Modularity in Health and Social Services: Perspectives on Organization and Management

Organizations that provide health and social services operate in a complex and constantly changing environment. Changes occur, for example, in ageing, technology and biotechnology, and customers’ expectations, as well as the global economic situation. Organizations typically aim to adapt the changes by introducing new organizational structures and managerial practices, such as process and lean management. Only recently has there been an interest in evaluating whether organizations providing health and social services could apply modularity in order to respond to some of the changes. The concept of modularity originates from manufacturing, but is applied in many other disciplines, such as information technology and logistics. However, thus far, the literature concerning modularity in health and social services is scarce. Therefore the purpose of this thesis is to increase understanding concerning modularity and the possibilities to apply modularity in the health and social services context. In addition, the purpose is to shed light on the viewpoints that are worth taking into account when considering the application of modularity in the health and social services context. The aim of the thesis is to analyze the way in which the modular structures are applied in the health and social services context and to analyze what advantages and possible barriers, as well as managerial concerns, might occur if modularity is applied in the health and social services context. The thesis is conducted by using multiple methods in order to provide a broad aspect to the topic. A systematic literature review provided solid ground for pre-understanding the topic and supported the formulation of the research questions. Theoretical reasoning provided a general overview of the special characteristics of the health and social services context and their effect on application of modularity. Empirical studies concentrated on managerial concerns of modularity particularly from the perspective of health and social services for the elderly. Results of the thesis reveal that structures in products, services, processes, and organizations are rather modular in health and social services. They can be decomposed in small independent units, while the challenges seem to occur especially in the compatibility of the services. It seems that health and social services managers have recognized this problem and they are increasingly paying attention to this challenge in order to enhance the flexible compatibility of services. Advantages and possible barriers of modularity are explored in this thesis, and from the theoretical perspective it could be argued that modularity seems to be beneficial in the context of health and social services. In fact, it has the potential to alleviate several of the challenges that the health and social services context is confronting. For example, modular structures could support organizations in their challenging task to respond to customers’ increasing demand for heterogeneous services. However, special characteristics of the health and social services context create barriers and provide significant challenges in application of modularity. For example, asymmetry of information, negative externalities, uncertainty of demand, and rigid regulation prevent managers from extensively drawing benefits from modularity. Results also reveal that modularity has managerial implications in health and social service. Modularity has the potential to promote and support new service development and outsourcing. Results also provide insights into network management and increases managerial understanding of different network management strategies. Standardization in health and social services is extensive due to legislation and recommendations. Modularity provides alternative paths to take an advantage of standardization while still ensuring the quality of the services. Based on this thesis, it can be concluded, both from a theoretical perspective and from empirical results concerning modularity in health and social services, that modularity might fit well and be beneficial. However, the special characteristics of the health and social services context prevent some of the benefits of modularity and complicate its application. This thesis contributes to the academic literature on the organization and management of health and social services by describing modularity as an alternative way for organizing and managing health and social services. In addition, it contributes to the literature of modularity by exploring the applicability of modularity in the context of health and social services. It also provides practical contribution to health and social services managers by evaluating the pros and cons of modularity when applied to health and social services.

Catalogue Interfaces of Integrated Library Management Systems (ILMS): Experiences in a Proprietary and Open Source Software

The Central Library of Cochin University of Science and Technology (CUSAT) has been automated by proprietary software (Adlib Library) since 2000. After 11 years, in 2011, the university authorities decided to shift to an open source software (OSS), for integrated library management system (ILMS), Koha for automating the library housekeeping operations. In this context, this study attempts to share the experiences in cataloging with both type of software. The features of the cataloging modules of both the software are analysed on the badis of certain check points. It is found that the cataloging module of Koha is almost in par with that of proven proprietary software that has been in market for the past 25 years. Some suggestions made by this study may be incorporated for the further development and perfection of Koha.

