The impact of architectural uncertainty on product introduction in dispersed environments

This research addresses product introduction dispersed across locations and companies. Mechanisms appropriate to integrate activities in collocated teams may not serve dispersed teams well. A semiconductor design licensor was studied in depth to explore how dispersed product introduction varies with uncertainty. We found that autonomous teams focused on sub-products (micro-products) were used rather than cross-functional teams in departments with high architectural uncertainty. Both types of teams were effectively dispersed across locations and companies. This suggests that small high-technology companies may find it easier to expand into new geographies and product lines than was previously believed.

Integrated billing mechanisms in the Internet of Things to support information sharing and enable new business opportunities

The Internet of Things (IOT) concept and enabling technologies such as RFID offer the prospect of linking the real world of physical objects with the virtual world of information technology to improve visibility and traceability information within supply chains and across the entire lifecycles of products, as well as enabling more intuitive interactions and greater automation possibilities. There is a huge potential for savings through process optimization and profit generation within the IOT, but the sharing of financial benefits across companies remains an unsolved issue. Existing approaches towards sharing of costs and benefits have failed to scale so far. The integration of payment solutions into the IOT architecture could solve this problem. We have reviewed different possible levels of integration. Multiple payment solutions have been researched. Finally we have developed a model that meets the requirements of the IOT in relation to openness and scalability. It supports both hardware-centric and software-centric approaches to integration of payment solutions with the IOT. Different requirements concerning payment solutions within the IOT have been defined and considered in the proposed model. Possible solution providers include telcos, e-payment service providers and new players such as banks and standardization bodies. The proposed model of integrating the Internet of Things with payment solutions will lower the barrier to invoicing for the more granular visibility information generated using the IOT. Thus, it has the potential to enable recovery of the necessary investments in IOT infrastructure and accelerate adoption of the IOT, especially for projects that are only viable when multiple benefits throughout the supply chain need to be accumulated in order to achieve a Return on Investment (ROI). In a long-term perspective, it may enable IT-departments to become profit centres instead of cost centres. © 2010 - IOS Press and the authors. All rights reserved.

Emergency department crowding: prioritising quantified crowding measures using a Delphi study.

AimsEmergency department (ED) crowding has been associated with a number of negative health outcomes, including unnecessary deaths, increased waiting times and a decrease in care quality. Despite the seriousness of this issue, there is little agreement on appropriate crowding measures to assess crowding effects on ED operations. The objective of this study was to prioritise a list of quantified crowding measures that would assess the current state of a department.MethodsA three round Delphi study was conducted via email and an Internet based survey tool. The panel consisted of 40 professionals who had exposure to and expertise in crowding. Participants submitted quantified crowding measures which, through three rounds, were evaluated and ranked to assess participant agreement for inclusion.ResultsThe panel identified 27 measures of which eight (29.6%) reached consensus at the end of the study. These measures comprised: (1) ability of ambulances to offload; (2) patients who leave without being seen or treated; (3) time until triage; (4) ED occupancy rate; (5) patients' total length of stay in the ED; (6) time to see a physician; (7) ED boarding time; and (8) number of patients boarding in the ED.ConclusionsThis study resulted in the identification of eight quantified crowding measures, which present a comprehensive view of how crowding is affecting ED operations, and highlighted areas of concern. These quantified measures have the potential to make a considerable contribution to decision making by ED management and to provide a basis for learning across different departments.

