Growing demand for emergency health services in Queensland, Australia

Introduction: The demand for emergency health services (EHS), both in the prehospital (ambulance) and hospital (emergency departments) settings, is growing rapidly in Australia. Broader health system changes have reduced available health infrastructure, particularly hospital beds, resulting in reduced access to and congestion of the EHS as demonstrated by longer waiting times and ambulance “ramping”. Ambulance ramping occurring when patients have a prolonged wait on the emergency vehicle due to the unavailability of hospital beds. This presentation will outline the trends in EHS demand in Queensland compared with the rest of Australia and factors that appear to be contributing to the growth in demand. Methods: Secondary analysis was conducted using data from publicly available sources. Data from the Queensland Ambulance Service and Queensland Health Emergency Department Information System (EDIS) also were analyzed. Results: The demand for ambulance services and emergency departments has been increasing at 8% and 4% per year over the last decade, respectively; while accessible hospital beds have reduced by almost 10% contributing to the emergency department congestion and possibly contributing to the prehospital demand. While the increase in the proportion of the elderly population seems to explain a great deal of the demand for EHS, other factors also influence this growth including patient characteristics, institutional and societal factors, economic, EHS arrangements, and clinical factors. Conclusions: Overcrowding of facilities that provide EHS are causing considerable community concern. This overcrowding is caused by the growing demand and reduced access. The causes of this growing demand are complex, and require further detailed analysis in order to quantify and qualify these causes in order to provide a resilient foundation of evidence for future policy direction.

Reconceptualising the information system as a service

The study will cross-fertilise Information Systems (IS) and Services Marketing ideas through reconceptualising the information system as a service (ISaaS). The study addresses known limitations of arguably the two most significant dependent variables in these disciplines - Information System Success or IS-Impact, and Service Quality. Planned efforts to synthesise analogous conceptions across these disciplines, are expected to force a deeper theoretical understanding of the broad notions of success, quality, value and satisfaction and their interrelations. The aims of this research are to: (1) yield a conceptually superior and more extensively validated IS success measurement model, and (2) develop and operationalise a more rigorously validated Service Quality measurement model, while extending the ‘service’ notion to ‘operational computer-based information systems in organisations’. In the development of the new models the study will address contemporary validation issues.

Infrastructure project planning decision making : challenges for decision support system applications

Most infrastructure projects share the same characteristics in term of management aspects and shortcomings. Human factor is believed to be the major drawbacks due to the nature of unstructured problems which can further contribute to management conflicts. This growing complexity in infrastructure projects has shift the paradigm of policy makers to adopt Information Communication Technology (ICT) as a driving force. For this reason, it is vital to fully maximise and utilise the recent technologies to accelerate management process particularly in planning phase. Therefore, a lot of tools have been developed to assist decision making in construction project management. The variety of uncertainties and alternatives in decision making can be entertained by using useful tool such as Decision Support System (DSS). However, the recent trend shows that most DSS in this area only concentrated in model development and left few fundamentals of computing. Thus, most of them were found complicated and less efficient to support decision making within project team members. Due to the current incapability of many software aspects, it is desirable for DSS to provide more simplicity, better collaborative platform, efficient data manipulation and reflection to user needs. By considering these factors, the paper illustrates four challenges for future DSS development i.e. requirement engineering, communication framework, data management and interoperability, and software usability

Parents’ choice of early childhood education service in Hong Kong : a pilot study

The introduction of a voucher scheme for early childhood education in Hong Kong has resulted in significant changes in the field. This paper reports data from a pilot study that aimed at gaining a deeper understanding of how parents chose early childhood education service following the introduction of a voucher scheme in Hong Kong. Eight-six Chinese parents with children aged three participated in interviews and focus group discussions. This group of parents had just gone through the process of selecting a kindergarten or nursery for their child for the school year of 2007-2008. Parents from a range of socioeconomic circumstances and educational levels who had selected non-profit kindergartens and nurseries in public and private housing estates participated. Results showed that what parents looked in their choice of service matched closely with how they defined quality. As evidenced in the study, parents’ changing views on quality shared a great deal of resemblance with the specific notion of quality being heavily promoted by recent reform policy. The findings pointed to the complex interactions of policy, choice and practices of early childhood education. The new voucher scheme is intensifying the governing of the self and the field, the impact of which can be worrying.