La adopción de un enfoque de trabajo en red: implicaciones en torno al proceso estratégico de las organizaciones

En el mundo actual el enfoque del proceso estratégico es una variable que cada vez va tomando un mayor peso e incidencia en las decisiones de los directores de empresa, sin embargo, poco se ha estudiado sobre esta variable al ser adoptado por los nuevos modelos de cooperación empresarial en las organizaciones. Es por esta razón que esta investigación busca esclarecer la aplicabilidad de las metodologías y herramientas utilizadas en la planeación estratégica de una empresa en una red, además de servir como un primer acercamiento a los aspectos más importantes en la planeación estratégica de una red.

Actitudes de los directivos en torno a la adopción del e-learning como herramienta de trabajo en las empresas

El desarrollo del presente documento constituye una investigación sobre las actitudes de los directivos frente a la adopción del e-learning como herramienta de trabajo en las organizaciones de Bogotá. Para ello se realizó una encuesta a 101 directivos, tomando como base el tipo de muestreo de conveniencia; esto con el objetivo de identificar sus actitudes frente al uso del e-learning y su influencia dentro de la organización. Como resultado se obtuvo que las actitudes de los directivos influencian en el uso de herramientas e-learning, así como también en las acciones que promueven su uso y en las actitudes de los empleados; por otro lado se identificó que las creencias relacionadas con la apropiación de herramientas e-learning y los factores facilitadores del uso de estas, influencian en las actitudes de los directivos. Lo anterior, corresponde a los análisis llevados a cabo a partir de los resultados contrastados con los estudios empíricos hallados y el marco teórico desarrollado.

El Outsourcing en la dinámica de sistemas hacia mercados extranjeros

Este trabajo recopila literatura académica relevante sobre estrategias de entrada y metodologías para la toma de decisión sobre la contratación de servicios de Outsourcing para el caso de empresas que planean expandirse hacia mercados extranjeros. La manera en que una empresa planifica su entrada a un mercado extranjero, y realiza la consideración y evaluación de información relevante y el diseño de la estrategia, determina el éxito o no de la misma. De otro lado, las metodologías consideradas se concentran en el nivel estratégico de la pirámide organizacional. Se parte de métodos simples para llegar a aquellos basados en la Teoría de Decisión Multicriterio, tanto individuales como híbridos. Finalmente, se presenta la Dinámica de Sistemas como herramienta valiosa en el proceso, por cuanto puede combinarse con métodos multicriterio.

Las TIC en la administración de la cadena de suministro y su incidencia en el desempeño operacional

Las tecnologías de la información han empezado a ser un factor importante a tener en cuenta en cada uno de los procesos que se llevan a cabo en la cadena de suministro. Su implementación y correcto uso otorgan a las empresas ventajas que favorecen el desempeño operacional a lo largo de la cadena. El desarrollo y aplicación de software han contribuido a la integración de los diferentes miembros de la cadena, de tal forma que desde los proveedores hasta el cliente final, perciben beneficios en las variables de desempeño operacional y nivel de satisfacción respectivamente. Por otra parte es importante considerar que su implementación no siempre presenta resultados positivos, por el contrario dicho proceso de implementación puede verse afectado seriamente por barreras que impiden maximizar los beneficios que otorgan las TIC.

Definition of an it project portfolio management methodology for a pharmaceutical company

Con la creciente popularidad de las soluciones de IT como factor clave para aumentar la competitividad y la creación de valor para las empresas, la necesidad de invertir en proyectos de IT se incrementa considerablemente. La limitación de los recursos como un obstáculo para invertir ha obligado a las empresas a buscar metodologías para seleccionar y priorizar proyectos, asegurándose de que las decisiones que se toman son aquellas que van alineadas con las estrategias corporativas para asegurar la creación de valor y la maximización de los beneficios. Esta tesis proporciona los fundamentos para la implementación del Portafolio de dirección de Proyectos de IT (IT PPM) como una metodología eficaz para la gestión de proyectos basados en IT, y una herramienta para proporcionar criterios claros para los directores ejecutivos para la toma de decisiones. El documento proporciona la información acerca de cómo implementar el IT PPM en siete pasos, el análisis de los procesos y las funciones necesarias para su ejecución exitosa. Además, proporciona diferentes métodos y criterios para la selección y priorización de proyectos. Después de la parte teórica donde se describe el IT PPM, la tesis aporta un análisis del estudio de caso de una empresa farmacéutica. La empresa ya cuenta con un departamento de gestión de proyectos, pero se encontró la necesidad de implementar el IT PPM debido a su amplia cobertura de procesos End-to-End en Proyectos de IT, y la manera de asegurar la maximización de los beneficios. Con la investigación teórica y el análisis del estudio de caso, la tesis concluye con una definición práctica de un modelo aproximado IT PPM como una recomendación para su implementación en el Departamento de Gestión de Proyectos.

