Strategic facilities management system in relation with building performance; the significance and relationship

Healthcare design frequently involves complex concepts that are difficult to measure and evaluate because the building require a modern, quality, functional and therapeutic environment. For this specific reason, facilities management has become a very important support system to ensure smoothness in healthcare business. Facilities management in healthcare building is a complicated system involving multiple layers of administrative division and sub-divisions. Building performance such as building impact, function and quality prove to have significant impact on strategic facilities management. This paper will do an extensive review of strategic healthcare business management as a holistic approach and examine how facilities management can effectively manage their division with consideration and understanding of building performance. The correlation between strategic facilities management and building performance will be identified and a framework for strategic FM system with regards to building performance will be developed.

Reported medication errors after introducing an electronic medication management system

Aims and objectives
To explore the effects of introducing an electronic medication management system on reported medication errors.
Background
Computerised medication management systems have been found to improve medication safety; however, introducing medication management system into healthcare environments can create unanticipated or new problems and opportunities for medication error.
Design
Descriptive analysis of medication error reports.
Methods
This was a retrospective analysis of 359 incident reports drawn from the period of 1 May 2005–30 April 2006 across two hospital sites of a single not-for-profit private health service located in metropolitan Melbourne. Site A used a conventional pen and paper system for medication management, and Site B had introduced a computerised medication management system.
Results
Most medication errors occurred at the nurse administration (71·5%) and prescribing (16·4%) stages of delivery. The most common medication error type reported at Site A was omission (33%), and at Site B was wrong documentation (24·2%). A higher proportion of errors at the prescribing phase, and less nurse administration errors, were detected at Site B where the medication management system was in use. The incidence of other, less frequent errors was similar across the two hospital sites.
Conclusions
This examination of medication error reports suggests there are differences in the types of medication errors that are reported in association with the introduction of electronic medication management system compared to pen and paper system systems. The findings provide a new insight into the effects of introducing an electronic medication management system on the types of medication errors reported.
Relevance to clinical practice
The findings provide a new insight into the types of medication errors that are reported during implementation of an electronic medication management system. Extra support for physicians prescribing practices should be considered.

E-commerce trust management system reliability

Various solutions have been proposed in managing trust relationship between trading partners in eCommerce environment. Determine the reliability of trust management systems in eCommerce is most difficult issue due to highly dynamic nature of eCommerce environments. As trust management systems depend on the feedback ratings provided by the trading partners, they are fallible to strategic manipulation of the feedback ratings attacks. This paper addressed the challenges of trust management systems. The requirements of a reliable trust management are also discussed. In particular, we introduce an adaptive credibility model that distinguishes between credible feedback ratings and malicious feedback ratings by considering transaction size, frequency of ratings and majority vote to form a feedback ratings verification metric. The approach has been validated by simulation result.

Through the looking glass : teaching and learning in blended immersive multiuser virtual and real world environments

This paper reports on the participation of higher education students and educators in blended immersive multi user virtual (MUVE) environments and real life teaching and learning experiences. Selected next generation technologies engage students and educators within the virtual socially networked elearning landscape of Deakin Arts Education Centre , and support the interaction of communities of learners in multiple modes, ranging from text and images accessed within the Deakin Studies Online learning management system to the "through the looking glass" virtual world in which the user’s creative imagination transports them to the “other side“ of their computer screens.

These constructed environments enable multiple simultaneous participants to access graphically built 3D environments, interact with digital artifacts and various functional tools, and represent themselves through avatars, to communicate with other participants and participate in collaborative art learning.

