Technology strategy and competitive performance in bridge construction

Pragmatic construction professionals, accustomed to intense price competition and focused on the bottom line, have difficulty justifying investments in advanced technology. Researchers and industry professionals need improved tools to analyze how technology affects the performance of the firm. This paper reports the results of research to begin answering the question, “does technology matter?” The researchers developed a set of five dimensions for technology strategy, collected information regarding these dimensions along with four measures of competitive performance in five bridge construction firms, and analyzed the information to identify relationships between technology strategy and competitive performance. Three technology strategy dimensions—competitive positioning, depth of technology strategy, and organizational fit—showed particularly strong correlations with the competitive performance indicators of absolute growth in contract awards and contract award value per technical employee. These findings indicate that technology does matter. The research also provides ways to analyze options for approaching technology and ways to relate technology to competitive performance for use by managers. It also provides a valuable set of research measures for technology strategy.

It’s about time : investing in transportation to keep Texas economically competitive

This current report, It’s About Time: Investing in Transportation to Keep Texas Economically Competitive, updates the February 2009 report by providing an enhanced analysis of the current state of the Texas transportation system, determining the household costs of under-investing in the system and identifying potential revenue options for funding the system. However, the general conclusion has not changed. There are tremendous needs and high costs associated with “doing nothing new.”

Technology strategy and competitive performance : A study of bridge construction

Doctoral dissertation, Stanford University, California, 1993

Strategies for appropriate technology and competitive performance in infrastructure construction

Earlier research developed theoretically-based aggregate metrics for technology strategy and used them to analyze California bridge construction firms (Hampson, 1993). Determinants of firm performance, including trend in contract awards, market share and contract awards per employee, were used as indicators for competitive performance. The results of this research were a series of refined theoretically-based measures for technology strategy and a demonstrated positive relationship between technology strategy and competitive performance within the bridge construction sector. This research showed that three technology strategy dimensions—competitive positioning, depth of technology strategy, and organizational fit— show very strong correlation with the competitive performance indicators of absolute growth in contract awards, and contract awards per employee. Both researchers and industry professionals need improved understanding of how technology affects results, and how to better target investments to improve competitive performance in particular industry sectors. This paper builds on the previous research findings by evaluating the strategic fit of firms' approach to technology with industry segment characteristics. It begins with a brief overview of the background regarding technology strategy. The major sections of the paper describe niches and firms in an example infrastructure construction market, analyze appropriate technology strategies, and describe managerial actions to implement these strategies and support the business objectives of the firm.

Perioperative mortality after hemiarthroplasty related to fixation method : a study based on the Australian Orthopaedic Association National Joint Replacement Registry

Background and purpose: The appropriate fixation method for hemiarthroplasty of the hip as it relates to implant survivorship and patient mortality is a matter of ongoing debate. We examined the influence of fixation method on revision rate and mortality.----- ----- Methods: We analyzed approximately 25,000 hemiarthroplasty cases from the AOA National Joint Replacement Registry. Deaths at 1 day, 1 week, 1 month, and 1 year were compared for all patients and among subgroups based on implant type.----- ----- Results: Patients treated with cemented monoblock hemiarthroplasty had a 1.7-times higher day-1 mortality compared to uncemented monoblock components (p < 0.001). This finding was reversed by 1 week, 1 month, and 1 year after surgery (p < 0.001). Modular hemiarthroplasties did not reveal a difference in mortality between fixation methods at any time point.----- ----- Interpretation: This study shows lower (or similar) overall mortality with cemented hemiarthroplasty of the hip.

Maximum recovery after knee replacement - the MARKER study rationale and protocol

Background There is little scientific evidence to support the usual practice of providing outpatient rehabilitation to patients undergoing total knee replacement surgery (TKR) immediately after discharge from the orthopaedic ward. It is hypothesised that the lack of clinical benefit is due to the low exercise intensity tolerated at this time, with patients still recovering from the effects of major orthopaedic surgery. The aim of the proposed clinical trial is to investigate the clinical and cost effectiveness of a novel rehabilitation strategy, consisting of an initial home exercise programme followed, approximately six weeks later, by higher intensity outpatient exercise classes. Methods/Design In this multicentre randomised controlled trial, 600 patients undergoing primary TKR will be recruited at the orthopaedic pre-admission clinic of 10 large public and private hospitals in Australia. There will be no change to the medical or rehabilitative care usually provided while the participant is admitted to the orthopaedic ward. After TKR, but prior to discharge from the orthopaedic ward, participants will be randomised to either the novel rehabilitation strategy or usual rehabilitative care as provided by the hospital or recommended by the orthopaedic surgeon. Outcomes assessments will be conducted at baseline (pre-admission clinic) and at 6 weeks, 6 months and 12 months following randomisation. The primary outcomes will be self-reported knee pain and physical function. Secondary outcomes include quality of life and objective measures of physical performance. Health economic data (health sector and community service utilisation, loss of productivity) will be recorded prospectively by participants in a patient diary. This patient cohort will also be followed-up annually for five years for knee pain, physical function and the need or actual incidence of further joint replacement surgery. Discussion The results of this pragmatic clinical trial can be directly implemented into clinical practice. If beneficial, the novel rehabilitation strategy of utilising outpatient exercise classes during a later rehabilitation phase would provide a feasible and potentially cost-effective intervention to optimise the physical well-being of the large number of people undergoing TKR.

The limits of competition : reasserting a role for consumer protection and fair trading regulation in competitive markets

In this paper we advocate for the continued need for consumer protection and fair trading regulation, even in competitive markets. For the purposes of this paper a ‘competitive market’ is defined as one that has low barriers to entry and exit, with homogenous products and services and numerous suppliers. Whilst competition is an important tool for providing consumer benefits, it will not be sufficient to protect at least some consumers, particularly vulnerable, low income consumers. For this reason, we argue, setting competition as the ‘end goal’ and assuming that consumer protection and consumer benefits will always follow, is a flawed regulatory approach. The ‘end goal’ should surely be consumer protection and fair markets, and a combination of competition law and consumer protection law should be applied in order to achieve those goals.

Acetabular impaction grafting in total hip replacement

Background and purpose: Acetabular impaction grafting has been shown to have excellent results, but concerns regarding its suitability for larger defects have been highlighted. We report the use of this technique in a large cohort of patients with the aim of better understanding the limitations of the technique. Methods: We investigated a consecutive group of 339 cases of impaction grafting of the cup with morcellised impacted allograft bone for survivorship and mechanisms for early failure. Results: Kaplan Meier survival was 89.1% (95% CI 83.2 to 95.0%) at 5.8 years for revision for any reason, and 91.6% (95% CI 85.9 to 97.3%) for revision for aseptic loosening of the cup. Of the 15 cases revised for aseptic cup loosening, nine were large rim mesh reconstructions, two were fractured Kerboull-Postel plates, two were migrating cages, one medial wall mesh failure and one impaction alone failed. Interpretation: In our series, results were disappointing where a large rim mesh or significant reconstruction was required. In light of these results, our technique has changed in that we now use predominantly larger chips of purely cancellous bone, 8-10 mm3 in size, to fill the cavity and larger diameter cups to better fill the mouth of the reconstructed acetabulum. In addition we now make greater use of i) implants made of a highly porous in-growth surface to constrain allograft chips and ii) bulk allografts combined with cages and morcellised chips in cases with very large segmental and cavitary defects.