Information servers, present and future

Mainframes, corporate and central servers are becoming information servers. The requirement for more powerful information servers is the best opportunity to exploit the potential of parallelism. ICL recognized the opportunity of the 'knowledge spectrum' namely to convert raw data into information and then into high grade knowledge. Parallel Processing and Data Management Its response to this and to the underlying search problems was to introduce the CAFS retrieval engine. The CAFS product demonstrates that it is possible to move functionality within an established architecture, introduce a different technology mix and exploit parallelism to achieve radically new levels of performance. CAFS also demonstrates the benefit of achieving this transparently behind existing interfaces. ICL is now working with Bull and Siemens to develop the information servers of the future by exploiting new technologies as available. The objective of the joint Esprit II European Declarative System project is to develop a smoothly scalable, highly parallel computer system, EDS. EDS will in the main be an SQL server and an information server. It will support the many data-intensive applications which the companies foresee; it will also support application-intensive and logic-intensive systems.

How could construction supply chain benefit from RFID/GPS integration: a knowledge management perspective

Construction materials and equipment are essential building blocks of every construction project and may account for 50-60 per cent of the total cost of construction. The rate of their utilization, on the other hand, is the element that most directly relates to a project progress. A growing concern in the industry that inadequate efficiency hinders its success could thus be accommodated by turning construction into a logistic process. Although mostly limited, recent attempts and studies show that Radio Frequency IDentification (RFID) applications have significant potentials in construction. However, the aim of this research is to show that the technology itself should not only be used for automation and tracking to overcome the supply chain complexity but also as a tool to generate, record and exchange process-related knowledge among the supply chain stakeholders. This would enable all involved parties to identify and understand consequences of any forthcoming difficulties and react accordingly before they cause major disruptions in the construction process. In order to achieve this aim the study focuses on a number of methods. First of all it develops a generic understanding of how RFID technology has been used in logistic processes in industrial supply chain management. Secondly, it investigates recent applications of RFID as an information and communication technology support facility in construction logistics for the management of construction supply chain. Based on these the study develops an improved concept of a construction logistics architecture that explicitly relies on integrating RFID with the Global Positioning System (GPS). The developed conceptual model architecture shows that categorisation provided through RFID and traceability as a result of RFID/GPS integration could be used as a tool to identify, record and share potential problems and thus vastly improve knowledge management processes within the entire supply chain. The findings thus clearly show a need for future research in this area.

Mapping IT innovation in Facilities Management

Over the past decade there has been significant growth in the facilities management (FM) sector resulting in a diverse and highly competitive marketplace. This marketplace engages contractors, in-house teams, suppliers, consultants and professional institutions. Many of these organisations have had to innovate to differentiate themselves from competitors. The subject of this paper is facilities management innovation. More specifically, it examines the introduction of information technology (IT) to support such innovations. Our understanding of how such innovations are brought about is scant. The intention of this paper is to examine the motivations and factors which have brought about ‘information system’ innovations in the sector based on an examination of a small but diverse collection of case studies. The study specifically considers the route by which the selected innovations came about and the way in which the innovation has diffused throughout the rest of the organisation. The IT innovations identified in case studies include whole life cost modelling, a content management solution, open book partnering, management information portal (fmNet), RFID technology, and capacity and capability planning. Taken together they characterise a sector that is using IT to codify and standardise information such that useful knowledge becomes widely dispersed.

