Training pharmacists to deliver a complex information technology intervention (PINCER) using the principles of educational outreach and root cause analysis

Objective: To describe the training undertaken by pharmacists employed in a pharmacist-led information technology-based intervention study to reduce medication errors in primary care (PINCER Trial), evaluate pharmacists’ assessment of the training, and the time implications of undertaking the training. Methods: Six pharmacists received training, which included training on root cause analysis and educational outreach, to enable them to deliver the PINCER Trial intervention. This was evaluated using self-report questionnaires at the end of each training session. The time taken to complete each session was recorded. Data from the evaluation forms were entered onto a Microsoft Excel spreadsheet, independently checked and the summary of results further verified. Frequencies were calculated for responses to the three-point Likert scale questions. Free-text comments from the evaluation forms and pharmacists’ diaries were analysed thematically. Key findings: All six pharmacists received 22 hours of training over five sessions. In four out of the five sessions, the pharmacists who completed an evaluation form (27 out of 30 were completed) stated they were satisfied or very satisfied with the various elements of the training package. Analysis of free-text comments and the pharmacists’ diaries showed that the principles of root cause analysis and educational outreach were viewed as useful tools to help pharmacists conduct pharmaceutical interventions in both the study and other pharmacy roles that they undertook. The opportunity to undertake role play was a valuable part of the training received. Conclusions: Findings presented in this paper suggest that providing the PINCER pharmacists with training in root cause analysis and educational outreach contributed to the successful delivery of PINCER interventions and could potentially be utilised by other pharmacists based in general practice to deliver pharmaceutical interventions to improve patient safety.

Description and process evaluation of pharmacists’ interventions in a pharmacist-led information technology-enabled multicentre cluster randomised controlled trial for reducing medication errors in general practice (PINCER trial)

Objective To undertake a process evaluation of pharmacists' recommendations arising in the context of a complex IT-enabled pharmacist-delivered randomised controlled trial (PINCER trial) to reduce the risk of hazardous medicines management in general practices. Methods PINCER pharmacists manually recorded patients’ demographics, details of interventions recommended, actions undertaken by practice staff and time taken to manage individual cases of hazardous medicines management. Data were coded and double entered into SPSS v15, and then summarised using percentages for categorical data (with 95% CI) and, as appropriate, means (SD) or medians (IQR) for continuous data. Key findings Pharmacists spent a median of 20 minutes (IQR 10, 30) reviewing medical records, recommending interventions and completing actions in each case of hazardous medicines management. Pharmacists judged 72% (95%CI 70, 74) (1463/2026) of cases of hazardous medicines management to be clinically relevant. Pharmacists recommended 2105 interventions in 74% (95%CI 73, 76) (1516/2038) of cases and 1685 actions were taken in 61% (95%CI 59, 63) (1246/2038) of cases; 66% (95%CI 64, 68) (1383/2105) of interventions recommended by pharmacists were completed and 5% (95%CI 4, 6) (104/2105) of recommendations were accepted by general practitioners (GPs), but not completed at the end of the pharmacists’ placement; the remaining recommendations were rejected or considered not relevant by GPs. Conclusions The outcome measures were used to target pharmacist activity in general practice towards patients at risk from hazardous medicines management. Recommendations from trained PINCER pharmacists were found to be broadly acceptable to GPs and led to ameliorative action in the majority of cases. It seems likely that the approach used by the PINCER pharmacists could be employed by other practice pharmacists following appropriate training.

Building networks to work: an ethnographic study of informal routes into the UK construction industry and pathways for migrant up-skilling

The UK construction industry labour market is characterised by high levels of self-employment, sub-contracting, informality and flexibility. A corollary of this, and a sign of the increasing globalisation of construction, has been an increasing reliance on migrant labour, particularly that from the Eastern European Accession states. Yet, little is known about how their experiences within and outside of work shape their work in the construction sector. In this context better qualitative understandings of the social and communication networks through which migrant workers gain employment, create routes through the sector and develop their role/career are needed. We draw on two examples from a short-term ethnographic study of migrant construction worker employment experiences and practices in the town of Crewe in Cheshire, UK, to demonstrate how informal networks intersect with formal elements of the sector to facilitate both recruitment and up-skilling. Such research knowledge, we argue, offers new evidence of the importance of attending to migrant worker’s own experiences in the development of more transparent recruitment processes.

