Competitive advantage through proprietary erp implementation: analysis of the project Väinämö

In the market where companies similar in size and resources are competing, it is challenging to have any advantage over others. In order to stay afloat company needs to have capability to perform with fewer resources and yet provide better service. Hence development of efficient processes which can cut costs and improve performance is crucial. As business expands, processes become complicated and large amount of data needs to be managed and available on request. Different tools are used in companies to store and manage data, which facilitates better production and transactions. In the modern business world the most utilized tool for that purpose is ERP - Enterprise Resource Planning system. The focus of this research is to study how competitive advantage can be achieved by implementing proprietary ERP system in the company; ERP system that is in-house created, tailor made to match and align business needs and processes. Market is full of ERP software, but choosing the right one is a big challenge. Identifying the key features that need improvement in processes and data management, choosing the right ERP, implementing it and the follow-up is a long and expensive journey companies undergo. Some companies prefer to invest in a ready-made package bought from vendor and adjust it according to own business needs, while others focus on creating own system with in-house IT capabilities. In this research a case company is used and author tries to identify and analyze why organization in question decided to pursue the development of proprietary ERP system, how it has been implemented and whether it has been successful. Main conclusion and recommendation of this research is for companies to know core capabilities and constraints before choosing and implementing ERP system. Knowledge of factors that affect system change outcome is important, to make the right decisions on strategic level and implement on operational level. Duration of the project in the case company has lasted longer than anticipated. It has been reported that in cases of buying ready product from vendor, projects are delayed and completed over budget as well. In general, in case company implementation of proprietary ERP has been successful both from business performance figures and usability of system by employees. In terms of future research, conducting a study to calculate statistically ROI of both approaches; of buying ready product and creating own ERP will be beneficial.

Miten kehittää ketjutoimintaa rautakaupassa; case Rautanet

TIIVISTELMÄ Tekijä: Urpalainen, Mika Tutkielman nimi: Miten kehittää ketjuliiketoimintaa rautakaupassa Case: Rautanet Tiedekunta: Kauppatieteellinen tiedekunta Pääaine / Maisteriohjelma: Kansainvälinen markkinointi Vuosi: 2014 Pro gradu – tutkielma: Lappeenrannan teknillinen yliopisto, 129 sivua, 28 kuvaa, 15 taulukkoa ja kaksi liitettä Tarkastajat: prof. Olli Kuivalainen, prof. Sanna-Katriina Asikainen Hakusanat: ketjutoiminta, Rautanet-ketju, sitoutuminen, markkinointi Keywords: Chain business, Rautanet-chain, commitment, marketing Rautanet-ketju on heterogeeninen, vapaaehtoisuuteen perustuva rautakauppaketju, joka on perustettu vuonna 1998. Tämän tutkimuksen tarkoituksena on selvittää Rautanet-kauppiaille ja koko ketjuorganisaatiolle ketjutoiminnan etuja, haasteita sekä kauppiaskunnan näkemyksiä ketjutoiminnasta tänä päivänä. Tutkimusmenetelmä oli kvalitatiivinen ja kvantitatiivinen, se perustui kauppiaille lähetettyyn kyselylomakkeeseen, joka sisälsi Likert-asteikollisia kysymyksiä 36 ja 3 kysymystä joihin vastattiin kirjallisesti. Kysymykset sisälsivät aiheita mm. Sitoutumisesta, markkinoinnista, sidosryhmistä jne. Tutkimusjoukkona oli Rautanet-kauppiaat. Kokonaisuutena arvioiden kauppiaat ovat tyytyväisiä ketjun toimintaan. Suurimmat edut ovat markkinointituki kuvastojen avulla ja ketjun voima, jonka kauppiaat tekevät yhdessä. Etuna voidaan pitää myös kauppiaiden sitoutumishalukkuutta ketjuun. Suurimpana haasteena on ehkä itsenäisyyden menettämisen pelko. Rautanet-ketjun toiminta on hyvällä tasolla. Kilpailun kiristyessä myös Rautanet-ketjun kauppiaiden sitoutumishalukkuutta on pidettävä yllä. Ketjuorganisaation on kunnioitettava kauppiaan itsenäisyyttä ja kuunneltava jatkossakin kauppiaita. Ketjun ja kauppiaiden selkeä yhteinen päämäärä, rakentaa vahva ketju, joka pystyy vastaamaan kilpailijoiden haasteisiin, on hyvin paljon riippuvainen yhdessä tekemisen halusta.