Immersive interfaces for art education teaching and learning in mixed reality virtual and real world environments

Selected ubiquitous technologies encourage collaborative participation between higher education students and educators within a virtual socially networked e-learning landscape. Multiple modes of teaching and learning, ranging from real world experiences, to text and digital images accessed within the Deakin Studies Online learning management system and a constructed virtual world in which the user’s creative imagination transports them to the “other side” of their computer screens is discussed in this paper. These constructed environments support interaction between communities of learners and enable multiple simultaneous participants to access graphically built 3D environments, interact with digital artifacts and various functional tools and represent themselves through avatars, to communicate with other participants and engage in collaborative art learning. A narrative interpretative research approach was used to profile the 21st century higher education student learner, to investigate the lived experience and multiple art learning perspectives documented in student visual journal entries and art educator observations to ascertain if an e-technology rich augmented learning environment resulted in the establishment of more effective e-learning communities of practice.

Immersive interfaces for art education teaching and learning in virtual and real world learning environments

Implementation of a quality care management system for patients with arthritis of the hip and knee

The Orthopaedic Unit of the Repatriation General Hospital (RGH) in Adelaide, South Australia has implemented a quality care management system for patients with arthritis of the hip and knee. The system not only optimises conservative management but ensures that joint replacement surgery is undertaken in an appropriate and timely manner. This new service model addresses identified barriers to service access and provides a comprehensive, coordinated strategy for patient management. Over 4 years the model has reduced waiting times for initial outpatient assessment from 8 to 3 months and surgery from 18 to 8 months, while decreasing length of stay from 6.3 to 5.3 days for hips and 5.8 to 5.3 days for knees. The service reforms have been accompanied by positive feedback from patients and referring general practitioners in relation to the improved coordination of care and enhanced efficiency in service delivery.

What is known about the topic? Several important initiatives both overseas and within Australia have contributed significantly to the development of this model of care. These include the UK National Health Service ‘18 weeks’ Project, the Western Canada Waiting List Project, the New Zealand priority criteria project, the Queensland Health Orthopaedic Physiotherapy Screening Clinic, and most importantly the Melbourne Health–University of Melbourne Orthopaedic Waiting List Project where a wide range of models were explored across Victorian hospitals from 2005 and the Multi-Attribute Prioritisation Tool (MAPT) was developed, validated and tested. This project became the Osteoarthritis Hip and Knee Service (OAHKS) and was operationalised in the Victorian healthcare system from 2012. These initiatives examined and addressed various aspects of management systems for patients with arthritis of the hip and knee in their particular setting.

What does this paper add? The development of this system is an extension of what is already known and is the first to encompass a comprehensive and coordinated strategy across all stages of the care management pathway for this patient group. Their management extends from the initial referral to development and implementation of a management plan, including surgery if assessed as necessary and organisation of long-term post operative follow up as required. By detailing the elements, key processes and measurable outcomes of the service redesign this paper provides a model for other institutions to implement a similar initiative.

What are the implications for practitioners? An important aspect of the design process was practitioner acceptance and engagement and the ability to improve their capacity to deliver services within an efficient and effective model. Intrinsic to the model’s development was assessment of practitioner satisfaction. Data obtained including practitioner surveys indicated an increased level of both satisfaction with the redesigned management service, and confidence in it to deliver its intended improvements.

Immersive interfaces for art education teaching and learning in virtual and real world learning environments

Selected ubiquitous technologies encourage collaborative participation between higher education students and educators within a virtual socially networked e-learning landscape. Multiple modes of teaching and learning, ranging from real world experiences, to text and digital images accessed within the Deakin Studies Online learning management system and a constructed virtual world in which the user's creative imagination transports them to the “other side” of their computer screens is discussed in this paper. These constructed environments support interaction between communities of learners and enable multiple simultaneous participants to access graphically built 3D environments, interact with digital artifacts and various functional tools and represent themselves through avatars, to communicate with other participants and engage in collaborative art learning. A narrative interpretative research approach was used to profile the 21st century higher education student learner, to investigate the lived experience and multiple art learning perspectives documented in student visual journal entries and art educator observations to ascertain if an e-technology rich augmented learning environment resulted in the establishment of more effective e-learning communities of practice.

