981 resultados para Temas de agenda


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Current research agendas are increasingly encouraging the construction industry to operate on the basis of 'added value'. Such debates echo the established concept of 'high value manufacturing' and associated trends towards servitization. Within construction, the so-called 'value agenda' draws heavily from the notion of integrated solutions. This is held to be especially appropriate in the context of PFI projects. Also relevant is the concept of service-led projects whereby the project rationale is driven by the client's objectives for delivering an enhanced service to its own customers. Such ideas are contextualized by a consideration of broader trends of privatization and outsourcing within and across the construction industry's client base. The current emphasis on integrated solutions reflects long-term trends within privatized client organizations towards the outsourcing of asset management capabilities. However, such trends are by no means uniform or consistent. An in-depth case study of three operating divisions within a major construction company illustrates that firms are unlikely to reorientate their business in response to the 'value agenda'. In the case of PFI, the tendency has been to establish specialist units for the purposes of winning work. Meanwhile, institutionally embedded operating routines within the rest of the business remain broadly unaffected.

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The built environment in which health and social care is delivered can have an impact on the efficiency and outcomes of care processes. The health-care estate is large and growing and is expensive to build, adapt and maintain. The design of these buildings is a complex, difficult and political process. Better use of care pathways as an input to the design and use of the built environment has the potential to deliver significant benefits. A number of variations on the idea of care pathways are already used in designing health-care buildings but this is under-researched. This paper provides a framework for thinking about care pathways and the health-care built environment. The framework distinguishes between five different pathway ‘types’ defined for the purpose of understanding the relationship between pathways and infrastructure. The five types are: ‘care pathways’, ‘integrated care pathways’, ‘patient pathways’, ‘patient journeys’ and ‘patient flows’. The built environment implications of each type are discussed and recommendations made for those involved in either building development or care pathway projects.

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The desirable coverage of the journal is considered including the need to focus on research which can lead to positive action. Criteria for establishing the desirability of research projects are proposed and these are then applied first, to four broad issues and, secondly, to the inputs and other requirements for a well functioning industry. Some conclusions are drawn as to the research most likely to enable action to be taken to improve the industry. It is found that certain other difficulties can sometimes be dealt with by experimentation with actual projects or, where there is consensus on desirable action, by bringing pressure to bear on those able to initiate change.