most efficient pollinators of all crops and are declining in various parts of the world. Crop pollination shortages are becoming increasingly common. We found that behavioral interactions between wild and honey bees increase the pollination efficiency of honey bees on hybrid sunflower up to 5-fold, effectively doubling honey bee pollination services on the average field. These indirect contributions caused by interspecific interactions between wild and honey bees were more than five times more important than the contributions wild bees make to sunflower pollination directly. Both proximity to natural habitat and crop planting practices were significantly correlated with pollination services provided directly and indirectly by wild bees. Our results suggest that conserving wild habitat at the landscape scale and altering selected farm management techniques could increase hybrid sunflower production. These findings also demonstrate the economic importance of interspecific interactions for ecosystem services and suggest that protecting wild bee populations can help buffer the human food supply from honey bee shortages.

Better management of Irish hospitals.

PubMed

Brugha, C M

1991-08-01

The establishment of the Dublin Hospitals Initiative and the Efficiency Review Group as first steps in an "action" plan was based on the report in 1989 of the Commission of Health Funding which suggested that "the solution to the problem facing the Irish health services...(lies) primarily...in the way that services are planned, organised and delivered". Our health service is in transition from the phase of facility management into that of functional management. This will involve facing the fact of the limit on resources, introducing information systems and getting the co-operation of hospital doctors. The most senior executive in a hospital must firstly be a good general manager with sufficient power to manage. Hospitals should be divided into centres of responsibility made up of one or more centres of activity. Formal education for hospital administrators should be extended. There is a need for training at all levels, particularly of those administrative and medical staff who have direct interaction with the computer-based system. There should be a commitment to management development particularly by means of teamwork and action learning.

Home Health Care (HHC) Managers Perceptions About Challenges and Obstacles that Hinder HHC Services in Jordan

PubMed Central

Ajlouni, Musa T.; Dawani, Hania; Diab, Salah M.

2015-01-01

Home care aims at supporting people with various degrees of dependency to remain at home rather than use residential, long-term, or institutional-based nursing care. Demographic, epidemiological, social, and cultural trends in Jordan as in other countries are changing the traditional patterns of care with growing emphasis on home care. The purpose of this study is to highlight the most common challenges related to home health care (HHC) services in Jordan as perceived by the managers of HHC agencies. Methods: a descriptive qualitative design that depends on focus group discussions has been used to collect data from a sample of 18 managers who met the selection criteria and who are willing to participate, the study found that, the main challenges of HHC services as perceived by managers were: shortage of female staff, lack of governance and regulation, poor management, unethical practices, lack of referral systems, and low accessibility of the poor and less privileged as HHC services are not included in health insurance schemes, it concludes also that the home health care industry in Jordan is facing many challenges and problems that may have negative effects on the effectiveness, efficiency, equity and quality of services and should be addressed by health policy makers. PMID:25946949

Alternative arrangements for the delivery of eye care services within staff model managed care organizations.

PubMed

Soroka, Mort; Reis, Lesley; Krumholz, David; Krasner, Mel; Portello, Joan

2003-11-01

Eye care services, though accounting for only a small fraction of healthcare costs, encompass a unique spectrum of professional staffing options that can enhance efficiency and decrease costs within staff model managed care organizations. This study was designed to describe and assess alternative staffing arrangements and cost implications for the delivery of eye care services by optometrists, ophthalmologists, and primary care physicians within staff model managed care organizations. The clinical records of individual patients--rather than administrative and billing files--at three managed care organizations are the principal source of information. Clinical auditors extracted data on ambulatory eye care services provided for conjunctivitis, corneal abrasion/erosion, cataract, diabetic retinopathy, glaucoma, and macular degeneration. Our findings document the substantial role optometrists play in the delivery of eye care, whether they provide the care independently or in collaboration with an ophthalmologist. The levels of remuneration for optometrists are roughly one third to one half the annual rate for ophthalmologists. Staffing arrangements that use optometrists to the full extent of their professional training can provide significant cost savings. The cost-effectiveness of using the services of optometrists capable of delivering high-quality eye care can be demonstrated. Potential cost savings for staff model managed care organizations may accrue if the roles, functions, and availability of eye providers are adjusted.

Workflow as a Service in the Cloud: Architecture and Scheduling Algorithms

PubMed Central

Wang, Jianwu; Korambath, Prakashan; Altintas, Ilkay; Davis, Jim; Crawl, Daniel

2017-01-01

With more and more workflow systems adopting cloud as their execution environment, it becomes increasingly challenging on how to efficiently manage various workflows, virtual machines (VMs) and workflow execution on VM instances. To make the system scalable and easy-to-extend, we design a Workflow as a Service (WFaaS) architecture with independent services. A core part of the architecture is how to efficiently respond continuous workflow requests from users and schedule their executions in the cloud. Based on different targets, we propose four heuristic workflow scheduling algorithms for the WFaaS architecture, and analyze the differences and best usages of the algorithms in terms of performance, cost and the price/performance ratio via experimental studies. PMID:29399237

An efficient protocol for providing integrated voice/data services to mobiles over power-limited satellite channels

NASA Astrophysics Data System (ADS)

Bose, Sanjay K.

1991-02-01

Various mobile satellite communication systems are being developed for providing integrated voice/data services over a shared satellite transponder which is power-limited in nature. A common strategy is to use slotted ALOHA request channels to request channel assignments for voice/data calls from a network management station. To maximize efficiency in a system with a power-limited satellite transponder, it is proposed that the bursty nature of voice sources be exploited by the NMS to 'over-assign' channels. This may cause problems of inefficiency and potential instability, as well as a degradation in the quality of service. Augmenting this with the introduction of simple state-dependent control procedures provides systems which exhibit more desirable operational features.

Building a new waste management strategy in Puerto Rico

DOE Office of Scientific and Technical Information (OSTI.GOV)

Boltz, C.

1995-06-01

Puerto Rico traditionally has not had a centrally organized waste management system. Most municipalities have provided service for their own residents, and the island used 62 unlined landfills before 32 of those closed in April 1994. But waste management on this Caribbean island is changing as the government-a self-governing commonwealth associated voluntarily with the US government-begins implementing its strategy for developing efficient, state-of-the-art waste management. This strategy includes plans to build an integrated system of collection, transfer stations, and disposal sites whose centerpieces are market-drives recycling, partnerships between the public and private sectors, and public education. The details of thismore » plan coincide with the mission statement of the Puerto Rico Solid Waste Management Authority (SWMA, San Juan), to ``develop and implement the necessary infrastructure for the efficient management of solid waste in Puerto Rico.« less

The Role of Audiologic Evaluation in Progressive Audiologic Tinnitus Management

PubMed Central

Henry, James A.; Zaugg, Tara L.; Myers, Paula J.; Schechter, Martin A.

2008-01-01

Progressive Audiologic Tinnitus Management (PATM) is based on the premise that tinnitus is managed most efficiently using a hierarchy of clinical services that address different levels of need. PATM includes five levels of management: (a) triage; (b) audiologic evaluation; (c) group education; (d) tinnitus evaluation; and (e) individualized management. This article provides an overview of PATM and focuses on the procedures that make up the Level 2 Audiologic Evaluation. The evaluation is conducted to assess the potential need for medical, audiologic (hearing loss, tinnitus, hyperacusis), and/or mental health services. The Tinnitus Handicap Inventory, Hearing Handicap Inventory, and Tinnitus and Hearing Survey are used to differentiate effects of tinnitus and hearing loss. If indicated, patients are interviewed with the Tinnitus-Impact Screening Interview. Patients requiring amplification receive hearing aids. Often, management of hearing loss at Level 2 addresses any problems that were attributed to the tinnitus, which obviates further tinnitus-specific intervention. PMID:18628281

Improving Air Support for Wildfire Management in the United States

DTIC Science & Technology

2014-09-01

1 It nearly torched the NASA Jet Propulsion Laboratory and vital electrical infrastructure for all of Los Angeles County in the months that it...Initial Attack and Large Fire Suppression: Phase 1” ( USDA Forest Service, Department of Interior: 1995), x, accessed from http://www.fs.fed.us/fire...publications/aviation/nats1_report.pdf 5“Management Efficiency Assessment on Aviation Activities in the USDA Forest Service” (Management Analysis

CO-CD base management model of Universitas Terbuka community service program

NASA Astrophysics Data System (ADS)

Kridasakti, S. W.; Sudirah; Siregar, H.

2018-03-01

These studies were to respond whether the UT social-aid management had been executed under CO-CD principles (Ife J. 1995) and what CO-CD base community service management model can be built. The goals of these evaluational studies were UT social-aid managerial performance profile (2011-2013) and CO-CD management model development. The methods used were Survey and FGD. For data collection were involving the UT officers, the counterparts, and the documents. The analysis used combination between the Performance Analysis (Irawan P., 2003) and the CIPP (Stuffelbeam, D, L., & Shinkfield, A, J., 1985). The findings showed that the quantitative targeting in program completion was credible in achievement (85%). However, the “qulitative targeting” of the management goals was indicating far from a good-stage (≤5.0_Interval-Force: 1-10 Scale). The “Gap” was due to the absent of socialization_needs-analysis_maintenance_release factors on the UT social-service grand-policy. The trial of CO-CD Base Management Model had been imposed to the community that turned out to be very effective to self-help, and the ensuing SOP had been successfully defined. Conclusion, ‘CO-CD Principles’ were not designed in UT community service programs management. However, if efficiency and effectivity likely to be achieved, the SOP of ‘CO-CD Base Management Model has to be adopted.

An Ecosystem Service Evaluation Tool to Support Ridge-to-Reef Management and Conservation in Hawaii

NASA Astrophysics Data System (ADS)

Oleson, K.; Callender, T.; Delevaux, J. M. S.; Falinski, K. A.; Htun, H.; Jin, G.

2014-12-01

Faced with increasing anthropogenic stressors and diverse stakeholders, local managers are adopting a ridge-to-reef and multi-objective management approach to restore declining coral reef health state. An ecosystem services framework, which integrates ecological indicators and stakeholder values, can foster more applied and integrated research, data collection, and modeling, and thus better inform the decision-making process and realize decision outcomes grounded in stakeholders' values. Here, we describe a research program that (i) leverages remotely sensed and empirical data to build an ecosystem services-based decision-support tool geared towards ridge-to-reef management; and (ii) applies it as part of a structured, value-based decision-making process to inform management in west Maui, a NOAA coral reef conservation priority site. The tool links terrestrial and marine biophysical models in a spatially explicit manner to quantify and map changes in ecosystem services delivery resulting from management actions, projected climate change impacts, and adaptive responses. We couple model outputs with localized valuation studies to translate ecosystem service outcomes into benefits and their associated socio-cultural and/or economic values. Managers can use this tool to run scenarios during their deliberations to evaluate trade-offs, cost-effectiveness, and equity implications of proposed policies. Ultimately, this research program aims at improving the effectiveness, efficiency, and equity outcomes of ecosystem-based management. This presentation will describe our approach, summarize initial results from the terrestrial modeling and economic valuations for west Maui, and highlight how this decision support tool benefits managers in west Maui.

Determinants of efficiency in the provision of municipal street-cleaning and refuse collection services

DOE Office of Scientific and Technical Information (OSTI.GOV)

Benito-Lopez, Bernardino, E-mail: benitobl@um.es; Rocio Moreno-Enguix, Maria del, E-mail: mrmoreno@um.es; Solana-Ibanez, Jose, E-mail: jsolana@um.es

Effective waste management systems can make critical contributions to public health, environmental sustainability and economic development. The challenge affects every person and institution in society, and measures cannot be undertaken without data collection and a quantitative analysis approach. In this paper, the two-stage double bootstrap procedure of is used to estimate the efficiency determinants of Spanish local entities in the provision of public street-cleaning and refuse collection services. The purpose is to identify factors that influence efficiency. The final sample comprised 1072 municipalities. In the first stage, robust efficiency estimates are obtained with Data Envelopment Analysis (DEA). We apply themore » second stage, based on a truncated-regression, to estimate the effect of a group of environmental factors on DEA estimates. The results show the existence of a significant relation between efficiency and all the variables analysed (per capita income, urban population density, the comparative index of the importance of tourism and that of the whole economic activity). We have also considered the influence of a dummy categorical variable - the political sign of the governing party - on the efficient provision of the services under study. The results from the methodology proposed show that municipalities governed by progressive parties are more efficient.« less

Determinants of efficiency in the provision of municipal street-cleaning and refuse collection services.

PubMed

Benito-López, Bernardino; Moreno-Enguix, María del Rocio; Solana-Ibañez, José

2011-06-01

Effective waste management systems can make critical contributions to public health, environmental sustainability and economic development. The challenge affects every person and institution in society, and measures cannot be undertaken without data collection and a quantitative analysis approach. In this paper, the two-stage double bootstrap procedure of Simar and Wilson (2007) is used to estimate the efficiency determinants of Spanish local entities in the provision of public street-cleaning and refuse collection services. The purpose is to identify factors that influence efficiency. The final sample comprised 1072 municipalities. In the first stage, robust efficiency estimates are obtained with Data Envelopment Analysis (DEA). We apply the second stage, based on a truncated-regression, to estimate the effect of a group of environmental factors on DEA estimates. The results show the existence of a significant relation between efficiency and all the variables analysed (per capita income, urban population density, the comparative index of the importance of tourism and that of the whole economic activity). We have also considered the influence of a dummy categorical variable - the political sign of the governing party - on the efficient provision of the services under study. The results from the methodology proposed show that municipalities governed by progressive parties are more efficient. Copyright © 2011 Elsevier Ltd. All rights reserved.

Design of a secure remote management module for a software-operated medical device.

PubMed

Burnik, Urban; Dobravec, Štefan; Meža, Marko

2017-12-09

Software-based medical devices need to be maintained throughout their entire life cycle. The efficiency of after-sales maintenance can be improved by managing medical systems remotely. This paper presents how to design the remote access function extensions in order to prevent risks imposed by uncontrolled remote access. A thorough analysis of standards and legislation requirements regarding safe operation and risk management of medical devices is presented. Based on the formal requirements, a multi-layer machine design solution is proposed that eliminates remote connectivity risks by strict separation of regular device functionalities from remote management service, deploys encrypted communication links and uses digital signatures to prevent mishandling of software images. The proposed system may also be used as an efficient version update of the existing medical device designs.

Business resilience: Reframing healthcare risk management.

PubMed

Simeone, Cynthia L

2015-09-01

The responsibility of risk management in healthcare is fractured, with multiple stakeholders. Most hospitals and healthcare systems do not have a fully integrated risk management system that spans the entire organizational and operational structure for the delivery of key services. This article provides insight toward utilizing a comprehensive Business Resilience program and associated methodology to understand and manage organizational risk leading to organizational effectiveness and operational efficiencies, with the fringe benefit of realizing sustainable operational capability during adverse conditions. © 2015 American Society for Healthcare Risk Management of the American Hospital Association.

Personal diabetes management system based on ubiquitous computing technology.

PubMed

Park, Kyung-Soon; Kim, Nam-Jin; Hong, Joo-Hyun; Park, Mi-Sook; Cha, Eun-Jung; Lee, Tae-Soo

2006-01-01

Assisting diabetes patients to self manage blood glucose test and insulin injection is of great importance for their healthcare. This study presented a PDA based system to manage the personal glucose level data interfaced with a small glucometer through a serial port. The data stored in the PDA can be transmitted by cradle or wireless communication to the remote web-server, where further medical analysis and service is provided. This system enables more efficient and systematic management of diabetes patients through self management and remote medical practice.

A cost and technical efficiency analysis of two alternative models for implementing the basic package of health services in Afghanistan.

PubMed

Blaakman, Aaron Philip; Salehi, Ahmad Shah; Boitard, Romain

2014-01-01

Since 2003, the Afghan Ministry of Public Health (MoPH) and international partners have directed a contracting-out model through which non-governmental organisations (NGOs) deliver the Basic Package of Health Services (BPHS) in 31 of the 34 Afghan provinces. The MoPH also managed health service delivery in three provinces under an alternative initiative entitled Strengthening Mechanisms (SM). In 2011, under the authority of the MoPH and Delegation of the European Union to Afghanistan, EPOS Health Management conducted a cost and technical efficiency study of the contracting-out and SM mechanisms in six provinces to examine economic trade-offs in the provision of the BPHS. The study provides analyses of all resource inputs and primary outputs of the BPHS in the six provinces during 2008 and 2009. The authors examined technical efficiency using Data Envelopment Analysis (DEA) at the BPHS facility level. Cost analysis results indicate that the weighted average cost per BPHS outpatient visit totalled $3.41 in the SM provinces and $5.39 in the NGO-led provinces in 2009. Furthermore, the data envelopment analyses (DEAs) indicate that facilities in the three NGO-led provinces scored 0.168 points higher on the DEA scale (0-1) than SM facilities. The authors conclude that an approximate 60% increase in costs yielded a 16.8% increase in technical efficiency in the delivery of the BPHS during 2009 in the six provinces.

Overview of devolution of health services in the Philippines.

PubMed

Grundy, J; Healy, V; Gorgolon, L; Sandig, E

2003-01-01

In 1991 the Philippines Government introduced a major devolution of national government services, which included the first wave of health sector reform, through the introduction of the Local Government Code of 1991. The Code devolved basic services for agriculture extension, forest management, health services, barangay (township) roads and social welfare to Local Government Units. In 1992, the Philippines Government devolved the management and delivery of health services from the National Department of Health to locally elected provincial, city and municipal governments. The aim of this review is to (i) Provide a background to the introduction of devolution to the health system in the Philippines and to (ii) describe the impact of devolution on the structure and functioning of the health system in defined locations. International literature was reviewed on the subjects of decentralization. Rapid appraisals of health management systems were conducted in both provinces. Additional data were accessed from the rural health information system and previous consultant reports. Subsequent to the introduction of devolution, quality and coverage of health services declined in some locations, particularly in rural and remote areas. It was found that in 1992-1997, system effects included a breakdown in management systems between levels of government, declining utilization particularly in the hospital sector, poor staff morale, a decline in maintenance of infrastructure and under financing of operational costs of services. The aim of decentralization is to widen decision-making space of middle level managers, enhance resource allocations from central to peripheral areas and to improve the efficiency and effectiveness of health services management. The findings of the historical review of devolution in the Philippines reveals some consistencies with the international literature, which describe some negative effects of decentralization, and provide a rationale for the Philippines in undertaking a second wave of reform in order to 'make devolution work'.

Rural district hospitals - essential cogs in the district health system - and primary healthcare re-engineering.

PubMed

le Roux, K W D P; Couper, I

2015-06-01

The re-engineering of primary healthcare (PHC) is regarded as an essential precursor to the implementation of National Health Insurance in South Africa, but improvements in the provision of PHC services have been patchy. The authors contend that the role of well- functioning rural district hospitals as a hub from which PHC services can be most efficiently managed has been underestimated, and that the management of district hospitals and PHC clinics need to be co-located at the level of the rural district hospital, to allow for proper integration of care and effective healthcare provision.

Earthquakes in El Salvador: a descriptive study of health concerns in a rural community and the clinical implications--part II.

PubMed

Woersching, Joanna C; Snyder, Audrey E

2004-01-01

Results reported in Part I of the Earthquakes in El Salvador series (see Disaster Management & Response 2003;1:105-9) indicated clinically relevant findings. The findings indicated a need for greater public health action within all five categories reviewed: healthcare, access to healthcare, housing, food, water and sanitation. Significant results between urban and rural communities indicated a need for broader community aid, public health and sanitation services to rural areas. Faster and more efficient disaster management and care services throughout the San Sebastian community were also necessary modifications.

U.S. National Institutes of Health core consolidation-investing in greater efficiency.

PubMed

Chang, Michael C; Birken, Steven; Grieder, Franziska; Anderson, James

2015-04-01

The U.S. National Institutes of Health (NIH) invests substantial resources in core research facilities (cores) that support research by providing advanced technologies and scientific and technical expertise as a shared resource. In 2010, the NIH issued an initiative to consolidate multiple core facilities into a single, more efficient core. Twenty-six institutions were awarded supplements to consolidate a number of similar core facilities. Although this approach may not work for all core settings, this effort resulted in consolidated cores that were more efficient and of greater benefit to investigators. The improvements in core operations resulted in both increased services and more core users through installation of advanced instrumentation, access to higher levels of management expertise; integration of information management and data systems; and consolidation of billing; purchasing, scheduling, and tracking services. Cost recovery to support core operations also benefitted from the consolidation effort, in some cases severalfold. In conclusion, this program of core consolidation resulted in improvements in the effective operation of core facilities, benefiting both investigators and their supporting institutions.

The impact of a novel resident leadership training curriculum.

PubMed

Awad, Samir S; Hayley, Barbara; Fagan, Shawn P; Berger, David H; Brunicardi, F Charles

2004-11-01

Today's complex health care environment coupled with the 80-hour workweek mandate has required that surgical resident team interactions evolve from a military command-and-control style to a collaborative leadership style. A novel educational curriculum was implemented with objectives of training the residents to have the capacity/ability to create and manage powerful teams through alignment, communication, and integrity integral tools to practicing a collaborative leadership style while working 80 hours per week. Specific strategies were as follows: (1) to focus on quality of patient care and service while receiving a high education-to-service ratio, and (2) to maximize efficiency through time management. This article shows that leadership training as part of a resident curriculum can significantly increase a resident's view of leadership in the areas of alignment, communication, and integrity; tools previously shown in business models to be vital for effective and efficient teams. This curriculum, over the course of the surgical residency, can provide residents with the necessary tools to deliver efficient quality of care while working within the 80-hour workweek mandate in a more collaborative style environment.

Applied Use Value of Scientific Information for Management of Ecosystem Services

NASA Astrophysics Data System (ADS)

Raunikar, R. P.; Forney, W.; Bernknopf, R.; Mishra, S.

2012-12-01

The U.S. Geological Survey has developed and applied methods for quantifying the value of scientific information (VOI) that are based on the applied use value of the information. In particular the applied use value of U.S. Geological Survey information often includes efficient management of ecosystem services. The economic nature of U.S. Geological Survey scientific information is largely equivalent to that of any information, but we focus application of our VOI quantification methods on the information products provided freely to the public by the U.S. Geological Survey. We describe VOI economics in general and illustrate by referring to previous studies that use the evolving applied use value methods, which includes examples of the siting of landfills in Louden County, the mineral exploration efficiencies of finer resolution geologic maps in Canada, and improved agricultural production and groundwater protection in Eastern Iowa possible with Landsat moderate resolution satellite imagery. Finally, we describe the adaptation of the applied use value method to the case of streamgage information used to improve the efficiency of water markets in New Mexico.

Parity for mental health and substance abuse care under managed care.

PubMed

Frank, Richard G.; McGuire, Thomas G.

1998-12-01

BACKGROUND: Parity in insurance coverage for mental health and substance abuse has been a key goal of mental health and substance abuse care advocates in the United States during most of the past 20 years. The push for parity began during the era of indemnity insurance and fee for service payment when benefit design was the main rationing device in health care. The central economic argument for enacting legislation aimed at regulating the insurance benefit was to address market failure stemming from adverse selection. The case against parity was based on inefficiency related to moral hazard. Empirical analyses provided evidence that ambulatory mental health services were considerably more responsive to the terms of insurance than were ambulatory medical services. AIMS: Our goal in this research is to reexamine the economics of parity in the light of recent changes in the delivery of health care in the United States. Specifically managed care has fundamentally altered the way in which health services are rationed. Benefit design is now only one mechanism among many that are used to allocate health care resources and control costs. We examine the implication of these changes for policies aimed at achieving parity in insurance coverage. METHOD: We develop a theoretical approach to characterizing rationing under managed care. We then analyze the traditional efficiency concerns in insurance, adverse selection and moral hazard in the context of policy aimed at regulating health and mental health benefits under private insurance. RESULTS: We show that since managed care controls costs and utilization in new ways parity in benefit design no longer implies equal access to and quality of mental health and substance abuse care. Because costs are controlled by management under managed care and not primarily by out of pocket prices paid by consumers, demand response recedes as an efficiency argument against parity. At the same time parity in benefit design may accomplish less with respect to providing a remedy to problems related to adverse selection.

Error management in blood establishments: results of eight years of experience (2003–2010) at the Croatian Institute of Transfusion Medicine

PubMed Central

Vuk, Tomislav; Barišić, Marijan; Očić, Tihomir; Mihaljević, Ivanka; Šarlija, Dorotea; Jukić, Irena

2012-01-01

Background. Continuous and efficient error management, including procedures from error detection to their resolution and prevention, is an important part of quality management in blood establishments. At the Croatian Institute of Transfusion Medicine (CITM), error management has been systematically performed since 2003. Materials and methods. Data derived from error management at the CITM during an 8-year period (2003–2010) formed the basis of this study. Throughout the study period, errors were reported to the Department of Quality Assurance. In addition to surveys and the necessary corrective activities, errors were analysed and classified according to the Medical Event Reporting System for Transfusion Medicine (MERS-TM). Results. During the study period, a total of 2,068 errors were recorded, including 1,778 (86.0%) in blood bank activities and 290 (14.0%) in blood transfusion services. As many as 1,744 (84.3%) errors were detected before issue of the product or service. Among the 324 errors identified upon release from the CITM, 163 (50.3%) errors were detected by customers and reported as complaints. In only five cases was an error detected after blood product transfusion however without any harmful consequences for the patients. All errors were, therefore, evaluated as “near miss” and “no harm” events. Fifty-two (2.5%) errors were evaluated as high-risk events. With regards to blood bank activities, the highest proportion of errors occurred in the processes of labelling (27.1%) and blood collection (23.7%). With regards to blood transfusion services, errors related to blood product issuing prevailed (24.5%). Conclusion. This study shows that comprehensive management of errors, including near miss errors, can generate data on the functioning of transfusion services, which is a precondition for implementation of efficient corrective and preventive actions that will ensure further improvement of the quality and safety of transfusion treatment. PMID:22395352

Health plan approach to operationalizing a specialty drug management program.

PubMed

Tegenu, Mesfin

2008-05-01

Expenditures related to specialty drugs consume a significant percentage of available health care resources. Explain the process of transitioning the management of specialty drugs from medical services to pharmacy services in 2 managed care plans and provide insight into the issues encountered and solutions implemented based on 6 years of experience using traditional and innovative pharmacy utilization management tools to insure appropriate specialty drug use and reimbursement. The level of involvement in a specialty management program varies from managing only products dispensed by the retail, mail, and specialty pharmacy vendor to encompassing a broad list of specialty drugs distributed through a variety of channels. Efficient administrative, operational, and clinical processes are critical to the success of the program. Additionally, an accurate and timely claims processing procedure is also essential for success as is the ability to mine data and effectively report on the use of specialty products. A clinically sound, cost-effective, and patient-friendly program requires input from health plan members, pharmacy service leaders, and physician providers, and must overcome challenges associated with disrupting current relationships and removing competing incentives. A well-constructed and properly funded specialty drug management program results in clinical and financial benefits for the plan.

Case management for the subacute patient in a skilled nursing facility.

PubMed

Carr, D D

2000-01-01

The goal of case management has always been to manage care, cost, and outcomes. The Balanced Budget Act of 1997 and the subsequent implementation of managed care and the prospective payment system have introduced many challenges to the postacute care delivery system. The implementation of sound clinical, fiscal, and operational strategies is critical to the continued delivery of quality services and the maximization of revenue. The implementation of case management principles provides an opportunity to balance care with cost. This article focuses on the development and implementation of a case management program at a skilled nursing facility that specifically addresses the needs of a subacute population. The program's purpose is to promote efficiency, efficacy, and effectiveness of services for short-term subacute patients who will eventually return to the community. The long-term goal of the program is to classify all patients into case management categories and assign them to RN case managers or social workers, based on acuity and need.

Efficient Airframe Management Using In-Situ Structural Health Monitoring

DTIC Science & Technology

2012-07-01

As a result, the Air Force intends to transition to a process that services aircraft based on their actual condition instead of the presumptive...at predetermined times regardless of their actual conditions . This _____________ Mark M. Derriso and Matthew S. Leonard, Air Force Research...services aircraft based on their actual condition instead of the presumptive schedule-based approach. Structural health monitoring (SHM) technologies are

NASA Marshall Space Flight Center Improves Cooling System Performance: Best Management Practice Case Study #10: Cooling Towers (Fact Sheet)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

National Aeronautics and Space Administration's (NASA) Marshall Space Flight Center (MSFC) has a longstanding sustainability program that revolves around energy and water efficiency as well as environmental protection. MSFC identified a problematic cooling loop with six separate compressor heat exchangers and a history of poor efficiency. The facility engineering team at MSFC partnered with Flozone Services, Incorporated to implement a comprehensive water treatment platform to improve the overall efficiency of the system.

Public services for distribution of drinking water and liquid sanitation in urban zones in Morocco Relevance of introduction the performance indicators for preservation water resources.

NASA Astrophysics Data System (ADS)

Habib, Akka; Abdelhamid, Bouzidi; Said, Housni

2018-05-01

Because of the absence of regulations and specific national norms, the unilaterally applied indicators for performance evaluation of water distribution management services are insufficient. This does not pave the way for a clear visibility of water resources. The indicators are also so heterogeneous that they are not in equilibrium with the applied management patterns. In fact: 1- The performance (yield and Linear loss index) of drinking water networks presents a discrepancy between operators and lack of homogeneity in terms of parameters put in its equation. Hence, It these indicators lose efficiency and reliability; 2- Liquid sanitation service has to go beyond the quantitative evaluation target in order to consider the qualitative aspects of water. To reach this aim, a reasonable enlargement of performance indicators is of paramount importance in order to better manage water resource which is becoming scarce and insufficient.

New MPLS network management techniques based on adaptive learning.

PubMed

Anjali, Tricha; Scoglio, Caterina; de Oliveira, Jaudelice Cavalcante

2005-09-01

The combined use of the differentiated services (DiffServ) and multiprotocol label switching (MPLS) technologies is envisioned to provide guaranteed quality of service (QoS) for multimedia traffic in IP networks, while effectively using network resources. These networks need to be managed adaptively to cope with the changing network conditions and provide satisfactory QoS. An efficient strategy is to map the traffic from different DiffServ classes of service on separate label switched paths (LSPs), which leads to distinct layers of MPLS networks corresponding to each DiffServ class. In this paper, three aspects of the management of such a layered MPLS network are discussed. In particular, an optimal technique for the setup of LSPs, capacity allocation of the LSPs and LSP routing are presented. The presented techniques are based on measurement of the network state to adapt the network configuration to changing traffic conditions.

Procurement of Architectural and Engineering Services for Sustainable Buildings: A Guide for Federal Project Managers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

2004-06-01

This guide was prepared to be a resource for federal construction project managers and others who want to integrate the principles of sustainable design into the procurement of professional building design and consulting services. To economize on energy costs and improve the safety, comfort, and health of building occupants, building design teams can incorporate daylighting, energy efficiency, renewable energy, and passive solar design into all projects in which these elements are technically and economically feasible. The information presented here will help project leaders begin the process and manage the inclusion of sustainable design in the procurement process. The section onmore » establishing selection criteria contains key elements to consider before selecting an architectural and engineering (A/E) firm. The section on preparing the statement of work discusses the broad spectrum of sustainable design services that an A/E firm can provide. Several helpful checklists are included.« less

Workflow management systems in radiology

NASA Astrophysics Data System (ADS)

Wendler, Thomas; Meetz, Kirsten; Schmidt, Joachim

1998-07-01

In a situation of shrinking health care budgets, increasing cost pressure and growing demands to increase the efficiency and the quality of medical services, health care enterprises are forced to optimize or complete re-design their processes. Although information technology is agreed to potentially contribute to cost reduction and efficiency improvement, the real success factors are the re-definition and automation of processes: Business Process Re-engineering and Workflow Management. In this paper we discuss architectures for the use of workflow management systems in radiology. We propose to move forward from information systems in radiology (RIS, PACS) to Radiology Management Systems, in which workflow functionality (process definitions and process automation) is implemented through autonomous workflow management systems (WfMS). In a workflow oriented architecture, an autonomous workflow enactment service communicates with workflow client applications via standardized interfaces. In this paper, we discuss the need for and the benefits of such an approach. The separation of workflow management system and application systems is emphasized, and the consequences that arise for the architecture of workflow oriented information systems. This includes an appropriate workflow terminology, and the definition of standard interfaces for workflow aware application systems. Workflow studies in various institutions have shown that most of the processes in radiology are well structured and suited for a workflow management approach. Numerous commercially available Workflow Management Systems (WfMS) were investigated, and some of them, which are process- oriented and application independent, appear suitable for use in radiology.

A System-Wide Approach to Physician Efficiency and Utilization Rates for Non-Operating Room Anesthesia Sites.

PubMed

Tsai, Mitchell H; Huynh, Tinh T; Breidenstein, Max W; O'Donnell, Stephen E; Ehrenfeld, Jesse M; Urman, Richard D

2017-07-01

There has been little in the development or application of operating room (OR) management metrics to non-operating room anesthesia (NORA) sites. This is in contrast to the well-developed management framework for the OR management. We hypothesized that by adopting the concept of physician efficiency, we could determine the applicability of this clinical productivity benchmark for physicians providing services for NORA cases at a tertiary care center. We conducted a retrospective data analysis of NORA sites at an academic, rural hospital, including both adult and pediatric patients. Using the time stamps from WiseOR® (Palo Alto, CA), we calculated site utilization and physician efficiency for each day. We defined scheduling efficiency (SE) as the number of staffed anesthesiologists divided by the number of staffed sites and stratified the data into three categories (SE < 1, SE = 1, and SE >1). The mean physician efficiency was 0.293 (95% CI, [0.281, 0.305]), and the mean site utilization was 0.328 (95% CI, [0.314, 0.343]). When days were stratified by scheduling efficiency (SE < 1, =1, or >1), we found differences between physician efficiency and site utilization. On days where scheduling efficiency was less than 1, that is, there are more sites than physicians, mean physician efficiency (95% CI, [0.326, 0.402]) was higher than mean site utilization (95% CI, [0.250, 0.296]). We demonstrate that scheduling efficiency vis-à-vis physician efficiency as an OR management metric diverge when anesthesiologists travel between NORA sites. When the opportunity to scale operational efficiencies is limited, increasing scheduling efficiency by incorporating different NORA sites into a "block" allocation on any given day may be the only suitable tactical alternative.

