Costs and efficiency of higher education institutions in England:a DEA analysis

As student numbers in higher education in the UK have expanded during recent years, it has become increasingly important to understand its cost structure. This study applies Data Envelopment Analysis (DEA) to higher education institutions in England to assess their cost structure, efficiency and productivity. The paper complements an earlier study that used parametric methods to analyse the same panel data. Interestingly, DEA provides estimates of subject-specific unit costs that are in the same ballpark as those provided by the parametric methods. The paper then extends the previous analysis and finds that further student number increases of the order of 20–27% are feasible through exploiting operating and scale efficiency gains and also adjusting student mix. Finally the paper uses a Malmquist index approach to assess productivity change in the UK higher education. The results reveal that for a majority of institutions productivity has actually decreased during the study period.

Estimating the scope for savings in referrals and drug prescription costs in the general Practice units of a UK primary care trust

This paper explores the potential for cost savings in the general Practice units of a Primary Care Trust (PCT) in the UK. We have used Data Envelopment Analysis (DEA) to identify benchmark Practices, which offer the lowest aggregate referral and drugs costs controlling for the number, age, gender, and deprivation level of the patients registered with each Practice. For the remaining, non-benchmark Practices, estimates of the potential for savings on referral and drug costs were obtained. Such savings could be delivered through a combination of the following actions: (i) reducing the levels of referrals and prescriptions without affecting their mix (£15.74 m savings were identified, representing 6.4% of total expenditure); (ii) switching between inpatient and outpatient referrals and/or drug treatment to exploit differences in their unit costs (£10.61 m savings were identified, representing 4.3% of total expenditure); (iii) seeking a different profile of referral and drug unit costs (£11.81 m savings were identified, representing 4.8% of total expenditure). © 2012 Elsevier B.V. All rights reserved.

Developing an enterprise simulator to support electronic supply chain for B2B electronic process

The application of any e-Solution promises significant returns. In particular, using internet technologies both within enterprises and across the supply (value) chain provides real opportunity, not only for operational improvement but also for innovative strategic positioning. However, significant questions obscure potential investment; how any value will actually be created and, importantly, how this value will be shared across the value chain is not clear. This paper will describe a programme of research that is developing an enterprise simulator that will provide a more fundamental understanding of the impact of e-Solutions across operational supply chains, in terms of both standard operational and financial measures of performance. An efficient supply chain reduces total costs of operations by sharing accurate real-time information and coordinating inter-organizational business processes. This form of electronic link between organizations is known as business-to-business (B2B) e-Business. The financial measures go beyond simple cost calculations to real bottom-line performance by modelling the financial transactions that business processes generate. The paper will show how this enterprise simulator allows for a complete supply chain to be modelled in this way across four key applications: control system design, virtual enterprises, pan-supply-chain performance metrics and supporting e-Supply-chain design methodology.

IT support for managing aircraft spares in a closed-loop supply chain

This paper reports on the development of elements of an e-supply chain management system for managing maintenance, repair and overhaul (MRO) relationships in the aerospace industry. A standard systems development methodology has been followed to produce a process model (i.e. the AMSCR model); an information model (i.e. business rules) and a computerised information management capability (i.e. automated optimisation). The proof of concept for this web-based MRO supply chain system has been established through the collaboration with a sample of the different types of supply chain members. The proven benefit is a reduction in the stock-holding costs for the whole supply chain whilst also minimising non-flying time of the aircraft that the supply chain supports. This type of system is now vital in an industry that has continuously decreasing profit margins, which in turn means pressure to reduce servicing times and increase the interval between maintenance actions.

Designing a support system for aerospace maintenance supply chains

Purpose - To develop a systems strategy for supply chain management in aerospace maintenance, repair and overhaul (MRO). Design/methodology/approach - A standard systems development methodology has been followed to produce a process model (i.e. the AMSCR model); an information model (i.e. business rules) and a computerised information management capability (i.e. automated optimisation). Findings - The proof of concept for this web-based MRO supply chain system has been established through collaboration with a sample of the different types of supply chain members. The proven benefits comprise new potential to minimise the stock holding costs of the whole supply chain whilst also minimising non-flying time of the aircraft that the supply chain supports. Research limitations/implications - The scale of change needed to successfully model and automate the supply chain is vast. This research is a limited-scale experiment intended to show the power of process analysis and automation, coupled with strategic use of management science techniques, to derive tangible business benefit. Practical implications - This type of system is now vital in an industry that has continuously decreasing profit margins; which in turn means pressure to reduce servicing times and increase the mean time between them. Originality/value - Original work has been conducted at several levels: process, information and automation. The proof-of-concept system has been applied to an aircraft MRO supply chain. This is an area of research that has been neglected, and as a result is not well served by current systems solutions. © Emerald Group Publishing Limited.

Mixing the grant cocktail:towards an understanding of the outcomes of financial support to small firms

One of the key policy objectives of government at national and regional level, is to overcome the constraints preventing local industry achieving greater competitiveness in the international market-place. This paper examines the impact of grant assistance to Northern Ireland small firms delivered over the period 1994 ^ 97 by the former Local Enterprise Development Unit through its Growth Business Support Programme (GBSP). Previous work by the authors showed that there was some tentative evidence to suggest a link between employment growth and grant aid provided to very small firms (fewer than 10 employees) assisted under the GBSP. The central objective of the empirical work reported in this paper is to extend the previous analysis by understanding the extent to which the value of financial assistance influences growth (employment, turnover, and productivity measures) and if differential impacts arise depending on the nature and timing (lag structures) of the grant assistance.