Stress on the ward: evidence of safety tipping points in hospitals

Do hospitals experience safety tipping points as utilization increases, and if so, what are the implications for hospital operations management? We argue that safety tipping points occur when managerial escalation policies are exhausted and workload variability buffers are depleted. Front-line clinical staff is forced to ration resources and, at the same time, becomes more error prone as a result of elevated stress hormone levels. We confirm the existence of safety tipping points for in-hospital mortality using the discharge records of 82,280 patients across six high-mortality-risk conditions from 256 clinical departments of 83 German hospitals. Focusing on survival during the first seven days following admission, we estimate a mortality tipping point at an occupancy level of 92.5%. Among the 17% of patients in our sample who experienced occupancy above the tipping point during the first seven days of their hospital stay, high occupancy accounted for one in seven deaths. The existence of a safety tipping point has important implications for hospital management. First, flexible capacity expansion is more cost-effective for safety improvement than rigid capacity, because it will only be used when occupancy reaches the tipping point. In the context of our sample, flexible staffing saves more than 40% of the cost of a fully staffed capacity expansion, while achieving the same reduction in mortality. Second, reducing the variability of demand by pooling capacity in hospital clusters can greatly increase safety in a hospital system, because it reduces the likelihood that a patient will experience occupancy levels beyond the tipping point. Pooling the capacity of nearby hospitals in our sample reduces the number of deaths due to high occupancy by 34%.

Detection of large-scale concrete columns for automated bridge inspection

There are over 600,000 bridges in the US, and not all of them can be inspected and maintained within the specified time frame. This is because manually inspecting bridges is a time-consuming and costly task, and some state Departments of Transportation (DOT) cannot afford the essential costs and manpower. In this paper, a novel method that can detect large-scale bridge concrete columns is proposed for the purpose of eventually creating an automated bridge condition assessment system. The method employs image stitching techniques (feature detection and matching, image affine transformation and blending) to combine images containing different segments of one column into a single image. Following that, bridge columns are detected by locating their boundaries and classifying the material within each boundary in the stitched image. Preliminary test results of 114 concrete bridge columns stitched from 373 close-up, partial images of the columns indicate that the method can correctly detect 89.7% of these elements, and thus, the viability of the application of this research.

The pursuit of academic excellence and business engagement: Is it irreconcilable?

Universities currently need to satisfy the demands of different audiences. In light of the increasing policy emphasis on "third mission" activities, universities are attempting to incorporate these into their traditional missions of teaching and research. University strategies to accomplishing its traditional missions are well-honed and routinized, but the incorporation of the third mission is posing important strategic and managerial challenges for universities. This study explores the relationship between university-business collaborations and academic excellence in order to examine the extent to which academic institutions can balance these objectives. Based on data from the UK Research Assessment Exercise 2001 at the level of the university department, we find no systematic positive or negative relationship between scientific excellence and engagement with industry. Across the disciplinary fields reported in the 2001 Research Assessment Exercise (i. e. engineering, hard sciences, biomedicine, social sciences and the humanities) the relationship between academic excellence and engagement with business is largely contingent on the institutional context of the university department. This paper adds to the growing body of literature on university engagement with business by examining this activity for the social sciences and the humanities. Our findings have important implications for the strategic management of university departments and for higher education policy related to measuring the performance of higher education research institutions. © 2013 Akadémiai Kiadó, Budapest, Hungary.

Stakeholder challenges in purchasing medical devices for patient safety.

OBJECTIVE: This study identifies the stakeholders who have a role in medical device purchasing within the wider system of health-care delivery and reports on their particular challenges to promote patient safety during purchasing decisions. METHODS: Data was collected through observational work, participatory workshops, and semi-structured qualitative interviews, which were analyzed and coded. The study takes a systems-based and engineering design approach to the study. Five hospitals took part in this study, and the participants included maintenance, training, clinical end-users, finance, and risk departments. RESULTS: The main stakeholders for purchasing were identified to be staff from clinical engineering (Maintenance), device users (Clinical), device trainers (Training), and clinical governance for analyzing incidents involving devices (Risk). These stakeholders display varied characteristics in terms of interpretation of their own roles, competencies for selecting devices, awareness and use of resources for purchasing devices, and attitudes toward the purchasing process. The role of "clinical engineering" is seen by these stakeholders to be critical in mediating between training, technical, and financial stakeholders but not always recognized in practice. CONCLUSIONS: The findings show that many device purchasing decisions are tackled in isolation, which is not optimal for decisions requiring knowledge that is currently distributed among different people within different departments. The challenges expressed relate to the wider system of care and equipment management, calling for a more systemic view of purchasing for medical devices.