Transforming the English NHS using information technology: the story so far

The use of information and communication technologies (ICT) for transforming the way publicservices are delivered, has been an area of investment and focus in many countries in recentyears. The UK government envisioned moving from e-Government to transformationalgovernment by 2008, and initiatives such as the National Programme for IT (NPfIT) wereunderway towards this end. NPfIT was the largest civil IT programme worldwide at an initialestimated cost of £12.4bn over a ten-year period. It was launched in 2002 by the UKgovernment as part of its policy to transform the English NHS and to implement standardised ITsolutions at a national level. However, this top down, government led approach came underincreasing scrutiny, and is now being reconfigured towards a more decentralised mode of operations. This paper looks into the implementation of NPfIT and analyses the reasons behindits failure, and what effect the new NHS reforms are likely to have on the health sector. Wedraw from past studies (Weill and Ross, 2005) to highlight the key areas of concern in ITgovernance, using the NPfIT as an illustration

Executive project management structure and the challenges acing its adoption in the Nigerian construction industry

Project management (PM) is a globally recognized discipline and has been widely adopted within the construction industry. Despite advancements in the PM discipline, the ineffective traditional management system, typical of the non-executive PM structure, is still widely used in the Nigerian construction industry. The aim of this paper is thus to explore the challenges facing the adoption of the executive PM structure in Nigeria. The paper first assesses the level of growth of PM in Nigeria using UK best practices as a benchmark and identifies the key PM characteristics in the two countries. Focus group interviews were used to collect the primary data for the study and content analysis was used to present the results in a thematic format. The study revealed the key barriers to the adoption of an executive PM structure in Nigeria as a lack of proper awareness, unfavorable policies, skill shortages, the traditional culture of stakeholders and the absence of a regulatory body. It is recommended that the government, as a major player/client in the Nigerian construction industry, should lead the campaign to change the traditional industry approach to project management. This is necessary if construction stakeholders in Nigeria are to be educated and encouraged towards adopting and putting into practice effective PM.

Investigating the level of awareness of building assessment tools in the construction industry of Botswana

Environmental building assessment tools have been developed to measure how well or poorly a building is performing, or likely to perform, against a declared set of criteria, or environmental considerations, in order to achieve sustainability principles. Knowledge of environmental building assessment tools is therefore important for successful design and construction of environmentally friendly buildings for countries. The purpose of the research is to investigate the knowledge and level of awareness of environmental building assessment tools among industry practitioners in Botswana. One hundred and seven paper-based questionnaires were delivered to industry practitioners, including architects, engineers, quantity surveyors, real estate developers and academics. Users were asked what they know about building assessment, whether they have used any building assessment tool in the past, and what they perceive as possible barriers to the implementation of environmental building assessment tools in Botswana. Sixty five were returned and statistical analysis, using IBM SPSS V19 software, was used for analysis. Almost 85 per cent of respondents indicate that they are extremely or moderately aware of environmental design. Furthermore, the results indicate that 32 per cent of respondents have gone through formal training, which suggests ‘reasonable knowledge’. This however does not correspond with the use of the tools on the ground as 69 per cent of practitioners report never to have used any environmental building assessment tool in any project. The study highlights the need to develop an assessment tool for Botswana to enhance knowledge and further improve the level of awareness of environmental issues relating to building design and construction.

Advancing construction industry development, innovative research and new thinking

Academic writing has a tendency to be turgid and impenetrable. This is not only anathema to communication between academics, but also a major barrier to advancing construction industry development. Clarity in our communication is a prerequisite to effective collaboration with industry. An exploration of what it means to be an academic in a University is presented in order to provide a context for a discussion on how academics might collaborate with industry to advance development. There are conflicting agendas that pull the academic in different directions: peer group recognition, institutional success and industry development. None can be achieved without the other, which results in the need for a careful balancing act. While academics search for better understandings and provisional explanations within the context of conceptual models, industry seeks the practical application of new ideas, whether the ideas come from research or experience. Universities have a key role to play in industry development and in economic development.

IT implementation in the construction organization

Organizational issues are inhibiting the implementation and strategic use of information technologies (IT) in the construction sector. This paper focuses on these issues and explores processes by which emerging technologies can be introduced into construction organizations. The paper is based on a case study, conducted in a major house building company that was implementing a virtual reality (VR) system for internal design review in the regional offices. Interviews were conducted with different members of the organization to explore the introduction process and the use of the system. The case study findings provide insight into the process of change, the constraints that inhibit IT implementation and the relationship between new technology and work patterns within construction organizations. They suggest that (1) user-developer communications are critical for the successful implementation of non-diffused innovations in the construction industry; and (2) successful uptake of IT requires both strategic decision-making by top management and decision-making by technical managers.