A University Support Model for eResearch

Queensland University of Technology (QUT) is faced with a rapidly growing research agenda built upon a strategic research capacity-building program. This presentation will outline the results of a project that has recently investigated QUT’s research support requirements and which has developed a model for the support of eResearch across the university. QUT’s research building strategy has produced growth at the faculty level and within its research institutes. This increased research activity is pushing the need for university-wide eResearch platforms capable of providing infrastructure and support in areas such as collaboration, data, networking, authentication and authorisation, workflows and the grid. One of the driving forces behind the investigation is data-centric nature of modern research. It is now critical that researchers have access to supported infrastructure that allows the collection, analysis, aggregation and sharing of large data volumes for exploration and mining in order to gain new insights and to generate new knowledge. However, recent surveys into current research data management practices by the Australian Partnership for Sustainable Repositories (APSR) and by QUT itself, has revealed serious shortcomings in areas such as research data management, especially its long term maintenance for reuse and authoritative evidence of research findings. While these internal university pressures are building, at the same time there are external pressures that are magnifying them. For example, recent compliance guidelines from bodies such as the ARC, and NHMRC and Universities Australia indicate that institutions need to provide facilities for the safe and secure storage of research data along with a surrounding set of policies, on its retention, ownership and accessibility. The newly formed Australian National Data Service (ANDS) is developing strategies and guidelines for research data management and research institutions are a central focus, responsible for managing and storing institutional data on platforms that can be federated nationally and internationally for wider use. For some time QUT has recognised the importance of eResearch and has been active in a number of related areas: ePrints to digitally publish research papers, grid computing portals and workflows, institutional-wide provisioning and authentication systems, and legal protocols for copyright management. QUT also has two widely recognised centres focused on fundamental research into eResearch itself: The OAK LAW project (Open Access to Knowledge) which focuses upon legal issues relating eResearch and the Microsoft QUT eResearch Centre whose goal is to accelerate scientific research discovery, through new smart software. In order to better harness all of these resources and improve research outcomes, the university recently established a project to investigate how it might better organise the support of eResearch. This presentation will outline the project outcomes, which include a flexible and sustainable eResearch support service model addressing short and longer term research needs, identification of resource requirements required to establish and sustain the service, and the development of research data management policies and implementation plans.

A Malaysian tale : pre-service teacher education and ICT integration for a better world

The use of Information and Communication Technologies (ICT) in education is often a topic of much discussion within all sectors of education with educators and educational researchers continually looking for innovative ways of using these technologies to support and enhance student outcomes in education. Consequently, Malaysia is no exception to this and as the Ministry of Education (MOE), Malaysia strives to meet its government’s Vision 2020, educational reform across all educational sectors has become imperative. ICT will play an integral role in the educational reform process and teacher education programs are no exception to this. ICT and capacity building will play an important role in the re-conceptualisation of teacher education programs. This paper reports on how a collaborative capacity building project between two Malaysian teacher education Institutes and an Australian University has given lecturers and pre-service teachers an opportunity to redefine their use of ICT in their prospective teaching areas of science, mathematics and design and technology. It also highlights the positive capacity building programs that occurred between both Australian university lecturers and Malaysian Institute lecturers and how this contributed to the effective integration and use of ICT.

Emerging urban futures, land, water, infrastructure

This paper will examine the intersection of design research and problem‐based teaching through the process and outcomes of a four year long ARC funded research project: the Emerging Futures Project. Sustainability is central to the project; in its overall content as well as in the broad aim of determining better outcomes for urban consolidation.   

Truck overloading study in developing countries and strategies to minimize its impact

Overloading truck traffic is an untenable problem around the world. The occurrence of overloaded truck traffic can be evidence of rapid development of an economy. Most of the developing countries emphasize the development of economy, thus supporting reform of infrastructure is limited. This research investigates the relationship between truck overloading and the condition of road damage. The objective of this research is to determine the amount of economic loss due to overloaded truck traffic is. Axle load will be used to calculate the total ESAL to pavement. This study intends to provide perspective on the relationship between change in axle load due to overloading and the resultant service life of pavement. It can then be used in the estimation of pavement damage in other developing countries facing the problem of truck overloading. In conclusion, economical loss was found, which include reduction of pavement life and increase in maintenance and rehabilitation (M&R) cost. As a result, net present value (NPV) of pavement investment with overloading truck traffic is higher than normal truck traffic.