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.

Protocol for the PINCER trial: a cluster randomised trial comparing the effectiveness of a pharmacist-led IT-based intervention with simple feedback in reducing rates of clinically important errors in medicines management in general practices

Background: Medication errors are an important cause of morbidity and mortality in primary care. The aims of this study are to determine the effectiveness, cost effectiveness and acceptability of a pharmacist-led information-technology-based complex intervention compared with simple feedback in reducing proportions of patients at risk from potentially hazardous prescribing and medicines management in general (family) practice. Methods: Research subject group: "At-risk" patients registered with computerised general practices in two geographical regions in England. Design: Parallel group pragmatic cluster randomised trial. Interventions: Practices will be randomised to either: (i) Computer-generated feedback; or (ii) Pharmacist-led intervention comprising of computer-generated feedback, educational outreach and dedicated support. Primary outcome measures: The proportion of patients in each practice at six and 12 months post intervention: - with a computer-recorded history of peptic ulcer being prescribed non-selective non-steroidal anti-inflammatory drugs - with a computer-recorded diagnosis of asthma being prescribed beta-blockers - aged 75 years and older receiving long-term prescriptions for angiotensin converting enzyme inhibitors or loop diuretics without a recorded assessment of renal function and electrolytes in the preceding 15 months. Secondary outcome measures; These relate to a number of other examples of potentially hazardous prescribing and medicines management. Economic analysis: An economic evaluation will be done of the cost per error avoided, from the perspective of the UK National Health Service (NHS), comparing the pharmacist-led intervention with simple feedback. Qualitative analysis: A qualitative study will be conducted to explore the views and experiences of health care professionals and NHS managers concerning the interventions, and investigate possible reasons why the interventions prove effective, or conversely prove ineffective. Sample size: 34 practices in each of the two treatment arms would provide at least 80% power (two-tailed alpha of 0.05) to demonstrate a 50% reduction in error rates for each of the three primary outcome measures in the pharmacist-led intervention arm compared with a 11% reduction in the simple feedback arm. Discussion: At the time of submission of this article, 72 general practices have been recruited (36 in each arm of the trial) and the interventions have been delivered. Analysis has not yet been undertaken.

Ontological modelling of content management and provision

Information provision to address the changing requirements can be best supported by content management. The Current information technology enables information to be stored and provided from various distributed sources. To identify and retrieve relevant information requires effective mechanisms for information discovery and assembly. This paper presents a method, which enables the design of such mechanisms, with a set of techniques for articulating and profiling users' requirements, formulating information provision specifications, realising management of information content in repositories, and facilitating response to the user's requirements dynamically during the process of knowledge construction. These functions are represented in an ontology which integrates the capability of the mechanisms. The ontological modelling in this paper has adopted semiotics principles with embedded norms to ensure coherent course of actions represented in these mechanisms. (C) 2008 Elsevier B.V. All rights reserved.

e-learning services provision and management

With the rapid development of information technology, learners demand effective personalised learning support, which imposes a new learning paradigm in learning content management. Standards as well as best practice in industry and research community have taken place to address the paradigm shift. With respect to this trend, it is recognised that finding learning content which meet personal learning requirements remains challenging. This paper describes a model of e-learning services provision which integrates the best practice in e-learning and Web services technology so that learning content management is capable of supporting applications of learning services.

A model of intelligent building energy management for the indoor environment

People's interaction with the indoor environment plays a significant role in energy consumption in buildings. Mismatching and delaying occupants' feedback on the indoor environment to the building energy management system is the major barrier to the efficient energy management of buildings. There is an increasing trend towards the application of digital technology to support control systems in order to achieve energy efficiency in buildings. This article introduces a holistic, integrated, building energy management model called `smart sensor, optimum decision and intelligent control' (SMODIC). The model takes into account occupants' responses to the indoor environments in the control system. The model of optimal decision-making based on multiple criteria of indoor environments has been integrated into the whole system. The SMODIC model combines information technology and people centric concepts to achieve energy savings in buildings.