Proceedings of the inaugural construction management and economics ‘Past, Present and Future’ conference CME25, 16-18 July 2007, University of Reading, UK

This conference was an unusual and interesting event. Celebrating 25 years of Construction Management and Economics provides us with an opportunity to reflect on the research that has been reported over the years, to consider where we are now, and to think about the future of academic research in this area. Hence the sub-title of this conference: “past, present and future”. Looking through these papers, some things are clear. First, the range of topics considered interesting has expanded hugely since the journal was first published. Second, the research methods are also more diverse. Third, the involvement of wider groups of stakeholder is evident. There is a danger that this might lead to dilution of the field. But my instinct has always been to argue against the notion that Construction Management and Economics represents a discipline, as such. Granted, there are plenty of university departments around the world that would justify the idea of a discipline. But the vast majority of academic departments who contribute to the life of this journal carry different names to this. Indeed, the range and breadth of methodological approaches to the research reported in Construction Management and Economics indicates that there are several different academic disciplines being brought to bear on the construction sector. Some papers are based on economics, some on psychology and others on operational research, sociology, law, statistics, information technology, and so on. This is why I maintain that construction management is not an academic discipline, but a field of study to which a range of academic disciplines are applied. This may be why it is so interesting to be involved in this journal. The problems to which the papers are applied develop and grow. But the broad topics of the earliest papers in the journal are still relevant today. What has changed a lot is our interpretation of the problems that confront the construction sector all over the world, and the methodological approaches to resolving them. There is a constant difficulty in dealing with topics as inherently practical as these. While the demands of the academic world are driven by the need for the rigorous application of sound methods, the demands of the practical world are quite different. It can be difficult to meet the needs of both sets of stakeholders at the same time. However, increasing numbers of postgraduate courses in our area result in larger numbers of practitioners with a deeper appreciation of what research is all about, and how to interpret and apply the lessons from research. It also seems that there are contributions coming not just from construction-related university departments, but also from departments with identifiable methodological traditions of their own. I like to think that our authors can publish in journals beyond the construction-related areas, to disseminate their theoretical insights into other disciplines, and to contribute to the strength of this journal by citing our articles in more mono-disciplinary journals. This would contribute to the future of the journal in a very strong and developmental way. The greatest danger we face is in excessive self-citation, i.e. referring only to sources within the CM&E literature or, worse, referring only to other articles in the same journal. The only way to ensure a strong and influential position for journals and university departments like ours is to be sure that our work is informing other academic disciplines. This is what I would see as the future, our logical next step. If, as a community of researchers, we are not producing papers that challenge and inform the fundamentals of research methods and analytical processes, then no matter how practically relevant our output is to the industry, it will remain derivative and secondary, based on the methodological insights of others. The balancing act between methodological rigour and practical relevance is a difficult one, but not, of course, a balance that has to be struck in every single paper.

Interactive learning in UK construction practice: examining the role of BIM process standards

From a construction innovation systems perspective, firms acquire knowledge from suppliers, clients, universities and institutional environment. Building information modelling (BIM) involves these firms using new process standards. To understand the implications on interactive learning using BIM process standards, a case study is conducted with the UK operations of a multinational construction firm. Data is drawn from: a) two workshops involving the firm and a wider industry group, b) observations of practice in the BIM core team and in three ongoing projects, c) 12 semi-structured interviews; and d) secondary publications. The firm uses a set of BIM process standards (IFC, PAS 1192, Uniclass, COBie) in its construction activities. It is also involved in a pilot to implement the COBie standard, supported by technical and management standards for BIM, such as Uniclass and PAS1192. Analyses suggest that such BIM process standards unconsciously shapes the firm's internal and external interactive learning processes. Internally standards allow engineers to learn from each through visualising 3D information and talking around designs with operatives to address problems during construction. Externally, the firm participates in trial and pilot projects involving other construction firms, government agencies, universities and suppliers to learn about the standard and access knowledge to solve its specific design problems. Through its BIM manager, the firm provides feedback to standards developers and information technology suppliers. The research contributes by articulating how BIM process standards unconsciously change interactive learning processes in construction practice. Further research could investigate these findings in the wider UK construction innovation system.

Financial protection in the UK building industry: a guide for clients and the construction supply chain.