Development of a large bus/small bus decision support tool

DOT National Transportation Integrated Search

2008-02-01

Transit managers continue to strive for greater operating efficiency while maintaining an appropriate balance between cost effectiveness and customer service. Over the past decade, the use of heavy-duty buses smaller than the traditional forty-foot v...

Expanded Transportation Performance Measures to Supplement Level of Service (LOS) for Growth Management and Transportation Impact Analysis

DOT National Transportation Integrated Search

2012-10-01

Floridas transportation infrastructure must continually evolve to meet the demands of its growing population. Many jurisdictions are moving toward multimodal transportation systems that utilize existing infrastructure more efficiently, providing u...

Strategic leadership: a view from quantum and chaos theories.

PubMed

McDaniel, R R

1997-01-01

Viewing health care from the perspective of chaos and quantum theories offers new insights into management techniques for effective and efficient delivery of health care services. This article introduces these concepts and gives specific prescriptions for managerial action.

Let the Professionals Do It.

ERIC Educational Resources Information Center

Hoover, James P.; Main, Ron

2003-01-01

Describes benefits of West Allegheny (Pennsylvania) School District's decision to outsource the management of its technology services. Benefits include improved efficiency, increased technical expertise, cost-effectiveness, personnel stability, and organizational focus. Lists important points to consider when selecting an outsourcing firm. (PKP)

Clinical image processing engine

NASA Astrophysics Data System (ADS)

Han, Wei; Yao, Jianhua; Chen, Jeremy; Summers, Ronald

2009-02-01

Our group provides clinical image processing services to various institutes at NIH. We develop or adapt image processing programs for a variety of applications. However, each program requires a human operator to select a specific set of images and execute the program, as well as store the results appropriately for later use. To improve efficiency, we design a parallelized clinical image processing engine (CIPE) to streamline and parallelize our service. The engine takes DICOM images from a PACS server, sorts and distributes the images to different applications, multithreads the execution of applications, and collects results from the applications. The engine consists of four modules: a listener, a router, a job manager and a data manager. A template filter in XML format is defined to specify the image specification for each application. A MySQL database is created to store and manage the incoming DICOM images and application results. The engine achieves two important goals: reduce the amount of time and manpower required to process medical images, and reduce the turnaround time for responding. We tested our engine on three different applications with 12 datasets and demonstrated that the engine improved the efficiency dramatically.

Urban water infrastructure asset management - a structured approach in four water utilities.

PubMed

Cardoso, M A; Silva, M Santos; Coelho, S T; Almeida, M C; Covas, D I C

2012-01-01

Water services are a strategic sector of large social and economic relevance. It is therefore essential that they are managed rationally and efficiently. Advanced water supply and wastewater infrastructure asset management (IAM) is key in achieving adequate levels of service in the future, particularly with regard to reliable and high quality drinking water supply, prevention of urban flooding, efficient use of natural resources and prevention of pollution. This paper presents a methodology for supporting the development of urban water IAM, developed during the AWARE-P project as well as an appraisal of its implementation in four water utilities. Both water supply and wastewater systems were considered. Due to the different contexts and features of the utilities, the main concerns vary from case to case; some problems essentially are related to performance, others to risk. Cost is a common deciding factor. The paper describes the procedure applied, focusing on the diversity of drivers, constraints, benefits and outcomes. It also points out the main challenges and the results obtained through the implementation of a structured procedure for supporting urban water IAM.

Implementation of Consolidated HIS: Improving Quality and Efficiency of Healthcare

PubMed Central

Choi, Jinwook; Seo, Jeong-Wook; Chung, Chun Kee; Kim, Kyung-Hwan; Kim, Ju Han; Kim, Jong Hyo; Chie, Eui Kyu; Cho, Hyun-Jai; Goo, Jin Mo; Lee, Hyuk-Joon; Wee, Won Ryang; Nam, Sang Mo; Lim, Mi-Sun; Kim, Young-Ah; Yang, Seung Hoon; Jo, Eun Mi; Hwang, Min-A; Kim, Wan Suk; Lee, Eun Hye; Choi, Su Hi

2010-01-01

Objectives Adoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management. Methods The hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services. Results Clinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures. Conclusions Seoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system. PMID:21818449

Employing the FITT framework to explore HIV case managers' perceptions of two electronic clinical data (ECD) summary systems.

PubMed

Schnall, Rebecca; Smith, Ann B; Sikka, Manik; Gordon, Peter; Camhi, Eli; Kanter, Timothy; Bakken, Suzanne

2012-10-01

Case managers facilitate continuity of care for persons living with HIV (PLWH) by coordination of resources and referrals to social services and medical care. The complexity of HIV care and associated comorbidities drives the need for medical and psychosocial care coordination, which may be achieved through health information exchange (HIE) systems. However, the use of HIE has not been well studied in the context of HIV services. The purpose of this descriptive qualitative study is to explore factors influencing case managers' adoption of electronic clinical data (ECD) summaries as an HIE strategy in HIV care through application of the "fit between individuals, task and technology" (FITT) framework. Focus group methodology was used to gather perceptions from 48 participants who provided direct case management services for PLWH in New York City. Questions addressed current quality and efficiency challenges to HIE utilization in the context of case management of PLWH as well as barriers and enablers to use of an ECD summary. Analysis of the data was guided by the FITT framework. Major themes by interaction type were: (1) task-technology fit - resources, time and workflow; (2) individual-task fit - training and technical support; and 3) individual-technology fit - ECD summary functionality, technical difficulties and the need of a computer for each end-user. Our findings provide evidence for the applicability of the FITT framework to explore case managers' perceptions of factors influencing the adoption of ECD summary systems for HIV care prior to actual implementation. Assessment of fit among individual, task, and technology and addressing the concerns identified prior to implementation is critical to successful adoption of health information technology as a strategy to improve quality and efficiency in health care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

[The Development of Information Centralization and Management Integration System for Monitors Based on Wireless Sensor Network].

PubMed

Xu, Xiu; Zhang, Honglei; Li, Yiming; Li, Bin

2015-07-01

Developed the information centralization and management integration system for monitors of different brands and models with wireless sensor network technologies such as wireless location and wireless communication, based on the existing wireless network. With adaptive implementation and low cost, the system which possesses the advantages of real-time, efficiency and elaboration is able to collect status and data of the monitors, locate the monitors, and provide services with web server, video server and locating server via local network. Using an intranet computer, the clinical and device management staffs can access the status and parameters of monitors. Applications of this system provide convenience and save human resource for clinical departments, as well as promote the efficiency, accuracy and elaboration for the device management. The successful achievement of this system provides solution for integrated and elaborated management of the mobile devices including ventilator and infusion pump.

Efficient Assignment of Multiple E-MBMS Sessions towards LTE

NASA Astrophysics Data System (ADS)

Alexiou, Antonios; Bouras, Christos; Kokkinos, Vasileios

One of the major prerequisites for Long Term Evolution (LTE) networks is the mass provision of multimedia services to mobile users. To this end, Evolved - Multimedia Broadcast/Multicast Service (E-MBMS) is envisaged to play an instrumental role during LTE standardization process and ensure LTE’s proliferation in mobile market. E-MBMS targets at the economic delivery, in terms of power and spectral efficiency, of multimedia data from a single source entity to multiple destinations. This paper proposes a novel mechanism for efficient radio bearer selection during E-MBMS transmissions in LTE networks. The proposed mechanism is based on the concept of transport channels combination in any cell of the network. Most significantly, the mechanism manages to efficiently deliver multiple E-MBMS sessions. The performance of the proposed mechanism is evaluated and compared with several radio bearer selection mechanisms in order to highlight the enhancements that it provides.

Quality management standards for facility services in the Italian health care sector.

PubMed

Cesarotti, Vittorio; Di Silvio, Bruna

2006-01-01

Health care, one of the most dynamic sectors in Italy, is studied with a particular focus on outsourcing non-core activities such as facility management (FM) services. The project's goals are to define national standards to balance and control facility service evolution, and to drive FM services towards organisational excellence. The authors, in cooperation with a pool of facility service providers and hospitals managers, studied cleaning services--one of the most critical areas. This article describes the research steps and findings following definition and publication of the Italian standard and its application to an international benchmarking process. The method chosen for developing the Italian standard was to merge technical, strategic and organisational aspects with the goal of standardising the contracting system, giving service providers the chance to improve efficiency and quality, while helping healthcare organisations gain from a better, more reliable and less expensive service. The Italian standard not only improved services but also provided adequate control systems for outsourcing organisations. In this win-win context, it is hoped to continually drive FM services towards organisational excellence. This study is specific to the Italian national healthcare system. However, the strategic dynamics described are common to many other contexts. A systematic method for improving hospital FM services is presented. The authors believe that lessons learned from their Italian case study can be used to better understand and drive similar services in other countries or in other FM service outsourcing sectors.

Optical fiber cable and wiring techniques for fiber to the home (FTTH)

NASA Astrophysics Data System (ADS)

Takai, Hirofumi; Yamauchi, Osamu

2009-08-01

NTT group's new medium-term management strategy calls for 20 million optical subscribers by 2010, and NTT Laboratories is pushing forward to meet this goal. Before that date, an efficient optical access network must be constructed, and afterwards, when the era of mass optical communications finally arrives, the facilities and equipment supporting the network will have to be effectively operated and maintained. At NTT Access Network Service Systems Laboratories, we are developing various technologies to correspond to the massive deployment of optical broadband services. We are also developing various new technologies for efficiently operating optical access network systems that will continue to expand in the future, and to supply our customers with good services. This paper provides an overview of the new optical access network system technologies that are being developed at NTT Access Network Service Systems Laboratories to address these issues.

Lean for Government: Eliminating the Seven Wastes

NASA Technical Reports Server (NTRS)

Shepherd, Christena C.

2012-01-01

With shrinking budgets and a slow economy, it is becoming increasingly important for all government agencies to become more efficient. Citizens expect and deserve efficient and effective services from federal, state and local government agencies. One of the best methods to improve efficiency and eliminate waste is to institute the business process improvement methodologies known collectively as Lean; however, with reduced budgets, it may not be possible to train everyone in Lean or to engage the services of a trained consultant. It is possible, however, to raise awareness of the "Seven Wastes" of Lean in each employee, and encourage them to identify areas for improvement. Management commitment is vital to the success of these initiatives, and it is also important to develop the right metrics that will track the success of these changes.

Meteorological disaster management and assessment system design and implementation

NASA Astrophysics Data System (ADS)

Tang, Wei; Luo, Bin; Wu, Huanping

2009-09-01

Disaster prevention and mitigation get more and more attentions by Chinese government, with the national economic development in recent years. Some problems exhibit in traditional disaster management, such as the chaotic management of data, low level of information, poor data sharing. To improve the capability of information in disaster management, Meteorological Disaster Management and Assessment System (MDMAS) was developed and is introduced in the paper. MDMAS uses three-tier C/S architecture, including the application layer, data layer and service layer. Current functions of MDMAS include the typhoon and rainstorm assessment, disaster data query and statistics, automatic cartography for disaster management. The typhoon and rainstorm assessment models can be used in both pre-assessment of pre-disaster and post-disaster assessment. Implementation of automatic cartography uses ArcGIS Geoprocessing and ModelBuilder. In practice, MDMAS has been utilized to provide warning information, disaster assessment and services products. MDMAS is an efficient tool for meteorological disaster management and assessment. It can provide decision supports for disaster prevention and mitigation.

Meteorological disaster management and assessment system design and implementation

NASA Astrophysics Data System (ADS)

Tang, Wei; Luo, Bin; Wu, Huanping

2010-11-01

Disaster prevention and mitigation get more and more attentions by Chinese government, with the national economic development in recent years. Some problems exhibit in traditional disaster management, such as the chaotic management of data, low level of information, poor data sharing. To improve the capability of information in disaster management, Meteorological Disaster Management and Assessment System (MDMAS) was developed and is introduced in the paper. MDMAS uses three-tier C/S architecture, including the application layer, data layer and service layer. Current functions of MDMAS include the typhoon and rainstorm assessment, disaster data query and statistics, automatic cartography for disaster management. The typhoon and rainstorm assessment models can be used in both pre-assessment of pre-disaster and post-disaster assessment. Implementation of automatic cartography uses ArcGIS Geoprocessing and ModelBuilder. In practice, MDMAS has been utilized to provide warning information, disaster assessment and services products. MDMAS is an efficient tool for meteorological disaster management and assessment. It can provide decision supports for disaster prevention and mitigation.

The impact of using kiosk on enterprise systems in service industry

NASA Astrophysics Data System (ADS)

Chen, Jengchung V.; Yen, David; Dunk, Kimberly; Widjaja, Andree E.

2015-11-01

The hospitality industry services many types of travellers. Each of them needs to be analysed differently in order to accurately determine their respective service quality attributes and customer delight. The effective and efficient enterprise information systems (EISs) play a significant role in traveller's experience and in the competitive advantages that hotels can gain. For this study, self-service kiosks and guest service agents as part of hotel's EISs are used to investigate the impact each has on the experience of business and leisure travellers. This study provides empirical results that further investigate how to improve the service quality for both types of travellers during the registration process. This process is the first physical interaction between the travellers and the hotel. Any problem in registering would generate a long-lasting negative first impression on the travellers, thus diminishing the customer delight. In the light of our findings, this study will contribute to the effective and efficient design of self-service kiosk systems, hotel's EISs, and improved front office management to better accommodate the specific needs of both types of travellers.

The status of IT service management in health care - ITIL® in selected European countries.

PubMed

Hoerbst, Alexander; Hackl, Werner O; Blomer, Roland; Ammenwerth, Elske

2011-12-21

Due to the strained financial situation in the healthcare sector, hospitals and other healthcare providers are facing an increasing pressure to improve their efficiency and to reduce costs. These trends challenge health care organizations to introduce innovative information technology (IT) based supportive processes. To guarantee that IT supports the clinical processes perfectly, IT must be managed proactively. However, until now, there is only very few research on IT service management especially on ITIL® implementations in the health care context. The current study aims at exploring knowledge about and acceptance of IT service management (especially ITIL®) in hospitals in Austria and its neighboring regions Bavaria (Germany), Slovakia, South Tyrol (Italy) and Switzerland. Therefore highly standardized interviews with the respective head of information technology (CIO, IT manager) were conducted for selected hospitals from the different regions. In total 75 hospitals were interviewed. Data gathered was analyzed using descriptive statistics and where necessary methods of qualitative content analysis. In most regions, two-thirds or more of the participating IT managers claim to be familiar with the concepts of IT service management and of ITIL®. IT managers expect from ITIL® mostly better IT services, followed by an increased productivity and a reduction of IT cost. But only five hospitals said to have implemented at least parts of ITIL®, and eight hospitals stated to be planning to do this in the next two years. When it comes to ITIL®, Switzerland and Bavaria seem to be ahead of the other countries. There, the highest levels of knowledge, the highest number of implementations or plans of an implementation as well as the highest number of ITIL® certified staff members were observed. The results collected through this study indicate that the idea of IT services and IT service management is still not widely recognized in hospitals in the countries and regions of the study. It is also indicated that hospitals need further assistance in order to be able to successfully implement ITIL®. Overall, research on IT service management and ITIL® in health care is rare.

Application of activity-based costing (ABC) for a Peruvian NGO healthcare provider.

PubMed

Waters, H; Abdallah, H; Santillán, D

2001-01-01

This article describes the application of activity-based costing (ABC) to calculate the unit costs of the services for a health care provider in Peru. While traditional costing allocates overhead and indirect costs in proportion to production volume or to direct costs, ABC assigns costs through activities within an organization. ABC uses personnel interviews to determine principal activities and the distribution of individual's time among these activities. Indirect costs are linked to services through time allocation and other tracing methods, and the result is a more accurate estimate of unit costs. The study concludes that applying ABC in a developing country setting is feasible, yielding results that are directly applicable to pricing and management. ABC determines costs for individual clinics, departments and services according to the activities that originate these costs, showing where an organization spends its money. With this information, it is possible to identify services that are generating extra revenue and those operating at a loss, and to calculate cross subsidies across services. ABC also highlights areas in the health care process where efficiency improvements are possible. Conclusions about the ultimate impact of the methodology are not drawn here, since the study was not repeated and changes in utilization patterns and the addition of new clinics affected applicability of the results. A potential constraint to implementing ABC is the availability and organization of cost information. Applying ABC efficiently requires information to be readily available, by cost category and department, since the greatest benefits of ABC come from frequent, systematic application of the methodology in order to monitor efficiency and provide feedback for management. The article concludes with a discussion of the potential applications of ABC in the health sector in developing countries.

A GIS-based framework for evaluating investments in fire management: Spatial allocation of recreation values

Treesearch

Kenneth A. Baerenklau; Armando González-Cabán; Catrina I. Páez; Edgard Chávez

2009-01-01

The U.S. Forest Service is responsible for developing tools to facilitate effective and efficient fire management on wildlands and urban-wildland interfaces. Existing GIS-based fire modeling software only permits estimation of the costs of fire prevention and mitigation efforts as well as the effects of those efforts on fire behavior. This research demonstrates how the...

Lessons Learned from Outsourcing the Pearl Harbor MK-48 Intermediate Maintenance Activity

DTIC Science & Technology

2008-03-01

transfer of ownership of assets. However, outsourcing is not simply a procurement decision. All organizations procure elements of their operations...systems, commercialization, and franchising (Office of Management and Budget, 2004). Strengths of Outsourcing Outsourcing is more efficient than...operating the IMA with organic resources vs . the cost of a comparable service provided by a contractor. Activity-based costing would also help managers

Replacing the Lab Manual with a Learning Management System in Physics Investigations for K-4 Pre-Service Teachers

ERIC Educational Resources Information Center

Sobolewski, Stanley; Numan, Muhammad Z.

2018-01-01

The traditional laboratory investigation uses a procedure written on paper; students then record their responses on a supplied data page or laboratory notebook. In an attempt to make this process more efficient, the use of a Learning Management System (in this case D2L) was used to present the material and collect student feedback. Each student…

Asset Management: Roof Maintenance and Facility Energy Retrofits

DTIC Science & Technology

2012-03-01

vapor low emission coatings. Floor finishes completed in ceramic stone tile were the most efficient floor coverings. Fixed insulated fiberglass window...been coined Asset Management which utilizes organizational levels of service, business case analysis, and risk analysis to address urgent...Force have left a number of facility systems such as roofs at risk to disrepair due to a lack of maintenance. Under the principles of asset

7 CFR 1942.17 - Community facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... economic purposes a single community having a contiguous boundary. (2) Project selection process. The... efficient management and economical service; and/or enlarge, extend, or otherwise modify existing facilities... account for items such as geographic distribution of funds and emergency conditions caused by economic...

7 CFR 1942.17 - Community facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... economic purposes a single community having a contiguous boundary. (2) Project selection process. The... efficient management and economical service; and/or enlarge, extend, or otherwise modify existing facilities... account for items such as geographic distribution of funds and emergency conditions caused by economic...

7 CFR 1942.17 - Community facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... economic purposes a single community having a contiguous boundary. (2) Project selection process. The... efficient management and economical service; and/or enlarge, extend, or otherwise modify existing facilities... account for items such as geographic distribution of funds and emergency conditions caused by economic...

7 CFR 1942.17 - Community facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... economic purposes a single community having a contiguous boundary. (2) Project selection process. The... efficient management and economical service; and/or enlarge, extend, or otherwise modify existing facilities... account for items such as geographic distribution of funds and emergency conditions caused by economic...

Defense transportation : more reliable information key to managing airlift services more efficiently

DOT National Transportation Integrated Search

2000-02-01

The Department of Defense's (DOD) guidance provides that the Air Mobility Command's airlift costs associated with its peacetime mission (operations and maintenance) are to be funded through a transportation working capital fund. Under the working cap...

Case management for high-intensity service users: towards a relational approach to care co-ordination.

PubMed

McEvoy, Phil; Escott, Diane; Bee, Penny

2011-01-01

This study is based on a formative evaluation of a case management service for high-intensity service users in Northern England. The evaluation had three main purposes: (i) to assess the quality of the organisational infrastructure; (ii) to obtain a better understanding of the key influences that played a role in shaping the development of the service; and (iii) to identify potential changes in practice that may help to improve the quality of service provision. The evaluation was informed by Gittell's relational co-ordination theory, which focuses upon cross-boundary working practices that facilitate task integration. The Assessment of Chronic Illness Care Survey was used to assess the organisational infrastructure and qualitative interviews with front line staff were conducted to explore the key influences that shaped the development of the service. A high level of strategic commitment and political support for integrated working was identified. However, the quality of care co-ordination was variable. The most prominent operational factor that appeared to influence the scope and quality of care co-ordination was the pattern of interaction between the case managers and their co-workers. The co-ordination of patient care was much more effective in integrated co-ordination networks. Key features included clearly defined, task focussed, relational workspaces with interactive forums where case managers could engage with co-workers in discussions about the management of interdependent care activities. In dispersed co-ordination networks with fewer relational workspaces, the case managers struggled to work as effectively. The evaluation concluded that the creation of flexible and efficient task focused relational workspaces that are systemically managed and adequately resourced could help to improve the quality of care co-ordination, particularly in dispersed networks. © 2010 Blackwell Publishing Ltd.

Modeling the Supply Process Using the Application of Selected Methods of Operational Analysis

NASA Astrophysics Data System (ADS)

Chovancová, Mária; Klapita, Vladimír

2017-03-01

Supply process is one of the most important enterprise activities. All raw materials, intermediate products and products, which are moved within enterprise, are the subject of inventory management and by their effective management significant improvement of enterprise position on the market can be achieved. For that reason, the inventory needs to be managed, monitored, evaluated and affected. The paper deals with utilizing the methods of the operational analysis in the field of inventory management in terms of achieving the economic efficiency and ensuring the particular customer's service level as well.

The Design and Development of a Management Information System for the Monterey Navy Flying Club.

DTIC Science & Technology

1986-03-27

Management Information System for the Monterey Navy Flying Club. It supplies the tools necessary to enable the club manager to maintain all club records and generate required administrative and financial reports. The Monterey Navy Flying Club has one of the largest memberships of the Navy sponsored flying clubs. As a result of this large membership and the amount of manual paperwork required to properly maintain club records, the Manager’s ability to provide necessary services and reports in severely hampered. The implementation of an efficient

Essential Concepts in Modern Health Services

PubMed Central

El Taguri, A

2008-01-01

Health services have the functions to define community health problems, to identify unmet needs and survey the resources to meet them, to establish SMART objectives, and to project administrative actions to accomplish the purpose of proposed action programs. For maximum efficacy, health systems should rely on newer approaches of management as management-by-objectives, risk-management, and performance management with full and equal participation from professionals and consumers. The public should be well informed about their needs and what is expected from them to improve their health. Inefficient use of budget allocated to health services should be prevented by tools like performance management and clinical governance. Data processed to information and intelligence is needed to deal with changing disease patterns and to encourage policies that could manage with the complex feedback system of health. e-health solutions should be instituted to increase effectiveness and improve efficiency and informing human resources and populations. Suitable legislations should be introduced including those that ensure coordination between different sectors. Competent workforce should be given the opportunity to receive lifetime appropriate adequate training. External continuous evaluation using appropriate indicators is vital. Actions should be done both inside and outside the health sector to monitor changes and overcome constraints. PMID:21499457

An Analysis of Marine Corps Training

DTIC Science & Technology

1978-06-01

total systems approach to datarmine how it can be made more effective and efficient with the ultimate goal of improved combat readiness. Six major...their attention in recent years on the costs and the effectiveness of military train- ing and ieducation.- This concern has -caused each of the Services...more-effi- cient-without a- loss- of effectiveness . To achieve--optimum effectiveness and-efficiency,_ decisions €o6ncerning -manage- ment of the-tr

Development of an integrated methodology for the sustainable environmental and socio-economic management of river ecosystems.

PubMed

Koundouri, P; Ker Rault, P; Pergamalis, V; Skianis, V; Souliotis, I

2016-01-01

The development of the Water Framework Directive aimed to establish an integrated framework of water management at European level. This framework revolves around inland surface waters, transitional waters, coastal waters and ground waters. In the process of achieving the environment and ecological objectives set from the Directive, the role of economics is put in the core of the water management. An important feature of the Directive is the recovery of total economic cost of water services by all users. The total cost of water services can be disaggregated into environmental, financial and resource costs. Another important aspect of the directive is the identification of major drivers and pressures in each River Basin District. We describe a methodology that is aiming to achieve sustainable and environmental and socioeconomic management of freshwater ecosystem services. The Ecosystem Services Approach is in the core of the suggested methodology for the implementation of a more sustainable and efficient water management. This approach consists of the following three steps: (i) socio-economic characterization of the River Basin area, (ii) assessment of the current recovery of water use cost, and (iii) identification and suggestion of appropriate programs of measures for sustainable water management over space and time. This methodology is consistent with a) the economic principles adopted explicitly by the Water Framework Directive (WFD), b) the three-step WFD implementation approach adopted in the WATECO document, c) the Ecosystem Services Approach to valuing freshwater goods and services to humans. Furthermore, we analyze how the effects of multiple stressors and socio-economic development can be quantified in the context of freshwater resources management. We also attempt to estimate the value of four ecosystem services using the benefit transfer approach for the Anglian River Basin, which showed the significance of such services. Copyright © 2015. Published by Elsevier B.V.

Ethical issues in hospital clients' satisfaction: a Brazilian perspective.

PubMed

Rocha, Elyrose S B; Ventura, Carla A A; de Godoy, Simone; Mendes, Isabel A C; Trevizan, Maria A

2015-03-01

Health institutions can be considered as complex organizations because they need to be prepared to receive and satisfy patients. This clientele differs from other organizations because the use of hospital services is not a matter of choice. Another motive for this difference is that, most often, the patients do not determine what services and products they will use during their stay. Although they are the clients, usually, health professionals decide which service or product they will consume. Hence, nursing care delivery based on competence, efficiency and ethics represents a challenge. This critical reflection is meant to draw attention to the relevance of the ethical aspects of nurses' actions involving patients' satisfaction with nursing care. This paper highlights the responsibility of nurses to develop ethical actions in their commitment to manage and provide care with quality, commitment and efficiency. Possibilities of actions needed emerged from this discussion, such as the provision of reliable and updated information to clients, respect for standards, routines of care, exams and others, as well as clients' education, in order to further their involvement and participation in decisions concerning the care planned for them. The adoption of this paradigm entails a change in the performance of nurses' management and care roles, which may have to observe attitudes previously disregarded in most services provided. © The Author(s) 2014.

Evaluation of an open access echocardiography service in the Netherlands: a mixed methods study of indications, outcomes, patient management and trends.

PubMed

van Heur, Leanne M S G; Baur, Leo H B; Tent, Marleen; Lodewijks-van der Bolt, Cara L B; Streppel, Marjolijn; Winkens, Ron A G; Stoffers, Henri E J H

2010-02-10

In our region (Eastern South Limburg, The Netherlands) an open access echocardiography service started in 2002. It was the first service of this kind in The Netherlands. Our study aims were: (1) to evaluate demand for the service, participation, indications, echocardiography outcomes, and management by the general practitioner (GP); (2) to analyse changes in indications and outcomes over the years. (1) Data from GP request forms, echocardiography reports and a retrospective GP questionnaire on management (response rate 83%) of 625 consecutive patients (Dec. 2002-March 2007) were analysed cross-sectionally. (2) For the analysis of changes over the years, data from GP request forms and echocardiography reports of the first and last 250 patients that visited the service between Dec. 2002 and Feb. 2008 (n = 1001) were compared. The echocardiography service was used by 81% of the regional GPs. On average, a GP referred one patient per year to the service. Intended indications for the service were dyspnoea (32%), cardiac murmur (59%), and peripheral oedema (17%). Of the other indications (22%), one-third was for evaluation of suspected left ventricular hypertrophy (LVH). Expected outcomes were left ventricular dysfunction (LVD) (43%, predominantly diastolic) and valve disease (25%). We also found a high proportion of LVH (50%). Only 24% of all echocardiograms showed no relevant disease. The GP followed the cardiologist's advice to refer the patient for further evaluation in 71%. In recent patients, more echocardiography requests were done for 'cardiac murmur' and 'other' indications, but less for 'dyspnoea'. The proportions of patients with LVD, LVH and valve disease decreased and the proportion of patients with no relevant disease increased. The number of advices by the cardiologists increased. Overall, GPs used the open access echocardiography service efficiently (i.e. with a high chance of finding relevant pathology), but efficiency decreased slightly over the years. To meet the needs of the GPs, indications might be widened with 'suspicion LVH'. Further specification of the indications for open access echocardiography--by defining a stepwise diagnostic approach including ECG and (NT-pro)BNP--might improve the service.

Evaluation of an open access echocardiography service in the Netherlands: a mixed methods study of indications, outcomes, patient management and trends

PubMed Central

2010-01-01

Background In our region (Eastern South Limburg, The Netherlands) an open access echocardiography service started in 2002. It was the first service of this kind in The Netherlands. Our study aims were: (1) to evaluate demand for the service, participation, indications, echocardiography outcomes, and management by the general practitioner (GP); (2) to analyse changes in indications and outcomes over the years. Methods (1) Data from GP request forms, echocardiography reports and a retrospective GP questionnaire on management (response rate 83%) of 625 consecutive patients (Dec. 2002 - March 2007) were analysed cross-sectionally. (2) For the analysis of changes over the years, data from GP request forms and echocardiography reports of the first and last 250 patients that visited the service between Dec. 2002 and Feb. 2008 (n = 1001) were compared. Results The echocardiography service was used by 81% of the regional GPs. On average, a GP referred one patient per year to the service. Intended indications for the service were dyspnoea (32%), cardiac murmur (59%), and peripheral oedema (17%). Of the other indications (22%), one-third was for evaluation of suspected left ventricular hypertrophy (LVH). Expected outcomes were left ventricular dysfunction (LVD) (43%, predominantly diastolic) and valve disease (25%). We also found a high proportion of LVH (50%). Only 24% of all echocardiograms showed no relevant disease. The GP followed the cardiologist's advice to refer the patient for further evaluation in 71%. In recent patients, more echocardiography requests were done for 'cardiac murmur' and 'other' indications, but less for 'dyspnoea'. The proportions of patients with LVD, LVH and valve disease decreased and the proportion of patients with no relevant disease increased. The number of advices by the cardiologists increased. Conclusion Overall, GPs used the open access echocardiography service efficiently (i.e. with a high chance of finding relevant pathology), but efficiency decreased slightly over the years. To meet the needs of the GPs, indications might be widened with 'suspicion LVH'. Further specification of the indications for open access echocardiography - by defining a stepwise diagnostic approach including ECG and (NT-pro)BNP - might improve the service. PMID:20144244

Critical Zone Services as Environmental Assessment Criteria in Intensively Managed Agricultural Landscapes

NASA Astrophysics Data System (ADS)

Richardson, M.; Kumar, P.

2016-12-01

The critical zone (CZ) includes the biophysical processes occurring from the top of the vegetation canopy to the weathering zone below the groundwater table. CZ services provide a measure for the goods and benefits derived from CZ processes. In intensively managed landscapes (IML), the provisioning, supporting, and regulating services are altered through anthropogenic energy inputs to derive more productivity, as agricultural products, from these landscapes than would be possible under natural conditions. However, the energy or cost equivalents of alterations to CZ functions within landscape profiles are unknown. The valuation of CZ services in energy or monetary terms provides a more concrete tool for characterizing seemingly abstract environmental damages from agricultural production systems. A multi-layer canopy-root-soil model is combined with nutrient and water flux models to simulate the movement of nutrients throughout the soil system. This data enables the measurement of agricultural anthropogenic impacts to the CZ's nutrient cycling supporting services and atmospheric stabilizing regulating services defined by the flux of carbon and nutrients. Such measurements include soil carbon storage, soil carbon respiration, nitrate leaching, and nitrous oxide flux into the atmosphere. Additionally, the socioeconomic values of corn feed and ethanol define the primary productivity supporting services of each crop use.In the debate between feed production and corn-based ethanol production, measured nutrient CZ services can cost up to four times more than traditionally estimated CO2 equivalences for the entire bioenergy production system. Energy efficiency in addition to environmental impacts demonstrate how the inclusion of CZ services is necessary in accounting for the entire life cycle of agricultural production systems. These results conclude that feed production systems are more energy efficient and less environmentally costly than corn-based ethanol systems.

CMS users data management service integration and first experiences with its NoSQL data storage

NASA Astrophysics Data System (ADS)

Riahi, H.; Spiga, D.; Boccali, T.; Ciangottini, D.; Cinquilli, M.; Hernàndez, J. M.; Konstantinov, P.; Mascheroni, M.; Santocchia, A.

2014-06-01

The distributed data analysis workflow in CMS assumes that jobs run in a different location to where their results are finally stored. Typically the user outputs must be transferred from one site to another by a dedicated CMS service, AsyncStageOut. This new service is originally developed to address the inefficiency in using the CMS computing resources when transferring the analysis job outputs, synchronously, once they are produced in the job execution node to the remote site. The AsyncStageOut is designed as a thin application relying only on the NoSQL database (CouchDB) as input and data storage. It has progressed from a limited prototype to a highly adaptable service which manages and monitors the whole user files steps, namely file transfer and publication. The AsyncStageOut is integrated with the Common CMS/Atlas Analysis Framework. It foresees the management of nearly nearly 200k users' files per day of close to 1000 individual users per month with minimal delays, and providing a real time monitoring and reports to users and service operators, while being highly available. The associated data volume represents a new set of challenges in the areas of database scalability and service performance and efficiency. In this paper, we present an overview of the AsyncStageOut model and the integration strategy with the Common Analysis Framework. The motivations for using the NoSQL technology are also presented, as well as data design and the techniques used for efficient indexing and monitoring of the data. We describe deployment model for the high availability and scalability of the service. We also discuss the hardware requirements and the results achieved as they were determined by testing with actual data and realistic loads during the commissioning and the initial production phase with the Common Analysis Framework.

Elevated soil nitrogen pools after conversion of turfgrass to water-efficient residential landscapes

NASA Astrophysics Data System (ADS)

Heavenrich, Hannah; Hall, Sharon J.