Using a group support system to aid input-output identification in DEA

In data envelopment analysis (DEA), operating units are compared on their outputs relative to their inputs. The identification of an appropriate input-output set is of decisive significance if assessment of the relative performance of the units is not to be biased. This paper reports on a novel approach used for identifying a suitable input-output set for assessing central administrative services at universities. A computer-supported group support system was used with an advisory board to enable the analysts to extract information pertaining to the boundaries of the unit of assessment and the corresponding input-output variables. The approach provides for a more comprehensive and less inhibited discussion of input-output variables to inform the DEA model. © 2005 Operational Research Society Ltd. All rights reserved.

Work stressors, strains and hospital unit performance

Hospital employees who work in an environment with zero tolerance to error, face several stressors that may result in psychological, physiological, and behavioural strains, and subsequently, in suboptimal performance. This thesis includes two studies which investigate the stressor-to-strain-to-performance relationships in hospitals. The first study is a cross-sectional, multi-group investigation based on secondary data from 65,142 respondents in 172 acute/specialist UK NHS trusts. This model proposes that senior management leadership predicts social support and job design which, in turn, moderate stressors-to-strains across team structure. The results confirm the model's robustness. Regression analysis provides support for main effects and minimal support for moderation hypotheses. Therefore, based on its conclusions and inherent limitations, study one lays the framework for study two. The second study is a cross-sectional, multilevel investigation of the strain-reducing effects of social environment on externally-rated unit-level performance based on primary data from 1,137 employees in 136 units, in a hospital in Malta. The term "social environment" refers to the prediction of the moderator variables, which is to say, social support and decision latitude/control, by transformational leadership and team climate across hospital units. This study demonstrates that transformational leadership is positively associated with social support, whereas team climate is positively associated with both moderators. At the same time, it identifies a number of moderating effects which social support and decision latitude/control, both separately and together, had on specific stressor-to-strain relationships. The results show significant mediated stressor-to-strain-to-performance relationships. Furthermore, at the higher level, unit-level performance is positively associated with shared unit-level team climate and with unit-level vision, the latter being one of the five sub-dimension of transformational leadership. At the same time, performance is also positively related to both transformational leadership and team climate when the two constructs are tested together. Few studies have linked the buffering effects of the social environment in occupational stress with performance. Therefore, this research strives to make a significant contribution to the occupational stress and performance literature with a focus on hospital practice. Indeed, the study highlights the wide-ranging and far-reaching implications that these findings provide for theory, management, and practice.

Mobile case-based decision support for intelligent patient knowledge management

Hospitals everywhere are integrating health data using electronic health record (EHR) systems, and disparate and multimedia patient data can be input by different caregivers at different locations as encapsulated patient profiles. Healthcare institutions are also using the flexibility and speed of wireless computing to improve quality and reduce costs. We are developing a mobile application that allows doctors to efficiently record and access complete and accurate real-time patient information. The system integrates medical imagery with textual patient profiles as well as expert interactions by healthcare personnel using knowledge management and case-based reasoning techniques. The application can assist other caregivers in searching large repositories of previous patient cases. Patients' symptoms can be input to a portable device and the application can quickly retrieve similar profiles which can be used to support effective diagnoses and prognoses by comparing symptoms, treatments, diagnosis, test results and other patient information. © 2007 Sage Publications.

Decision support system for vendor managed inventory supply chain:a case study

Vendor-managed inventory (VMI) is a widely used collaborative inventory management policy in which manufacturers manages the inventory of retailers and takes responsibility for making decisions related to the timing and extent of inventory replenishment. VMI partnerships help organisations to reduce demand variability, inventory holding and distribution costs. This study provides empirical evidence that significant economic benefits can be achieved with the use of a genetic algorithm (GA)-based decision support system (DSS) in a VMI supply chain. A two-stage serial supply chain in which retailers and their supplier are operating VMI in an uncertain demand environment is studied. Performance was measured in terms of cost, profit, stockouts and service levels. The results generated from GA-based model were compared to traditional alternatives. The study found that the GA-based approach outperformed traditional methods and its use can be economically justified in small- and medium-sized enterprises (SMEs).

Learning to live with Parkinson’s disease in the family unit:an interpretative phenomenological analysis of well-being

We investigated family members’ lived experience of Parkinson’s disease (PD) aiming to investigate opportunities for well-being. A lifeworld-led approach to healthcare was adopted. Interpretative phenomenological analysis was used to explore in-depth interviews with people living with PD and their partners. The analysis generated four themes: It’s more than just an illness revealed the existential challenge of diagnosis; Like a bird with a broken wing emphasizing the need to adapt to increasing immobility through embodied agency; Being together with PD exploring the kinship within couples and belonging experienced through support groups; and Carpe diem! illuminated the significance of time and fractured future orientation created by diagnosis. Findings were interpreted using an existential-phenomenological theory of well-being. We highlighted how partners shared the impact of PD in their own ontological challenges. Further research with different types of families and in different situations is required to identify services required to facilitate the process of learning to live with PD. Care and support for the family unit needs to provide emotional support to manage threats to identity and agency alongside problem-solving for bodily changes. Adopting a lifeworld-led healthcare approach would increase opportunities for well-being within the PD illness journey.