There is a clear need for financial protection in the construction industry, both to guarantee satisfactory completion of construction projects and to guard against non-payment. However, the cost of financial protection is often felt to be disproportionately high, with unnecessary overlap between different measures. The Reading Construction Forum has commissioned and steered research which is published in this report in an effort to bring the problem out into the open and to clarify the various options open to the various parties and stakeholders in the construction process. "Financial Protection in the UK Building Industry" is the first definitive report on the subject, offering an accurate and simple guide that all levels within the construction industry can understand. This accessible new guide considers the problem of financial protection and clearly lays out the alternative solutions.It looks by turn at the client, the main contractor, and the sub-contractor, discussing which financial protection options are available to each of them, and considers the pros and cons of each option. The cost of each type of financial protection is weighed against the amount of protection provided and the risks involved. The book concludes with guidance for consultants, emphasising relevant points to consider when advising clients and contractors about which type of financial protection to choose. "Financial Protection in the UK Building Industry" was researched by a literature search, collection of statistical data, and financial data, as well as discussions with clients, contractors, sub-contractors and consultants. This investigation has shown that the direct costs of implementing financial protection measures are marginal, and that wider adoption of payment protection would create a more equitable situation between contracting parties.This guide will enable anyone in the construction industry to consider all the options, and determine what is the best solution for them. "Reading Construction Forum Financial Protection for the UK Building Industry" was complied by the University of Reading, funded by the Reading Construction Forum. The Forum has recently commissioned and steered a number of high-profile reports covering important aspects of the construction industry. Members of the Forum include major companies which are concerned with achieving high quality in the design, construction and use of commercial, retail and industrial buildings. All are committed to change and innovation in the British and European construction industries.

Century-of-Information Research (CIR): a strategy for research and innovation in the century of information

More data will be produced in the next five years than in the entire history of human kind, a digital deluge that marks the beginning of the Century of Information. Through a year-long consultation with UK researchers, a coherent strategy has been developed, which will nurture Century-of-Information Research (CIR); it crystallises the ideas developed by the e-Science Directors' Forum Strategy Working Group. This paper is an abridged version of their latest report which can be found at: http://wikis.nesc.ac.uk/escienvoy/Century_of_Information_Research_Strategy which also records the consultation process and the affiliations of the authors. This document is derived from a paper presented at the Oxford e-Research Conference 2008 and takes into account suggestions made in the ensuing panel discussion. The goals of the CIR Strategy are to facilitate the growth of UK research and innovation that is data and computationally intensive and to develop a new culture of 'digital-systems judgement' that will equip research communities, businesses, government and society as a whole, with the skills essential to compete and prosper in the Century of Information. The CIR Strategy identifies a national requirement for a balanced programme of coordination, research, infrastructure, translational investment and education to empower UK researchers, industry, government and society. The Strategy is designed to deliver an environment which meets the needs of UK researchers so that they can respond agilely to challenges, can create knowledge and skills, and can lead new kinds of research. It is a call to action for those engaged in research, those providing data and computational facilities, those governing research and those shaping education policies. The ultimate aim is to help researchers strengthen the international competitiveness of the UK research base and increase its contribution to the economy. The objectives of the Strategy are to better enable UK researchers across all disciplines to contribute world-leading fundamental research; to accelerate the translation of research into practice; and to develop improved capabilities, facilities and context for research and innovation. It envisages a culture that is better able to grasp the opportunities provided by the growing wealth of digital information. Computing has, of course, already become a fundamental tool in all research disciplines. The UK e-Science programme (2001-06)—since emulated internationally—pioneered the invention and use of new research methods, and a new wave of innovations in digital-information technologies which have enabled them. The Strategy argues that the UK must now harness and leverage its own, plus the now global, investment in digital-information technology in order to spread the benefits as widely as possible in research, education, industry and government. Implementing the Strategy would deliver the computational infrastructure and its benefits as envisaged in the Science & Innovation Investment Framework 2004-2014 (July 2004), and in the reports developing those proposals. To achieve this, the Strategy proposes the following actions: support the continuous innovation of digital-information research methods; provide easily used, pervasive and sustained e-Infrastructure for all research; enlarge the productive research community which exploits the new methods efficiently; generate capacity, propagate knowledge and develop skills via new curricula; and develop coordination mechanisms to improve the opportunities for interdisciplinary research and to make digital-infrastructure provision more cost effective. To gain the best value for money strategic coordination is required across a broad spectrum of stakeholders. A coherent strategy is essential in order to establish and sustain the UK as an international leader of well-curated national data assets and computational infrastructure, which is expertly used to shape policy, support decisions, empower researchers and to roll out the results to the wider benefit of society. The value of data as a foundation for wellbeing and a sustainable society must be appreciated; national resources must be more wisely directed to the collection, curation, discovery, widening access, analysis and exploitation of these data. Every researcher must be able to draw on skills, tools and computational resources to develop insights, test hypotheses and translate inventions into productive use, or to extract knowledge in support of governmental decision making. This foundation plus the skills developed will launch significant advances in research, in business, in professional practice and in government with many consequent benefits for UK citizens. The Strategy presented here addresses these complex and interlocking requirements.