2016-08-01

As a result of uncertain resource availability and growing populations, city managers are implementing conservation plans that aim to provide services for people while reducing household resource use. For example, in the US, municipalities are incentivizing homeowners to replace their water-intensive turfgrass lawns with water-efficient landscapes consisting of interspersed drought-tolerant shrubs and trees with rock or mulch groundcover (e.g. xeriscapes, rain gardens, water-wise landscapes). While these strategies are likely to reduce water demand, the consequences for other ecosystem services are unclear. Previous studies in controlled, experimental landscapes have shown that conversion from turfgrass to shrubs may lead to high rates of nutrient leaching from soils. However, little is known about the long-term biogeochemical consequences of this increasingly common land cover change across diverse homeowner management practices. We explored the fate of soil nitrogen (N) across a chronosequence of land cover change from turfgrass to water-efficient landscapes in privately owned yards in metropolitan Phoenix, Arizona, in the arid US Southwest. Soil nitrate ({{{{NO}}}3}--N) pools were four times larger in water-efficient landscapes (25 ± 4 kg {{{{NO}}}3}--N/ha 0-45 cm depth) compared to turfgrass lawns (6 ± 7 kg {{{{NO}}}3}--N/ha). Soil {{{{NO}}}3}--N also varied significantly with time since landscape conversion; the largest pools occurred at 9-13 years after turfgrass removal and declined to levels comparable to turfgrass thereafter. Variation in soil {{{{NO}}}3}--N with landscape age was strongly influenced by management practices related to soil water availability, including shrub cover, sub-surface plastic sheeting, and irrigation frequency. Our findings show that transitioning from turfgrass to water-efficient residential landscaping can lead to an accumulation of {{{{NO}}}3}--N that may be lost from the plant rooting zone over time following irrigation or rainfall. These results have implications for best management practices to optimize the benefits of water-conserving landscapes while protecting water quality.

Healthcare knowledge management through building and operationalising healthcare enterprise memory.

PubMed

Cheah, Y N; Abidi, S S

1999-01-01

In this paper we suggest that the healthcare enterprise needs to be more conscious of its vast knowledge resources vis-à-vis the exploitation of knowledge management techniques to efficiently manage its knowledge. The development of healthcare enterprise memory is suggested as a solution, together with a novel approach advocating the operationalisation of healthcare enterprise memories leading to the modelling of healthcare processes for strategic planning. As an example, we present a simulation of Service Delivery Time in a hospital's OPD.

Privatization of solid waste collection services: Lessons from Gaborone.

PubMed

Bolaane, Benjamin; Isaac, Emmanuel

2015-06-01

Formal privatization of solid waste collection activities has often been flagged as a suitable intervention for some of the challenges of solid waste management experienced by developing countries. Proponents of outsourcing collection to the private sector argue that in contrast to the public sector, it is more effective and efficient in delivering services. This essay is a comparative case study of efficiency and effectiveness attributes between the public and the formal private sector, in relation to the collection of commercial waste in Gaborone. The paper is based on analysis of secondary data and key informant interviews. It was found that while, the private sector performed comparatively well in most of the chosen indicators of efficiency and effectiveness, the public sector also had areas where it had a competitive advantage. For instance, the private sector used the collection crew more efficiently, while the public sector was found to have a more reliable workforce. The study recommends that, while formal private sector participation in waste collection has some positive effects in terms of quality of service rendered, in most developing countries, it has to be enhanced by building sufficient capacity within the public sector on information about services contracted out and evaluation of performance criteria within the contracting process. Copyright © 2015 Elsevier Ltd. All rights reserved.

Health workforce planning and service expansion during an economic crisis: A case study of the national breast screening programme in Ireland.

PubMed

McHugh, S M; Tyrrell, E; Johnson, B; Healy, O; Perry, I J; Normand, C

2015-12-01

This article aims to estimate the workforce and resource implications of the proposed age extension of the national breast screening programme, under the economic constraints of reduced health budgets and staffing levels in the Irish health system. Using a mixed method design, a purposive sample of 20 participants were interviewed and data were analysed thematically (June-September 2012). Quantitative data (programme-level activity data, screening activity, staffing levels and screening plans) were used to model potential workload and resource requirements. The analysis indicates that over 90% operational efficiency was achieved throughout the first six months of 2012. Accounting for maternity leave (10%) and sick leave (3.5%), 16.1 additional radiographers (whole time equivalent) would be required for the workload created by the age extension of the screening programme, at 90% operational efficiency. The results suggest that service expansion is possible with relatively minimal additional radiography resources if the efficiency of the skill mix and the use of equipment are improved. Investing in the appropriate skill mix should not be limited to clinical groups but should also include administrative staff to manage and support the service. Workload modelling may contribute to improved health workforce planning and service efficiency. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Highly efficient light management for perovskite solar cells

PubMed Central

Wang, Dong-Lin; Cui, Hui-Juan; Hou, Guo-Jiao; Zhu, Zhen-Gang; Yan, Qing-Bo; Su, Gang

2016-01-01

Organic-inorganic halide perovskite solar cells have enormous potential to impact the existing photovoltaic industry. As realizing a higher conversion efficiency of the solar cell is still the most crucial task, a great number of schemes were proposed to minimize the carrier loss by optimizing the electrical properties of the perovskite solar cells. Here, we focus on another significant aspect that is to minimize the light loss by optimizing the light management to gain a high efficiency for perovskite solar cells. In our scheme, the slotted and inverted prism structured SiO2 layers are adopted to trap more light into the solar cells, and a better transparent conducting oxide layer is employed to reduce the parasitic absorption. For such an implementation, the efficiency and the serviceable angle of the perovskite solar cell can be promoted impressively. This proposal would shed new light on developing the high-performance perovskite solar cells. PMID:26733112

Highly efficient light management for perovskite solar cells

NASA Astrophysics Data System (ADS)

Wang, Dong-Lin; Cui, Hui-Juan; Hou, Guo-Jiao; Zhu, Zhen-Gang; Yan, Qing-Bo; Su, Gang

2016-01-01

Organic-inorganic halide perovskite solar cells have enormous potential to impact the existing photovoltaic industry. As realizing a higher conversion efficiency of the solar cell is still the most crucial task, a great number of schemes were proposed to minimize the carrier loss by optimizing the electrical properties of the perovskite solar cells. Here, we focus on another significant aspect that is to minimize the light loss by optimizing the light management to gain a high efficiency for perovskite solar cells. In our scheme, the slotted and inverted prism structured SiO2 layers are adopted to trap more light into the solar cells, and a better transparent conducting oxide layer is employed to reduce the parasitic absorption. For such an implementation, the efficiency and the serviceable angle of the perovskite solar cell can be promoted impressively. This proposal would shed new light on developing the high-performance perovskite solar cells.

Highly efficient light management for perovskite solar cells.

PubMed

Wang, Dong-Lin; Cui, Hui-Juan; Hou, Guo-Jiao; Zhu, Zhen-Gang; Yan, Qing-Bo; Su, Gang

2016-01-06

Organic-inorganic halide perovskite solar cells have enormous potential to impact the existing photovoltaic industry. As realizing a higher conversion efficiency of the solar cell is still the most crucial task, a great number of schemes were proposed to minimize the carrier loss by optimizing the electrical properties of the perovskite solar cells. Here, we focus on another significant aspect that is to minimize the light loss by optimizing the light management to gain a high efficiency for perovskite solar cells. In our scheme, the slotted and inverted prism structured SiO2 layers are adopted to trap more light into the solar cells, and a better transparent conducting oxide layer is employed to reduce the parasitic absorption. For such an implementation, the efficiency and the serviceable angle of the perovskite solar cell can be promoted impressively. This proposal would shed new light on developing the high-performance perovskite solar cells.

International Space Station Bacteria Filter Element Service Life Evaluation

NASA Technical Reports Server (NTRS)

Perry, J. L.

2005-01-01

The International Space Station (ISS) uses high-efficiency particulate air filters to remove particulate matter from the cabin atmosphere. Known as bacteria filter elements (BFEs), there are 13 elements deployed on board the ISS's U.S. segment in the flight 4R assembly level. The preflight service life prediction of 1 yr for the BFEs is based upon engineering analysis of data collected during developmental testing that used a synthetic dust challenge. While this challenge is considered reasonable and conservative from a design perspective, an understanding of the actual filter loading is required to best manage the critical ISS program resources. Testing was conducted on BFEs returned from the ISS to refine the service life prediction. Results from this testing and implications to ISS resource management are provided.

Semantic Catalog of Things, Services, and Data to Support a Wind Data Management Facility

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stephan, E. G.; Elsethagen, T. O.; Berg, L. K.

The purpose of this paper is to discuss how community vocabularies and linked open data best practices are being used to seamlessly link things, data, and off the shelf services to support scientific offshore wind energy research for the U.S. Department of Energy’s Office of Energy Efficiency and Renewable Energy (EERE) Wind and Water Power Program. This is largely made possible by leveraging collaborative advances in the Internet of Things (IoT), Semantic Web, Linked Services, Linked Open Data (LOD), and RDF vocabulary communities, which provide the foundation for our design. By adapting these linked community best practices, we designed amore » wind characterization data management facility capable of continually collecting, processing, and preservation of in situ and remote sensing instrume« less

Implementation Of Quality Management System For Irradiation Processing Services

NASA Astrophysics Data System (ADS)

Lungu, Ion-Bogdan; Manea, Maria-Mihaela

2015-07-01

In today's market, due to an increasing competitiveness, quality management has set itself as an indispensable tool and a reference point for every business. It is ultimately focused on customer satisfaction which is a stringent factor for every business. Implementing and maintaining a QMS is a rather difficult, time consuming and expensive process which must be done with respect of many factors. The aim of this paper is to present a case study for implementing QMS ISO 9001 in a gamma irradiation treatment service provider. The research goals are the identification of key benefits, reasons, advantages, disadvantages, drawbacks etc for a successful QMS implementation and use. Finally, the expected results focus on creating a general framework for implementing an efficient QMS plan that can be easily adapted to other kind of services and markets.

Deferred Maintenance.

ERIC Educational Resources Information Center

DeLong, Richard A.

1984-01-01

Unusually hard hit by the 1970s recession, the University of Michigan accumulated more deferred maintenance problems than could be analyzed efficiently either by hand or with existing computer systems. Using an existing microcomputer and a database management software package, the maintenance service developed its own database to support…

7 CFR 1207.335 - Research and promotion.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (MARKETING... projects and studies to the end that the marketing and utilization of potatoes may be encouraged, expanded, improved, or made more efficient: Provided, That quality control, grade standards and supply management...

Adding intelligence to mobile asset management in hospitals: the true value of RFID.

PubMed

Castro, Linda; Lefebvre, Elisabeth; Lefebvre, Louis A

2013-10-01

RFID (Radio Frequency Identification) technology is expected to play a vital role in the healthcare arena, especially in times when cost containments are at the top of the priorities of healthcare management authorities. Medical equipment represents a significant share of yearly healthcare operational costs; hence, ensuring an effective and efficient management of such key assets is critical to promptly and reliably deliver a diversity of clinical services at the patient bedside. Empirical evidence from a phased-out RFID implementation in one European hospital demonstrates that RFID has the potential to transform asset management by improving inventory management, enhancing asset utilization, increasing staff productivity, improving care services, enhancing maintenance compliance, and increasing information visibility. Most importantly, RFID allows the emergence of intelligent asset management processes, which is, undoubtedly, the most important benefit that could be derived from the RFID system. Results show that the added intelligence can be rather basic (auto-status change) or a bit more advanced (personalized automatic triggers). More importantly, adding intelligence improves planning and decision-making processes.

[Hospital efficiency measured by bed space use in a secondary care hospital].

PubMed

Moreno-Martínez, Roberto; Martínez-Cruz, Rocío Alejandra

2015-01-01

In recognition that the availability of resources in the medical facility forms part of the factors that influence the quality of healthcare, it is of vital importance to measure their outcome. The aim of this study was determine the efficiency of the medical facility through the use of beds in a secondary level hospital. Through the Health Information Management System (HIMS), we examined statistical reports from July 2012 to June 2013 including variables such as expenses, patient days, occupancy rate, average length of stay by specialty and medical division, results were obtained for each strategic indicator, and these results were related assumptions proposing to assess hospital efficiency. Overall, we identified optimal efficiency of the medical facility without analysis of services, leads to deteriorating and low efficiency. The overall outcome of the five indicators applied overlooked saturation of services within the medical unit. However, the overall analysis shows the problem, noting the advantage of evaluating the same scenario from different perspectives. The include indicators measuring hospital efficiency resource based bed, allows considering deficiencies identified, so that decision making is strengthened the decision making health.

Asan medical information system for healthcare quality improvement.

PubMed

Ryu, Hyeon Jeong; Kim, Woo Sung; Lee, Jae Ho; Min, Sung Woo; Kim, Sun Ja; Lee, Yong Su; Lee, Young Ha; Nam, Sang Woo; Eo, Gi Seung; Seo, Sook Gyoung; Nam, Mi Hyun

2010-09-01

This purpose of this paper is to introduce the status of the Asan Medical Center (AMC) medical information system with respect to healthcare quality improvement. Asan Medical Information System (AMIS) is projected to become a completely electronic and digital information hospital. AMIS has played a role in improving the health care quality based on the following measures: safety, effectiveness, patient-centeredness, timeliness, efficiency, privacy, and security. AMIS CONSISTED OF SEVERAL DISTINCTIVE SYSTEMS: order communication system, electronic medical record, picture archiving communication system, clinical research information system, data warehouse, enterprise resource planning, IT service management system, and disaster recovery system. The most distinctive features of AMIS were the high alert-medication recognition & management system, the integrated and severity stratified alert system, the integrated patient monitoring system, the perioperative diabetic care monitoring and support system, and the clinical indicator management system. AMIS provides IT services for AMC, 7 affiliated hospitals and over 5,000 partners clinics, and was developed to improve healthcare services. The current challenge of AMIS is standard and interoperability. A global health IT strategy is needed to get through the current challenges and to provide new services as needed.

Optimal control of soybean aphid in the presence of natural enemies and the implied value of their ecosystem services.

PubMed

Zhang, Wei; Swinton, Scott M

2012-04-15

By suppressing pest populations, natural enemies provide an important ecosystem service that maintains the stability of agricultural ecosystems systems and potentially mitigates producers' pest control costs. Integrating natural control services into decisions about pesticide-based control has the potential to significantly improve the economic efficiency of pesticide use, with socially desirable outcomes. Two gaps have hindered the incorporation of natural enemies into pest management decision rules: (1) insufficient knowledge of pest and predator population dynamics and (2) lack of a decision framework for the economic tradeoffs among pest control options. Using a new intra-seasonal, dynamic bioeconomic optimization model, this study assesses how predation by natural enemies contributes to profit-maximizing pest management strategies. The model is applied to the management of the invasive soybean aphid, the most significant serious insect threat to soybean production in North America. The resulting lower bound estimate of the value of natural pest control ecosystem services was estimated at $84 million for the states of Illinois, Indiana, Iowa, Michigan and Minnesota in 2005. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Methods in health services research. The example of the evaluation of the German disease management programmes].

PubMed

Morfeld, M; Wirtz, M

2006-02-01

According to the established definition of Pfaff, health services research analyses patients' path through the institutions of the health care system. The focus is on development, evaluation and implementation of innovative measures of health care. By increasing its quality health services research strives for an improvement of efficacy and efficiency of the health care system. In order to allow for an appropriate evaluation it is essential to differentiate between structure, process and outcome quality referring to (1) the health care system in its entirety, (2) specific health care units as well as (3) processes of communication in different settings. Health services research comprises a large array of scientific disciplines like public health, medicine, social sciences and social care. For the purpose of managing its tasks adequately a special combination of instruments and methodological procedures is needed. Thus, diverse techniques of evaluation research as well as special requirements for study designs and assessment procedures are of vital importance. The example of the German disease management programmes illustrates the methodical requirements for a scientific evaluation.

Patients’ Data Management System Protected by Identity-Based Authentication and Key Exchange

PubMed Central

Rivero-García, Alexandra; Santos-González, Iván; Hernández-Goya, Candelaria; Caballero-Gil, Pino; Yung, Moti

2017-01-01

A secure and distributed framework for the management of patients’ information in emergency and hospitalization services is proposed here in order to seek improvements in efficiency and security in this important area. In particular, confidentiality protection, mutual authentication, and automatic identification of patients are provided. The proposed system is based on two types of devices: Near Field Communication (NFC) wristbands assigned to patients, and mobile devices assigned to medical staff. Two other main elements of the system are an intermediate server to manage the involved data, and a second server with a private key generator to define the information required to protect communications. An identity-based authentication and key exchange scheme is essential to provide confidential communication and mutual authentication between the medical staff and the private key generator through an intermediate server. The identification of patients is carried out through a keyed-hash message authentication code. Thanks to the combination of the aforementioned tools, a secure alternative mobile health (mHealth) scheme for managing patients’ data is defined for emergency and hospitalization services. Different parts of the proposed system have been implemented, including mobile application, intermediate server, private key generator and communication channels. Apart from that, several simulations have been performed, and, compared with the current system, significant improvements in efficiency have been observed. PMID:28362328

Patients' Data Management System Protected by Identity-Based Authentication and Key Exchange.

PubMed

Rivero-García, Alexandra; Santos-González, Iván; Hernández-Goya, Candelaria; Caballero-Gil, Pino; Yung, Moti

2017-03-31

A secure and distributed framework for the management of patients' information in emergency and hospitalization services is proposed here in order to seek improvements in efficiency and security in this important area. In particular, confidentiality protection, mutual authentication, and automatic identification of patients are provided. The proposed system is based on two types of devices: Near Field Communication (NFC) wristbands assigned to patients, and mobile devices assigned to medical staff. Two other main elements of the system are an intermediate server to manage the involved data, and a second server with a private key generator to define the information required to protect communications. An identity-based authentication and key exchange scheme is essential to provide confidential communication and mutual authentication between the medical staff and the private key generator through an intermediate server. The identification of patients is carried out through a keyed-hash message authentication code. Thanks to the combination of the aforementioned tools, a secure alternative mobile health (mHealth) scheme for managing patients' data is defined for emergency and hospitalization services. Different parts of the proposed system have been implemented, including mobile application, intermediate server, private key generator and communication channels. Apart from that, several simulations have been performed, and, compared with the current system, significant improvements in efficiency have been observed.

Office of Inspector General audit report on Fluor Daniel Fernald`s use of temporary services subcontractors

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1998-04-01

The Department of Energy (Department) and Fluor Daniel Fernald (Fluor Daniel) implemented two work force restructurings at the Fernald Environmental Management Project between Fiscal Years (FY) 1994 and 1996. During the restructurings, the Department`s cost for temporary service subcontracts increased from $2.8 million to $9.8 million annually. The objective of this audit was to determine whether Fluor Daniel utilized temporary service agreements in an economical and efficient manner and in accordance with the policy and goals of the Department`s Work Force Restructuring Program.

Matching services with local preferences: managing primary education services in a rural district of India.

PubMed

Subrahmanian, R

1999-02-01

India's poorest households have particularly little access to education. Urgent reforms are therefore needed to improve the universal availability of quality basic services and universal access to those services. At least 32 million children in India are estimated to not be enrolled and attending school. These children must be brought into schools in order to meet the goal of Universal Elementary Education (UEE). Widespread support exists for the decentralization of public services due to the equity and efficiency benefits associated with it. In particular, decentralization is seen to facilitate the matching of services with local preferences, increasing the chances of meeting policy goals. This approach is explored in the context of research conducted in a village of Raichur district, where poor households' preferences with regard to school timing are analyzed. Sections consider the equity and efficiency merits of decentralization, the agenda for improving education service delivery in India, users' relationship to the education system in Raichur district, how preferences are revealed, whose preferences are important in the conflict between local and policy perspectives, preference heterogeneity in the village context, and whether aspects of education services can be selectively decentralized.

Service Quality Assessment for NASA's Deep Space Network: No Longer a Luxury

NASA Technical Reports Server (NTRS)

Barkley, Erik; Wolgast, Paul; Zendejas, Silvino

2010-01-01

When NASA's Deep Space Network (DSN) was established almost a half century ago, the concept of computer-based service delivery was impractical or infeasible due to the state of information technology As a result, the interface the DSN exposes to its customers tends to be equipment-centric, lacking a clear demarcation between the DSN and the mission operation systems (MOS) of its customers. As the number of customers has continued to increase, the need to improve efficiency and minimize costs has grown. This growth has been the impetus for a DSN transformation from an equipment-forrent provider to a provider of standard services. Service orientation naturally leads to requirements for service management, including proactive measurement of service quality and service levels as well as the efficiency of internal processes and the performance of service provisioning systems. DSN System Engineering has surveyed industry offerings to determine if commercial successes in decision support and Business Intelligence (BI) solutions can be applied to the DSN. A pilot project was initiated, and subsequently executed to determine the feasibility of repurposing a commercial Business Intelligence platform for engineering analysis in conjunction with the platform's intended business reporting and analysis functions.

Patterns of care for clinically distinct segments of high cost Medicare beneficiaries.

PubMed

Clough, Jeffrey D; Riley, Gerald F; Cohen, Melissa; Hanley, Sheila M; Sanghavi, Darshak; DeWalt, Darren A; Rajkumar, Rahul; Conway, Patrick H

2016-09-01

Efforts to improve the efficiency of care for the Medicare population commonly target high cost beneficiaries. We describe and evaluate a novel management approach, population segmentation, for identifying and managing high cost beneficiaries. A retrospective cross-sectional analysis of 6,919,439 Medicare fee-for-service beneficiaries in 2012. We defined and characterized eight distinct clinical population segments, and assessed heterogeneity in managing practitioners. The eight segments comprised 9.8% of the population and 47.6% of annual Medicare payments. The eight segments included 61% and 69% of the population in the top decile and top 5% of annual Medicare payments. The positive-predictive values within each segment for meeting thresholds of Medicare payments ranged from 72% to 100%, 30% to 83%, and 14% to 56% for the upper quartile, upper decile, and upper 5% of Medicare payments respectively. Sensitivity and positive-predictive values were substantially improved over predictive algorithms based on historical utilization patterns and comorbidities. The mean [95% confidence interval] number of unique practitioners and practices delivering E&M services ranged from 1.82 [1.79-1.84] to 6.94 [6.91-6.98] and 1.48 [1.46-1.50] to 4.98 [4.95-5.00] respectively. The percentage of cognitive services delivered by primary care practitioners ranged from 23.8% to 67.9% across segments, with significant variability among specialty types. Most high cost Medicare beneficiaries can be identified based on a single clinical reason and are managed by different practitioners. Population segmentation holds potential to improve efficiency in the Medicare population by identifying opportunities to improve care for specific populations and managing clinicians, and forecasting and evaluating the impact of specific interventions. Copyright © 2015 Elsevier Inc. All rights reserved.

Unmanned Aerial System (UAS) Traffic Management (UTM): Enabling Low-Altitude Airspace and UAS Operations

NASA Technical Reports Server (NTRS)

Kopardekar, Parimal H.

2014-01-01

Many civilian applications of Unmanned Aerial Systems (UAS) have been imagined ranging from remote to congested urban areas, including goods delivery, infrastructure surveillance, agricultural support, and medical services delivery. Further, these UAS will have different equipage and capabilities based on considerations such as affordability, and mission needs applications. Such heterogeneous UAS mix, along with operations such as general aviation, helicopters, gliders must be safely accommodated at lower altitudes. However, key infrastructure to enable and safely manage widespread use of low-altitude airspace and UAS operations therein does not exist. Therefore, NASA is exploring functional design, concept and technology development, and a prototype UAS Traffic Management (UTM) system. UTM will support safe and efficient UAS operations for the delivery of goods and services

Technology support to a telehealth in the home service: Qualitative observations.

PubMed

Taylor, Alan; Wade, Victoria; Morris, Greg; Pech, Joanne; Rechter, Stuart; Kidd, Michael; Carati, Colin

2016-07-01

The Flinders University Telehealth in the Home (FTH) trial was an action research initiative that introduced and evaluated the impact of telehealth services on palliative care patients living in the community, home-based rehabilitation services for the elderly, and services to the elderly in residential aged care. The aim of this study was to understand the issues encountered during the provision of technology services that supported this trial. A mixed methods approach was undertaken to analyse the roles of information and communication technology (ICT) and clinical staff in design, technology management and training. The data sources were staff observations and documents including job logs, meetings, emails and technology descriptions. Use of consumer technology for telehealth required customisation of applications and services. Clinicians played a key role in definition of applications and the embedding of workflow into applications. Usability of applications was key to their subsequent use. Management of design creep and technology services, coupled with support and training for clinicians were important to maintenance of a telehealth service. In the setting described, an iterative approach to the development of telehealth services to the home using consumer technologies was needed. The efficient management of consumer devices in multiple settings will become critical as telehealth services grow in scale. Effective collaboration between clinical and technical stakeholders and further workforce education in telehealth can be key enablers for the transition of face-to-face care to a telehealth mode of delivery. © The Author(s) 2015.

Managing resources and reducing waste in healthcare settings.

PubMed

Minogue, Virginia; Wells, Bill

2016-05-18

The NHS is under pressure to increase its effectiveness and productivity. Nurses are tasked with delivering effective and efficient care, as well as improving patient safety, experiences and results. The reduction of waste in service delivery, care and treatment can release time and resources for nurses to engage in direct patient care. Nurses have an important role in reducing waste and influencing other professionals in the healthcare environment to increase their efficiency and productivity.

Teledermatology: quality assessment by user satisfaction and clinical efficiency.

PubMed

Klaz, Itay; Wohl, Yonit; Nathansohn, Nir; Yerushalmi, Nir; Sharvit, Sharon; Kochba, Ilan; Brenner, Sarah

2005-08-01

The Israel Defense Forces implemented a pilot teledermatology service in primary clinics. To assess user satisfaction and clinical short-term effectiveness of a computerized store and forward teledermatology service in urban and rural units. A multi-center prospective uncontrolled cohort pilot trial was conducted for a period of 6 months. Primary care physicians referred patients to a board-certified dermatologist using text email accompanied by digital photographs. Diagnosis, therapy and management were sent back to the referring PCP. Patients were asked to evaluate the level of the CSAFTD service, effect of the service on accessibility to dermatologists, respect for privacy, availability of drugs, health improvement and overall satisfaction. PCPs assessed the quality of the teledermatology consultations they received, the contribution to their knowledge, and their overall satisfaction. Tele-diagnosis alone was possible for 95% (n=413) of 435 CSAFTD referrals; 22% (n=95) of referrals also required face-to-face consultation, Satisfaction with CSAFTD was high among patients in both rural and urban clinics, with significantly higher scores in rural units. Rural patients rated the level of service, accessibility and overall satisfaction higher than did urban patients. PCPs were satisfied with the quality of the service and its contribution to their knowledge. Rural physicians rated level of service and overall satisfaction higher than did urban physicians. Tele-referrals were completed more efficiently than referral for face-to-face appointments. CSAFTD provided efficient, high quality medical service to rural and urban military clinics in the IDF.

Evaluation of the Effect of Decision Support on the Efficiency of Primary Care Providers in the Outpatient Practice

PubMed Central

Hankey, Ronald A.; Decker, Lindsay K.; Cha, Stephen S.; Greenes, Robert A.; Liu, Hongfang; Chaudhry, Rajeev

2015-01-01

Background: Clinical decision support (CDS) for primary care has been shown to improve delivery of preventive services. However, there is little evidence for efficiency of physicians due to CDS assistance. In this article, we report a pilot study for measuring the impact of CDS on the time spent by physicians for deciding on preventive services and chronic disease management. Methods: We randomly selected 30 patients from a primary care practice, and assigned them to 10 physicians. The physicians were requested to perform chart review to decide on preventive services and chronic disease management for the assigned patients. The patients assignment was done in a randomized crossover design, such that each patient received 2 sets of recommendations—one from a physician with CDS assistance and the other from a different physician without CDS assistance. We compared the physician recommendations made using CDS assistance, with the recommendations made without CDS assistance. Results: The physicians required an average of 1 minute 44 seconds, when they were they had access to the decision support system and 5 minutes when they were unassisted. Hence the CDS assistance resulted in an estimated saving of 3 minutes 16 seconds (65%) of the physicians’ time, which was statistically significant (P < .0001). There was no statistically significant difference in the number of recommendations. Conclusion: Our findings suggest that CDS assistance significantly reduced the time spent by physicians for deciding on preventive services and chronic disease management. The result needs to be confirmed by performing similar studies at other institutions. PMID:25155103

Next Generation RFID-Based Medical Service Management System Architecture in Wireless Sensor Network

NASA Astrophysics Data System (ADS)

Tolentino, Randy S.; Lee, Kijeong; Kim, Yong-Tae; Park, Gil-Cheol

Radio Frequency Identification (RFID) and Wireless Sensor Network (WSN) are two important wireless technologies that have wide variety of applications and provide unlimited future potentials most especially in healthcare systems. RFID is used to detect presence and location of objects while WSN is used to sense and monitor the environment. Integrating RFID with WSN not only provides identity and location of an object but also provides information regarding the condition of the object carrying the sensors enabled RFID tag. However, there isn't any flexible and robust communication infrastructure to integrate these devices into an emergency care setting. An efficient wireless communication substrate for medical devices that addresses ad hoc or fixed network formation, naming and discovery, transmission efficiency of data, data security and authentication, as well as filtration and aggregation of vital sign data need to be study and analyze. This paper proposed an efficient next generation architecture for RFID-based medical service management system in WSN that possesses the essential elements of each future medical application that are integrated with existing medical practices and technologies in real-time, remote monitoring, in giving medication, and patient status tracking assisted by embedded wearable wireless sensors which are integrated in wireless sensor network.

A cost and performance comparison of Public Private Partnership and public hospitals in Spain.

PubMed

Caballer-Tarazona, Maria; Clemente-Collado, Antonio; Vivas-Consuelo, David

2016-12-01

Public-private partnership (PPP) initiatives are extending around the world, especially in Europe, as an innovation to traditional public health systems, with the intention of making them more efficient.There is a varied range of PPP models with different degrees of responsibility from simple public sector contracts with the private, up to the complete privatisation of the service. As such, we may say the involvement of the private sector embraces the development, financing and provision of public infrastructures and delivery services.In this paper, one of the oldest PPP initiatives developed in Spain and transferred to other European and Latin American countries is evaluated for first time: the integrated healthcare delivery Alzira model.Through a comparison of public and PPP hospital performance, cost and quality indicators, the efficiency of the PPP experience in five hospitals is evaluated to identify the influence of private management in the results.Regarding the performance and efficiency analysis, it is seen that the PPP group obtains good results, above the average, but not always better than those directly managed. It is necessary to conduct studies with a greater number of PPP hospitals to obtain conclusive results.

NASA's Aeronautics Vision

NASA Technical Reports Server (NTRS)

Tenney, Darrel R.

2004-01-01

Six long-term technology focus areas are: 1. Environmentally Friendly, Clean Burning Engines. Focus: Develop innovative technologies to enable intelligent turbine engines that significantly reduce harmful emissions while maintaining high performance and increasing reliability. 2. New Aircraft Energy Sources and Management. Focus: Discover new energy sources and intelligent management techniques directed towards zero emissions and enable new vehicle concepts for public mobility and new science missions. 3. Quiet Aircraft for Community Friendly Service. Focus: Develop and integrate noise reduction technology to enable unrestricted air transportation service to all communities. 4. Aerodynamic Performance for Fuel Efficiency. Focus: Improve aerodynamic efficiency,structures and materials technologies, and design tools and methodologies to reduce fuel burn and minimize environmental impact and enable new vehicle concepts and capabilities for public mobility and new science missions. 5. Aircraft Weight Reduction and Community Access. Focus: Develop ultralight smart materials and structures, aerodynamic concepts, and lightweight subsystems to increase vehicle efficiency, leading to high altitude long endurance vehicles, planetary aircraft, advanced vertical and short takeoff and landing vehicles and beyond. 6. Smart Aircraft and Autonomous Control. Focus: Enable aircraft to fly with reduced or no human intervention, to optimize flight over multiple regimes, and to provide maintenance on demand towards the goal of a feeling, seeing, sensing, sentient air vehicle.

Retaining a Resilient and Enduring Workforce: Examination of Duty/Position Rotational Assignments for Civilian Acquisition Positions

DTIC Science & Technology

2015-04-12

decrease the number of errors due to fatigue” and improve production and efficiency ( Ivancevich , Konopaske, & Matteson, 2014, p. 151). “There are...Services, Ford, and Deloitte Services LP have utilized different forms of job rotation strategy” ( Ivancevich et al., 2014, p. 151). Further research...L. (2005, July). Job rotation. Credit Union Management, 28(7), 50–53. Ivancevich , J. M., Konopaske, R., & Matteson, M. T. (2014). Organizational

Human resource management practices in a medical complex in the Eastern Cape, South Africa: assessing their impact on the retention of doctors.

PubMed

Longmore, Bruce; Ronnie, Linda

2014-03-26

Human resource management (HRM) practices have the potential to influence the retention of doctors in the public health sector. To explore the key human resource (HR) practices affecting doctors in a medical complex in the Eastern Cape, South Africa. We used an open-ended questionnaire to gather data from 75 doctors in this setting. The most important HR practices were paying salaries on time and accurately, the management of documentation, communication, HR staff showing that they respected and valued the doctors, and reimbursement for conferences and special leave requests. All these practices were judged to be poorly administered. Essential HR characteristics were ranked in the following order: task competence of HR staff, accountability, general HR efficiency, occupation-specific dispensation adjustments and performance management and development system efficiency, and availability of HR staff. All these characteristics were judged to be poor. HRM practices in this Eastern Cape medical complex were inadequate and a source of frustration. This lack of efficiency could lead to further problems with regard to retaining doctors in public sector service.

Towards building high performance medical image management system for clinical trials

NASA Astrophysics Data System (ADS)

Wang, Fusheng; Lee, Rubao; Zhang, Xiaodong; Saltz, Joel

2011-03-01

Medical image based biomarkers are being established for therapeutic cancer clinical trials, where image assessment is among the essential tasks. Large scale image assessment is often performed by a large group of experts by retrieving images from a centralized image repository to workstations to markup and annotate images. In such environment, it is critical to provide a high performance image management system that supports efficient concurrent image retrievals in a distributed environment. There are several major challenges: high throughput of large scale image data over the Internet from the server for multiple concurrent client users, efficient communication protocols for transporting data, and effective management of versioning of data for audit trails. We study the major bottlenecks for such a system, propose and evaluate a solution by using a hybrid image storage with solid state drives and hard disk drives, RESTfulWeb Services based protocols for exchanging image data, and a database based versioning scheme for efficient archive of image revision history. Our experiments show promising results of our methods, and our work provides a guideline for building enterprise level high performance medical image management systems.