Bariatric and Post-Bariatric Surgery: from Metabolic Surgery to Plastic Surgery Indications

Background: Controversy exists concerning indications and outcomes of major bariatric surgery procedures. Massive weight loss after bariatric surgery leads to excess skin with functional and aesthetic impairments. The aim of this study was to investigate the major bariatric surgery procedures and their outcomes in two specific subgroups of morbidly obese patients, ≥55-year-olds and the superobese. Further aims were to evaluate whether the preoperative weight loss correlates with laparoscopic gastric bypass complications. The prevalence and impact of excess skin and the desire for body contouring after bariatric surgery were also studied. Patients and Methods: Data from patients who underwent Laparoscopic Adjustable Gastric Banding (LAGB) and Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) at Vaasa Central Hospital were collected and postoperative outcomes were evaluated according to the BMI, age and preoperative weight loss. Patients who had undergone bariatric surgery procedures were asked to complete a questionnaire to estimate any impairment due to redundant skin and to analyse each patient’s desire for body contouring by area. Results: No significant difference was found in operative time, hospital stay, or overall early postoperative morbidity between LAGB and LRYGB. Mean excess weight loss percents (EWL%) at 6 and 12 months after LRYGB were significantly higher. A significant difference was found in operative time favouring patients <55 years. Intraoperative complications were significantly more frequent in the group aged >55 years. No significant difference was detected in overall postoperative morbidity rates. A significant difference was found in operative time and hospital stay favouring all patients who lost weight preoperatively. Most patients reported problems with redundant skin, especially on the abdomen, upper arms and rear/buttocks, which impaired daily physical activity in half of them. Excess skin was significantly associated with female gender, weight loss and ΔBMI. Patients with a WL >20 kg, ΔBMI ≥10 kg/m2 and an EWL % > 50 showed a significantly surplus skin discomfort (p < 0.001). Most patients desired body contouring surgery, with high or very high desire for waist/abdomen (62.2%), upper arm (37.6%), chest/breast (28.3%), and rear/buttock (35.6%) contouring. Conclusions: LRYGB is effective and safe in superobese (BMI >50) and elderly (>55 years) patients. A preoperative weight loss >5% is recommended to improve the outcomes and reduce complications. A WL >20 kg, ΔBMI ≥10 kg/m2 and an EWL % > 50 are associated with a higher functional discomfort due to redundant skin and to a stronger desire for body contouring plastic surgery.

The effects of congestion in the daily management of a trauma hospital

Today’s healthcare organizations are under constant pressure for change, as hospitals should be able to offer their patients the best possible medical care with limited resources and, at the same time, to retain steady efficiency level in their operation. This is challenging, especially in trauma hospitals, in which the variation in the patient cases and volumes is relatively high. Furthermore, the trauma patient's care requires plenty of resources as most the patients have to be treated as single cases. Occasionally, the sudden increases in demand causes congestion in the operations of the hospital, which in Töölö hospital appears as an increase in the surgery waiting times within the yellow urgency class patients. An increase in the surgery waiting times may cause the diminution of the patient's condition, which also raises the surgery risks. The congestion itself causes overloading of the hospital capacity and staff. The aim of this master’s thesis is to introduce the factors contributing to the trauma process, and to examine the correlation between the different variables and the lengthened surgery waiting times. The results of this study are based on a three-year patient data and different quantitative analysis. Based on the analysis, a daily usable indicator was created in order to support the decision making in the operations management. By using the selected indicator, the effects of congestion can be acknowledged and the corrective action can also be taken more proactively.

Incidence, risk factors and prognostic factors of acute renal failure in patients admitted to an intensive care unit

The objective of the present study was to assess the incidence, risk factors and outcome of patients who develop acute renal failure (ARF) in intensive care units. In this prospective observational study, 221 patients with a 48-h minimum stay, 18-year-old minimum age and absence of overt acute or chronic renal failure were included. Exclusion criteria were organ donors and renal transplantation patients. ARF was defined as a creatinine level above 1.5 mg/dL. Statistics were performed using Pearsons' chi2 test, Student t-test, and Wilcoxon test. Multivariate analysis was run using all variables with P < 0.1 in the univariate analysis. ARF developed in 19.0% of the patients, with 76.19% resulting in death. Main risk factors (univariate analysis) were: higher intra-operative hydration and bleeding, higher death risk by APACHE II score, logist organ dysfunction system on the first day, mechanical ventilation, shock due to systemic inflammatory response syndrome (SIRS)/sepsis, noradrenaline use, and plasma creatinine and urea levels on admission. Heart rate on admission (OR = 1.023 (1.002-1.044)), male gender (OR = 4.275 (1.340-13642)), shock due to SIRS/sepsis (OR = 8.590 (2.710-27.229)), higher intra-operative hydration (OR = 1.002 (1.000-1004)), and plasma urea on admission (OR = 1.012 (0.980-1044)) remained significant (multivariate analysis). The mortality risk factors (univariate analysis) were shock due to SIRS/sepsis, mechanical ventilation, blood stream infection, potassium and bicarbonate levels. Only potassium levels remained significant (P = 0.037). In conclusion, ARF has a high incidence, morbidity and mortality when it occurs in intensive care unit. There is a very close association with hemodynamic status and multiple organ dysfunction.