Integration of cloud based learning in project oriented design based learning

The School of Engineering at Deakin University has been practicing design based learning as one of its engineering learning principles for further development in the learning and teaching process. It has been exploring the student and industry perspectives in this regards and has embarked in the development of a new framework for a project oriented design based learning approach for the development of the engineering curriculum. Along with this change in the engineering curriculum Deakin University also has been going through a major change in the delivery of education. The policy shift has been initiated through Live the Future: Agenda 2020 which focusses on Cloud and Located Learning. This change in policy has had an impact on delivery framework for the project oriented design based learning model which has been incorporated through the use of lecture videos, a learning management system called Cloud Deakin and online tutorials through the eLive system.

SMEDIA: Designing to create a social and dynamic learning framework

This article discusses the design of social networking sites created through a PhD action research study. Social and participatory media was used as an active, flexible and motivating learning management system. The study investigated ways in which a social learning framework could be designed for students aged 13 to 16 and aimed to encourage student knowledge growth through peer-to-peer interaction while supporting both formal and informal learning. New literacies and multimodality were infused into the design. It was found that the practitioner-researcher’s cycles of planning, acting, observing and reflecting, action research, provided a mechanism for scaffolding the redesign of curriculum content and instruction. Social media in education can be dynamic, interactive and appreciated (SMEDIA) by the students.

The social network learning cloud: architectural education for the 21 century

In less than a decade, architectural education has, in some ways, significantly evolved. The advent of computation has not so much triggered the change, but Social Networks (SN) have ignited a novel way of learning, interaction and knowledge construction. SN enable learners to engage with friends, tutors, professionals and peers, form the base for learning resources, allow students to make their voices heard, to listen to other views and much more. They offer a more authentic, inter-professional and integrated problem based, Just-in-Time (JIT), Just-in-Place (JIP) learning. Online SN work in close association with offline SN to form a blended social learning realm-the Social Network Learning Cloud (SNLC)-that greatly enables and enhances students' learning in a far more influential way than any other learning means, resources or methods do. This paper presents a SNLC for architectural education that provides opportunities for linking the academic Learning Management Systems (LMS) with private or professional SN such that it enhances the learning experience and deepens the knowledge of the students. The paper proposes ways of utilising SNLC in other learning and teaching areas of the curriculum and concludes with directions of how SNLC then may be employed in professional settings.

Cost-effectiveness analysis of a hospital electronic medication management system

OBJECTIVE: To conduct a cost-effectiveness analysis of a hospital electronic medication management system (eMMS). METHODS: We compared costs and benefits of paper-based prescribing with a commercial eMMS (CSC MedChart) on one cardiology ward in a major 326-bed teaching hospital, assuming a 15-year time horizon and a health system perspective. The eMMS implementation and operating costs were obtained from the study site. We used data on eMMS effectiveness in reducing potential adverse drug events (ADEs), and potential ADEs intercepted, based on review of 1 202 patient charts before (n = 801) and after (n = 401) eMMS. These were combined with published estimates of actual ADEs and their costs. RESULTS: The rate of potential ADEs following eMMS fell from 0.17 per admission to 0.05; a reduction of 71%. The annualized eMMS implementation, maintenance, and operating costs for the cardiology ward were A$61 741 (US$55 296). The estimated reduction in ADEs post eMMS was approximately 80 actual ADEs per year. The reduced costs associated with these ADEs were more than sufficient to offset the costs of the eMMS. Estimated savings resulting from eMMS implementation were A$63-66 (US$56-59) per admission (A$97 740-$102 000 per annum for this ward). Sensitivity analyses demonstrated results were robust when both eMMS effectiveness and costs of actual ADEs were varied substantially. CONCLUSION: The eMMS within this setting was more effective and less expensive than paper-based prescribing. Comparison with the few previous full economic evaluations available suggests a marked improvement in the cost-effectiveness of eMMS, largely driven by increased effectiveness of contemporary eMMs in reducing medication errors.