Proceedings of the West Africa Built Environment Research (WABER) Conference 2010

FOREWORD Welcome to this West Africa Built Environment Research (WABER) conference taking place here in Ghana. Thank you for coming and welcome to Accra. The main aims of the WABER conference are: to help young researchers and early-career scholars in West Africa to develop their research work and skills through constructive face-to-face interaction with experienced academics; to provide a platform for networking and collaborative work among senior built environment academics in West Africa; and to serve as a vehicle for developing the field of construction management and economics in Africa. Waber 2009 The WABER event in 2009 was held at the British Council in Accra, Ghana on 2-3 June. The event was a resounding success. It attracted participation from 32 researchers, from 12 different institutions, who presented their work to an audience of approximately 100 people. Each presenter received immediate and constructive feedback from an international panel. The event was opened by Professor K.K. Adarkwa, Vice Chancellor of KNUST, Kumasi, Ghana, with several senior academics and researchers from universities, polytechnics, and other institutions in Ghana and Nigeria in attendance. There was also a significant level of attendance by senior construction practitioners in Ghana. Thank you to the School of Construction Management and Engineering, University of Reading, UK for funding the inaugural event in 2009. We are also grateful to all of you who helped to make the event a success and to those of you who have joined us here today to build upon the success and legacy of WABER 2009. Waber 2010 This year, we have 60+ peer-reviewed papers and presentations on topics relating to Building services and maintenance, Construction costs, Construction design and technology, Construction education, Construction finance, Construction procurement, Contract administration, Contract management, Contractor development, Decision support systems, Dispute resolution, Economic development, Energy efficiency, Environment and sustainability, Health and safety, Human resources, Information technology, Marketing, Materials science, Organisation strategy and business performance, Productivity, Project management, Quantity surveying, Real estate and planning, Solar energy systems, Supply chain management and Urban development. We hope that these papers will generate interest among delagates and stimulate discussion here and beyond the conference into the wider community of academia and industry. The delegates at this conference come from 10 different countries. This provides a rich international and multicultural blend and a perfect platform for networking and developing collaborations. This year we are blessed to have three high profile keynote speakers in the persons of Professor George Ofori (National University of Singapore), Dr Roine Leiringer (University of Reading, UK) and Professor Will Hughes (University of Reading, UK). We are also thankful to Dr Chris Harty (University of Reading, UK) who is facilitating the Research Skills Workshop on ‘Writing a scientific article’. Thank you to Dr Sena Agyepong of our conference organising team for her capable management of local organising arrangements. And above all, thank you to all of you for coming to this conference. Enjoy and have a safe journey back home. Dr Samuel Laryea School of Construction Management and Engineering University of Reading, July 2010

A knowledge-driven management approach to environmental-conscious construction

This paper aims to introduce a knowledge-based managemental prototype entitled Eþ for environmental-conscious construction relied on an integration of current environmental management tools in construction area. The overall objective of developing the Eþ prototype is to facilitate selectively reusing the retrievable knowledge in construction engineering and management areas assembled from previous projects for the best practice in environmental-conscious construction. The methodologies adopted in previous and ongoing research related to the development of the Eþ belong to the operations research area and the information technology area, including literature review, questionnaire survey and interview, statistical analysis, system analysis and development, experimental research and simulation, and so on. The content presented in this paper includes an advanced Eþ prototype, a comprehensive review of environmental management tools integrated to the Eþ prototype, and an experimental case study of the implementation of the Eþ prototype. It is expected that the adoption and implementation of the Eþ prototype can effectively facilitate contractors to improve their environmental performance in the lifecycle of projectbased construction and to reduce adverse environmental impacts due to the deployment of various engineering and management processes at each construction stage.