Service Management Database for DSN Equipment

NASA Technical Reports Server (NTRS)

Zendejas, Silvino; Bui, Tung; Bui, Bach; Malhotra, Shantanu; Chen, Fannie; Wolgast, Paul; Allen, Christopher; Luong, Ivy; Chang, George; Sadaqathulla, Syed

2009-01-01

This data- and event-driven persistent storage system leverages the use of commercial software provided by Oracle for portability, ease of maintenance, scalability, and ease of integration with embedded, client-server, and multi-tiered applications. In this role, the Service Management Database (SMDB) is a key component of the overall end-to-end process involved in the scheduling, preparation, and configuration of the Deep Space Network (DSN) equipment needed to perform the various telecommunication services the DSN provides to its customers worldwide. SMDB makes efficient use of triggers, stored procedures, queuing functions, e-mail capabilities, data management, and Java integration features provided by the Oracle relational database management system. SMDB uses a third normal form schema design that allows for simple data maintenance procedures and thin layers of integration with client applications. The software provides an integrated event logging system with ability to publish events to a JMS messaging system for synchronous and asynchronous delivery to subscribed applications. It provides a structured classification of events and application-level messages stored in database tables that are accessible by monitoring applications for real-time monitoring or for troubleshooting and analysis over historical archives.

Role of information systems in public health services.

PubMed

Hartshorne, J E; Carstens, I L

1990-07-01

The purpose of this review is to establish a conceptual framework on the role of information systems in public health care. Information is indispensable for effective management and development of health services and therefore considered as an important operational asset or resource. A Health Information System is mainly required to support management and operations at four levels: namely transactional and functional; operational control; management planning and control; and strategic planning. To provide the necessary information needs of users at these levels of management in the health care system, a structured information system coupled with appropriate information technology is required. Adequate and relevant information is needed regarding population characteristics, resources available and expended, output and outcome of health care activities. Additionally information needs to be reliable, accurate, timely, easily accessible and presented in a compact and meaningful form. With a well-planned health information system health authorities would be in a position to provide a quality, cost-effective and efficient health service for as many people as need it, optimal utilisation of resources and to maintain and improve the community's health status.

Program Evaluation Grant. Final Report.

ERIC Educational Resources Information Center

Quadco Rehabilitation Center, Inc., Stryker, OH.

The purpose of the project was to increase the effectiveness and efficiency of those rehabilitation facilities which were utilized by the Ohio Rehabilitation Services Commission (RSC) through the development, installation, and utilization of a program evaluation system and a management information system. The two systems were developed and…

78 FR 28137 - Exchange Visitor Program-Fees and Charges

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-14

... following the guidelines set forth in Office of Management and Budget (OMB) Circular A-25 regarding such fee... allowed so that academic institutions could properly budget for the 47% increase in the application fee... efficiency and enhance the office's customer service. Five [[Page 28138

User Statistics and Studies. SPEC Kit 25.

ERIC Educational Resources Information Center

Association of Research Libraries, Washington, DC. Office of Management Studies.

A result of the Association of Research Libraries' (ARL) November 1975 Services Survey, this kit presents statistical studies developed from management information sources such as circulation records or generated expressly for a particular study. While academic and research libraries maintain statistical records measuring library efficiency or…

Interoperability in Personalized Adaptive Learning

ERIC Educational Resources Information Center

Aroyo, Lora; Dolog, Peter; Houben, Geert-Jan; Kravcik, Milos; Naeve, Ambjorn; Nilsson, Mikael; Wild, Fridolin

2006-01-01

Personalized adaptive learning requires semantic-based and context-aware systems to manage the Web knowledge efficiently as well as to achieve semantic interoperability between heterogeneous information resources and services. The technological and conceptual differences can be bridged either by means of standards or via approaches based on the…

Issues with medication supply and management in a rural community in Queensland.

PubMed

Tan, Amy C W; Emmerton, Lynne M; Hattingh, H Laetitia

2012-06-01

To identify the key issues reported by rural health-care providers in their provision of medication supply and related cognitive services, and in order to advise health workforce and role development and thus improve the quality use of medicines in rural communities. Exploratory semistructured interview research. A rural community comprising four towns in a rural health service district in Queensland, Australia.   Forty-nine health-care providers (medical practitioners, pharmacists, nurses and others) with medication-related roles who serviced the study community, identified through databases and local contacts. Medication-related roles undertaken by the health-care providers, focusing on medication supply and cognitive services; challenges in undertaking these roles. Medical and nursing providers reported challenges in ensuring continuity in supply of medications due to their existing medical workload demands. Local pharmacists were largely involved in medication supply, with limited capacity for extended cognitive roles. Participants identified a lack of support for their medication roles and the potential value of clinically focused pharmacists in medication management services. Medication supply may become more efficient with extended roles for certain health-care providers. The need for cognitive medication management services suggests potential for clinical pharmacists' role development in rural areas. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

Cloudbus Toolkit for Market-Oriented Cloud Computing

NASA Astrophysics Data System (ADS)

Buyya, Rajkumar; Pandey, Suraj; Vecchiola, Christian

This keynote paper: (1) presents the 21st century vision of computing and identifies various IT paradigms promising to deliver computing as a utility; (2) defines the architecture for creating market-oriented Clouds and computing atmosphere by leveraging technologies such as virtual machines; (3) provides thoughts on market-based resource management strategies that encompass both customer-driven service management and computational risk management to sustain SLA-oriented resource allocation; (4) presents the work carried out as part of our new Cloud Computing initiative, called Cloudbus: (i) Aneka, a Platform as a Service software system containing SDK (Software Development Kit) for construction of Cloud applications and deployment on private or public Clouds, in addition to supporting market-oriented resource management; (ii) internetworking of Clouds for dynamic creation of federated computing environments for scaling of elastic applications; (iii) creation of 3rd party Cloud brokering services for building content delivery networks and e-Science applications and their deployment on capabilities of IaaS providers such as Amazon along with Grid mashups; (iv) CloudSim supporting modelling and simulation of Clouds for performance studies; (v) Energy Efficient Resource Allocation Mechanisms and Techniques for creation and management of Green Clouds; and (vi) pathways for future research.

Improving care for people with osteoarthritis of the hip and knee: how has national policy for osteoarthritis been translated into service models in Australia?

PubMed

Brand, Caroline; Hunter, David; Hinman, Rana; March, Lyn; Osborne, Richard; Bennell, Kim

2011-05-01

There is strong rationale for improving care for people with chronic conditions, including osteoarthritis (OA). Successful implementation of healthcare reform requires new concepts and directions that are strongly supported by policy, new models of care (service redesign) and changes in day-to-day practice (healthcare provider and patient practice). In this paper we discuss the extent to which policy about management of OA of the hip and knee has been translated into new service models in Australia. A structured search of government and other key health websites in Australia was performed to identify policy, funding initiatives and new services models for managing OA of the hip and knee. This search was supported by a literature review. Musculoskeletal conditions were designated a National Health Priority in Australia in 2002. Under the Better Arthritis and Osteoporosis Care initiative, Australia has developed a national policy for OA care and national evidence-based clinical practice guidelines for management of OA of the hip and knee. Only two well-described examples of new chronic disease management service models, the Osteoarthritis Clinical Pathway (OACP) model and the Osteoarthritis Hip and Knee Service (OAHKS) were identified. Primarily focused within acute care public hospital settings, these have been shown to be feasible and acceptable but have limited data on clinical impact and cost-effectiveness. While policy is extant, implementation has not been systematic and comprehensive. Clinicians have evidence-based recommendations for OA management but are poorly supported by service models to deliver these effectively and efficiently. © 2011 The Authors. International Journal of Rheumatic Diseases © 2011 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.

The effect of medication therapy management service combined with a national PharmaCloud system for polypharmacy patients.

PubMed

Chen, Chang-Ming; Kuo, Li-Na; Cheng, Kuei-Ju; Shen, Wan-Chen; Bai, Kuan-Jen; Wang, Chih-Chi; Chiang, Yi-Chun; Chen, Hsiang-Yin

2016-10-01

This study evaluated a medication therapy management service using the Taiwan National Health Insurance Administration's PharmaCloud system in a medical center in Taiwan. The new PharmaCloud System, launched in 2013, links a complete list of prescribed and dispensed medication from different hospitals, clinics, and pharmacies for all insured patients. The study included patients with polypharmacy (≥5 drugs) at a medication therapy management service from March 2013 to March 2014. A structured questionnaire was designed to collect patients' baseline data and record patients' knowledge, attitudes, and practice scores before and after the service intervention. Phone follow-ups for practice and adherence scores on medication use were performed after 3 months. There were 152 patients recruited in the study. Scores for medication use attitudes and practice significantly increased after the service (attitudes: 40.06 ± 0.26 to 43.07 ± 0.19, p <0.001; practice: 33.42 ± 0.30 to 40.37 ± 0.30, p <0.001). The scores for medication adherence also increased from 3.02 ± 0.07 to 3.92 ± 0.02 (p <0.001). The PharmaCloud system facilitates accurate and efficient medication reconciliation for pharmacists in the medication therapy management service. The model improved patients' attitudes and practice of the rational use of medications and adherence with medications. Further studies are warranted to evaluate human resources, executing costs, and the cost-benefit ratio of this medication therapy management service with the PharmaCloud system. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Modeling work of the dispatching service of high-rise building as queuing system

NASA Astrophysics Data System (ADS)

Dement'eva, Marina; Dement'eva, Anastasiya

2018-03-01

The article presents the results of calculating the performance indicators of the dispatcher service of a high-rise building as a queuing system with an unlimited queue. The calculation was carried out for three models: with a single control room and brigade of service, with a single control room and a specialized service, with several dispatch centers and specialized services. The aim of the work was to investigate the influence of the structural scheme of the organization of the dispatcher service of a high-rise building on the amount of operating costs and the time of processing and fulfilling applications. The problems of high-rise construction and their impact on the complication of exploitation are analyzed. The composition of exploitation activities of high-rise buildings is analyzed. The relevance of the study is justified by the need to review the role of dispatch services in the structure of management of the quality of buildings. Dispatching service from the lower level of management of individual engineering systems becomes the main link in the centralized automated management of the exploitation of high-rise buildings. With the transition to market relations, the criterion of profitability at the organization of the dispatching service becomes one of the main parameters of the effectiveness of its work. A mathematical model for assessing the efficiency of the dispatching service on a set of quality of service indicators is proposed. The structure of operating costs is presented. The algorithm of decision-making is given when choosing the optimal structural scheme of the dispatching service of a high-rise building.

Water use efficiency and integrated water resource management for river basin

NASA Astrophysics Data System (ADS)

Deng, Xiangzheng; Singh, R. B.; Liu, Junguo; Güneralp, Burak

Water use efficiency and management have attracted increasing attention as water has become scare to challenge the world's sustainable development. Water use efficiency is correlated to the land use and cover changes (LUCC), population distribution, industrial structure, economic development, climate changes, and environmental governance. These factors significantly alter water productivity for water balance through the changes in natural environment and socio-economic system (Wang et al., 2015b). Consequently, dynamics of water inefficiency lower the social welfare of water allocation (Wang et al., 2015b), and induce water management alternation interactively and financially (Wang et al., 2015a). This triggers on actual water price changes through both natural resource and socioeconomic system (Zhou et al., 2015). Therefore, it is very important to figure out a mechanism of water allocation in the course of LUCC (Jin et al., 2015) at a global perspective (Zhao et al., 2015), climate and economic changes of ecosystem service at various spatial and temporal scales (Li et al., 2015).

Management of medical care, a fundamental tool for resident doctors.

PubMed

Fajardo-Ortiz, Guillermo; Robledo, Héctor

2018-01-01

In the area of medical education, and particularly in our country, medical residencies are the best educational programs for a graduated physicians; however, when young medical doctors begin a residence at hospitals, they hardly poses knowledge about the way medical services work as well as the processes they involve, which directly affects the fulfillment of their tasks, their process of learning and more importantly, it interferes in the services provided by the hospital. Therefore, it is imperative to immerse residents in the management of medical care and let them know that its main function is to harmoniously articulate every medical-administrative process related to patients as well as human, material and financial resources. One of the main goals is to achieve the fulfillment of the hospital's mission and vision with operational efficiency and humanism. This path will help physicians to make the best decisions, as well as achieving an adequate management of resources always remembering that quality in medical services and patient's safety are important. Copyright: © 2018 Permanyer.

Governance and management of national telehealth programs in Asia.

PubMed

Marcelo, Alvin; Ganesh, Jai; Mohan, Jai; Kadam, D B; Ratta, B S; Kulatunga, Gumindu; John, Sheila; Chandra, Andry; Primadi, Oscar; Mohamed, Athika Abdul Sattar; Khan, Muhammad Abdul Hannan; Azad, Abul Alam; Marcelo, Portia

2015-01-01

Telehealth and telemedicine are increasingly becoming accepted practices in Asia, but challenges remain in deploying these services to the farthest areas of many developing countries. With the increasing popularity of universal health coverage, there is a resurgence in promoting telehealth services. But while telehealth that reaches the remotest part of a nation is the ideal endpoint, such goals are burdened by various constraints ranging from governance to funding to infrastructure and operational efficiency. enumerate the public funded national telehealth programs in Asia and determine the state of their governance and management. Review of literature, review of official program websites and request for information from key informants. While there are national telehealth programs already in operation in Asia, most experience challenges with governance and subsequently, with management and sustainability of operations. It is important to learn from successful programs that have built and maintained their services over time. An IT governance framework may assist countries to achieve success in offering telehealth and telemedicine to their citizens.

MSAT signalling and network management architectures

NASA Technical Reports Server (NTRS)

Garland, Peter; Keelty, J. Malcolm

1989-01-01

Spar Aerospace has been active in the design and definition of Mobile Satellite Systems since the mid 1970's. In work sponsored by the Canadian Department of Communications, various payload configurations have evolved. In addressing the payload configuration, the requirements of the mobile user, the service provider and the satellite operator have always been the most important consideration. The current Spar 11 beam satellite design is reviewed, and its capabilities to provide flexibility and potential for network growth within the WARC87 allocations are explored. To enable the full capabilities of the payload to be realized, a large amount of ground based Switching and Network Management infrastructure will be required, when space segment becomes available. Early indications were that a single custom designed Demand Assignment Multiple Access (DAMA) switch should be implemented to provide efficient use of the space segment. As MSAT has evolved into a multiple service concept, supporting many service providers, this architecture should be reviewed. Some possible signalling and Network Management solutions are explored.

Digital patient: Personalized and translational data management through the MyHealthAvatar EU project.

PubMed

Kondylakis, Haridimos; Spanakis, Emmanouil G; Sfakianakis, Stelios; Sakkalis, Vangelis; Tsiknakis, Manolis; Marias, Kostas; Xia Zhao; Hong Qing Yu; Feng Dong

2015-08-01

The advancements in healthcare practice have brought to the fore the need for flexible access to health-related information and created an ever-growing demand for the design and the development of data management infrastructures for translational and personalized medicine. In this paper, we present the data management solution implemented for the MyHealthAvatar EU research project, a project that attempts to create a digital representation of a patient's health status. The platform is capable of aggregating several knowledge sources relevant for the provision of individualized personal services. To this end, state of the art technologies are exploited, such as ontologies to model all available information, semantic integration to enable data and query translation and a variety of linking services to allow connecting to external sources. All original information is stored in a NoSQL database for reasons of efficiency and fault tolerance. Then it is semantically uplifted through a semantic warehouse which enables efficient access to it. All different technologies are combined to create a novel web-based platform allowing seamless user interaction through APIs that support personalized, granular and secure access to the relevant information.

An Architecture for Automated Fire Detection Early Warning System Based on Geoprocessing Service Composition

NASA Astrophysics Data System (ADS)

Samadzadegan, F.; Saber, M.; Zahmatkesh, H.; Joze Ghazi Khanlou, H.

2013-09-01

Rapidly discovering, sharing, integrating and applying geospatial information are key issues in the domain of emergency response and disaster management. Due to the distributed nature of data and processing resources in disaster management, utilizing a Service Oriented Architecture (SOA) to take advantages of workflow of services provides an efficient, flexible and reliable implementations to encounter different hazardous situation. The implementation specification of the Web Processing Service (WPS) has guided geospatial data processing in a Service Oriented Architecture (SOA) platform to become a widely accepted solution for processing remotely sensed data on the web. This paper presents an architecture design based on OGC web services for automated workflow for acquisition, processing remotely sensed data, detecting fire and sending notifications to the authorities. A basic architecture and its building blocks for an automated fire detection early warning system are represented using web-based processing of remote sensing imageries utilizing MODIS data. A composition of WPS processes is proposed as a WPS service to extract fire events from MODIS data. Subsequently, the paper highlights the role of WPS as a middleware interface in the domain of geospatial web service technology that can be used to invoke a large variety of geoprocessing operations and chaining of other web services as an engine of composition. The applicability of proposed architecture by a real world fire event detection and notification use case is evaluated. A GeoPortal client with open-source software was developed to manage data, metadata, processes, and authorities. Investigating feasibility and benefits of proposed framework shows that this framework can be used for wide area of geospatial applications specially disaster management and environmental monitoring.

Remote patient management: technology-enabled innovation and evolving business models for chronic disease care.

PubMed

Coye, Molly Joel; Haselkorn, Ateret; DeMello, Steven

2009-01-01

Remote patient management (RPM) is a transformative technology that improves chronic care management while reducing net spending for chronic disease. Broadly deployed within the Veterans Health Administration and in many small trials elsewhere, RPM has been shown to support patient self-management, shift responsibilities to non-clinical providers, and reduce the use of emergency department and hospital services. Because transformative technologies offer major opportunities to advance national goals of improved quality and efficiency in health care, it is important to understand their evolution, the experiences of early adopters, and the business models that may support their deployment.

Energy efficient engine high-pressure turbine detailed design report

NASA Technical Reports Server (NTRS)

Thulin, R. D.; Howe, D. C.; Singer, I. D.

1982-01-01

The energy efficient engine high-pressure turbine is a single stage system based on technology advancements in the areas of aerodynamics, structures and materials to achieve high performance, low operating economics and durability commensurate with commercial service requirements. Low loss performance features combined with a low through-flow velocity approach results in a predicted efficiency of 88.8 for a flight propulsion system. Turbine airfoil durability goals are achieved through the use of advanced high-strength and high-temperature capability single crystal materials and effective cooling management. Overall, this design reflects a considerable extension in turbine technology that is applicable to future, energy efficient gas-turbine engines.

Teleradiology from the provider's perspective-cost analysis for a mid-size university hospital.

PubMed

Rosenberg, Christian; Kroos, Kristin; Rosenberg, Britta; Hosten, Norbert; Flessa, Steffen

2013-08-01

Real costs of teleradiology services have not been systematically calculated. Pricing policies are not evidence-based. This study aims to prove the feasibility of performing an original cost analysis for teleradiology services and show break-even points to perform cost-effective practice. Based on the teleradiology services provided by the Greifswald University Hospital in northeastern Germany, a detailed process analysis and an activity-based costing model revealed costs per service unit according to eight examination categories. The Monte Carlo method was used to simulate the cost amplitude and identify pricing thresholds. Twenty-two sub-processes and four staff categories were identified. The average working time for one unit was 55 (x-ray) to 72 min (whole-body CT). Personnel costs were dominant (up to 68 %), representing lower limit costs. The Monte Carlo method showed the cost distribution per category according to the deficiency risk. Avoiding deficient pricing by a likelihood of 90 % increased the cost of a cranial CT almost twofold as compared with the lower limit cost. Original cost analysis is possible when providing teleradiology services with complex statutory requirements in place. Methodology and results provide useful data to help enhance efficiency in hospital management as well as implement realistic reimbursement fees. • Analysis of original costs of teleradiology is possible for a providing hospital • Results discriminate pricing thresholds and lower limit costs to perform cost-effective practice • The study methods represent a managing tool to enhance efficiency in providing facilities • The data are useful to help represent telemedicine services in regular medical fee schedules.

Interoperability And Value Added To Earth Observation Data

NASA Astrophysics Data System (ADS)

Gasperi, J.

2012-04-01

Geospatial web services technology has provided a new means for geospatial data interoperability. Open Geospatial Consortium (OGC) services such as Web Map Service (WMS) to request maps on the Internet, Web Feature Service (WFS) to exchange vectors or Catalog Service for the Web (CSW) to search for geospatialized data have been widely adopted in the Geosciences community in general and in the remote sensing community in particular. These services make Earth Observation data available to a wider range of public users than ever before. The mapshup web client offers an innovative and efficient user interface that takes advantage of the power of interoperability. This presentation will demonstrate how mapshup can be effectively used in the context of natural disasters management.

An intelligent monitoring and management system for cross-enterprise biomedical data sharing platform

NASA Astrophysics Data System (ADS)

Wang, Tusheng; Yang, Yuanyuan; Zhang, Jianguo

2013-03-01

In order to enable multiple disciplines of medical researchers, clinical physicians and biomedical engineers working together in a secured, efficient, and transparent cooperative environment, we had designed an e-Science platform for biomedical imaging research and application cross multiple academic institutions and hospitals in Shanghai by using grid-based or cloud-based distributed architecture and presented this work in SPIE Medical Imaging conference held in San Diego in 2012. However, when the platform integrates more and more nodes over different networks, the first challenge is that how to monitor and maintain all the hosts and services operating cross multiple academic institutions and hospitals in the e-Science platform, such as DICOM and Web based image communication services, messaging services and XDS ITI transaction services. In this presentation, we presented a system design and implementation of intelligent monitoring and management which can collect system resource status of every node in real time, alert when node or service failure occurs, and can finally improve the robustness, reliability and service continuity of this e-Science platform.

Examination of Regional Transit Service under Contracting : A Case Study in the Greater New Orleans Region : [Executive Summary

DOT National Transportation Integrated Search

2011-03-01

In late 2008, New Orleans Regional Transit Authority (RTA) began to execute a delegated management contract with a multinational private firm, in order to not only increase efficiency and effectiveness in operation and maintenance of public tra...

78 FR 49186 - Fisheries of the Northeastern United States; Tilefish Fishery Management Plan; Regulatory...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-13

... Plan; Regulatory Amendment, Corrections, and Clarifications AGENCY: National Marine Fisheries Service... October 10 of each fishing year; and (6) modifies the regulations governing the cost recovery fee... and efficient collection of the required cost-recovery fees. Additional detail and explanation...

75 FR 77847 - Proposed Information Collection; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-14

... Corporation's web- based grants management system, eGrants. Current Action The Corporation seeks to renew the... Summary to improve the efficiency and effectiveness of the peer review process. The information collection...: Corporation for National and Community Service, Senior Corps, Attention: Mr. Zach Rhein, Program Officer, Room...

Retrieval medicine: a review and guide for UK practitioners. Part 2: safety in patient retrieval systems

PubMed Central

Hearns, S; Shirley, P J

2006-01-01

Retrieval and transfer of critically ill and injured patients is a high risk activity. Risk can be minimised with robust safety and clinical governance systems in place. This article describes the various governance systems that can be employed to optimise safety and efficiency in retrieval services. These include operating procedure development, equipment management, communications procedures, crew resource management, significant event analysis, audit and training. PMID:17130608

Spatiotemporal Data Organization and Application Research

NASA Astrophysics Data System (ADS)

Tan, C.; Yan, S.

2017-09-01

Organization and management of spatiotemporal data is a key support technology for intelligence in all fields of the smart city. The construction of a smart city cannot be realized without spatiotemporal data. Oriented to support intelligent applications this paper proposes an organizational model for spatiotemporal data, and details the construction of a spatiotemporal big data calculation, analysis, and service framework for highly efficient management and intelligent application of spatiotemporal data for the entire data life cycle.

Micromanaging the IoT space

NASA Astrophysics Data System (ADS)

Mayer, Irak Vicarte

2017-05-01

The speed of IoT devices currently connected in our daily lives has drastically accelerated in the last couple of years. The lack of standardization, regulation, and an efficient process to integrate these devices to our ecosystem has led to a relaxed security and an ineffective use of the data generated. This paper presents a new approach to the IoT ecosystem management that improves data sharing and security by categorizing and micromanaging the connected devices. The use of micromanaging multiple access points (M2AP) allows the architecture to respond faster and efficiently to events and attacks to the digital hive. The "local beehive"/ "master beehive" approach seals a compromise of delegating tasks and improving the network management capacity. Finally, an efficient data storage and compact reports of the raw information collected can then be transmitted to cloud services for further analysis if required.

Energy monitoring based on human activity in the workplace

NASA Astrophysics Data System (ADS)

Mustafa, N. H.; Husain, M. N.; Abd Aziz, M. Z. A.; Othman, M. A.; Malek, F.

2014-04-01

Human behavior is the most important factor in order to manage energy usage. Nowadays, smart house technology offers a better quality of life by introducing automated appliance control and assistive services. However, human behaviors will contribute to the efficiency of the system. This paper will focus on monitoring efficiency based on duration time in office hours around 8am until 5pm which depend on human behavior atb the workplace. Then, the correlation coefficient method is used to show the relation between energy consumption and energy saving based on the total hours of time energy spent. In future, the percentages of energy monitoring system usage will be increase to manage energy in efficient ways based on human behaviours. This scenario will lead to the positive impact in order to achieve the energy saving in the building and support the green environment.

Administration in ambulatory care.

PubMed

Nardone, D A; Webb, D W

1989-10-01

Deficiencies in management of U.S. Department of Veterans Affairs (USDVA) ambulatory care programs have been documented in the literature and were reaffirmed by conference participants. These represent significant barriers to developing an effective and efficient system of outpatient health care delivery for veterans and to expanding educational opportunities for trainees. Based on impact and feasibility rankings from the symposium, review of the literature, and the personal experiences of USDVA ambulatory care managers, several recommendations emerged: (1) implement a system of matrix management; (2) invest in a leader; (3) develop "user-friendly" management information systems; (4) utilize existing resources efficiently; (5) embrace quality assurance; and (6) improve support from clerical and diagnostic services, nursing, and pharmacy personnel. Although intervention from leadership at the level of the USDVA Central Office will be necessary, many of these recommendations can be adopted by managers at the local facilities. The biggest challenge is to change the attitudes of clinical and support staff whose responsibilities have traditionally been inpatient-oriented.

Evaluating the Impact of Hospital Efficiency on Wellness in the Military Health System.

PubMed

Bastian, Nathaniel D; Kang, Hyojung; Swenson, Eric R; Fulton, Lawrence V; Griffin, Paul M

2016-08-01

Like all health care delivery systems, the U.S. Department of Defense Military Health System (MHS) strives to achieve top preventative care and population health outcomes for its members while operating at an efficient level and containing costs. The objective of this study is to understand the overall efficiency performance of military hospitals and investigate the relationship between efficiency and wellness. This study uses data envelopment analysis and stochastic frontier analysis to compare the efficiency of 128 military treatment facilities from the Army, Navy, and Air Force during the period of 2011 to 2013. Fixed effects panel regression is used to determine the association between the hospital efficiency and wellness scores. The results indicate that data envelopment analysis and stochastic frontier analysis efficiency scores are congruent in direction. Both results indicate that the majority of the MHS hospitals and clinics can potentially improve their productive efficiency by managing their input resources better. When comparing the performance of the three military branches of service, Army hospitals as a group outperformed their Navy and Air Force counterparts; thus, best practices from the Army should be shared across service components. The findings also suggest no statistically significant, positive association between efficiency and wellness over time in the MHS. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Radiation safety requirements for radioactive waste management in the framework of a quality management system

DOE Office of Scientific and Technical Information (OSTI.GOV)

Salgado, M.M.; Benitez, J.C.; Pernas, R.

2007-07-01

The Center for Radiation Protection and Hygiene (CPHR) is the institution responsible for the management of radioactive wastes generated from nuclear applications in medicine, industry and research in Cuba. Radioactive Waste Management Service is provided at a national level and it includes the collection and transportation of radioactive wastes to the Centralized Waste Management Facilities, where they are characterized, segregated, treated, conditioned and stored. A Quality Management System, according to the ISO 9001 Standard has been implemented for the RWM Service at CPHR. The Management System includes the radiation safety requirements established for RWM in national regulations and in themore » Licence's conditions. The role of the Regulatory Body and the Radiation Protection Officer in the Quality Management System, the authorization of practices, training and personal qualification, record keeping, inspections of the Regulatory Body and internal inspection of the Radiation Protection Officer, among other aspects, are described in this paper. The Quality Management System has shown to be an efficient tool to demonstrate that adequate measures are in place to ensure the safety in radioactive waste management activities and their continual improvement. (authors)« less

International Space Station Bacteria Filter Element Post-Flight Testing and Service Life Prediction

NASA Technical Reports Server (NTRS)

Perry, J. L.; von Jouanne, R. G.; Turner, E. H.

2003-01-01

The International Space Station uses high efficiency particulate air (HEPA) filters to remove particulate matter from the cabin atmosphere. Known as Bacteria Filter Elements (BFEs), there are 13 elements deployed on board the ISS's U.S. Segment. The pre-flight service life prediction of 1 year for the BFEs is based upon performance engineering analysis of data collected during developmental testing that used a synthetic dust challenge. While this challenge is considered reasonable and conservative from a design perspective, an understanding of the actual filter loading is required to best manage the critical ISS Program resources. Thus testing was conducted on BFEs returned from the ISS to refine the service life prediction. Results from this testing and implications to ISS resource management are discussed. Recommendations for realizing significant savings to the ISS Program are presented.

Productivity Analysis of Public and Private Airports: A Causal Investigation

NASA Technical Reports Server (NTRS)

Vasigh, Bijan; Gorjidooz, Javad

2007-01-01

Around the world, airports are being viewed as enterprises, rather than public services, which are expected to be managed efficiently and provide passengers with courteous customer services. Governments are, increasingly, turning to the private sectors for their efficiency in managing the operation, financing, and development, as well as providing security for airports. Operational and financial performance evaluation has become increasingly important to airport operators due to recent trends in airport privatization. Assessing performance allows the airport operators to plan for human resources and capital investment as efficiently as possible. Productivity measurements may be used as comparisons and guidelines in strategic planning, in the internal analysis of operational efficiency and effectiveness, and in assessing the competitive position of an airport in transportation industry. The primary purpose of this paper is to investigate the operational and financial efficiencies of 22 major airports in the United States and Europe. These airports are divided into three groups based on private ownership (7 British Airport Authority airports), public ownership (8 major United States airports), and a mix of private and public ownership (7 major European Union airports. The detail ownership structures of these airports are presented in Appendix A. Total factor productivity (TFP) model was utilized to measure airport performance in terms of financial and operational efficiencies and to develop a benchmarking tool to identify the areas of strength and weakness. A regression model was then employed to measure the relationship between TFP and ownership structure. Finally a Granger causality test was performed to determine whether ownership structure is a Granger cause of TFP. The results of the analysis presented in this paper demonstrate that there is not a significant relationship between airport TFP and ownership structure. Airport productivity and efficiency is, however dependent upon the level of competition, choice of the market, and regulatory control.

City of San Antonio, Texas Better Buildings Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Meyer, Liza C.; Hammer, Mary C.

2014-06-30

The San Antonio Better Buildings Program is a unified single-point-of-service energy efficiency delivery mechanism targeting residential, commercial, institutional, industrial and public buildings. This comprehensive and replicable energy efficiency program is designed to be an effective demand side management initiative to provide a seamless process for program participants to have turn-key access to expert analysis, support and incentives to improve the performance of their in-place energy using systems, while reducing electrical energy use and demand.

State of the Art in LP-WAN Solutions for Industrial IoT Services

PubMed Central

Sanchez-Iborra, Ramon; Cano, Maria-Dolores

2016-01-01

The emergence of low-cost connected devices is enabling a new wave of sensorization services. These services can be highly leveraged in industrial applications. However, the technologies employed so far for managing this kind of system do not fully cover the strict requirements of industrial networks, especially those regarding energy efficiency. In this article a novel paradigm, called Low-Power Wide Area Networking (LP-WAN), is explored. By means of a cellular-type architecture, LP-WAN–based solutions aim at fulfilling the reliability and efficiency challenges posed by long-term industrial networks. Thus, the most prominent LP-WAN solutions are reviewed, identifying and discussing the pros and cons of each of them. The focus is also on examining the current deployment state of these platforms in Spain. Although LP-WAN systems are at early stages of development, they represent a promising alternative for boosting future industrial IIoT (Industrial Internet of Things) networks and services. PMID:27196909

State of the Art in LP-WAN Solutions for Industrial IoT Services.

PubMed

Sanchez-Iborra, Ramon; Cano, Maria-Dolores

2016-05-17

The emergence of low-cost connected devices is enabling a new wave of sensorization services. These services can be highly leveraged in industrial applications. However, the technologies employed so far for managing this kind of system do not fully cover the strict requirements of industrial networks, especially those regarding energy efficiency. In this article a novel paradigm, called Low-Power Wide Area Networking (LP-WAN), is explored. By means of a cellular-type architecture, LP-WAN-based solutions aim at fulfilling the reliability and efficiency challenges posed by long-term industrial networks. Thus, the most prominent LP-WAN solutions are reviewed, identifying and discussing the pros and cons of each of them. The focus is also on examining the current deployment state of these platforms in Spain. Although LP-WAN systems are at early stages of development, they represent a promising alternative for boosting future industrial IIoT (Industrial Internet of Things) networks and services.

Security and Efficiency Concerns With Distributed Collaborative Networking Environments

DTIC Science & Technology

2003-09-01

have the ability to access Web communications services of the WebEx MediaTone Network from a single login. [24] WebEx provides a range of secure...Web. WebEx services enable secure data, voice and video communications through the browser and are supported by the WebEx MediaTone Network, a global...designed to host large-scale, structured events and conferences, featuring a Q&A Manager that allows multiple moderators to handle questions while

Assessing Canadian Bank Branch Operating Efficiency Using Data Envelopment Analysis

NASA Astrophysics Data System (ADS)

Yang, Zijiang

2009-10-01

In today's economy and society, performance analyses in the services industries attract more and more attention. This paper presents an evaluation of 240 branches of one big Canadian bank in Greater Toronto Area using Data Envelopment Analysis (DEA). Special emphasis was placed on how to present the DEA results to management so as to provide more guidance to them on what to manage and how to accomplish the changes. Finally the potential management uses of the DEA results were presented. All the findings are discussed in the context of the Canadian banking market.

The Carle Clinic.

