Using Discrete Event Simulation (DES) to manage theatre operations in healthcare: An audit-based case study

This paper discusses the application of Discrete Event Simulation (DES) in modelling the complex relationship between patient types, case-mix and operating theatre allocation in a large National Health Service (NHS) Trust in London. The simulation model that was constructed described the main features of nine theatres, focusing on operational processes and patient throughput times. The model was used to test three scenarios of case-mix and to demonstrate the potential of using simulation modelling as a cost effective method for understanding the issues of healthcare operations management and the role of simulation techniques in problem solving. The results indicated that removing all day cases will reduce patient throughput by 23.3% and the utilization of the orthopaedic theatre in particular by 6.5%. This represents a case example of how DES can be used by healthcare managers to inform decision making. © 2008 IEEE.

Sustainability: A new imperative in contaminated land remediation

Land is not only a critical component of the earth's life support system, but also a precious resource and an important factor of production in economic systems. However, historical industrial operations have resulted in large areas of contaminated land that are only slowly being remediated. In recent years, sustainability has drawn increasing attention in the environmental remediation field. In Europe, there has been a movement towards sustainable land management; and in the US, there is an urge for green remediation. Based on a questionnaire survey and a review of existing theories and empirical evidence, this paper suggests the expanding emphasis on sustainable remediation is driven by three general factors: (1) increased recognition of secondary environmental impacts (e.g., life-cycle greenhouse gas emissions, air pollution, energy consumption, and waste production) from remediation operations, (2) stakeholders' demand for economically sustainable brownfield remediation and "green" practices, and (3) institutional pressures (e.g., social norm and public policy) that promote sustainable practices (e.g., renewable energy, green building, and waste recycling). This paper further argues that the rise of the "sustainable remediation" concept represents a critical intervention point from where the remediation field will be reshaped and new norms and standards will be established for practitioners to follow in future years. This paper presents a holistic view of sustainability considerations in remediation, and an integrated framework for sustainability assessment and decision making. The paper concludes that "sustainability" is becoming a new imperative in the environmental remediation field, with important implications for regulators, liability owners, consultants, contractors, and technology vendors. © 2014 Elsevier Ltd.