AITPM Email Newsletter Volume 0907, July 2009 : President's Message

President’s Message AITPM President’s Message, July 2009 Hello fellow AITPM members, It’s now very early July so many Australians are going to experience a range of new, or increases in, fees, charges, and perhaps taxes by State and local governments. For example, Queenslanders are to be hit at the petrol pump, no longer living with the luxury of the State’s previous 8c per litre fuel subsidy, bringing general motorists’ fuel costs into line with the other States. A consolation is that they now don’t have to live with the real or perceived “price gouging” that has appeared in the past to make Queensland prices much closer than 8c to those in other States. Environmental lobbyists argue that this Government’s decision brings public transport costs closer to parity with private transport. However, my sense from sloppy petrol price elasticities is that the State’s motorists will get used to the reversal of what was a reverse tax pretty quickly, an amount which can be less than day-of-the week fluctuation. On the other hand, withholding this State revenue may help in some way the funding of the several major public transport infrastructure projects in progress; not to mention some of the cost of running the Transit Authority’s expanding service commitments. Other policy actions, such as a Federal Government review of taxation on employees’ package vehicles, which might discourage rather than encourage excess kilometres travelled, may have a greater environmental benefit. Of course, a downside is that many vehicles used so are Australian built, and discouraging fleet turnover may damage an industry which faces ever increasing uncertainty, and particularly at the present, is in need of some care and attention. I for one hope to this end that the new 4 cylinder (1.8L petrol or 2L diesel) so called “true Holden” Cruze and Toyota’s pending Camry Hybrid are both roaring successes, and will be taken up in droves as fleet and employee use vehicles. I’m not sure what drive-trains Ford and Holden plan to drop into their next full sized models but even if they’re not Australian sourced, let’s hope they coordinate the requisite performance expected by the “Aussie Battler” with suitable green credentials. I am also encouraged to see that already many Government fleet vehicles are smaller in size, but still fit for purpose. For instance, my local police station uses the Camry based Aurion as a district car. I close again in reminding everyone that AITPM’s flagship event, the 2009 AITPM National Conference, Traffic Beyond Tomorrow, is being held in Adelaide from 5 to 7 August. www.aitpm.com has all of the details about how to register, sponsor a booth, session, etc. Best regards all, Jon Bunker

A framework for network RTK data processing based on grid computing

Real-Time Kinematic (RTK) positioning is a technique used to provide precise positioning services at centimetre accuracy level in the context of Global Navigation Satellite Systems (GNSS). While a Network-based RTK (N-RTK) system involves multiple continuously operating reference stations (CORS), the simplest form of a NRTK system is a single-base RTK. In Australia there are several NRTK services operating in different states and over 1000 single-base RTK systems to support precise positioning applications for surveying, mining, agriculture, and civil construction in regional areas. Additionally, future generation GNSS constellations, including modernised GPS, Galileo, GLONASS, and Compass, with multiple frequencies have been either developed or will become fully operational in the next decade. A trend of future development of RTK systems is to make use of various isolated operating network and single-base RTK systems and multiple GNSS constellations for extended service coverage and improved performance. Several computational challenges have been identified for future NRTK services including: • Multiple GNSS constellations and multiple frequencies • Large scale, wide area NRTK services with a network of networks • Complex computation algorithms and processes • Greater part of positioning processes shifting from user end to network centre with the ability to cope with hundreds of simultaneous users’ requests (reverse RTK) There are two major requirements for NRTK data processing based on the four challenges faced by future NRTK systems, expandable computing power and scalable data sharing/transferring capability. This research explores new approaches to address these future NRTK challenges and requirements using the Grid Computing facility, in particular for large data processing burdens and complex computation algorithms. A Grid Computing based NRTK framework is proposed in this research, which is a layered framework consisting of: 1) Client layer with the form of Grid portal; 2) Service layer; 3) Execution layer. The user’s request is passed through these layers, and scheduled to different Grid nodes in the network infrastructure. A proof-of-concept demonstration for the proposed framework is performed in a five-node Grid environment at QUT and also Grid Australia. The Networked Transport of RTCM via Internet Protocol (Ntrip) open source software is adopted to download real-time RTCM data from multiple reference stations through the Internet, followed by job scheduling and simplified RTK computing. The system performance has been analysed and the results have preliminarily demonstrated the concepts and functionality of the new NRTK framework based on Grid Computing, whilst some aspects of the performance of the system are yet to be improved in future work.