Rankapuun ja -hakkeen laadun vaihtelu terminaalivarastoinnissa

Työssä tutkittiin polttoaineterminaalissa varastoitavan puupolttoaineen laadunmuutoksia. Tutkimuksessa tarkasteltiin hakettamattomien rankapuiden ja rankapuuhakkeen kosteuden ja lämpöarvon muutosta. Myös kuiva-ainetappiota tutkittiin aikaisempien tutkimusten perusteella. Tutkimusaineisto kerättiin Etelä-Savon Energian polttoaineterminaaleista. Kosteus-pitoisuuksia mitattiin Hydromette M2050 -pikakosteusmittarilla ja uunikuivaus-menetelmällä standardin SFS-EN 14774 mukaisesti. Tutkimuksessa huomattiin pikakosteusmittarin toimivan riittävän luotettavalla tasolla rankapuiden mittauksissa, mutta hakkeen mittauksissa mittari osoittautui toimimattomaksi. Varastointiaika ei vaikuttanut polttoaineiden lämpöarvoihin, mutta kosteuspitoisuus vaihteli suuresti. Tutkimustuloksista pääteltiin rangan kuivuvan terminaalivarastossa ja hakkeen kosteuden pysyvän vakiona. Energiasisällön puolesta rankapuuta voidaan varastoida yli 2 vuotta, mutta hakkeen varastointiaika tulisi pitää mahdollisimman lyhyenä.

Maakaasupolttimen säätöjärjestelmän kehittäminen

Jatkuvasti kiristyvät päästörajoitukset pakottavat teollisuuden kehittämään uusia ratkaisuja päästöjen vähentämiseksi. Hiilimonoksidin ja typen oksidien päästörajoitukset ovat erityi-sen tiukat esimerkiksi Kiinassa ja Yhdysvalloissa. Maakaasun ja ilman epätäydellisessä pa-lamisessa muodostuu hiilimonoksidia ja typen oksideja. Käytännön sovelluksissa palaminen on lähes aina epätäydellistä polttoaineen ja ilman epätäydellisen sekoittumisen takia, joten palamisreaktiossa muodostuva savukaasu sisältää edellä mainittuja haitallisia komponentteja lähes poikkeuksetta. Savukaasua voidaan puhdistaa erilaisilla menetelmillä ennen sen pää-tymistä ympäristöön. Tässä diplomityössä esitellään maakaasupoltinjärjestelmän keskeiset komponentit ja aihee-seen liittyvät tarpeelliset käsitteet sekä suunnitellaan polttoaine-ilma-seossuhdesäätö eräälle maakaasupoltinjärjestelmälle. Säädön ensisijaisena tavoitteena on pitää seossuhde mahdolli-simman tarkasti halutussa arvossa savukaasun puhdistuksen kannalta. Lisäksi säädön on tarkoitus taata mahdollisimman hyvä suorituskyky transienttitilanteissa. Järjestelmän eri osien toiminta mallinnetaan ja analysoidaan. Mallinnuksen perusteella suunnitellaan ja simu-loidaan säätöjärjestelmä. Suunniteltu säätöjärjestelmä toteutetaan osaksi polttolaitoksen automaatiojärjestelmää. Mittaustulokset osoittavat, että päästöjen kannalta säätö pitää seossuhteen riittävän tarkasti halutussa arvossa: hiilimonoksidin ja typen oksidien päästöt ovat asetettujen rajojen sisällä. Testiajojen perusteella prosessi on kuitenkin erittäin häiriöinen ja transienttitilanteissa ei saavuteta simulointien mukaista suorituskykyä.