PubMed

Schraeder, C; Britt, T

1997-03-01

Confronting the challenge of effective, efficient health care for the elderly has led to many variations in service delivery modalities. The approach employed by the Community Nursing Organization (CNO) is based on nurse coordinated care. Nurses are integrally involved in the authorization, coordination, evaluation and payment of services. The nursing role encompasses case management, including coordination of non-CNO covered services as well as those provided through the capitated payment schedule. Thus, in addition to authorizing CNO services, the nurse also may coordinate services such as physician visits, home repair, transportation, respite services and home-delivered meals, even though they are not covered financially under the auspices of the CNO. Preliminary findings indicate that this model may be successful clinically and financially by determining and utilizing an appropriate mix, intensity and duration of services.

Exploring representations and experiences of case-management users: towards difficulties and solutions to leading qualitative interviews with older people with complex living conditions.

PubMed

Balard, Frédéric; Corre, Stéphanie Pin Le; Trouvé, Hélène; Saint-Jean, Olivier; Somme, Dominique

2013-01-01

By matching needs to resource services, case management could be a useful tool for improving the care of older people with complex living conditions. Collecting and analysing the users' experiences represents a good way to evaluate the effectiveness and efficiency of a case-management service. However, in the literature, fieldwork is very rarely considered and the users included in qualitative research seem to be the most accessible. This study was undertaken to describe the challenges of conducting qualitative research with older people with complex living conditions in order to understand their experiences with case-management services. Reflective analysis was applied to describe the process of recruiting and interviewing older people with complex living conditions in private homes, describing the protocol with respect to fieldwork chronology. The practical difficulties inherent in this type of study are addressed, particularly in terms of defining a sample, the procedure for contacting the users and conducting the interview. The users are people who suffer from a loss of autonomy because of cognitive impairment, severe disease and/or psychiatric or social problems. Notably, most of them refuse care and assistance. Reflective analysis of our protocol showed that the methodology and difficulties encountered constituted the first phase of data analysis. Understanding the experience of users of case management to analyse the outcomes of case-management services requires a clear methodology for the fieldwork.

Alberta Healthy Living Program--a model for successful integration of chronic disease management services.

PubMed

Morrin, Louise; Britten, Judith; Davachi, Shahnaz; Knight, Holly

2013-08-01

The most common presentation of chronic disease is multimorbidity. Disease management strategies are similar across most chronic diseases. Given the prevalence of multimorbidity and the commonality in approaches, fragmented single disease management must be replaced with integrated care of the whole person. The Alberta Healthy Living Program, a community-based chronic disease management program, supports adults with, or at risk for, chronic disease to improve their health and well being. Participants gain confidence and skills in how to manage their chronic disease(s) by learning to understand their health condition, make healthy eating choices, exercise safely and cope emotionally. The program includes 3 service pillars: disease-specific and general health patient education, disease-spanning supervised exercise and Better Choices, Better Health(TM) self-management workshops. Services are delivered in the community by an interprofessional team and can be tailored to target specific diverse and vulnerable populations, such as Aboriginal, ethno-cultural and francophone groups and those experiencing homelessness. Programs may be offered as a partnership between Alberta Health Services, primary care and community organizations. Common standards reduce provincial variation in care, yet maintain sufficient flexibility to meet local and diverse needs and achieve equity in care. The model has been implemented successfully in 108 communities across Alberta. This approach is associated with reduced acute care utilization and improved clinical indicators, and achieves efficiencies through an integrated, disease-spanning patient-centred approach. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Asset management in theory and practice.

PubMed

Mace, J D

1998-01-01

Managing capital-intensive imaging environments continues to be a challenge for nearly all administrators. Asset management, the strategic management of equipment inventory, must include planning, assessment, procurement, utilization review, maintenance, repair and disposal of equipment to reduce costs and improve efficiency. It must involve some shared risk between the facility and the provider, whether an original equipment manufacturer (OEM) or independent service organization (ISO). An absence of risk in the arrangement implies the provider is offering service management or consulting. A case study reports on three hospitals in the OhioHealth system. Their immediate goal, as they began to investigate asset management: cut costs immediately. A cross-functional team from the three hospitals began its investigation of various options, including working with ISOs, OEMs and development of inhouse clinical engineering. After developing a process to evaluate vendors, the team was able to score each against their cost-reduction potential, quality and implementation skills. The team narrowed its selection quickly to two multivendor service providers. An initial contract guaranteed savings of 20 percent of the annual budget, with a projected two to five percent additional savings. OEM relationships were moved to a time-and-materials basis, and ISOs were used in selected areas. In addition, the internal inhouse clinical engineering services group was moved into a "first call" approach in some areas. That expanded role resulted in savings and improved response time. The process, although not without its problems, was viewed favorably overall.

Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014.

PubMed

Guo, Lijun; Bao, Yong; Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong

2018-01-01

Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (P<0.001). In addition, among the seven principal components, four principal component scores were better in urban areas than in suburban areas (P = <0.001, 0.004, 0.036, and 0.022). The urban comprehensive score also exceeded that of the suburbs (P<0.001). In summary, over the 6-year period, there was a rapidly increasing trend in basic medical service utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction.

Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014

PubMed Central

Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong

2018-01-01

Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (P<0.001). In addition, among the seven principal components, four principal component scores were better in urban areas than in suburban areas (P = <0.001, 0.004, 0.036, and 0.022). The urban comprehensive score also exceeded that of the suburbs (P<0.001). In summary, over the 6-year period, there was a rapidly increasing trend in basic medical service utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction. PMID:29791470

The Lindsay Leg Club: supporting the NHS to provide leg ulcer care.

PubMed

McKenzie, Morag

2013-06-01

Public health services will need to cope with additional demands due to an ageing society and the increasing prevalence of chronic conditions. Lower-limb ulceration is a long-term, life-changing condition and leg ulcer management can be challenging for nursing staff. The Lindsay Leg Club model is a unique partnership between community nurses, members and the local community, which provides quality of care and empowerment for patients with leg ulcers, while also supporting and educating nursing staff. The Leg Club model works in accord with core themes of Government and NHS policy. Patient feedback on the Leg Club model is positive and the Leg Clubs provide a service to members which is well accepted by patients, yet is more economically efficient than the traditional district nursing practice of home visits. Lindsay Leg Clubs provide a valuable support service to the NHS in delivering improved quality of care while improving efficiency.

An approach to efficient mobility management in intelligent networks

NASA Technical Reports Server (NTRS)

Murthy, K. M. S.

1995-01-01

Providing personal communication systems supporting full mobility require intelligent networks for tracking mobile users and facilitating outgoing and incoming calls over different physical and network environments. In realizing the intelligent network functionalities, databases play a major role. Currently proposed network architectures envision using the SS7-based signaling network for linking these DB's and also for interconnecting DB's with switches. If the network has to support ubiquitous, seamless mobile services, then it has to support additionally mobile application parts, viz., mobile origination calls, mobile destination calls, mobile location updates and inter-switch handovers. These functions will generate significant amount of data and require them to be transferred between databases (HLR, VLR) and switches (MSC's) very efficiently. In the future, the users (fixed or mobile) may use and communicate with sophisticated CPE's (e.g. multimedia, multipoint and multisession calls) which may require complex signaling functions. This will generate volumness service handling data and require efficient transfer of these message between databases and switches. Consequently, the network providers would be able to add new services and capabilities to their networks incrementally, quickly and cost-effectively.

Consolidation of medical groups into physician practice management organizations.

PubMed

Robinson, J C

1998-01-14

Medical groups are growing and merging to improve efficiency and bargaining leverage in the competitive managed care environment. An increasing number are affiliating with physician practice management (PPM) firms that offer capital financing, expertise in utilization management, and global capitation contracts with health insurance entities. These physician organizations provide an alternative to affiliation with a hospital system and to individual physician contracting with health plans. To describe the growth, structure, and strategy of PPM organizations that coordinate medical groups in multiple markets and contract with health maintenance organizations (HMOs). Case studies, including interviews with administrative and clinical leaders, review of company documents, and analysis of documents from investment bankers, the Securities and Exchange Commission, and industry observers. Medical groups and independent practice associations (IPAs) in California and New Jersey affiliated with MedPartners, FPA Medical Management, and UniMed. Growth in number of primary care and specialty care physicians employed by and contracting with affiliated medical groups; growth in patient enrollment from commercial, Medicare, and Medicaid HMOs; growth in capitation and noncapitation revenues; structure and governance of affiliated management service organizations and professional corporations; and contracting strategies with HMOs. Between 1994 and 1996, medical groups and IPAs affiliated with 3 PPMs grew from 3787 to 25763 physicians; 65% of employed physicians provide primary care, while the majority of contracting physicians provide specialty care. Patient enrollment in HMOs grew from 285503 to 3028881. Annual capitation revenues grew from $190 million to $2.1 billion. Medical groups affiliated with PPMs are capitated for most professional, hospital, and ancillary clinical services and are increasingly delegated responsibility by HMOs for utilization management and quality assurance. Physician practice management organizations and their affiliated medical groups face the challenge of continuing rapid growth, sustaining stock values, and improving practice efficiencies while maintaining the loyalty of physicians and patients.

Resource Management in QoS-Aware Wireless Cellular Networks

ERIC Educational Resources Information Center

Zhang, Zhi

2011-01-01

Emerging broadband wireless networks that support high speed packet data with heterogeneous quality of service (QoS) requirements demand more flexible and efficient use of the scarce spectral resource. Opportunistic scheduling exploits the time-varying, location-dependent channel conditions to achieve multiuser diversity. In this work, we study…

Construction alternatives for free-standing facilities.

PubMed

Brown, G

1990-01-01

Many hospitals are exploring free-standing facilities as an option for providing more efficient imaging services. Mr. Brown discusses the pros and cons of an emerging building technology, manufactured construction, in which building and site preparation are done simultaneously. He presents the criteria managers should use to make a knowledgeable decision.

36 CFR 251.56 - Terms and conditions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Section 251.56 Parks, Forests, and Public Property FOREST SERVICE, DEPARTMENT OF AGRICULTURE LAND USES... and economic interests; (B) Manage efficiently the lands subject to the use and adjacent thereto; (C) Protect other lawful users of the lands adjacent to or occupied by such use; (D) Protect lives and...

Marine, Tropical, and Tsunami Services

Science.gov Websites

essential to the conduct of safe and efficient maritime operations and for the protection of the marine - Managed by National Data Buoy Center (NDBC) Awareness Weeks: Tsunami Preparedness Campaigns National Safe Prepared and Stay Safe! Tsunami Preparedness: Applying Lessons from the Past Pacific Tsunami Warning Center

Intranet 2.0 from a Project Management Perspective

ERIC Educational Resources Information Center

Sharpe, Paul A.; Vacek, Rachel E.

2010-01-01

Library intranets require flexibility and efficiency and enhance the internal communication and collaborative nature of creating and organizing the institution's information. At the University of Houston Libraries, the focus was on public services, so little attention was given to the intranet--the tool every department relied on for quick access…

Years of Challenge: Workforce and Demographic Trends Provide Agenda for 1990s.

ERIC Educational Resources Information Center

Hughes, K. Scott; And Others

1991-01-01

Higher education is under pressure to create a workforce making the United States more competitive internationally. Demographic and workforce influences are shaping teaching, support services and management. Colleges and universities should increase quality, use of technology and communications, and labor productivity and efficiency, and reduce…

Utilizing Radiofrequency Identification Technology to Improve Safety and Management of Blood Bank Supply Chains.

PubMed

Coustasse, Alberto; Meadows, Pamela; Hall, Robert S; Hibner, Travis; Deslich, Stacie

2015-11-01

The importance of efficiency in the supply chain of perishable products, such as the blood products used in transfusion services, cannot be overstated. Many problems can occur, such as the outdating of products, inventory management issues, patient misidentification, and mistransfusion. The purpose of this article was to identify the benefits and barriers associated with radiofrequency identification (RFID) usage in improving the blood bank supply chain. The methodology for this study was a qualitative literature review following a systematic approach. The review was limited to sources published from 2000 to 2014 in the English language. Sixty-five sources were found, and 56 were used in this research study. According to the finding of the present study, there are numerous benefits and barriers to RFID utilization in blood bank supply chains. RFID technology offers several benefits with regard to blood bank product management, including decreased transfusion errors, reduction of product loss, and more efficient inventory management. Barriers to RFID implementation include the cost associated with system implementation and patient privacy issues. Implementation of an RFID system can be a significant investment. However, when observing the positive impact that such systems may have on transfusion safety and inventory management, the cost associated with RFID systems can easily be justified. RFID in blood bank inventory management is vital to ensuring efficient product inventory management and positive patient outcomes.

A joining of forces. The promise of community health information management systems (CHIMSs).

PubMed

Hendren, S

1993-11-01

Every time you buy a bag of Frito-Lay corn chips, information regarding your purchase becomes part of a customer database within hours. America's snack food "needs" are analyzed and decisions are made about filling the shelves of every corner convenience store in the nation with exactly the right product. This system has saved the company more than $20 million a year through increased efficiency. But when you buy a diagnostic test to identify a potentially life-threatening condition, results can remain unavailable for days. If we can bring computerized efficiencies to marketing corn chips, why aren't we doing it for healthcare? Imagine--managers of community health systems who know their customers' needs so precisely that they "fill the shelves" of local "convenience health stops" with exactly the right services to maximize the health of the customers. As a by-product, they save a few million dollars per year in costs. Managers of other industries use information technology to deliver the right product or service to customers at just the right time, to differentiate their services by adding value, to compete effectively on cost and/or quality. Many members of the healthcare industry, where only 2.6 percent of expenditures go to information systems (compared to 5 percent in manufacturing and 7 percent in banking) and where the basic unit of work--the patient record--is still a manual process, are years behind in their thinking about how information systems can make their business better.

Measuring human capital cost through benchmarking in health care environment.

PubMed

Kocakülâh, Mehmet C; Harris, Donna

2002-01-01

Each organization should seek to maximize its human capital investments, which ultimately lead to increased profits and asset efficiency. Service companies utilize less capital equipment and more human productivity, customer service, and/or delivery of service as the product. With the measurement of human capital, one can understand what is happening, exercise some degree of control, and make positive changes. Senior management lives or dies by the numbers and if Human Resources (HR) really wants to be a strategic business partner, HR must be judged by the same standards as everyone else in the health care organization.

Using standard treatment protocols to manage costs and quality of hospital services.

PubMed

Meyer, J W; Feingold, M G

1993-06-01

The current health care environment has made it critically important that hospital costs and quality be managed in an integrated fashion. Promised health care reforms are expected to make cost reduction and quality enhancement only more important. Traditional methods of hospital cost and quality control have largely been replaced by such approaches as practice parameters, outcomes measurement, clinical indicators, clinical paths, benchmarking, patient-centered care, and a focus on patient selection criteria. This Special Report describes an integrated process for strategically managing costs and quality simultaneously, incorporating key elements of many important new quality and cost control tools. By using a multidisciplinary group process to develop standard treatment protocols, hospitals and their medical staffs address the most important services provided within major product lines. Using both clinical and financial data, groups of physicians, nurses, department managers, financial analysts, and administrators redesign key patterns of care within their hospital, incorporating the best practices of their own and other institutions. The outcome of this process is a new, standardized set of clinical guidelines that reduce unnecessary variation in care, eliminate redundant interventions, establish clear lines of communication for all caregivers, and reduce the cost of each stay. The hospital, medical staff, and patients benefit from the improved opportunities for managed care contracting, more efficient hospital systems, consensus-based quality measures, and reductions in the cost of care. STPs offer a workable and worthwhile approach to positioning the hospital of the 1990s for operational efficiency and cost and quality competitiveness.

The Greek National Observatory of Forest Fires (NOFFi)

NASA Astrophysics Data System (ADS)

Tompoulidou, Maria; Stefanidou, Alexandra; Grigoriadis, Dionysios; Dragozi, Eleni; Stavrakoudis, Dimitris; Gitas, Ioannis Z.

2016-08-01

Efficient forest fire management is a key element for alleviating the catastrophic impacts of wildfires. Overall, the effective response to fire events necessitates adequate planning and preparedness before the start of the fire season, as well as quantifying the environmental impacts in case of wildfires. Moreover, the estimation of fire danger provides crucial information required for the optimal allocation and distribution of the available resources. The Greek National Observatory of Forest Fires (NOFFi)—established by the Greek Forestry Service in collaboration with the Laboratory of Forest Management and Remote Sensing of the Aristotle University of Thessaloniki and the International Balkan Center—aims to develop a series of modern products and services for supporting the efficient forest fire prevention management in Greece and the Balkan region, as well as to stimulate the development of transnational fire prevention and impacts mitigation policies. More specifically, NOFFi provides three main fire-related products and services: a) a remote sensing-based fuel type mapping methodology, b) a semi-automatic burned area mapping service, and c) a dynamically updatable fire danger index providing mid- to long-term predictions. The fuel type mapping methodology was developed and applied across the country, following an object-oriented approach and using Landsat 8 OLI satellite imagery. The results showcase the effectiveness of the generated methodology in obtaining highly accurate fuel type maps on a national level. The burned area mapping methodology was developed as a semi-automatic object-based classification process, carefully crafted to minimize user interaction and, hence, be easily applicable on a near real-time operational level as well as for mapping historical events. NOFFi's products can be visualized through the interactive Fire Forest portal, which allows the involvement and awareness of the relevant stakeholders via the Public Participation GIS (PPGIS) tool.

The number of service per conception of Indonesian Friesian Holstein with artificial insemination in Selo, Boyolali, Central Java, Indonesia

NASA Astrophysics Data System (ADS)

Wicaksono, A. M.; Pramono, A.; Susilowati, A.; Sutarno; Widyas, N.; Prastowo, S.

2018-03-01

Boyolali is an area in Central Java Indonesia, it has large number of Indonesian Friesian Holstein (IFH; dairy cattle). To improve its population as well as genetic quality of milk production, artificial insemination (AI) is widely applied as mating program. The success of AI can be evaluated from the number of service per conception (S/C), represent a number of service using AI to achieve one pregnancy. Its mirroring mating management and reproductive efficiency in dairy cattle, estimated in herd during specific time and location. For that, this study aims to estimate S/C in Selo, Boyolali during October 2016 to January 2017. Data were gathered with 95% confidence level. Sample size were 367 IFH, visited and selected purposively based on criteria one-time partus, 3 y.o and have complete AI record. Animal data were collected in reproduction and mating management. In addition, 124 dairy farmer who have minimum 5 years experiences in rearing IFH cow were interviewed as respondent in estrus detection, followed with 2 skilled inseminators for AI performing time data. Result shows that S/C is 1.71, this mean one pregnancy need 1.71 times AI services. In the estrus detection, most of dairy farmers were able to observe estrus sign in vulva color, size and the present of mucus by visual. Moreover, AI was performed in 9 to 12 hours after the sign of estrus observed. It is concluded that AI of IFH in Selo, Boyolali has been successfully applied, however there are still rooms to improve the reproduction efficiency through mating management in regard to lower S/C.

Impacts of outsourcing in educational hospitals in Iran: A study on Isfahan University of Medical Sciences-2010.

PubMed

Karimi, Saeed; Agharahimi, Zahra; Yaghoubi, Maryam

2012-01-01

Outsourcing in healthcare is a cost-effective strategy that can lead to increase services quality. The aim of this study was to determine the types of services that have been outsourced in educational hospitals in Isfahan and to investigate managers' view about the impact of Outsourcing. A descriptive-survey study carried out in 2010. Our samples consisted of 100 educational hospital and treatment deputy senior managers of Isfahan University of Medical Sciences and 53 usable questionnaires were received. Survey instrument main points were the extent to which educational hospital outsource services and the impact of Outsourcing. Reliability and validity of the questionnaire have been verified. Data are analyzed with SPSS18 software. The results for medical-diagnostics services showed physiotherapy, radiology, and ultrasound that have the highest rate (33%) of being outsourced. Between logistic and administrative activities, housekeeping, and facility engineering maintenance services are the highest rate of outsourced (100%) and green space, CSR, laundry, and medical records are the lowest rate of outsourced (16%). In managers' view, in relation to advantages of outsourcing, pay more attention to internal and external customers in private sector (57.2%) was the highest. In relation to disadvantages of outsourcing, costs increase for the patients (45.6%) was the highest. In relation to barriers of outsourcing, forgetting the goal of outsourcing (efficiency) (60.6%) was the highest. Finally, managers' views about outsourcing in health services organizations were rather acceptable, but in their views, there are barriers in implementation of outsourcing and they are focused on removing the barriers before outsourcing. Fundamental infrastructure developments as making competing market, promoting of cultures, education, modifying the management attitude and approach, and establishing incentive policies are emphasized for successful implementation of outsourcing.

A Cloud-Based Internet of Things Platform for Ambient Assisted Living

PubMed Central

Cubo, Javier; Nieto, Adrián; Pimentel, Ernesto

2014-01-01

A common feature of ambient intelligence is that many objects are inter-connected and act in unison, which is also a challenge in the Internet of Things. There has been a shift in research towards integrating both concepts, considering the Internet of Things as representing the future of computing and communications. However, the efficient combination and management of heterogeneous things or devices in the ambient intelligence domain is still a tedious task, and it presents crucial challenges. Therefore, to appropriately manage the inter-connection of diverse devices in these systems requires: (1) specifying and efficiently implementing the devices (e.g., as services); (2) handling and verifying their heterogeneity and composition; and (3) standardizing and managing their data, so as to tackle large numbers of systems together, avoiding standalone applications on local servers. To overcome these challenges, this paper proposes a platform to manage the integration and behavior-aware orchestration of heterogeneous devices as services, stored and accessed via the cloud, with the following contributions: (i) we describe a lightweight model to specify the behavior of devices, to determine the order of the sequence of exchanged messages during the composition of devices; (ii) we define a common architecture using a service-oriented standard environment, to integrate heterogeneous devices by means of their interfaces, via a gateway, and to orchestrate them according to their behavior; (iii) we design a framework based on cloud computing technology, connecting the gateway in charge of acquiring the data from the devices with a cloud platform, to remotely access and monitor the data at run-time and react to emergency situations; and (iv) we implement and generate a novel cloud-based IoT platform of behavior-aware devices as services for ambient intelligence systems, validating the whole approach in real scenarios related to a specific ambient assisted living application. PMID:25093343

A cloud-based Internet of Things platform for ambient assisted living.

PubMed

Cubo, Javier; Nieto, Adrián; Pimentel, Ernesto

2014-08-04

A common feature of ambient intelligence is that many objects are inter-connected and act in unison, which is also a challenge in the Internet of Things. There has been a shift in research towards integrating both concepts, considering the Internet of Things as representing the future of computing and communications. However, the efficient combination and management of heterogeneous things or devices in the ambient intelligence domain is still a tedious task, and it presents crucial challenges. Therefore, to appropriately manage the inter-connection of diverse devices in these systems requires: (1) specifying and efficiently implementing the devices (e.g., as services); (2) handling and verifying their heterogeneity and composition; and (3) standardizing and managing their data, so as to tackle large numbers of systems together, avoiding standalone applications on local servers. To overcome these challenges, this paper proposes a platform to manage the integration and behavior-aware orchestration of heterogeneous devices as services, stored and accessed via the cloud, with the following contributions: (i) we describe a lightweight model to specify the behavior of devices, to determine the order of the sequence of exchanged messages during the composition of devices; (ii) we define a common architecture using a service-oriented standard environment, to integrate heterogeneous devices by means of their interfaces, via a gateway, and to orchestrate them according to their behavior; (iii) we design a framework based on cloud computing technology, connecting the gateway in charge of acquiring the data from the devices with a cloud platform, to remotely access and monitor the data at run-time and react to emergency situations; and (iv) we implement and generate a novel cloud-based IoT platform of behavior-aware devices as services for ambient intelligence systems, validating the whole approach in real scenarios related to a specific ambient assisted living application.

Evaluation of AL-FEC performance for IP television services QoS

NASA Astrophysics Data System (ADS)

Mammi, E.; Russo, G.; Neri, A.

2010-01-01

The IP television services quality is a critical issue because of the nature of transport infrastructure. Packet loss is the main cause of service degradation in such kind of network platforms. The use of forward error correction (FEC) techniques in the application layer (AL-FEC), between the source of TV service (video server) and the user terminal, seams to be an efficient strategy to counteract packet losses alternatively or in addiction to suitable traffic management policies (only feasible in "managed networks"). A number of AL-FEC techniques have been discussed in literature and proposed for inclusion in TV over IP international standards. In this paper a performance evaluation of the AL-FEC defined in SMPTE 2022-1 standard is presented. Different typical events occurring in IP networks causing different types (in terms of statistic distribution) of IP packet losses have been studied and AL-FEC performance to counteract these kind of losses have been evaluated. The performed analysis has been carried out in view of fulfilling the TV services QoS requirements that are usually very demanding. For managed networks, this paper envisages a strategy to combine the use of AL-FEC with the set-up of a transport quality based on FEC packets prioritization. Promising results regard this kind of strategy have been obtained.

Operations research in intensive care unit management: a literature review.

PubMed

Bai, Jie; Fügener, Andreas; Schoenfelder, Jan; Brunner, Jens O

2018-03-01

The intensive care unit (ICU) is a crucial and expensive resource largely affected by uncertainty and variability. Insufficient ICU capacity causes many negative effects not only in the ICU itself, but also in other connected departments along the patient care path. Operations research/management science (OR/MS) plays an important role in identifying ways to manage ICU capacities efficiently and in ensuring desired levels of service quality. As a consequence, numerous papers on the topic exist. The goal of this paper is to provide the first structured literature review on how OR/MS may support ICU management. We start our review by illustrating the important role the ICU plays in the hospital patient flow. Then we focus on the ICU management problem (single department management problem) and classify the literature from multiple angles, including decision horizons, problem settings, and modeling and solution techniques. Based on the classification logic, research gaps and opportunities are highlighted, e.g., combining bed capacity planning and personnel scheduling, modeling uncertainty with non-homogenous distribution functions, and exploring more efficient solution approaches.

A natural fit: home healthcare and biomedical engineering.

PubMed

Damasco, Nestor; Abe, Chris

2010-01-01

The involvement of Biomed in management of home care equipment has become a natural fit for Rady Children's Hospital. Managing all aspects of home care equipment through an in-house biomedical engineering department is cost-effective, efficient, provides excellent customer service, and enhances the relationship with the clinical staff and patients. It develops a sense of security for patients and staff that home care equipment is tested and maintained in a stringent manner that promotes safety.

Design and Verification of Remote Sensing Image Data Center Storage Architecture Based on Hadoop

NASA Astrophysics Data System (ADS)

Tang, D.; Zhou, X.; Jing, Y.; Cong, W.; Li, C.

2018-04-01

The data center is a new concept of data processing and application proposed in recent years. It is a new method of processing technologies based on data, parallel computing, and compatibility with different hardware clusters. While optimizing the data storage management structure, it fully utilizes cluster resource computing nodes and improves the efficiency of data parallel application. This paper used mature Hadoop technology to build a large-scale distributed image management architecture for remote sensing imagery. Using MapReduce parallel processing technology, it called many computing nodes to process image storage blocks and pyramids in the background to improve the efficiency of image reading and application and sovled the need for concurrent multi-user high-speed access to remotely sensed data. It verified the rationality, reliability and superiority of the system design by testing the storage efficiency of different image data and multi-users and analyzing the distributed storage architecture to improve the application efficiency of remote sensing images through building an actual Hadoop service system.

The Value of Advanced Smart Metering in the Management of Urban Water Supply Services

NASA Astrophysics Data System (ADS)

Guardiola, J.; Pulido-Velazquez, M.; Giuliani, M.; Castelletti, A.; Cominola, A.; Arregui de la Cruz, F.; Escriva-Bou, A.; Soriano, J.; Pérez, J. J.; Castillo, J.; Barba, J.; González, V.; Rizzoli, A. E.

2016-12-01

This work intends to outline the experience of the implementation and further exploitation of an extensive network of smart meters (SM) in the city of Valencia by Aguas de Valencia, the water utility that offers water supply and sanitation services to the city of Valencia and its metropolitan area. Valencia has become the first large city in Europe fully equipped with a point-to-point fixed network of SM (currently with more than 430,000 units, about 90% of the meters of the city). The shift towards a water supply management system based on SM is a complex process that entails changes and impacts on different management areas of the water supply organization. A new data management and processing platform has been developed and is already proving notable benefits in the operation of the system. For example, a tool allows to automatically issue and manage work orders when abnormalities such as internal leaks (constant consumption) or meter alarms are detected. Another tool has been developed to reduce levels of non-revenue water by continuously balancing supply and demand in district metered areas. Improving leak detection and adjusting pressure levels has significantly increased the efficiency of the water distribution network. Finally, a service of post-meter leak detection has been also implemented. But the SM also contribute to improve demand management. The customers now receive detailed information on their water consumption, valuable for improving household water management and assessing the value of water conservation strategies. SM are also key tools for improving the level of understanding of demand patterns. Users have been categorized into different clusters depending in their consumption patterns characteristics. Within the EU SmartH2O project, a high resolution and frequency monitoring of residential uses has been conducted in a selected sample of households for a precise disaggregation of residential end-uses. The disaggregation of end-uses allows for a better characterization and modelling of residential water demand, and, ultimately, designing efficient user-oriented water management strategies.

The old care paradigm is dead, long live the new sustainable care paradigm: how can GP commissioning consortia meet the demand challenges of 21st century healthcare?

PubMed

Mackenzie, James

2011-07-01

There are many challenges facing the health system in the 21st century - the majority of which are related to managing demand for health services. To meet these challenges emerging GP commissioning consortia will need to take a new approach to commissioning health services - an approach that moves beyond the current acute-centred curative paradigm of care to a new sustainable paradigm of care that focuses on primary care, integrated services and upstream prevention to manage demand. A key part of this shift is the recognition that the health system does not operate in a vacuum and that strategic commissioning decisions must take account of wider determinants of health and well-being, and operate within the finite limits of the planet's natural resources. The sustainable development principle of balancing financial, social and environmental considerations is crucial in managing demand for health services and ensuring that the health system is resilient to risks of resource uncertainty and a changing climate. Building sustainability into the governance and contracting processes of GP commissioning consortia will help deliver efficiency savings, impact on system productivity, manage system risk and help manage demand through the health co-benefits of taking a whole systems approach to commissioning decisions. Commissioning services from providers committed to corporate social responsibility and sustainable business practices allows us to move beyond a health system that cures people reactively to one in which the health of individuals and populations is managed proactively through prevention and education. The opportunity to build sustainability principles into the culture of GP commissioning consortia upfront should be seized now to ensure the new model of commissioning endures and is fit for the future.

The old care paradigm is dead, long live the new sustainable care paradigm: how can GP commissioning consortia meet the demand challenges of 21st century healthcare?

PubMed Central

2011-01-01

There are many challenges facing the health system in the 21st century – the majority of which are related to managing demand for health services. To meet these challenges emerging GP commissioning consortia will need to take a new approach to commissioning health services – an approach that moves beyond the current acute-centred curative paradigm of care to a new sustainable paradigm of care that focuses on primary care, integrated services and upstream prevention to manage demand. A key part of this shift is the recognition that the health system does not operate in a vacuum and that strategic commissioning decisions must take account of wider determinants of health and well-being, and operate within the finite limits of the planet's natural resources. The sustainable development principle of balancing financial, social and environmental considerations is crucial in managing demand for health services and ensuring that the health system is resilient to risks of resource uncertainty and a changing climate. Building sustainability into the governance and contracting processes of GP commissioning consortia will help deliver efficiency savings, impact on system productivity, manage system risk and help manage demand through the health co-benefits of taking a whole systems approach to commissioning decisions. Commissioning services from providers committed to corporate social responsibility and sustainable business practices allows us to move beyond a health system that cures people reactively to one in which the health of individuals and populations is managed proactively through prevention and education. The opportunity to build sustainability principles into the culture of GP commissioning consortia upfront should be seized now to ensure the new model of commissioning endures and is fit for the future. PMID:25949650

[Fundamental strategies to address the problem of public health service delivery insufficiency of disease prevention and control system of China].

PubMed

Shao, Jing-jing; Yu, Jing-jin; Yu, Ming-zhu; Duan, Yong; Gong, Xiangguang; Chen, Zheng; Wang, Hua; Shi, Peiwu; Liang, Zhankai; Yang, Feng; Wang, Dunzhi; Yue, Jianning; Luo, Shi; Luo, Li; Wang, Weicheng; Wang, Ying; Sun, Mei; Su, Zhongxin; Ma, Ning; Xie, Hongbin; Hao, Mo

2005-03-01

To develop and demonstrate the strategies to solve the problem of public health service delivery insufficiency of disease prevention and control system of China. 205 literatures in 8 national academic journals concerning health service management have been reviewed. The method of boundary analysis has been employed to conclude the various reform strategies. Based on the causes and mechanism of public health service delivery insufficiency of disease prevention and control system, the logic analysis has been employed to develop fundamental strategies, which has been demonstrated by 154 CDC using intention questionnaires. There are fundamental strategies to which the agreeing rate for sampling CDC was over 95%: to make sure government should afford the financing function of disease prevention and control and secure the feasible investment for centers of disease prevention and control. Meanwhile, the working efficiency of CDC should be improved through strengthening management and reforming government investing manner.

Total quality management: It works for aerospace information services

NASA Technical Reports Server (NTRS)

Erwin, James; Eberline, Carl; Colquitt, Wanda

1993-01-01

Today we are in the midst of information and 'total quality' revolutions. At the NASA STI Program's Center for AeroSpace Information (CASI), we are focused on using continuous improvements techniques to enrich today's services and products and to ensure that tomorrow's technology supports the TQM-based improvement of future STI program products and services. The Continuous Improvements Program at CASI is the foundation for Total Quality Management in products and services. The focus is customer-driven; its goal, to identify processes and procedures that can be improved and new technologies that can be integrated with the processes to gain efficiencies, provide effectiveness, and promote customer satisfaction. This Program seeks to establish quality through an iterative defect prevention approach that is based on the incorporation of standards and measurements into the processing cycle. Four projects are described that utilize cross-functional, problem-solving teams for identifying requirements and defining tasks and task standards, management participation, attention to critical processes, and measurable long-term goals. The implementation of these projects provides the customer with measurably improved access to information that is provided through several channels: the NASA STI Database, document requests for microfiche and hardcopy, and the Centralized Help Desk.