Revisiting the conceptualization and measurement of service quality

Since the 1980s, industries and researchers have sought to better understand the quality of services due to the rise in their importance (Brogowicz, Delene and Lyth 1990). More recent developments with online services, coupled with growing recognition of service quality (SQ) as a key contributor to national economies and as an increasingly important competitive differentiator, amplify the need to revisit our understanding of SQ and its measurement. Although ‘SQ’ can be broadly defined as “a global overarching judgment or attitude relating to the overall excellence or superiority of a service” (Parasuraman, Berry and Zeithaml 1988), the term has many interpretations. There has been considerable progress on how to measure SQ perceptions, but little consensus has been achieved on what should be measured. There is agreement that SQ is multi-dimensional, but little agreement as to the nature or content of these dimensions (Brady and Cronin 2001). For example, within the banking sector, there exist multiple SQ models, each consisting of varying dimensions. The existence of multiple conceptions and the lack of a unifying theory bring the credibility of existing conceptions into question, and beg the question of whether it is possible at some higher level to define SQ broadly such that it spans all service types and industries. This research aims to explore the viability of a universal conception of SQ, primarily through a careful re-visitation of the services and SQ literature. The study analyses the strengths and weaknesses of the highly regarded and widely used global SQ model (SERVQUAL) which reflects a single-level approach to SQ measurement. The SERVQUAL model states that customers evaluate SQ (of each service encounter) based on five dimensions namely reliability, assurance, tangibles, empathy and responsibility. SERVQUAL, however, failed to address what needs to be reliable, assured, tangible, empathetic and responsible. This research also addresses a more recent global SQ model from Brady and Cronin (2001); the B&C (2001) model, that has potential to be the successor of SERVQUAL in that it encompasses other global SQ models and addresses the ‘what’ questions that SERVQUAL didn’t. The B&C (2001) model conceives SQ as being multidimensional and multi-level; this hierarchical approach to SQ measurement better reflecting human perceptions. In-line with the initial intention of SERVQUAL, which was developed to be generalizable across industries and service types, this research aims to develop a conceptual understanding of SQ, via literature and reflection, that encompasses the content/nature of factors related to SQ; and addresses the benefits and weaknesses of various SQ measurement approaches (i.e. disconfirmation versus perceptions-only). Such understanding of SQ seeks to transcend industries and service types with the intention of extending our knowledge of SQ and assisting practitioners in understanding and evaluating SQ. The candidate’s research has been conducted within, and seeks to contribute to, the ‘IS-Impact’ research track of the IT Professional Services (ITPS) Research Program at QUT. The vision of the track is “to develop the most widely employed model for benchmarking Information Systems in organizations for the joint benefit of research and practice.” The ‘IS-Impact’ research track has developed an Information Systems (IS) success measurement model, the IS-Impact Model (Gable, Sedera and Chan 2008), which seeks to fulfill the track’s vision. Results of this study will help future researchers in the ‘IS-Impact’ research track address questions such as: • Is SQ an antecedent or consequence of the IS-Impact model or both? • Has SQ already been addressed by existing measures of the IS-Impact model? • Is SQ a separate, new dimension of the IS-Impact model? • Is SQ an alternative conception of the IS? Results from the candidate’s research suggest that SQ dimensions can be classified at a higher level which is encompassed by the B&C (2001) model’s 3 primary dimensions (interaction, physical environment and outcome). The candidate also notes that it might be viable to re-word the ‘physical environment quality’ primary dimension to ‘environment quality’ so as to better encompass both physical and virtual scenarios (E.g: web sites). The candidate does not rule out the global feasibility of the B&C (2001) model’s nine sub-dimensions, however, acknowledges that more work has to be done to better define the sub-dimensions. The candidate observes that the ‘expertise’, ‘design’ and ‘valence’ sub-dimensions are supportive representations of the ‘interaction’, physical environment’ and ‘outcome’ primary dimensions respectively. The latter statement suggests that customers evaluate each primary dimension (or each higher level of SQ classification) namely ‘interaction’, physical environment’ and ‘outcome’ based on the ‘expertise’, ‘design’ and ‘valence’ sub-dimensions respectively. The ability to classify SQ dimensions at a higher level coupled with support for the measures that make up this higher level, leads the candidate to propose the B&C (2001) model as a unifying theory that acts as a starting point to measuring SQ and the SQ of IS. The candidate also notes, in parallel with the continuing validation and generalization of the IS-Impact model, that there is value in alternatively conceptualizing the IS as a ‘service’ and ultimately triangulating measures of IS SQ with the IS-Impact model. These further efforts are beyond the scope of the candidate’s study. Results from the candidate’s research also suggest that both the disconfirmation and perceptions-only approaches have their merits and the choice of approach would depend on the objective(s) of the study. Should the objective(s) be an overall evaluation of SQ, the perceptions-only approached is more appropriate as this approach is more straightforward and reduces administrative overheads in the process. However, should the objective(s) be to identify SQ gaps (shortfalls), the (measured) disconfirmation approach is more appropriate as this approach has the ability to identify areas that need improvement.

Mental health issues and resources in rural and regional communities : an exploration of perceptions of service providers

Objective: To identify service providers’ and community organisations’ perceptions of the resources available to support people with mental illness and the unmet needs of this client group in rural Queensland. Design: An exploratory study was undertaken involving focus group interviews across the study sites. Setting: Five regional towns in rural Queensland. Participants: Ten to 14 members were recruited for each of the five focus groups. The groups represented a diverse mix of participants including health and community service providers and representatives from community organisations. Results: Participants identified gaps in services in relation to health, employment and education, housing and accommodation, transport and social inclusion and health promotion. Inter-service communication and inappropriate funding models were themes affecting service delivery. Conclusions: Specific service issues of housing and transport were identified to be particularly problematic for people with mental illness across all towns. Intersectoral communication and funding models require further research.

Virtual vignettes and pedagogical potentials : Insights into a virtual schooling service

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