Dynamic SLA Negotiation in Autonomic Federated Environments

NASA Astrophysics Data System (ADS)

Rubach, Pawel; Sobolewski, Michael

Federated computing environments offer requestors the ability to dynamically invoke services offered by collaborating providers in the virtual service network. Without an efficient resource management that includes Dynamic SLA Negotiation, however, the assignment of providers to customer's requests cannot be optimized and cannot offer high reliability without relevant SLA guarantees. We propose a new SLA-based SERViceable Metacomputing Environment (SERVME) capable of matching providers based on QoS requirements and performing autonomic provisioning and deprovisioning of services according to dynamic requestor needs. This paper presents the SLA negotiation process that includes on-demand provisioning and uses an object-oriented SLA model for large-scale service-oriented systems supported by SERVME. An initial reference implementation in the SORCER environment is also described.

The health hazard assessment process in support of joint weapon system acquisitions.

PubMed

Kluchinsky, Timothy A; Jokel, Charles R; Cambre, John V; Goddard, Donald E; Batts, Robert W

2013-01-01

Since 1981, the Army's HHA Program has provided an invaluable service to combat developers and materiel program managers by providing recommendations designed to eliminate or control health hazards associated with materiel and weapon systems. The program has consistently strived to improve its services by providing more meaningful and efficient assistance to the acquisition community. In the uncertain fiscal times ahead, the Army's HHA Program will continue to provide valuable and cost-effective solutions to mitigate the health risks of weapons systems.

A Comparative Analysis of Patient Access Modes at Wilford Hall United States Air Force Medical Center and Selected Civilian Medical Centers

DTIC Science & Technology

1983-12-01

system is the provision of quality health care to patients . In recognition of this fundamental component of the social contract, executive management...deemed it necessary to request research be conducted to assure there were responsive and efficient patient access modes to health care services at...each of the other observed facilities. 2. The demand for health care by the patient population, seeking access to similar clinics or services at each of

Employment-based health benefits and public-sector coverage: opportunity for leadership.

PubMed

Darling, Helen

2006-01-01

In this commentary, Helen Darling, speaking from the large-employer perspective, responds to James Robinson's paper on the mature health insurance industry, which faces declining opportunities with employer-based health benefits and growing but less appealing public-sector opportunities for management and other services. The similar needs of public and private employers and payers provide an opportunity for leadership, accelerating innovation and using value-added services to improve safety, quality, and efficiency of health care for all.

Distributed network management in the flat structured mobile communities

NASA Astrophysics Data System (ADS)

Balandina, Elena

2005-10-01

Delivering proper management into the flat structured mobile communities is crucial for improving users experience and increase applications diversity in mobile networks. The available P2P applications do application-centric management, but it cannot replace network-wide management, especially when a number of different applications are used simultaneously in the network. The network-wide management is the key element required for a smooth transition from standalone P2P applications to the self-organizing mobile communities that maintain various services with quality and security guaranties. The classical centralized network management solutions are not applicable in the flat structured mobile communities due to the decentralized nature and high mobility of the underlying networks. Also the basic network management tasks have to be revised taking into account specialties of the flat structured mobile communities. The network performance management becomes more dependent on the current nodes' context, which also requires extension of the configuration management functionality. The fault management has to take into account high mobility of the network nodes. The performance and accounting managements are mainly targeted in maintain an efficient and fair access to the resources within the community, however they also allow unbalanced resource use of the nodes that explicitly permit it, e.g. as a voluntary donation to the community or due to the profession (commercial) reasons. The security management must implement the new trust models, which are based on the community feedback, professional authorization, and a mix of both. For fulfilling these and another specialties of the flat structured mobile communities, a new network management solution is demanded. The paper presents a distributed network management solution for flat structured mobile communities. Also the paper points out possible network management roles for the different parties (e.g. operators, service providing hubs/super nodes, etc.) involved in a service providing chain.

The Research on Safety Management Information System of Railway Passenger Based on Risk Management Theory

NASA Astrophysics Data System (ADS)

Zhu, Wenmin; Jia, Yuanhua

2018-01-01

Based on the risk management theory and the PDCA cycle model, requirements of the railway passenger transport safety production is analyzed, and the establishment of the security risk assessment team is proposed to manage risk by FTA with Delphi from both qualitative and quantitative aspects. The safety production committee is also established to accomplish performance appraisal, which is for further ensuring the correctness of risk management results, optimizing the safety management business processes and improving risk management capabilities. The basic framework and risk information database of risk management information system of railway passenger transport safety are designed by Ajax, Web Services and SQL technologies. The system realizes functions about risk management, performance appraisal and data management, and provides an efficient and convenient information management platform for railway passenger safety manager.

Renal telemedicine through video-as-a-service delivered to patients on home dialysis: A qualitative study on the renal care team members' experience.

PubMed

Ditchburn, Jae-Llane; Marshall, Alison

2017-09-01

The Lancashire Teaching Hospitals NHS Trust in the UK has been providing renal care through video-as-a-service (VAAS) to patients since 2013, with support from the North West NHS Shared Infrastructure Service, a collaborative team that supports information and communication technology use in the UK National Health Service. Renal telemedicine offered remotely to patients on home dialysis supports renal care through the provision of a live high-quality video link directly to unsupported patients undergoing haemodialysis at home. Home haemodialysis is known to provide benefits to patients, particularly in making them more independent. The use of a telemedicine video-link in Lancashire and South Cumbria, UK, further reduces patient dependence on the professional team. The purpose of this paper is to present the perspectives of the renal care team members using the renal telemedicine service to understand the perceived benefits and issues with the service. Ten semi-structured interviews with members of the renal care team (two renal specialists, one matron, two renal nurses, one business manager, one renal technical services manager, two IT technicians and one hardware maintenance technician) were conducted. Thematic analysis was undertaken to analyse the qualitative data. A range of incremental benefits to the renal team members were reported, including more efficient use of staff time, reduced travel, peace of mind and a strong sense of job satisfaction. Healthcare staff believed that remote renal care through video was useful, encouraged concordance and could nurture confidence in patients. Key technological issues and adjustments which would improve the renal telemedicine service were also identified. The impact of renal telemedicine was positive on the renal team members. The use of telemedicine has been demonstrated to make home dialysis delivery more efficient and safe. The learning from staff feedback could inform development of services elsewhere. © 2017 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Trade in health services in the ASEAN region.

PubMed

Arunanondchai, Jutamas; Fink, Carsten

2006-12-01

Promoting quality health services to large population segments is a key ingredient to human and economic development. At its core, healthcare policymaking involves complex trade-offs between promoting equitable and affordable access to a basic set of health services, creating incentives for efficiencies in the healthcare system and managing constraints in government budgets. International trade in health services influences these trade-offs. It presents opportunities for cost savings and access to better quality care, but it also raises challenges in promoting equitable and affordable access. This paper offers a discussion of trade policy in health services for the ASEAN region. It reviews the existing patterns of trade and identifies policy measures that could further harness the benefits from trade in health services and address potential pitfalls that deeper integration may bring about.

Providing Multi-Page Data Extraction Services with XWRAPComposer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Ling; Zhang, Jianjun; Han, Wei

2008-04-30

Dynamic Web data sources – sometimes known collectively as the Deep Web – increase the utility of the Web by providing intuitive access to data repositories anywhere that Web access is available. Deep Web services provide access to real-time information, like entertainment event listings, or present a Web interface to large databases or other data repositories. Recent studies suggest that the size and growth rate of the dynamic Web greatly exceed that of the static Web, yet dynamic content is often ignored by existing search engine indexers owing to the technical challenges that arise when attempting to search the Deepmore » Web. To address these challenges, we present DYNABOT, a service-centric crawler for discovering and clustering Deep Web sources offering dynamic content. DYNABOT has three unique characteristics. First, DYNABOT utilizes a service class model of the Web implemented through the construction of service class descriptions (SCDs). Second, DYNABOT employs a modular, self-tuning system architecture for focused crawling of the Deep Web using service class descriptions. Third, DYNABOT incorporates methods and algorithms for efficient probing of the Deep Web and for discovering and clustering Deep Web sources and services through SCD-based service matching analysis. Our experimental results demonstrate the effectiveness of the service class discovery, probing, and matching algorithms and suggest techniques for efficiently managing service discovery in the face of the immense scale of the Deep Web.« less

Hospitalist time usage and cyclicality: opportunities to improve efficiency.

PubMed

Kim, Christopher S; Lovejoy, William; Paulsen, Michael; Chang, Robert; Flanders, Scott A

2010-01-01

Academic medical centers (AMCs) have a constrained resident work force. Many AMCs have increased the use of nonresident service hospitalists to manage continued growth in clinical volume. To optimize their time in the hospital, it is important to understand hospitalists' work flow. We performed a time-motion study of hospitalists carrying the admission pager throughout the 3 types of shifts we have at our hospital (day shift, swing shift, and night shift). Tertiary academic medical center in the Midwest. Hospitalists spend about 15% of their time on direct patient care, and two-thirds of their time on indirect patient care. Of the indirect activities, communication and documentation dominate. Travel demands make up over 7% of a hospitalists' time. There are spikes in indirect patient care, followed closely by spikes in direct patient care, at shift changes. At our AMC, indirect patient care activities accounted for the majority of the admitting hospitalists' time spent in the hospital, with documentation and communication dominating this time. Travel takes a significant fraction of hospitalists' time. There is also a cyclical nature to activities performed throughout the day, which can cause patient delays and impose variability on support services. There is a need for both service-specific and systemic improvements for AMCs to efficiently manage further growth in their inpatient volume. (c) 2010 Society of Hospital Medicine.

Effectiveness of incentives for agri-environment measure in Mediterranean degraded and eroded vineyards

NASA Astrophysics Data System (ADS)

Galati, Antonino; Gristina, Luciano; Crescimanno, Maria; Barone, Ettore; Novara, Agata

2015-04-01

The evaluation of the economic damage caused by soil erosion assumes great importance. It serves to increase awareness of the problem among farmers and policy makers. Moreover, it can promote the implementation of conservative measures at the field and basin level by spurring the development of more sustainable soil management practices. In the present study we have developed a new approach to evaluate the incentive for the adoption of Agri-Environment Measure (AEM) in Mediterranean degraded and eroded vineyards. In order to estimate this incentive, the replacement cost and the loss of income are calculated under two different soil management such as Conventional Tillage (CT) and Cover crop (AEM). Our findings show that the incentive could range between the loss of income due to AEM adoption and ecosystem service benefit (RCCT - RC AEM). In the case of study the incentive ranged between 315 € ha-1 (loss of income) and 1,087.86 € ha-1 (Ecosystem service benefit). Within this range, the incentive amount is determined according to efficiency criteria taking into account the morphological conditions of the territory in which operate the farms. Moreover, a conceptual model on the public spending efficiency has been developed to allocate the incentives where the economic return in term of ecosystem service is higher.

Recommendation of a More Effective Alternative to the NASA Launch Services Program Mission Integration Reporting System (MIRS) and Implementation of Updates to the Mission Plan

NASA Technical Reports Server (NTRS)

Dunn, Michael R.

2014-01-01

Over the course of my internship in the Flight Projects Office of NASA's Launch Services Program (LSP), I worked on two major projects, both of which dealt with updating current systems to make them more accurate and to allow them to operate more efficiently. The first project dealt with the Mission Integration Reporting System (MIRS), a web-accessible database application used to manage and provide mission status reporting for the LSP portfolio of awarded missions. MIRS had not gone through any major updates since its implementation in 2005, and it was my job to formulate a recommendation for the improvement of the system. The second project I worked on dealt with the Mission Plan, a document that contains an overview of the general life cycle that is followed by every LSP mission. My job on this project was to update the information currently in the mission plan and to add certain features in order to increase the accuracy and thoroughness of the document. The outcomes of these projects have implications in the orderly and efficient operation of the Flight Projects Office, and the process of Mission Management in the Launch Services Program as a whole.

Improving Access to Pediatric Cardiology in Cape Verde via a Collaborative International Telemedicine Service.

PubMed

Lapão, Luís Velez; Correia, Artur

2015-01-01

This paper addresses the role of international telemedicine services in supporting the evacuation procedures from Cape Verde to Portugal, enabling better quality and cost reductions in the management of the global health system. The Cape Verde, as other African countries, health system lacks many medical specialists, like pediatric cardiologists, neurosurgery, etc. In this study, tele-cardiology shows good results as diagnostic support to the evacuation decision. Telemedicine services show benefits while monitoring patients in post-evacuation, helping to address the lack of responsive care in some specialties whose actual use will help save resources both in provision and in management of the evacuation procedures. Additionally, with tele-cardiology collaborative service many evacuations can be avoided whereas many cases will be treated and followed locally in Cape Verde with remote technical support from Portugal. This international telemedicine service enabled more efficient evacuations, by reducing expenses in travel and housing, and therefore contributed to the health system's improvement. This study provides some evidence of how important telemedicine really is to cope with both the geography and the shortage of physicians.

Point of care use of a personal digital assistant for patient consultation management: experience of an intravenous resource nurse team in a major Canadian teaching hospital.

PubMed

Bosma, Laine; Balen, Robert M; Davidson, Erin; Jewesson, Peter J

2003-01-01

The development and integration of a personal digital assistant (PDA)-based point-of-care database into an intravenous resource nurse (IVRN) consultation service for the purposes of consultation management and service characterization are described. The IVRN team provides a consultation service 7 days a week in this 1000-bed tertiary adult care teaching hospital. No simple, reliable method for documenting IVRN patient care activity and facilitating IVRN-initiated patient follow-up evaluation was available. Implementation of a PDA database with exportability of data to statistical analysis software was undertaken in July 2001. A Palm IIIXE PDA was purchased and a three-table, 13-field database was developed using HanDBase software. During the 7-month period of data collection, the IVRN team recorded 4868 consultations for 40 patient care areas. Full analysis of service characteristics was conducted using SPSS 10.0 software. Team members adopted the new technology with few problems, and the authors now can efficiently track and analyze the services provided by their IVRN team.

High-performance web services for querying gene and variant annotation.

PubMed

Xin, Jiwen; Mark, Adam; Afrasiabi, Cyrus; Tsueng, Ginger; Juchler, Moritz; Gopal, Nikhil; Stupp, Gregory S; Putman, Timothy E; Ainscough, Benjamin J; Griffith, Obi L; Torkamani, Ali; Whetzel, Patricia L; Mungall, Christopher J; Mooney, Sean D; Su, Andrew I; Wu, Chunlei

2016-05-06

Efficient tools for data management and integration are essential for many aspects of high-throughput biology. In particular, annotations of genes and human genetic variants are commonly used but highly fragmented across many resources. Here, we describe MyGene.info and MyVariant.info, high-performance web services for querying gene and variant annotation information. These web services are currently accessed more than three million times permonth. They also demonstrate a generalizable cloud-based model for organizing and querying biological annotation information. MyGene.info and MyVariant.info are provided as high-performance web services, accessible at http://mygene.info and http://myvariant.info . Both are offered free of charge to the research community.

Implementation of spatial smart waste management system in malaysia

NASA Astrophysics Data System (ADS)

Omar, M. F.; Termizi, A. A. A.; Zainal, D.; Wahap, N. A.; Ismail, N. M.; Ahmad, N.

2016-06-01

One of the challenges to innovate and create an IoT -enabled solution is in monitoring and management of the environment. Waste collection utilizing the Internet of Things (IoT) with the technology of smart wireless sensors will able to gather fill-level data from waste containers hence providing a waste monitoring solution that brings up savings in waste collection costs. One of the challenges to the local authority is how to monitor the works of contractor effective and efficiently in waste management. This paper will propose to the local authority the implementation of smart waste management in Malaysia to improve the city management and to provide better services to the public towards smart city applications.

Market failure, policy failure and other distortions in chronic disease markets

PubMed Central

Watts, Jennifer J; Segal, Leonie

2009-01-01

Background The increasing prevalence of chronic disease represents a significant burden on most health systems. This paper explores the market failures and policy failures that exist in the management of chronic diseases. Discussion There are many sources of market failure in health care that undermine the efficiency of chronic disease management. These include incomplete information as well as information asymmetry between providers and consumers, the effect of externalities on consumer behaviour, and the divergence between social and private time preference rates. This has seen government and policy interventions to address both market failures and distributional issues resulting from the inability of private markets to reach an efficient and equitable distribution of resources. However, these have introduced a series of policy failures such as distorted re-imbursement arrangements across modalities and delivery settings. Summary The paper concludes that market failure resulting from a preference of individuals for 'immediate gratification' in the form of health care and disease management, rather than preventative services, where the benefits are delayed, has a major impact on achieving an efficient allocation of resources in markets for the management of chronic diseases. This distortion is compounded by government health policy that tends to favour medical and pharmaceutical interventions further contributing to distortions in the allocation of resources and inefficiencies in the management of chronic disease. PMID:19534822

Integration mechanisms and hospital efficiency in integrated health care delivery systems.

PubMed

Wan, Thomas T H; Lin, Blossom Yen-Ju; Ma, Allen

2002-04-01

This study analyzes integration mechanisms that affect system performances measured by indicators of efficiency in integrated delivery systems (IDSs) in the United States. The research question is, do integration mechanisms improve IDSs' efficiency in hospital care? American Hospital Association's Annual Survey (1998) and Dorenfest's Survey on Information Systems in Integrated Healthcare Delivery Systems (1998) were used to conduct the study, using IDS as the unit of analysis. A covariance structure equation model of the effects of system integration mechanisms on IDS performance was formulated and validated by an empirical examination of IDSs. The study sample includes 973 hospital-based integrated health care delivery systems operating in the United States, carried in the list of Dorenfests Survey on Information Systems in Integrated Health care Delivery Systems. The measurement indicators of system integration mechanisms are categorized into six related domains: informatic integration, case management, hybrid physician-hospital integration, forward integration, backward integration, and high tech medical services. The multivariate analysis reveals that integration mechanisms in system operation are positively correlated and positively affect IDSs' efficiency. The six domains of integration mechanisms account for 58.9% of the total variance in hospital performance. The service differentiation strategy such as having more high tech medical services have much stronger influences on efficiency than other integration mechanisms do. The beneficial effects of integration mechanisms have been realized in IDS performance. High efficiency in hospital care can be achieved by employing proper integration strategies in operations.

Web-HLA and Service-Enabled RTI in the Simulation Grid

NASA Astrophysics Data System (ADS)

Huang, Jijie; Li, Bo Hu; Chai, Xudong; Zhang, Lin

HLA-based simulations in a grid environment have now become a main research hotspot in the M&S community, but there are many shortcomings of the current HLA running in a grid environment. This paper analyzes the analogies between HLA and OGSA from the software architecture point of view, and points out the service-oriented method should be introduced into the three components of HLA to overcome its shortcomings. This paper proposes an expanded running architecture that can integrate the HLA with OGSA and realizes a service-enabled RTI (SE-RTI). In addition, in order to handle the bottleneck problem that is how to efficiently realize the HLA time management mechanism, this paper proposes a centralized way by which the CRC of the SE-RTI takes charge of the time management and the dispatching of TSO events of each federate. Benchmark experiments indicate that the running velocity of simulations in Internet or WAN is properly improved.

An MIP model to schedule the call center workforce and organize the breaks

NASA Astrophysics Data System (ADS)

Türker, Turgay; Demiriz, Ayhan

2016-06-01

In modern economies, companies place a premium on managing their workforce efficiently especially in labor intensive service sector, since the services have become the significant portion of the economies. Tour scheduling is an important tool to minimize the overall workforce costs while satisfying the minimum service level constraints. In this study, we consider the workforce management problem of an inbound call-center while satisfying the call demand within the short time periods with the minimum cost. We propose a mixed-integer programming model to assign workers to the daily shifts, to determine the weekly off-days, and to determine the timings of lunch and other daily breaks for each worker. The proposed model has been verified on the weekly demand data observed at a specific call center location of a satellite TV operator. The model was run on both 15 and 10 minutes demand estimation periods (planning time intervals).

Soft optics in intelligent optical networks

NASA Astrophysics Data System (ADS)

Shue, Chikong; Cao, Yang

2001-10-01

In addition to the recent advances in Hard-optics that pushes the optical transmission speed, distance, wave density and optical switching capacity, Soft-optics provides the necessary intelligence and control software that reduces operational costs, increase efficiency, and enhances revenue generating services by automating optimal optical circuit placement and restoration, and enabling value-added new services like Optical VPN. This paper describes the advances in 1) Overall Hard-optics and Soft-optics 2) Layered hierarchy of Soft-optics 3) Component of Soft-optics, including hard-optics drivers, Management Soft-optics, Routing Soft-optics and System Soft-optics 4) Key component of Routing and System Soft-optics, namely optical routing and signaling (including UNI/NNI and GMPLS signaling). In summary, the soft-optics on a new generation of OXC's enables Intelligent Optical Networks to provide just-in-time service delivery and fast restoration, and real-time capacity management that eliminates stranded bandwidth. It reduces operational costs and provides new revenue opportunities.

Market mechanisms and the management of health care. The UK model and experience.

PubMed

Lapsley, I

1997-01-01

Examines recent reforms of the UK's National Health Service (NHS), and explores the pressures for change in the pursuit of an efficient NHS and the conflicts which this causes in an organization which was based on the aim of equity. In particular, addresses the "false revolutions" of managerial change introduced after the Griffiths Report (1983) and the accounting changes introduced in the wake of the Griffiths proposals. Evidence shows that these intended revolutions were limited in impact. The result of these failures has been the introduction of the "real revolution"--the internal market in health care. This is a radical change in both the NHS management arrangements and in service delivery, with the division of the NHS into purchasers (health authorities and GP fund holders) and providers (hospital and community services, whether provided by private, voluntary or state-owned facilities.

Explaining the heterogeneity in average costs per HIV/AIDS patient in Nigeria: The role of supply-side and service delivery characteristics

PubMed Central

Amanze, Ogbonna O.; La Hera-Fuentes, Gina; Silverman-Retana, Omar; Contreras-Loya, David; Ashefor, Gregory A.; Ogungbemi, Kayode M.

2018-01-01

Objective We estimated the average annual cost per patient of ART per facility (unit cost) in Nigeria, described the variation in costs across facilities, and identified factors associated with this variation. Methods We used facility-level data of 80 facilities in Nigeria, collected between December 2014 and May 2015. We estimated unit costs at each facility as the ratio of total costs (the sum of costs of staff, recurrent inputs and services, capital, training, laboratory tests, and antiretroviral and TB treatment drugs) divided by the annual number of patients. We applied linear regressions to estimate factors associated with ART cost per patient. Results The unit ART cost in Nigeria was $157 USD nationally and the facility-level mean was $231 USD. The study found a wide variability in unit costs across facilities. Variations in costs were explained by number of patients, level of care, task shifting (shifting tasks from doctors to less specialized staff, mainly nurses, to provide ART) and provider´s competence. The study illuminated the potentially important role that management practices can play in improving the efficiency of ART services. Conclusions Our study identifies characteristics of services associated with the most efficient implementation of ART services in Nigeria. These results will help design efficient program scale-up to deliver comprehensive HIV services in Nigeria by distinguishing features linked to lower unit costs. PMID:29718906

Adding Data Management Services to Parallel File Systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Brandt, Scott

2015-03-04

The objective of this project, called DAMASC for “Data Management in Scientific Computing”, is to coalesce data management with parallel file system management to present a declarative interface to scientists for managing, querying, and analyzing extremely large data sets efficiently and predictably. Managing extremely large data sets is a key challenge of exascale computing. The overhead, energy, and cost of moving massive volumes of data demand designs where computation is close to storage. In current architectures, compute/analysis clusters access data in a physically separate parallel file system and largely leave it scientist to reduce data movement. Over the past decadesmore » the high-end computing community has adopted middleware with multiple layers of abstractions and specialized file formats such as NetCDF-4 and HDF5. These abstractions provide a limited set of high-level data processing functions, but have inherent functionality and performance limitations: middleware that provides access to the highly structured contents of scientific data files stored in the (unstructured) file systems can only optimize to the extent that file system interfaces permit; the highly structured formats of these files often impedes native file system performance optimizations. We are developing Damasc, an enhanced high-performance file system with native rich data management services. Damasc will enable efficient queries and updates over files stored in their native byte-stream format while retaining the inherent performance of file system data storage via declarative queries and updates over views of underlying files. Damasc has four key benefits for the development of data-intensive scientific code: (1) applications can use important data-management services, such as declarative queries, views, and provenance tracking, that are currently available only within database systems; (2) the use of these services becomes easier, as they are provided within a familiar file-based ecosystem; (3) common optimizations, e.g., indexing and caching, are readily supported across several file formats, avoiding effort duplication; and (4) performance improves significantly, as data processing is integrated more tightly with data storage. Our key contributions are: SciHadoop which explores changes to MapReduce assumption by taking advantage of semantics of structured data while preserving MapReduce’s failure and resource management; DataMods which extends common abstractions of parallel file systems so they become programmable such that they can be extended to natively support a variety of data models and can be hooked into emerging distributed runtimes such as Stanford’s Legion; and Miso which combines Hadoop and relational data warehousing to minimize time to insight, taking into account the overhead of ingesting data into data warehousing.« less

Controlling Legal Risk for Effective Hospital Management

PubMed Central

Park, Hyun Jun; Cho, Duk Young; Park, Yong Sug; Kim, Sun Wook; Park, Jae-Hong

2016-01-01

Purpose To analyze the types of medical malpractice, medical errors, and medical disputes in a university hospital for the proposal of countermeasures that maximize the efficiency of hospital management, medical departments, and healthcare providers. Materials and Methods This study retrospectively reviewed and analyzed 55 closed civil lawsuits among 64 medical lawsuit cases carried out in Pusan National University Hospital from January 2000 to April 2013 using medical records, petitions, briefs, and data from the Medical Dispute Mediation Committee. Results Of 55 civil lawsuits, men were the main plaintiffs in 31 cases (56.4%). The average period from medical malpractice to malpractice proceeding was 16.5 months (range, 1 month to 6.4 years), and the average period from malpractice proceeding to the disposition of a lawsuit was 21.7 months (range, 1 month to 4 years and 11 months). Conclusions Hospitals can effectively manage their legal risks by implementing a systematic medical system, eliminating risk factors in administrative service, educating all hospital employees on preventative strategies, and improving customer service. Furthermore, efforts should be made to establish standard coping strategies to manage medical disputes and malpractice lawsuits, operate alternative dispute resolution methods including the Medical Dispute Mediation Committee, create a compliance support center, deploy a specialized workforce including improved legal services for employees, and specialize the management-level tasks of the hospital. PMID:27169130

Modelling a radiology department service using a VDL integrated approach.

PubMed

Guglielmino, Maria Gabriella; Celano, Giovanni; Costa, Antonio; Fichera, Sergio

2009-01-01

The healthcare industry is facing several challenges such as the reduction of costs and quality improvement of the provided services. Engineering studies could be very useful in supporting organizational and management processes. Healthcare service efficiency depends on a strong collaboration between clinical and engineering experts, especially when it comes to analyzing the system and its constraints in detail and subsequently, when it comes to deciding on the reengineering of some key activities. The purpose of this paper is to propose a case study showing how a mix of representation tools allow a manager of a radiology department to solve some human and technological resource re-organizational issues, which have to be faced due to the introduction of a new technology and a new portfolio of services. In order to simulate the activities within the radiology department and examine the relationship between human and technological resources, different visual diagrammatic language (VDL) techniques have been implemented to get knowledge about the heterogeneous factors related to the healthcare service delivery. In particular, flow charts, IDEFO diagrams and Petri nets have been integrated each other with success as a modelisation tools. The simulation study performed through the application of the aforementioned VDL techniques suggests the opportunity of re-organizing the nurse activities within the radiology department. The re-organization of a healthcare service and in particular of a radiology department by means of joint flow charts, IDEF0 diagrams and Petri nets is a poorly investigated topic in literature. This paper demonstrates how flow charts and IDEF0 can help people working within the department to understand the weak points of their organization and constitute an efficient base of knowledge for the implementation of a Petri net aimed at improving the departmental performance.

Airport Analyses Informing New Mobility Shifts: Opportunities to Adapt Energy-Efficient Mobility Services and Infrastructure: Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

Henao, Alejandro; Sperling, Joshua; Young, Stanley E

An airport is one of the most important assets for a region's economic development and connectivity with the rest of the nation and world. Key aspects for investigation of energy efficient mobility at airports is ground transportation including factors ranging from the infrastructure, mobility services, and associated revenues. Data is critical to understand the maturity of new mobility services that can inform both cities and airports on how to respond, approach, manage, and adapt to the challenges, opportunities, and uncertainties associated with shifts in new mobility that influence human behavior, energy-efficiency and sustainability strategies. One key question identified in thismore » article is how quickly we are adapting to new mobility options - such as app-based ride-hailing and 'pooling' services - that may provide an opportunity to influence energy efficiency of ground transportation to and from airports. By starting with airports in the regions of four smart city finalists in the U.S. DOT Smart City Challenge, this paper focuses on key observability aspects of new modes and the rate of shifts in mobility patterns across San Francisco, Portland, Denver, and Kansas City. With the emerging megatrend of rising urbanization and rising air travel demand (a predicted doubling in demand by 2035), airports are expected to increasingly be on the front lines of adaptation to new transportation technology and services in terms of infrastructure investments, policies, and revenues. As airports have demonstrated the most potential and capability of any public institution to implement fees for new ride-hailing services, they are also a prime resource for collecting important data to help understand smart mobility transitions. Results focused on the shifts in revenues for ground transportation at airports offer one vantage point into the pace of transitions and adaptations in the new emerging mobility landscape, and present an opportunity to analyze how future adaptations could support more energy-efficient scenarios.« less

A data protection scheme for medical research networks. Review after five years of operation.

PubMed

Helbing, K; Demiroglu, S Y; Rakebrandt, F; Pommerening, K; Rienhoff, O; Sax, U

2010-01-01

The data protection requirements matured in parallel to new clinical tests generating more personal data since the 1960s. About ten years ago it was recognized that a generic data protection scheme for medical research networks is required, which reinforces patient rights but also allows economically feasible medical research compared to "hand-carved" individual solutions. To give recommendations for more efficient IT infrastructures for medical research networks in compliance with data protection requirements. The IT infrastructures of three medical research networks were reviewed with respect to the relevant data management modules. Recommendations are derived to increase cost efficiency in research networks assessing the consequences of a service provider approach without lowering the data protection level. The existing data protection schemes are very complex. Smaller research networks cannot afford the implementation of such schemes. Larger networks struggle to keep them sustainable. Due to a modular redesign in the medical research network community, a new approach offers opportunities for an efficient sustainable IT infrastructure involving a service provider concept. For standard components 70-80% of the costs could be cut down, for open source components about 37% over a three-year period. Future research networks should switch to a service-oriented approach to achieve a sustainable, cost-efficient IT infrastructure.

In-service education and training as experienced by registered nurses.

PubMed

Norushe, T F; Van Rooyen, D; Strumpher, J

2004-11-01

Nursing is a dynamic profession that is subject to rapid changes in health care provision, hence the need for in-service training programmes for nurses. Newly employed registered nurses require in-service training in order to update them regarding the latest developments in nursing practice. The researcher noted that some newly appointed registered nurses were not competent in all aspects relating to their tasks. This could have been due to a knowledge deficit relating to either new developments or of the procedure relating to a specific task. In some institutions newly-appointed registered nurses on probation reported not receiving in-service training for six months or longer, yet they were still expected to perform their tasks efficiently. The objectives of the study were to, firstly, explore and describe the experiences of registered nurses regarding in-service training programmes in their institutions and, secondly, to make recommendations to Nursing Service Managers relating to the development of effective in-service training programmes in their institutions. A qualitative, exploratory, descriptive design was implemented. Data was analysed using Tesch's descriptive approach (in Creswell, 1994:155). Two main themes emerged, namely that registered nurses experienced in-service training programmes as inadequate and reacted negatively towards them. This article focuses on the experiences of registered nurses relating to in-service training programmes, as well as the formulation of guidelines to assist nursing service managers in the development of effective in-service training programmes.

UTM UAS Service Supplier Specification

NASA Technical Reports Server (NTRS)

Rios, Joseph Lucio

2017-01-01

Within the Unmanned Aircraft Systems (UAS) Traffic Management (UTM) system, the UAS Service Supplier (USS) is a key component. The USS serves several functions. At a high level, those include the following: Bridging communication between UAS Operators and Flight Information Management System (FIMS) Supporting planning of UAS operations Assisting strategic deconfliction of the UTM airspace Providing information support to UAS Operators during operations Helping UAS Operators meet their formal requirements This document provides the minimum set of requirements for a USS. In order to be recognized as a USS within UTM, successful demonstration of satisfying the requirements described herein will be a prerequisite. To ensure various desired qualities (security, fairness, availability, efficiency, maintainability, etc.), this specification relies on references to existing public specifications whenever possible.

TAS::89 0927::TAS RECOVERY - The Lean Green Energy Controller Machine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Teeter, John; Wang, Gene; Moss, David

Achieving efficiency improvements and providing demand-response programs have been identified as key elements of our national energy initiative. The residential market is the largest, yet most difficult, segment to engage in efforts to meet these objectives. This project developed Energy Management System that engages the consumer and enables Smart Grid services, applications, and business processes to address this need. Our innovative solution provides smart controller providing dynamic optimization of energy consumption for the residential energy consumer. Our solution extends the technical platform to include a cloud based Internet of Things (IoT) aggregation of data sensors and actuators the go beyondmore » energy management and extend to life style services provided through compelling mobile and console based user experiences.« less

FORESEE™ User-Centric Energy Automation

DOE Office of Scientific and Technical Information (OSTI.GOV)

FORESEE™ is a home energy management system (HEMS) that provides a user centric energy automation solution for residential building occupants. Built upon advanced control and machine learning algorithms, FORESEE intelligently manages the home appliances and distributed energy resources (DERs) such as photovoltaics and battery storage in a home. Unlike existing HEMS in the market, FORESEE provides a tailored home automation solution for individual occupants by learning and adapting to their preferences on cost, comfort, convenience and carbon. FORESEE improves not only the energy efficiency of the home but also its capability to provide grid services such as demand response. Highlymore » reliable demand response services are likely to be incentivized by utility companies, making FORESEE economically viable for most homes.« less

Information integration for a sky survey by data warehousing

NASA Astrophysics Data System (ADS)

Luo, A.; Zhang, Y.; Zhao, Y.

The virtualization service of data system for a sky survey LAMOST is very important for astronomers The service needs to integrate information from data collections catalogs and references and support simple federation of a set of distributed files and associated metadata Data warehousing has been in existence for several years and demonstrated superiority over traditional relational database management systems by providing novel indexing schemes that supported efficient on-line analytical processing OLAP of large databases Now relational database systems such as Oracle etc support the warehouse capability which including extensions to the SQL language to support OLAP operations and a number of metadata management tools have been created The information integration of LAMOST by applying data warehousing is to effectively provide data and knowledge on-line

Efficient Secure and Privacy-Preserving Route Reporting Scheme for VANETs

NASA Astrophysics Data System (ADS)

Zhang, Yuanfei; Pei, Qianwen; Dai, Feifei; Zhang, Lei

2017-10-01

Vehicular ad-hoc network (VANET) is a core component of intelligent traffic management system which could provide various of applications such as accident prediction, route reporting, etc. Due to the problems caused by traffic congestion, route reporting becomes a prospective application which can help a driver to get optimal route to save her travel time. Before enjoying the convenience of route reporting, security and privacy-preserving issues need to be concerned. In this paper, we propose a new secure and privacy-preserving route reporting scheme for VANETs. In our scheme, only an authenticated vehicle can use the route reporting service provided by the traffic management center. Further, a vehicle may receive the response from the traffic management center with low latency and without violating the privacy of the vehicle. Experiment results show that our scheme is much more efficiency than the existing one.

Risk assessment of sewer condition using artificial intelligence tools: application to the SANEST sewer system.

PubMed

Sousa, V; Matos, J P; Almeida, N; Saldanha Matos, J

2014-01-01

Operation, maintenance and rehabilitation comprise the main concerns of wastewater infrastructure asset management. Given the nature of the service provided by a wastewater system and the characteristics of the supporting infrastructure, technical issues are relevant to support asset management decisions. In particular, in densely urbanized areas served by large, complex and aging sewer networks, the sustainability of the infrastructures largely depends on the implementation of an efficient asset management system. The efficiency of such a system may be enhanced with technical decision support tools. This paper describes the role of artificial intelligence tools such as artificial neural networks and support vector machines for assisting the planning of operation and maintenance activities of wastewater infrastructures. A case study of the application of this type of tool to the wastewater infrastructures of Sistema de Saneamento da Costa do Estoril is presented.

EVALUATION OF OPPORTUNITIES TO IMPROVE STRUCTURAL INSPECTION CAPABILITIES FOR WATER MAINS: LARGE DIAMETER CAST IRON PIPE

EPA Science Inventory

The U.S. EPA and other organizations have projected that a large portion of the United States’ aging water conveyance infrastructure will reach the end of its service life in the next several decades. EPA has identified asset management as a critical factor in efficiently addre...

School Plant Management: Organizing the Maintenance Program. Bulletin, 1960, No. 15. OE-21002

ERIC Educational Resources Information Center

Finchum, R. N.

1960-01-01

Present capital outlay investments in elementary and secondary school buildings, sites, and equipment in the United States are being increased at the rate of about $3 billion annually. Maintenance and operational services, important aspects of property protection, educational progress, pupil safety, and plant efficiency, are being provided in…

42 CFR 35.1 - Hospital and station rules.

Code of Federal Regulations, 2010 CFR

2010-10-01

... EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.1 Hospital and station rules. The officer in charge of a station or hospital of the Service is authorized to adopt such rules and issue such instructions... for the efficient operation of the station or hospital and for the proper and humane care and...

77 FR 58802 - Notice of Intent To Seek OMB Approval To Collect Information: Forms Pertaining to the Peer Review...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-24

... Collect Information: Forms Pertaining to the Peer Review of ARS Research Projects AGENCY: Agricultural Research Service (ARS), USDA. ACTION: Notice and request for comments. SUMMARY: The proposed information... allow the ARS to efficiently manage data associated with the peer review of agricultural research. All...

41 CFR 102-73.10 - What is the basic real estate acquisition policy?

Code of Federal Regulations, 2013 CFR

2013-07-01

... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2013-07-01 2013-07-01 false What is the basic real...

41 CFR 102-73.10 - What is the basic real estate acquisition policy?

Code of Federal Regulations, 2012 CFR

2012-01-01

... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2012-01-01 2012-01-01 false What is the basic real...

41 CFR 102-73.10 - What is the basic real estate acquisition policy?

Code of Federal Regulations, 2014 CFR

2014-01-01

... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2014-01-01 2014-01-01 false What is the basic real...

41 CFR 102-73.10 - What is the basic real estate acquisition policy?

Code of Federal Regulations, 2010 CFR

2010-07-01

... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What is the basic real...

41 CFR 102-73.10 - What is the basic real estate acquisition policy?

Code of Federal Regulations, 2011 CFR

2011-01-01

... ESTATE ACQUISITION General Provisions § 102-73.10 What is the basic real estate acquisition policy? When... real estate and related services in an efficient and cost effective manner. ... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false What is the basic real...

Aeronautical mobile satellite service: Air traffic control applications

NASA Technical Reports Server (NTRS)

Sim, Dave

1990-01-01

Canada's history both in aviation and in satellite communications development spans several decades. The introduction of aeronautical mobile satellite communications will serve our requirements for airspace management in areas not served by line-of-sight radio and radar facilities. The ensuing improvements in air safety and operating efficiency are eagerly awaited by the aviation community.

78 FR 41868 - Energy Conservation Program for Consumer Products and Certain Commercial and Industrial Equipment...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-12

... services and manage networked resources for client devices such as desktop and laptop computers. These... include desktop or laptop computers, which are not primarily accessed via network connections. DOE seeks... Determination of Computer Servers as a Covered Consumer Product AGENCY: Office of Energy Efficiency and...

Urban solid waste generation and disposal in Mexico: a case study.

PubMed

Buenrostro, O; Bocco, G; Bernache, G

2001-04-01

The adequate management of municipal solid waste in developing countries is difficult because of the scarcity of studies about their composition. This paper analyses the composition of urban solid waste (USW) in the city of Morelia, Michoacán, Mexico. Residential and non-residential waste sources were sampled, and a structured interview was made to evaluate the socioeconomic characteristics of the studied area. Also, to determine the seasonal patterns of solid waste generation and the efficiency level of the collection service, quantification of solid waste deposited in the dumping ground was measured. Our results show that the recorded amount of SW deposited in the municipal dumping-ground is less than the estimated amount of SW generated; for this reason, the former amount is not recommended as an unbiased indicator for planning public waste collection services. It is essential that dumping-grounds are permanently monitored and that the incoming waste be weighed in order to have a more efficient record of USW deposited in the dumping-ground per day; these data are fundamental for developing adequate managing strategies.

a Task-Oriented Disaster Information Correlation Method

NASA Astrophysics Data System (ADS)

Linyao, Q.; Zhiqiang, D.; Qing, Z.

2015-07-01

With the rapid development of sensor networks and Earth observation technology, a large quantity of disaster-related data is available, such as remotely sensed data, historic data, case data, simulated data, and disaster products. However, the efficiency of current data management and service systems has become increasingly difficult due to the task variety and heterogeneous data. For emergency task-oriented applications, the data searches primarily rely on artificial experience based on simple metadata indices, the high time consumption and low accuracy of which cannot satisfy the speed and veracity requirements for disaster products. In this paper, a task-oriented correlation method is proposed for efficient disaster data management and intelligent service with the objectives of 1) putting forward disaster task ontology and data ontology to unify the different semantics of multi-source information, 2) identifying the semantic mapping from emergency tasks to multiple data sources on the basis of uniform description in 1), and 3) linking task-related data automatically and calculating the correlation between each data set and a certain task. The method goes beyond traditional static management of disaster data and establishes a basis for intelligent retrieval and active dissemination of disaster information. The case study presented in this paper illustrates the use of the method on an example flood emergency relief task.

a Task-Driven Disaster Data Link Approach

NASA Astrophysics Data System (ADS)

Qiu, L. Y.; Zhu, Q.; Gu, J. Y.; Du, Z. Q.

2015-08-01

With the rapid development of sensor networks and Earth observation technology, a large quantity of disaster-related data is available, such as remotely sensed data, historic data, cases data, simulation data, disaster products and so on. However, the efficiency of current data management and service systems has become increasingly serious due to the task variety and heterogeneous data. For emergency task-oriented applications, data searching mainly relies on artificial experience based on simple metadata index, whose high time-consuming and low accuracy cannot satisfy the requirements of disaster products on velocity and veracity. In this paper, a task-oriented linking method is proposed for efficient disaster data management and intelligent service, with the objectives of 1) putting forward ontologies of disaster task and data to unify the different semantics of multi-source information, 2) identifying the semantic mapping from emergency tasks to multiple sources on the basis of uniform description in 1), 3) linking task-related data automatically and calculating the degree of correlation between each data and a target task. The method breaks through traditional static management of disaster data and establishes a base for intelligent retrieval and active push of disaster information. The case study presented in this paper illustrates the use of the method with a flood emergency relief task.

Clinical governance and operations management methodologies.

PubMed

Davies, C; Walley, P

2000-01-01

The clinical governance mechanism, introduced since 1998 in the UK National Health Service (NHS), aims to deliver high quality care with efficient, effective and cost-effective patient services. Scally and Donaldson recognised that new approaches are needed, and operations management techniques comprise potentially powerful methodologies in understanding the process of care, which can be applied both within and across professional boundaries. This paper summarises four studies in hospital Trusts which took approaches to improving process that were different from and less structured than business process re-engineering (BPR). The problems were then amenable to change at a relatively low cost and short timescale, producing significant improvement to patient care. This less structured approach to operations management avoided incurring overhead costs of large scale and costly change such as new information technology (IT) systems. The most successful changes were brought about by formal tools to control quantity, content and timing of changes.

Pharmacy benefit management contracting: an assessment from a recent public sector procurement experience.

PubMed

Bae, Jay P; Justice, Paul G

2002-01-01

In order to contain the cost of pharmaceuticals while preserving access to medically necessary drugs, Georgia state government competitively selected a single vendor in May of 2000 to manage combined pharmacy benefits under all of the state's health programs. By initiating this procedure, it intended to maximize the state's purchasing power and improve efficiency while streamlining the administrative structure. Synthesizing information from the request for proposal (RFP) and technical proposals submitted by 11 pharmacy benefit managers (PBMs) in response, we describe a model of public sector PBM contracting approach and present an assessment of the industry's service capability and performance statistics. Payers who have been using PBM services may find it interesting to compare their experience with the recent Georgia experience. Those who are considering contracting with a PBM will find the assessment of the PBM industry timely and informative.

SPD-based Logistics Management Model of Medical Consumables in Hospitals.

PubMed

Liu, Tongzhu; Shen, Aizong; Hu, Xiaojian; Tong, Guixian; Gu, Wei; Yang, Shanlin

2016-10-01

With the rapid development of health services, the progress of medical science and technology, and the improvement of materials research, the consumption of medical consumables (MCs) in medical activities has increased in recent years. However, owing to the lack of effective management methods and the complexity of MCs, there are several management problems including MC waste, low management efficiency, high management difficulty, and frequent medical accidents. Therefore, there is urgent need for an effective logistics management model to handle these problems and challenges in hospitals. We reviewed books and scientific literature (by searching the articles published from 2010 to 2015 in Engineering Village database) to understand supply chain related theories and methods and performed field investigations in hospitals across many cities to determine the actual state of MC logistics management of hospitals in China. We describe the definition, physical model, construction, and logistics operation processes of the supply, processing, and distribution (SPD) of MC logistics because of the traditional SPD model. With the establishment of a supply-procurement platform and a logistics lean management system, we applied the model to the MC logistics management of Anhui Provincial Hospital with good effects. The SPD model plays a critical role in optimizing the logistics procedures of MCs, improving the management efficiency of logistics, and reducing the costs of logistics of hospitals in China.

Managing for efficiency in health care: the case of Greek public hospitals.

PubMed

Mitropoulos, Panagiotis; Mitropoulos, Ioannis; Sissouras, Aris

2013-12-01

This paper evaluates the efficiency of public hospitals with two alternative conceptual models. One model targets resource usage directly to assess production efficiency, while the other model incorporates financial results to assess economic efficiency. Performance analysis of these models was conducted in two stages. In stage one, we utilized data envelopment analysis to obtain the efficiency score of each hospital, while in stage two we took into account the influence of the operational environment on efficiency by regressing those scores on explanatory variables that concern the performance of hospital services. We applied these methods to evaluate 96 general hospitals in the Greek national health system. The results indicate that, although the average efficiency scores in both models have remained relatively stable compared to past assessments, internal changes in hospital performances do exist. This study provides a clear framework for policy implications to increase the overall efficiency of general hospitals.

[Primary care: decentralization and efficiency].

PubMed

Pinillos, M; Antoñanzas, F

2002-01-01

The purpose of this study was to evaluate whether the productive behavior of health centers in autonomous communities with competence in health is more efficient than that among centers belonging to Spanish public health system (INSALUD). The technical efficiency of 66 health centers in Alava, Navarre and La Rioja was analyzed. Centers in autonomous communities that in 1997 had been granted complete authority from the central government to manage their healthcare services were compared with centers whose administration, in the same year, was still in the hands of INSALUD. The method used to measure and quantify the efficiency of these centers was data envelopment analysis. Nonparametric contrast of the health centers' mean efficiency rates revealed no significant differences in the (in)efficiency of centers from La Rioja, Navarre and Alava. The results obtained from the model of efficiency measurement used did not indicate that decentralization improves the productive efficiency of primary care centers.

Manufacturing Bms/Iso System Review

NASA Technical Reports Server (NTRS)

Gomez, Yazmin

2004-01-01

The Quality Management System (QMS) is one that recognizes the need to continuously change and improve an organization s products and services as determined by system feedback, and corresponding management decisions. The purpose of a Quality Management System is to minimize quality variability of an organization's products and services. The optimal Quality Management System balances the need for an organization to maintain flexibility in the products and services it provides with the need for providing the appropriate level of discipline and control over the processes used to provide them. The goal of a Quality Management System is to ensure the quality of the products and services while consistently (through minimizing quality variability) meeting or exceeding customer expectations. The GRC Business Management System (BMS) is the foundation of the Center's ISO 9001:2000 registered quality system. ISO 9001 is a quality system model developed by the International Organization for Standardization. BMS supports and promote the Glenn Research Center Quality Policy and wants to ensure the customer satisfaction while also meeting quality standards. My assignment during this summer is to examine the manufacturing processes used to develop research hardware, which in most cases are one of a kind hardware, made with non conventional equipment and materials. During this process of observation I will make a determination, based on my observations of the hardware development processes the best way to meet customer requirements and at the same time achieve the GRC quality standards. The purpose of my task is to review the manufacturing processes identifying opportunities in which to optimize the efficiency of the processes and establish a plan for implementation and continuous improvement.

Commissioning Education Programs Surveys: Active Duty, Reserve, and Air National Guard Officers in Paygrades O-1 through O-3, Field Grade Officers With 1-60 Months Active Commissioned Service

DTIC Science & Technology

1994-09-01

to insure effective/ 6.80 efficient accomplishment of mission C119 Principles of management 6.80 C121 Role of the NCO-responsibilities and duties of...Budgeting System (PPBS) 7.11 C119 Principles of management 7.06 C 114 Career development-know the general structure and career progression patterns 7.06...communication and give effective 6.23 feedback C1 19 Principles of management 6.23 B49 Group problem solving-understand the positive and negative aspects of

[Development and application of a medical device maintenance information platform based on BS architecture].

PubMed

Liu, Shenglin; Zhang, Xutian; Wang, Guohong; Zhang, Qiang

2012-03-01

Based on specified demands on medical devices maintenance for clinical engineers and Browser/Server architecture technology, a medical device maintenance information platform was developed, which implemented the following modules such as repair, preventive maintenance, accessories management, training, document, system management and regional cooperation. The characteristics of this system were summarized and application in increase of repair efficiency, improvement of preventive maintenance and cost control was introduced. The application of this platform increases medical device maintenance service level.

Cost and efficiency lead to increased value for the patient and bottom line for the practice.

PubMed

Dahl, Owen J

2009-01-01

Understanding how much it costs to provide a service is a basic premise of any business. In addition, healthcare is in need of improved processes to provide and increase value to the patient. This can be accomplished by the application of principles called Six Sigma and Lean Management. Today's medical practice leader must be aware of the costs of doing business and be able to apply proven management principles to the processes involved in providing patient care.

Towards more efficient burn care: Identifying factors associated with good quality of life post-burn.

PubMed

Finlay, V; Phillips, M; Allison, G T; Wood, F M; Ching, D; Wicaksono, D; Plowman, S; Hendrie, D; Edgar, D W

2015-11-01

As minor burn patients constitute the vast majority of a developed nation case-mix, streamlining care for this group can promote efficiency from a service-wide perspective. This study tested the hypothesis that a predictive nomogram model that estimates likelihood of good long-term quality of life (QoL) post-burn is a valid way to optimise patient selection and risk management when applying a streamlined model of care. A sample of 224 burn patients managed by the Burn Service of Western Australia who provided both short and long-term outcomes was used to estimate the probability of achieving a good QoL defined as 150 out of a possible 160 points on the Burn Specific Health Scale-Brief (BSHS-B) at least six months from injury. A multivariate logistic regression analysis produced a predictive model provisioned as a nomogram for clinical application. A second, independent cohort of consecutive patients (n=106) was used to validate the predictive merit of the nomogram. Male gender (p=0.02), conservative management (p=0.03), upper limb burn (p=0.04) and high BSHS-B score within one month of burn (p<0.001) were significant predictors of good outcome at six months and beyond. A Receiver Operating Curve (ROC) analysis demonstrated excellent (90%) accuracy overall. At 80% probability of good outcome, the false positive risk was 14%. The nomogram was validated by running a second ROC analysis of the model in an independent cohort. The analysis confirmed high (86%) overall accuracy of the model, the risk of false positive was reduced to 10% at a lower (70%) probability. This affirms the stability of the nomogram model in different patient groups over time. An investigation of the effect of missing data on sample selection determined that a greater proportion of younger patients with smaller TBSA burns were excluded due to loss to follow up. For clinicians managing comparable burn populations, the BSWA burns nomogram is an effective tool to assist the selection of patients to a streamlined care pathway with the aim of improving efficiency of service delivery. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Achievements of the DOT-NASA Joint Program on Remote Sensing and Spatial Information Technologies: Application to Multimodal Transportation

NASA Technical Reports Server (NTRS)

2002-01-01

This report presents three-year accomplishments from the national program on Commercial Remote Sensing and Geospatial Technology (CRSGT) application to transportation, administered by the U.S. Department of Transportation (U.S. DOT) in collaboration with the National Aeronautics and Space Administration (NASA). The joint program was authorized under Section 5113 of the Transportation Equity Act for the 21st Century (TEA-21). This is the first national program of its type focusing on transportation applications of emerging commercial remote sensing technologies. U.S. DOT's Research and Special Programs Administration manages the program in coordination with NASA's Earth Science Enterprise's application programs. The program focuses on applications of CRSGT products and systems for providing smarter and more efficient transportation operations and services. The program is performed in partnership with four major National Consortia for Remote Sensing in Transportation (NCRST). Each consortium focuses on research and development of products in one of the four priority areas for transportation application, and includes technical application and demonstration projects carried out in partnership with industries and service providers in their respective areas. The report identifies products and accomplishments from each of the four consortia in meeting the goal of providing smarter and more efficient transportation services. The products and results emerging from the program are being implemented in transportation operations and services through state and local agencies. The Environmental Assessment and Application Consortium (NCRST-E) provides leadership for developing and deploying cost effective environmental and transportation planning services, and integrates CRSGT advances for achieving smarter and cost effective corridor planning. The Infrastructure Management Consortium (NCRST-I) provides leadership in technologies that achieve smarter and cheaper ways of managing transportation infrastructure assets, operation, and inspection, and integrates CRSGT advances for achieving infrastructure security. The Traffic Flow Consortium (NCRST-F) provides leadership to develop new tools for regional traffic flow management including heavy vehicles and intermodal flow of freight, and integrates CRSGT advances for complementing and extending the reach of ITS user services. The Safety, Hazards and Disasters (NCRST-H) provides leadership for deploying remote sensing technology to locate transportation hazards and improve disaster recovery, and integrates CRSGT advances for application to protect transportation systems from terrorism. The DOT-NASA team is proud to present this report of accomplishments on products and results emerging from the joint program for application to transportation practice.

Linking soil systems to societal value systems

NASA Astrophysics Data System (ADS)

Helming, Katharina; Daedlow, Katrin; Techen, Anja; Kaiser, David Brian

2017-04-01

Sustainable management of soils is needed to avoid soil degradation and to maintain soil functions. This requires the assessment of how human activities drive soil management, how soil management affect soil functions and soil degradation, which trade-offs occur and how they compromise sustainable development targets. In the frame of the German research programme "Soils as a sustainable resource for the bio-economy - BonaRes", we developed an enhanced approach of the DPSIR (driver-pressure-state-impact-response) cycle which helps to assess these interrelations. Because not all soil functions can be maximized simultaneously in space and time and trade-offs are inevitable, it depends on the societal value system to decide which management practices and respective soil functional performances are valued sustainably. We analysed the applicability of three valuation concepts being prominent in research about social-ecological systems, namely resource efficiency, ecosystem services, and ethics and equity. The concept of resource efficiency is based in the life-cycle thinking and is often applied at the level of the farming systems and in the context of bio-economy strategies. It covers the use of natural (water, energy, nutrients, land) and economic resources. At the landscape level, the concept of ecosystem services is prominent. Here, the contribution of soils to the provisioning, regulating and cultural services of the natural ecosystems is considered. Ethical considerations include the intrinsic values of nature as well as issues of local and global equity between different societal groups, generations, and localities. The three concepts cover different problem dimensions and complexity levels of soil management and decision making. Alone, none of them are capable to discover complex questions of sustainable soil management and development. Rather, the exact spatial and temporal framing of the sustainability problem at stake determines which combination of the value system is appropriate. Exemplified by some studies on soil management, we conclude with an outlook on criteria for selecting and combining value systems to assess the involvement of soil functions to specific Sustainable Development Goals at different spatial, temporal and decision making scales.

Review on Malaysian Rail Transit Operation and Management System: Issues and Solution in Integration

NASA Astrophysics Data System (ADS)

Masirin, Mohd Idrus Mohd; Salin, Aminah Mohd; Zainorabidin, Adnan; Martin, David; Samsuddin, Norshakina

2017-08-01

In any context, operation and management of transportation systems are key issues which may affect both life quality and economic development. In large urban agglomerations, an efficient public transportation system may help abate the negative externalities of private car use such as congestion, air and noise pollution, accident and fuel consumption, without excessively penalizing user travel times or zone accessibility. Thus, this study is conducted to appraise the Malaysian rural rail transit operation and management system, which are considered important as there are many issues and solution in integration of the services that need to be tackled more conscientiously. The purpose of this paper is to describe some of the most important issues on integration of services and rail transit system in Malaysian and how to solve or reduce these problems and conflicts. In this paper, it consists of the historical development of rail transit construction in Malaysia. This paper also attempts to identify the important issues related to rail transit services and integration in Malaysian rural rail operation and management system. Comparison is also conducted with other countries such as UK, France, and Japan. Finally, a critical analysis is presented in this paper by looking at the possible application for future Malaysian rail transit operation system and management, especially focusing on enhancing the quality of Malaysian rural rail transit. In conclusion, this paper is expected to successfully review and appraise the existing Malaysian rural rail transit operation and management system pertaining to issues & solution in integration. It is also hoped that reformation or transformation of present service delivery quality of the rail transit operation and management will enable Malaysia to succeed in transforming Malaysian transportation system to greater heights.

The Efficiency of Increasing the Capacity of Physiotherapy Screening Clinics or Traditional Medical Services to Address Unmet Demand in Orthopaedic Outpatients: A Practical Application of Discrete Event Simulation with Dynamic Queuing.

PubMed

Standfield, L; Comans, T; Raymer, M; O'Leary, S; Moretto, N; Scuffham, P

2016-08-01

Hospital outpatient orthopaedic services traditionally rely on medical specialists to assess all new patients to determine appropriate care. This has resulted in significant delays in service provision. In response, Orthopaedic Physiotherapy Screening Clinics and Multidisciplinary Services (OPSC) have been introduced to assess and co-ordinate care for semi- and non-urgent patients. To compare the efficiency of delivering increased semi- and non-urgent orthopaedic outpatient services through: (1) additional OPSC services; (2) additional traditional orthopaedic medical services with added surgical resources (TOMS + Surg); or (3) additional TOMS without added surgical resources (TOMS - Surg). A cost-utility analysis using discrete event simulation (DES) with dynamic queuing (DQ) was used to predict the cost effectiveness, throughput, queuing times, and resource utilisation, associated with introducing additional OPSC or TOMS ± Surg versus usual care. The introduction of additional OPSC or TOMS (±surgery) would be considered cost effective in Australia. However, OPSC was the most cost-effective option. Increasing the capacity of current OPSC services is an efficient way to improve patient throughput and waiting times without exceeding current surgical resources. An OPSC capacity increase of ~100 patients per month appears cost effective (A$8546 per quality-adjusted life-year) and results in a high level of OPSC utilisation (98 %). Increasing OPSC capacity to manage semi- and non-urgent patients would be cost effective, improve throughput, and reduce waiting times without exceeding current surgical resources. Unlike Markov cohort modelling, microsimulation, or DES without DQ, employing DES-DQ in situations where capacity constraints predominate provides valuable additional information beyond cost effectiveness to guide resource allocation decisions.

Approaches to quality management and accreditation in a genetic testing laboratory

PubMed Central

Berwouts, Sarah; Morris, Michael A; Dequeker, Elisabeth

2010-01-01

Medical laboratories, and specifically genetic testing laboratories, provide vital medical services to different clients: clinicians requesting a test, patients from whom the sample was collected, public health and medical-legal instances, referral laboratories and authoritative bodies. All expect results that are accurate and obtained in an efficient and effective manner, within a suitable time frame and at acceptable cost. There are different ways of achieving the end results, but compliance with International Organization for Standardization (ISO) 15189, the international standard for the accreditation of medical laboratories, is becoming progressively accepted as the optimal approach to assuring quality in medical testing. We present recommendations and strategies designed to aid genetic testing laboratories with the implementation of a quality management system, including key aspects such as document control, external quality assessment, internal quality control, internal audit, management review, validation, as well as managing the human side of change. The focus is on pragmatic approaches to attain the levels of quality management and quality assurance required for accreditation according to ISO 15189, within the context of genetic testing. Attention is also given to implementing efficient and effective quality improvement. PMID:20720559

The use of private-sector contracts for primary health care: theory, evidence and lessons for low-income and middle-income countries.

PubMed Central

Palmer, N.

2000-01-01

Contracts for the delivery of public services are promoted as a means of harnessing the resources of the private sector and making publicly funded services more accountable, transparent and efficient. This is also argued for health reforms in many low- and middle-income countries, where reform packages often promote the use of contracts despite the comparatively weaker capacity of markets and governments to manage them. This review highlights theories and evidence relating to contracts for primary health care services and examines their implications for contractual relationships in low- and middle-income countries. PMID:10916919

[Assessment and comparison of hospital operating efficiency under different management systems].

PubMed

2017-06-18

To assess and analyze the operation efficiency of 8 commission general public hospitals managed directly by National Health and Family Planning Commission and 8 municipal general hospitals managed directly by Beijing Municipal Administration of Hospitals in Beijing and to provide suggestions on improving service capacity and designing relevant health policy. Input and output data of 8 commission hospitals and 8 municipal hospitals were obtained from Beijing Direct-Reported Health Statistics data from 2011 to 2014. Data envelopment analysis was used as the hospital operation efficiency measurement tool. The CCR and BCC models were built to calculate technical efficiency (TE), pure technical efficiency (PTE), scale efficiency (SE) and the status of scale efficiency of 16 hospitals in 2011 and 2014; the Malmquist index model was built to analyze the total factor productivity change (TFPC), technological change (TC), technical efficiency change, pure technical efficiency change and scale efficiency change of the 16 hospitals from 2011 to 2014. In 2011, the TE, PTE and SE of the commission hospitals were higher than those of the municipal hospitals, and the TEs of the commission hospitals and the municipal hospitals were 0.918 and 0.873 respectively. In 2014, the TE, PTE and SE of commission hospitals were lower than those of the municipal hospitals, and the TE of the commission hospitals and the municipal hospitals were 0.906 and 0.951, respectively, which was contrary to the results in 2011. According to the Malmquist index model, the average of TFPC of the municipal hospitals was larger than that of the commission hospitals, the former increased 5.9% and the latter increased 2.8% per year; the average of TC was greater than the one in both the municipal hospitals and the commission hospitals, with a growth of 3.2% and 2.9% per year, respectively; the average growth of PTE in the commission hospitals was lower than that of the municipal hospitals, and the average descent of SE in the commission hospitals was larger than that in the municipal hospitals. There are significant differences in the operation efficiency between different management systems and the main factors associated with operation efficiency are the technological and management level. Given scale efficiency status and macroeconomic medical policies, the commission hospitals and the municipal hospitals require further adjusting the distribution of medical resources, and it is of great significance for all the commission hospitals and the municipal hospitals to improve the management level and resource integration capability.

EUDAT and EPOS moving towards the efficient management of scientific data sets

NASA Astrophysics Data System (ADS)

Fiameni, Giuseppe; Bailo, Daniele; Cacciari, Claudio

2016-04-01

This abstract presents the collaboration between the European Collaborative Data Infrastructure (EUDAT) and the pan-European infrastructure for solid Earth science (EPOS) which draws on the management of scientific data sets through a reciprocal support agreement. EUDAT is a Consortium of European Data Centers and Scientific Communities whose focus is the development and realisation of the Collaborative Data Infrastructure (CDI), a common model for managing data spanning all European research data centres and data repositories and providing an interoperable layer of common data services. The EUDAT Service Suite is a set of a) implementations of the CDI model and b) standards, developed and offered by members of the EUDAT Consortium. These EUDAT Services include a baseline of CDI-compliant interface and API services - a "CDI Gateway" - plus a number of web-based GUIs and command-line client tools. On the other hand,the EPOS initiative aims at creating a pan-European infrastructure for the solid Earth science to support a safe and sustainable society. In accordance with this scientific vision, the mission of EPOS is to integrate the diverse and advanced European Research Infrastructures for solid Earth Science relying on new e-science opportunities to monitor and unravel the dynamic and complex Earth System. EPOS will enable innovative multidisciplinary research for a better understanding of the Earth's physical and chemical processes that control earthquakes, volcanic eruptions, ground instability and tsunami as well as the processes driving tectonics and Earth's surface dynamics. Through the integration of data, models and facilities EPOS will allow the Earth Science community to make a step change in developing new concepts and tools for key answers to scientific and socio-economic questions concerning geo-hazards and geo-resources as well as Earth sciences applications to the environment and to human welfare. To achieve this integration challenge and the interoperability among all involved communities, EPOS has designed an architecture capable to organize and manage distributed discipline-oriented centers (called Thematic Core Services - TCS). Such design envisage the creation of an integrating e-Infrastructure called Integrated Core Service (ICS), whose aim is to collect and integrate Data, Data Products, Software and Services, and provide homogeneous access to them to the end user, hiding all the complexity of the underlying network of TCS and National data centers. Therefore, EPOS can take advantage of EUDAT CDI at different levels: at the TCS level, providing technologies, knowledge and B2* services to discipline-oriented communities, and at the ICS level, by facilitating the integration and interoperability of different communities with different level of maturity in terms of technology expertise. EUDAT services are particularly suitable to facilitate this process as they can be deployed across the community centers to complement or augment existing services of more mature communities as well as be used by less mature communities as a gateway towards the EPOS integration. To this purpose, a pilot is being carried on in the context of the EPOS Seismological community to foster the uptake of EUDAT services among centers and thus ensure the efficient and sustainable management of scientific data sets. Data sets, e.g. seismic waveforms, collected through the Italian Seismic Network and the ORFEUS organization, are currently replicated onto EUDAT resources to ensure their long-term preservation and accessibility. The pilot will be extend to cover other use cases such as the management of meta-data and the fine-grained control of access.

Modeling wildfire incident complexity dynamics.

PubMed

Thompson, Matthew P

2013-01-01

Wildfire management in the United States and elsewhere is challenged by substantial uncertainty regarding the location and timing of fire events, the socioeconomic and ecological consequences of these events, and the costs of suppression. Escalating U.S. Forest Service suppression expenditures is of particular concern at a time of fiscal austerity as swelling fire management budgets lead to decreases for non-fire programs, and as the likelihood of disruptive within-season borrowing potentially increases. Thus there is a strong interest in better understanding factors influencing suppression decisions and in turn their influence on suppression costs. As a step in that direction, this paper presents a probabilistic analysis of geographic and temporal variation in incident management team response to wildfires. The specific focus is incident complexity dynamics through time for fires managed by the U.S. Forest Service. The modeling framework is based on the recognition that large wildfire management entails recurrent decisions across time in response to changing conditions, which can be represented as a stochastic dynamic system. Daily incident complexity dynamics are modeled according to a first-order Markov chain, with containment represented as an absorbing state. A statistically significant difference in complexity dynamics between Forest Service Regions is demonstrated. Incident complexity probability transition matrices and expected times until containment are presented at national and regional levels. Results of this analysis can help improve understanding of geographic variation in incident management and associated cost structures, and can be incorporated into future analyses examining the economic efficiency of wildfire management.

Waste Management Improvement Initiatives at Atomic Energy of Canada Limited - 13091

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chan, Nicholas; Adams, Lynne; Wong, Pierre

2013-07-01

Atomic Energy of Canada Limited's (AECL) Chalk River Laboratories (CRL) has been in operation for over 60 years. Radioactive, mixed, hazardous and non-hazardous wastes have been and continue to be generated at CRL as a result of research and development, radioisotope production, reactor operation and facility decommissioning activities. AECL has implemented several improvement initiatives at CRL to simplify the interface between waste generators and waste receivers: - Introduction of trained Waste Officers representing their facilities or activities at CRL; - Establishment of a Waste Management Customer Support Service as a Single-Point of Contact to provide guidance to waste generators formore » all waste management processes; and - Implementation of a streamlined approach for waste identification with emphasis on early identification of waste types and potential disposition paths. As a result of implementing these improvement initiatives, improvements in waste management and waste transfer efficiencies have been realized at CRL. These included: 1) waste generators contacting the Customer Support Service for information or guidance instead of various waste receivers; 2) more clear and consistent guidance provided to waste generators for waste management through the Customer Support Service; 3) more consistent and correct waste information provided to waste receivers through Waste Officers, resulting in reduced time and resources required for waste management (i.e., overall cost); 4) improved waste minimization and segregation approaches, as identified by in-house Waste Officers; and 5) enhanced communication between waste generators and waste management groups. (authors)« less

Acute pain management efficiency improves with point-of-care handheld electronic billing system.

PubMed

Fahy, Brenda G

2009-02-01

Technology advances continue to impact patient care and physician workflow. To enable more efficient performance of billing activities, a point-of-care (POC) handheld computer technology replaced a paper-based system on an acute pain management service. Using a handheld personal digital assistant (PDA) and software from MDeverywhere (MDe, MDeverywhere, Long Island, NY), we performed a 1-yr prospective observational study of an anesthesiology acute pain management service billings and collections. Seventeen anesthesiologists providing billable acute pain services were trained and entered their charges on a PDA. Twelve months of data, just before electronic implementation (pre-elec), were compared to a 12-m period after implementation (post-elec). The total charges were 4883 for 890 patients pre-elec and 5368 for 1128 patients post-elec. With adoption of handheld billing, the charge lag days decreased from 29.3 to 7.0 (P < 0.001). The days in accounts receivable trended downward from 59.9 to 51.1 (P = 0.031). The average number of charge lag days decreased significantly with month (P = 0.0002). The net collection rate increased from 37.4% pre-elec to 40.3% post-elec (P < 0.001). The return on investment was 1.18 fold (118%). Implementation of POC electronic billing using PDAs to replace a paper-based billing system improved the collection rate and decreased the number of charge lag days with a positive return on investment. The handheld PDA billing system provided POC support for physicians during their daily clinical (e.g., patient locations, rounding lists) and billing activities, improving workflow.

Assessment of management approaches in a public water utility: A case study of the Namibia water corporation (NAMWATER)

NASA Astrophysics Data System (ADS)

Ndokosho, Johnson; Hoko, Zvikomborero; Makurira, Hodson

More than 90% of urban water supply and sanitation services in developing countries are provided by public organizations. However, public provision of services has been inherently inefficient. As a result a number of initiatives have emerged in recent years with a common goal to improve service delivery. In Namibia, the water sector reform resulted in the creation of a public utility called the Namibia Water Corporation (NAMWATER) which is responsible for bulk water supply countrywide. Since its inception in 1998, NAMWATER has been experiencing poor financial performance. This paper presents the findings of a case study that compared the management approaches of NAMWATER to the New Public Management (NPM) paradigm. The focus of the NPM approach is for the public water sector to mirror private sector methods of management so that public utilities can accrue the benefits of effectiveness, efficiency and flexibility often associated with private sector. The study tools used were a combination of literature review, interviews and questionnaires. It was found out that NAMWATER has a high degree of autonomy in its operations, albeit government approved tariffs and sourcing of external financing. The utility reports to government annually to account for results. The utility embraces a notion of good corporate culture and adheres to sound management practices. NAMWATER demonstrated a strong market-orientation indicated by the outsourcing of non-core functions but benchmarking was poorly done. NAMWATER’s customer-orientation is poor as evidenced by the lack of customer care facilities. NAMWATER’s senior management delegated operational authority to lower management to facilitate flexibility and eliminate bottlenecks. The lower management is in turn held accountable for performance by the senior management. There are no robust methods of ensuring sufficient accountability indicated by absence of performance contracts or service level agreements. It was concluded that NAMWATER’s management approaches adhere to the NPM paradigm but some NPM core-ideas such as customer orientation and external accountability (performance contracts) were visibly missing.

Prepared for the future? Evaluating the costs and benefits of voluntary work for natural disaster management under a changing climate - data on recent flood events, stakeholder needs and policy applications

NASA Astrophysics Data System (ADS)

Pfurtscheller, Clemens; Brucker, Anja; Seebauer, Sebastian

2014-05-01

Voluntary emergency and relief services, such as fire brigades or rescue organisations, form the backbone of disaster management in most of European countries. In Austria, disaster management relies on the cooperation between governmental and non-governmental institutions: When a disaster occurs, the volunteer organizations act as auxiliaries to the responsible disaster management authority. The assessment of costs and benefits of these emergency services is a crucial component of risk and disaster management strategies, since public means are getting scarcer and these costs can reach critical levels for low-income municipalities. As extreme events and emergency operations are likely to increase due to climate change, the efficient allocation of public budgets for risk and disaster management becomes more important. Hence, both, the costs and the benefits must be known, but voluntary and professional work is hardly documented and assessed comprehensively. Whereas the costs of emergency services can be calculated using market values and an analysis of public and institutional budgets, the benefits of voluntary efforts cannot be assessed easily. We present empirical data on costs of voluntary and professional emergency services during the floods of 2002, 2005 and 2013 in Austria and Germany on different scales, obtained from public authorities, fire brigades and by means of public surveys. From these results, we derive a calculation framework and data requirements for assessing costs of emergency services. To consider the different stakeholders needs of administration, emergency institutions and voluntary members, we carried out workshops, first to identify future challenges in voluntary work for disaster management instigated by climate change and second, to develop approaches how the voluntary system can be uphold when facing increasing adverse impacts of natural hazards. The empirical results as well as the workshop outcome shall be translated into policy recommendations and research needs to derive strategies for strengthening resilience at the local and regional level and to design appropriate incentives.

Implementation of a reimbursed medication review program: Corporate and pharmacy level strategies.

PubMed

MacKeigan, Linda D; Ijaz, Nadine; Bojarski, Elizabeth A; Dolovich, Lisa

In 2006, the Ontario drug plan greatly reduced community pharmacy reimbursement for generic drugs. In exchange, a fee-for-service medication review program was introduced to help patients better understand their medication therapy and ensure that medications were taken as prescribed. A qualitative study of community pharmacy implementation strategies was undertaken to inform a mixed methods evaluation of the program. To describe strategies used by community pharmacies to implement a government-funded medication review service. Key informant interviews were conducted with pharmacy corporate executives and managers, as well as independent pharmacy owners. All pharmacy corporations in the province were approached; owners were purposively sampled from the registry of the pharmacist licensing body to obtain diversity in pharmacy attributes; and pharmacy managers were identified through a mix of snowball and registry sampling. Thematic qualitative coding and analysis were applied to interview transcripts. 42 key informants, including 14 executives, 15 managers/franchisees, and 11 owners, participated. The most common implementation strategy was software adaptation to flag eligible patients and to document the service. Human resource management (task shifting to technicians and increasing the technician complement), staff training, and patient identification and recruitment processes were widely mentioned. Motivational strategies including service targets and financial incentives were less frequent but controversial. Strategies typically unfolded over time, and became multifaceted. Apart from the use of targets in chain pharmacies only, strategies were similar across pharmacy ownership types. Ontario community pharmacies appeared to have done little preplanning of implementation strategies. Strategies focused on service efficiency and quantity, rather than quality. Unlike other jurisdictions, many managers supported the use of targets as motivators, and very few reported feeling pressured. This detailed account of a range of implementation strategies may be of practical value to community pharmacy decision makers. Copyright © 2017 Elsevier Inc. All rights reserved.

Quality audit--a review of the literature concerning delivery of continence care.

PubMed

Swaffield, J

1995-09-01

This paper outlines the role of quality audit within the framework of quality assurance, presenting the concurrent and retrospective approaches available. The literature survey provides a review of the limited audit tools available and their application to continence services and care delivery, as well as attempts to produce tools from national and local standard setting. Audit is part of a process; it can involve staff, patients and their relatives and the team of professionals providing care, as well as focusing on organizational and management levels. In an era of market delivery of services there is a need to justify why audit is important to continence advisors and managers. Effectiveness, efficiency and economics may drive the National Health Service, but quality assurance, which includes standards and audit tools, offers the means to ensure the quality of continence services and care to patients and auditing is also required in the purchaser/provider contracts for patient services. An overview and progress to date of published and other a projects in auditing continence care and service is presented. By outlining and highlighting the audit of continence service delivery and care as a basis on which to build quality assurance programmes, it is hoped that this knowledge will be shared through the setting up of a central auditing clearing project.

Using a Time-Driven Activity-Based Costing Model To Determine the Actual Cost of Services Provided by a Transgenic Core.

PubMed

Gerwin, Philip M; Norinsky, Rada M; Tolwani, Ravi J

2018-03-01

Laboratory animal programs and core laboratories often set service rates based on cost estimates. However, actual costs may be unknown, and service rates may not reflect the actual cost of services. Accurately evaluating the actual costs of services can be challenging and time-consuming. We used a time-driven activity-based costing (ABC) model to determine the cost of services provided by a resource laboratory at our institution. The time-driven approach is a more efficient approach to calculating costs than using a traditional ABC model. We calculated only 2 parameters: the time required to perform an activity and the unit cost of the activity based on employee cost. This method allowed us to rapidly and accurately calculate the actual cost of services provided, including microinjection of a DNA construct, microinjection of embryonic stem cells, embryo transfer, and in vitro fertilization. We successfully implemented a time-driven ABC model to evaluate the cost of these services and the capacity of labor used to deliver them. We determined how actual costs compared with current service rates. In addition, we determined that the labor supplied to conduct all services (10,645 min/wk) exceeded the practical labor capacity (8400 min/wk), indicating that the laboratory team was highly efficient and that additional labor capacity was needed to prevent overloading of the current team. Importantly, this time-driven ABC approach allowed us to establish a baseline model that can easily be updated to reflect operational changes or changes in labor costs. We demonstrated that a time-driven ABC model is a powerful management tool that can be applied to other core facilities as well as to entire animal programs, providing valuable information that can be used to set rates based on the actual cost of services and to improve operating efficiency.

Impacts of market and organizational characteristics on hospital efficiency and uncompensated care.

PubMed

Hsieh, Hui-Min; Clement, Dolores G; Bazzoli, Gloria J

2010-01-01

Hospitals have confronted a difficult financial environment given many factors, including expansion of managed care, changes in public policy, growing market competition for certain services, and growth in the number of uninsured. Policy makers have expressed concern that hospitals may forgo providing care to the indigent as a means to reduce costs and become more efficient when faced with financial pressures. This article examined the effects of environmental pressures on two dimensions of hospital performance: hospital efficiency and uncompensated care provision. Longitudinal data for the Commonwealth of Virginia from 1998 to 2004 were analyzed. Data Envelopment Analysis and bivariate probit were used to examine the factors associated with efficiency and uncompensated care. The results indicated that a positive relationship between hospital efficiency and uncompensated care provision exists. That is, hospitals that are categorized as efficient are likely to provide more uncompensated care. We also found that hospitals tended to provide more uncompensated care when increased demand for these services occurred in a market. Increases in Medicare or Medicaid patient share reduced the provision of uncompensated care. In relation to hospital efficiency, the results indicated that HMO penetration and Medicaid patient share reduced hospital efficiency. This study found that efficient hospitals tend to provide more uncompensated care over time. The findings also suggest that hospitals alter their efficiency and provision of uncompensated care in response to a number of environmental pressures, but it may depend on the type of pressures or uncertainties encountered.

Integrated billing and accounts receivable management system needed to maximize payments and cope with managed care.

PubMed

Sanders, J; Wold, D; Sullivan, T

1999-01-01

The billing and accounts receivable management process in medical practices today has evolved into a multidisciplinary function. This function requires efficient, coordinated performance by physicians and all staff members, from the point of initial patient contact through aggressive follow-up on delinquent payments for services rendered. Offices with deficient or nonexistent billing and accounts receivable management systems typically experience collection ratios that are less than industry norms. They also experience poor cash flow and unnecessary overhead costs. To avoid costly inefficiencies and ensure that it maximizes payments from third-party payors and patients, a medical practice must have an integrated billing and accounts receivable management system that includes components outlined in this article.

Evaluating ecosystem services provided by non-native species: an experimental test in California grasslands.

PubMed

Stein, Claudia; Hallett, Lauren M; Harpole, W Stanley; Suding, Katharine N

2014-01-01

The concept of ecosystem services--the benefits that nature provides to human's society--has gained increasing attention over the past decade. Increasing global abiotic and biotic change, including species invasions, is threatening the secure delivery of these ecosystem services. Efficient evaluation methods of ecosystem services are urgently needed to improve our ability to determine management strategies and restoration goals in face of these new emerging ecosystems. Considering a range of multiple ecosystem functions may be a useful way to determine such strategies. We tested this framework experimentally in California grasslands, where large shifts in species composition have occurred since the late 1700's. We compared a suite of ecosystem functions within one historic native and two non-native species assemblages under different grazing intensities to address how different species assemblages vary in provisioning, regulatory and supporting ecosystem services. Forage production was reduced in one non-native assemblage (medusahead). Cultural ecosystem services, such as native species diversity, were inherently lower in both non-native assemblages, whereas most other services were maintained across grazing intensities. All systems provided similar ecosystem services under the highest grazing intensity treatment, which simulated unsustainable grazing intensity. We suggest that applying a more comprehensive ecosystem framework that considers multiple ecosystem services to evaluate new emerging ecosystems is a valuable tool to determine management goals and how to intervene in a changing ecosystem.

Building capacity in primary care: the implementation of a novel 'Pharmacy First' scheme for the management of UTI, impetigo and COPD exacerbation.

PubMed

Stewart, Fiona; Caldwell, Gail; Cassells, Kirstin; Burton, Jonathan; Watson, Anne

2018-01-24

Aim This service aimed to improve patient access to treatment for urinary tract infections (UTI), impetigo and exacerbation of chronic obstructive pulmonary disease (COPD) and relieve pressure on general practice and out of hours services. In 2016, a service (Pharmacy First) was introduced in Forth Valley for the management of UTI, impetigo and exacerbation of COPD using patient group directions in community pharmacies. Trained pharmacists supplied a limited range of prescription medicines. Pathways for GP referral were defined. After 5 months of implementation, the service was evaluated. A quantitative evaluation was undertaken. Feedback was sought from patients, GPs, pharmacists and GP reception staff, using structured questionnaires. Pharmacy records were used to assess referrals and pharmacy data summarised the number and type of consultations. Basic cost data was obtained from the Health Board. Findings In all, 75 pharmacies (of 76), and all 55 GP practices in the area, participated in the service. Over a 5-month period, 1189 cases were managed, the majority being for UTI (75.4%) followed by impetigo (15.2%), then COPD (9.3%). Of all cases, 77.9% were prescribed medication by the pharmacist, 9.1% were given advice only and 16.7% were referred to the GP. Independent clinical assessment of a random sample of 30 GP referrals considered all to be 'appropriate'. Feedback was received from 69 pharmacists, 34 GPs, 54 reception staff and 73 patients. Patients were very satisfied with the service, most frequently citing the 'quick and efficient' access to treatment, and a 'professional service'. Two thirds of GPs (67%) and 59% of reception staff found the service useful, mainly because it reduced pressure on GP appointments. A further cost benefit evaluation would allow objective assessment of the value of this service.

CENDI - A strategic interagency alliance in the 1990s

NASA Technical Reports Server (NTRS)

Caponio, Joseph; Buffum, Elizabeth; Cotter, Gladys; Smith, Kent; Molholm, Kurt

1991-01-01

The goals, functions, and accomplishments of the CENDI Group, a government interagency cooperative organization formed to improve federal research and development productivity and R&D information management systems through information exchange, are briefly reviewed. The five member agencies are the Departments of Commerce, Energy, Defense, and Health and Human Services, and NASA. CENDI provides a means for its members to share technologies, resources, ideas, information, management activities, and standards. The top priorities of CENDI are: work with R&D managers to improve productivity; provide technical data and information to all users; improve the effectiveness and efficiency of all CENDI agency operations; and familiarize R&D managers and policy makers with the value of STI.

Focused Crawling of the Deep Web Using Service Class Descriptions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rocco, D; Liu, L; Critchlow, T

2004-06-21

Dynamic Web data sources--sometimes known collectively as the Deep Web--increase the utility of the Web by providing intuitive access to data repositories anywhere that Web access is available. Deep Web services provide access to real-time information, like entertainment event listings, or present a Web interface to large databases or other data repositories. Recent studies suggest that the size and growth rate of the dynamic Web greatly exceed that of the static Web, yet dynamic content is often ignored by existing search engine indexers owing to the technical challenges that arise when attempting to search the Deep Web. To address thesemore » challenges, we present DynaBot, a service-centric crawler for discovering and clustering Deep Web sources offering dynamic content. DynaBot has three unique characteristics. First, DynaBot utilizes a service class model of the Web implemented through the construction of service class descriptions (SCDs). Second, DynaBot employs a modular, self-tuning system architecture for focused crawling of the DeepWeb using service class descriptions. Third, DynaBot incorporates methods and algorithms for efficient probing of the Deep Web and for discovering and clustering Deep Web sources and services through SCD-based service matching analysis. Our experimental results demonstrate the effectiveness of the service class discovery, probing, and matching algorithms and suggest techniques for efficiently managing service discovery in the face of the immense scale of the Deep Web.« less

Current and planned shared service arrangements in Wisconsin local and tribal health departments.

PubMed

Madamala, Kusuma; Young, Nancy; Young, Dustin; Giese, Lieske; Brandenberg, Terry; Zahner, Susan

2014-01-01

The objective of this study was to explore current and future use of shared service arrangements as a management strategy to increase capacity to provide public health essential services in Wisconsin. An online cross-sectional survey of 99 local and tribal health departments in Wisconsin was conducted. Select variables from the 2010 Wisconsin Local Health Department Survey were merged. Other data sources included results from a Board of Health governance analysis and the Wisconsin Department of Health Services region data. Descriptive analysis was performed of current and future shared service arrangements and the characteristics of the types of arrangements and agreements in place. Ninety-one of 99 Wisconsin local and tribal health departments responded, yielding a 92% response rate. Seventy-one percent of respondents currently share services with 1 or more other health departments. More frequent arrangements were present in programmatic areas than in departmental operations. Most frequently reported motivators include making better use of resources, providing better services, and responding to program requirements. Extensive qualitative comments indicate arrangements accomplished what the local health department hoped it would with perceived gains in efficiency and effectiveness. There is widespread use of shared services among health departments in Wisconsin. Extensive qualitative comments suggest participant satisfaction with what the arrangements have accomplished. Motivating factors in developing the arrangements and limited mention of expiration dates suggest continued study of how these arrangements may evolve. Further examination of shared services as a potential mechanism to advance service effectiveness and efficiency is needed.

Being Spontaneous: The Future of Telehealth Implementation?

PubMed

Mars, Maurice; Scott, Richard E

2017-09-01

The smartphone simplifies interprofessional communication, and smartphone applications can facilitate telemedicine activity. Much has been written about the steps that need to be followed to implement and establish a successful telemedicine service that is integrated into everyday clinical practice. A traditional and systematic approach has evolved incorporating activities such as strategy development, needs assessment, business cases and plans, readiness assessment, implementation plans, change management interventions, and ongoing monitoring and evaluation. This "best practice" has been promoted in the telehealth literature for many years. In contrast, several recent initiatives have arisen without any such formal undertakings. This article describes the strengths and weaknesses of two "spontaneous" telemedicine services in dermatology and burn management that have evolved in South Africa. Two spontaneous services were identified and reviewed. In one unsolicited service, doctors at rural referring hospitals have been taking photographs of skin lesions and sending them with a brief text message history to dermatologists using the instant messaging smartphone app, WhatsApp. In the other, burns service, admissions to the burns unit or the clinic were triaged by telephonic description of the case and completion of a preadmission questionnaire. More recently, management and referral decisions are made only after completion of the questionnaire and subsequent submission of photographs of the burn sent by WhatsApp, with the decision transmitted by text message. Although efficient and effective, potential legal and ethical shortcomings have been identified. These "spontaneous" telehealth services challenge traditional best practice, yet appear to lead to truly integrated practice and, therefore, are successful and warrant further study.

How to design a horizontal patient-focused hospital.

PubMed

Murphy, E C; Ruflin, P

1993-05-01

Work Imaging is an executive information system for analyzing the cost effectiveness and efficiency of work processes and structures in health care. Advanced Work Imaging relational database technology allows managers and employees to take a sample work activities profile organization-wide. This is married to financial and organizational data to produce images of work within and across all functions, departments, and levels. The images are benchmarked against best practice data to provide insight on the quality and cost efficiency of work practice patterns, from individual roles to departmental skill mix to organization-wide service processes.

Commercial Building Energy Asset Score

DOE Office of Scientific and Technical Information (OSTI.GOV)

This software (Asset Scoring Tool) is designed to help building owners and managers to gain insight into the as-built efficiency of their buildings. It is a web tool where users can enter their building information and obtain an asset score report. The asset score report consists of modeled building energy use (by end use and by fuel type), building systems (envelope, lighting, heating, cooling, service hot water) evaluations, and recommended energy efficiency measures. The intended users are building owners and operators who have limited knowledge of building energy efficiency. The scoring tool collects minimum building data (~20 data entries) frommore » users and build a full-scale energy model using the inference functionalities from Facility Energy Decision System (FEDS). The scoring tool runs real-time building energy simulation using EnergyPlus and performs life-cycle cost analysis using FEDS. An API is also under development to allow the third-party applications to exchange data with the web service of the scoring tool.« less

An Efficient Resource Management System for a Streaming Media Distribution Network

ERIC Educational Resources Information Center

Cahill, Adrian J.; Sreenan, Cormac J.

2006-01-01

This paper examines the design and evaluation of a TV on Demand (TVoD) system, consisting of a globally accessible storage architecture where all TV content broadcast over a period of time is made available for streaming. The proposed architecture consists of idle Internet Service Provider (ISP) servers that can be rented and released dynamically…

A Quantitative Risk Analysis Framework for Evaluating and Monitoring Operational Reliability of Cloud Computing

ERIC Educational Resources Information Center

Islam, Muhammad Faysal

2013-01-01

Cloud computing offers the advantage of on-demand, reliable and cost efficient computing solutions without the capital investment and management resources to build and maintain in-house data centers and network infrastructures. Scalability of cloud solutions enable consumers to upgrade or downsize their services as needed. In a cloud environment,…

Productivity: America's Critical Need to Work Smarter. Fundamentals of Free Enterprise, No. 5. Revised.

ERIC Educational Resources Information Center

American Fletcher National Bank and Trust Co., Indianapolis, IN.

Designed for high school economics students as a public service project of the American Fletcher National Bank, the booklet examines America's decreasing productivity rate in terms of the efficiency. Natural resources, labor, skilled management, and capital are essential to the productive process. When there is an increase in the cost of the…

A Point to Share: Streamlining Access Services Workflow through Online Collaboration, Communication, and Storage with Microsoft SharePoint

ERIC Educational Resources Information Center

Diffin, Jennifer; Chirombo, Fanuel; Nangle, Dennis; de Jong, Mark

2010-01-01

This article explains how the document management team (circulation and interlibrary loan) at the University of Maryland University College implemented Microsoft's SharePoint product to create a central hub for online collaboration, communication, and storage. Enhancing the team's efficiency, organization, and cooperation was the primary goal.…

Promoting efficient water management through effective outreach education in the High Plains and beyond: Role of the Ogallala Aquifer Program

USDA-ARS?s Scientific Manuscript database

The Ogallala Aquifer Program (OAP) is a consortium between the USDA Agricultural Research Service and partnering universities in Texas and Kansas. The OAP has coordinated and leveraged highly effective irrigation research and extension programs with overarching goals to prolong the life of the Ogall...

Managerialist vis-à-vis Learning and Development Goals for EAL Teachers: A Case Study of an In-Service Professional Development Provider

ERIC Educational Resources Information Center

Gurney, Laura; Liyanage, Indika

2015-01-01

Under current Western neoliberal philosophy, promotion of efficiency and resolution of issues are typically expected to result from effective management. The education sector, too, has responded well to these expectations. Amongst such expectations, engagement in professional development activities (PDAs) by teachers of English as an additional…

Optimizing the patient transport function at Mayo Clinic.

PubMed

Kuchera, Dustin; Rohleder, Thomas R

2011-01-01

In this article, we report on the implementation of a computerized scheduling tool to optimize staffing for patient transport at the Mayo Clinic. The tool was developed and implemented in Microsoft Excel and Visual Basic for Applications and includes an easy-to-use interface. The tool allows transport management to consider the trade-offs between patient waiting time and staffing levels. While improved staffing efficiency was a desire of the project, it was important that patient service quality was also maintained. The results show that staffing could be reduced while maintaining historical patient service levels.

Management of reforming of housing-and-communal services

NASA Astrophysics Data System (ADS)

Skripnik, Oksana

2017-10-01

The international experience of reforming of housing and communal services is considered. The main scientific and methodical approaches of system transformation of the housing sphere are analyzed in the article. The main models of reforming are pointed out, interaction of participants of structural change process from the point of view of their commercial and social importance is characterized, advantages and shortcomings are revealed, model elements of the reform transformations from the point of view of the formation of investment appeal, competitiveness, energy efficiency and social importance of the carried-out actions are allocated.

Recipe for Success: Digital Viewables

NASA Technical Reports Server (NTRS)

LaPha, Steven; Gaydos, Frank

2014-01-01

The Engineering Services Contract (ESC) and Information Management Communication Support contract (IMCS) at Kennedy Space Center (KSC) provide services to NASA in respect to flight and ground systems design and development. These groups provides the necessary tools, aid, and best practice methodologies required for efficient, optimized design and process development. The team is responsible for configuring and implementing systems, software, along with training, documentation, and administering standards. The team supports over 200 engineers and design specialists with the use of Windchill, Creo Parametric, NX, AutoCAD, and a variety of other design and analysis tools.

Workforce mobility: Contributing towards smart city

NASA Astrophysics Data System (ADS)

Nor, N. M.; Wahap, N. A.

2014-02-01

Smart cities gained importance as a means of making ICT enabled services and applications available to the citizens, companies and authorities that form part of a city's system. It aims at increasing citizen's quality of life, and improving the efficiency and quality of the services provided by governing entities and businesses. This perspective requires an integrated vision of a city and of its infrastructures in all components. One of the characteristics of a smart city is mobility. The concept of mobility, especially for the workforce, is studied through a research carried out on a daily work undertaken as a prototype in the administrative town of Putrajaya, Malaysia. Utilizing the location track from GNSS integrated with mobile devices platform, information on movement and mobility was analysed for quality and efficiency of services rendered. This paper will highlight the research and outcomes that were successfully carried out and will suggest that workforce mobility management can benefit the authorities towards implementing a smart city concept.

Value-added Data Services at the Goddard Earth Sciences Data and Information Services Center

NASA Technical Reports Server (NTRS)

Leptoukh, Gregory G.; Alcott, Gary T.; Kempler, Steven J.; Lynnes, Christopher S.; Vollmer, Bruce E.

2004-01-01

The NASA Goddard Earth Sciences Data and Information Services Center (GES DISC), in addition to serving the Earth Science community as one of the major Distributed Active Archives Centers (DAACs), provides much more than just data. Among the value-added services available to general users are subsetting data spatially and/or by parameter, online analysis (to avoid downloading unnecessarily all the data), and assistance in obtaining data from other centers. Services available to data producers and high-volume users include consulting on building new products with standard formats and metadata and construction of data management systems. A particularly useful service is data processing at the DISC (i.e., close to the input data) with the users algorithm. This can take a number of different forms: as a configuration-managed algorithm within the main processing stream; as a stand-alone program next to the on-line data storage; as build-it-yourself code within the Near-Archive Data Mining (NADM) system; or as an on-the-fly analysis with simple algorithms embedded into the web-based tools. Partnerships between the GES DISC and scientists, both producers and users, allow the scientists to concentrate on science, while the GES DISC handles the data management, e.g., formats, integration, and data processing. The existing data management infrastructure at the GES DISC supports a wide spectrum of options: from simple data support to sophisticated on-line analysis tools, producing economies of scale and rapid time-to-deploy. At the same time, such partnerships allow the GES DISC to serve the user community more efficiently and to better prioritize on-line holdings. Several examples of successful partnerships are described in the presentation.

Teaching customer-centric operations management - evidence from an experiential learning-oriented mass customisation class

NASA Astrophysics Data System (ADS)

Medini, Khaled

2018-01-01

The increase of individualised customer demands and tough competition in the manufacturing sector gave rise to more customer-centric operations management such as products and services (mass) customisation. Mass customisation (MC), which inherits the 'economy of scale' from mass production (MP), aims to meet specific customer demands with near MP efficiency. Such an overarching concept has multiple impacts on operations management. This requires highly qualified and multi-skilled engineers who are well prepared for managing MC. Therefore, this concept should be properly addressed by engineering education curricula which needs to keep up with the emerging business trends. This paper introduces a novel course about MC and variety in operations management which recalls several Experiential Learning (EL) practices consistently with the principle of an active learning. The paper aims to analyse to which extent EL can improve the efficiency of the teaching methods and the retention rate in the context of operations management. The proposed course is given to engineering students whose' perceptions are collected using semi-structured questionnaires and analysed quantitatively and qualitatively. The paper highlights the relevance (i) of teaching MC, and (ii) of active learning in engineering education, through the specific application in the domain of MC.

An ICT-Based Diabetes Management System Tested for Health Care Delivery in the African Context.

PubMed

Takenga, Claude; Berndt, Rolf-Dietrich; Musongya, Olivier; Kitero, Joël; Katoke, Remi; Molo, Kakule; Kazingufu, Basile; Meni, Malikwisha; Vikandy, Mambo; Takenga, Henri

2014-01-01

The demand for new healthcare services is growing rapidly. Improving accessibility of the African population to diabetes care seems to be a big challenge in most countries where the number of care centers and medical staff is reduced. Information and communication technologies (ICT) have great potential to address some of these challenges faced by several countries in providing accessible, cost-effective, and high-quality health care services. This paper presents the Mobil Diab system which is a telemedical approach proposed for the management of long-term diseases. The system applies modern mobile and web technologies which overcome geographical barriers, and increase access to health care services. The idea of the system is to involve patients in the therapy process and motivate them for an active participation. For validation of the system in African context, a trial was conducted in the Democratic Republic of Congo. 40 Subjects with diabetes divided randomly into control and intervention groups were included in the test. Results show that Mobil Diab is suitable for African countries and presents a number of benefits for the population and public health care system. It improves clinical management and delivery of diabetes care services by enhancing access, quality, motivation, reassurance, efficiency, and cost-effectiveness.

An ICT-Based Diabetes Management System Tested for Health Care Delivery in the African Context

PubMed Central

Takenga, Claude; Berndt, Rolf-Dietrich; Musongya, Olivier; Kitero, Joël; Katoke, Remi; Molo, Kakule; Kazingufu, Basile; Meni, Malikwisha; Vikandy, Mambo; Takenga, Henri

2014-01-01

The demand for new healthcare services is growing rapidly. Improving accessibility of the African population to diabetes care seems to be a big challenge in most countries where the number of care centers and medical staff is reduced. Information and communication technologies (ICT) have great potential to address some of these challenges faced by several countries in providing accessible, cost-effective, and high-quality health care services. This paper presents the Mobil Diab system which is a telemedical approach proposed for the management of long-term diseases. The system applies modern mobile and web technologies which overcome geographical barriers, and increase access to health care services. The idea of the system is to involve patients in the therapy process and motivate them for an active participation. For validation of the system in African context, a trial was conducted in the Democratic Republic of Congo. 40 Subjects with diabetes divided randomly into control and intervention groups were included in the test. Results show that Mobil Diab is suitable for African countries and presents a number of benefits for the population and public health care system. It improves clinical management and delivery of diabetes care services by enhancing access, quality, motivation, reassurance, efficiency, and cost-effectiveness. PMID:25136358

Is strategic asset management applicable to small and medium utilities?

PubMed

Alegre, Helena

2010-01-01

Urban water infrastructures provide essential services to modern societies and represent a major portion of the value of municipal physical assets. Managing these assets rationally is therefore fundamental for the sustainability of the services and to the economy of societies. "Asset Management" (AM) is a modern term for an old practice--assets have always been managed. In recent years, significant evolution occurred in terms of the AM formal approaches, of the monitoring and decision support tools and of the implementation success cases. However, most tools developed are too sophisticated and data seek for small utilities. The European R&D network COST Action C18 ( E-mail: www.costc18.org) identified key research problems related to the management of urban water infrastructures, currently not covered by on-going projects of the European Framework Program. The top 1 topic is "Efficient management of small community". This paper addresses challenges and opportunities for small and medium utilities with regard to infrastructure AM (IAM). To put this into context, the first sections discuss the need for IAM, highlight key recent developments, and present IAM drivers, as well as research and development gaps, priorities and products needed.

A Way to Understand Inpatients Based on the Electronic Medical Records in the Big Data Environment

PubMed Central

2017-01-01

In recent decades, information technology in healthcare, such as Electronic Medical Record (EMR) system, is potential to improve service quality and cost efficiency of the hospital. The continuous use of EMR systems has generated a great amount of data. However, hospitals tend to use these data to report their operational efficiency rather than to understand their patients. Base on a dataset of inpatients' medical records from a Chinese general public hospital, this study applies a configuration analysis from a managerial perspective and explains inpatients management in a different way. Four inpatient configurations (valued patients, managed patients, normal patients, and potential patients) are identified by the measure of the length of stay and the total hospital cost. The implications of the finding are discussed. PMID:28280506

Energy Efficiency in Small Server Rooms: Field Surveys and Findings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cheung, Iris; Greenberg, Steve; Mahdavi, Roozbeh

Fifty-seven percent of US servers are housed in server closets, server rooms, and localized data centers, in what are commonly referred to as small server rooms, which comprise 99percent of all server spaces in the US. While many mid-tier and enterprise-class data centers are owned by large corporations that consider energy efficiency a goal to minimize business operating costs, small server rooms typically are not similarly motivated. They are characterized by decentralized ownership and management and come in many configurations, which creates a unique set of efficiency challenges. To develop energy efficiency strategies for these spaces, we surveyed 30 smallmore » server rooms across eight institutions, and selected four of them for detailed assessments. The four rooms had Power Usage Effectiveness (PUE) values ranging from 1.5 to 2.1. Energy saving opportunities ranged from no- to low-cost measures such as raising cooling set points and better airflow management, to more involved but cost-effective measures including server consolidation and virtualization, and dedicated cooling with economizers. We found that inefficiencies mainly resulted from organizational rather than technical issues. Because of the inherent space and resource limitations, the most effective measure is to operate servers through energy-efficient cloud-based services or well-managed larger data centers, rather than server rooms. Backup power requirement, and IT and cooling efficiency should be evaluated to minimize energy waste in the server space. Utility programs are instrumental in raising awareness and spreading technical knowledge on server operation, and the implementation of energy efficiency measures in small server rooms.« less