Outcomes and organ dysfunctions of critically ill patients with systemic lupus erythematosus and other systemic rheumatic diseases

Our objective was to compare the pattern of organ dysfunctions and outcomes of critically ill patients with systemic lupus erythematosus (SLE) with patients with other systemic rheumatic diseases (SRD). We studied 116 critically ill SRD patients, 59 SLE and 57 other-SRD patients. The SLE group was younger and included more women. Respiratory failure (61%) and shock (39%) were the most common causes of ICU admission for other-SRD and SLE groups, respectively. ICU length-of-stay was similar for the two groups. The 60-day survival adjusted for the groups’ baseline imbalances was not different (P = 0.792). Total SOFA scores were equal for the two groups at admission and during ICU stay, although respiratory function was worse in the other-SRD group at admission and renal and hematological functions were worse in the SLE group at admission. The incidence of severe respiratory dysfunction (respiratory SOFA >2) at admission was higher in the other-SRD group, whereas severe hematological dysfunction (hematological SOFA >2) during ICU stay was higher in the SLE group. SLE patients were younger and displayed a decreased incidence of respiratory failure compared to patients with other-SRDs. However, the incidences of renal and hematological failure and the presence of shock at admission were higher in the SLE group. The 60-day survival rates were similar.

Vancomycin-resistant enterococcus outbreak in a pediatric intensive care unit: report of successful interventions for control and prevention

The objective of this study is to retrospectively report the results of interventions for controlling a vancomycin-resistant enterococcus (VRE) outbreak in a tertiary-care pediatric intensive care unit (PICU) of a University Hospital. After identification of the outbreak, interventions were made at the following levels: patient care, microbiological surveillance, and medical and nursing staff training. Data were collected from computer-based databases and from the electronic prescription system. Vancomycin use progressively increased after March 2008, peaking in August 2009. Five cases of VRE infection were identified, with 3 deaths. After the interventions, we noted a significant reduction in vancomycin prescription and use (75% reduction), and the last case of VRE infection was identified 4 months later. The survivors remained colonized until hospital discharge. After interventions there was a transient increase in PICU length-of-stay and mortality. Since then, the use of vancomycin has remained relatively constant and strict, no other cases of VRE infection or colonization have been identified and length-of-stay and mortality returned to baseline. In conclusion, we showed that a bundle intervention aiming at a strict control of vancomycin use and full compliance with the Hospital Infection Control Practices Advisory Committee guidelines, along with contact precautions and hand-hygiene promotion, can be effective in reducing vancomycin use and the emergence and spread of vancomycin-resistant bacteria in a tertiary-care PICU.

Effect of heat and moisture exchangers on the prevention of ventilator-associated pneumonia in critically ill patients

Ventilator-associated pneumonia (VAP) remains one of the major causes of infection in the intensive care unit (ICU) and is associated with the length of hospital stay, duration of mechanical ventilation, and use of broad-spectrum antibiotics. We compared the frequency of VAP 10 months prior to (pre-intervention group) and 13 months after (post-intervention group) initiation of the use of a heat and moisture exchanger (HME) filter. This is a study with prospective before-and-after design performed in the ICU in a tertiary university hospital. Three hundred and fourteen patients were admitted to the ICU under mechanical ventilation, 168 of whom were included in group HH (heated humidifier) and 146 in group HME. The frequency of VAP per 1000 ventilator-days was similar for both the HH and HME groups (18.7 vs 17.4, respectively; P = 0.97). Duration of mechanical ventilation (11 vs 12 days, respectively; P = 0.48) and length of ICU stay (11 vs 12 days, respectively; P = 0.39) did not differ between the HH and HME groups. The chance of developing VAP was higher in patients with a longer ICU stay and longer duration of mechanical ventilation. This finding was similar when adjusted for the use of HME. The use of HME in intensive care did not reduce the incidence of VAP, the duration of mechanical ventilation, or the length of stay in the ICU in the study population.

Application of continuous positive airway pressure in the delivery room: a multicenter randomized clinical trial

This study evaluated whether the use of continuous positive airway pressure (CPAP) in the delivery room alters the need for mechanical ventilation and surfactant during the first 5 days of life and modifies the incidence of respiratory morbidity and mortality during the hospital stay. The study was a multicenter randomized clinical trial conducted in five public university hospitals in Brazil, from June 2008 to December 2009. Participants were 197 infants with birth weight of 1000-1500 g and without major birth defects. They were treated according to the guidelines of the American Academy of Pediatrics (APP). Infants not intubated or extubated less than 15 min after birth were randomized for two treatments, routine or CPAP, and were followed until hospital discharge. The routine (n=99) and CPAP (n=98) infants studied presented no statistically significant differences regarding birth characteristics, complications during the prenatal period, the need for mechanical ventilation during the first 5 days of life (19.2 vs 23.4%, P=0.50), use of surfactant (18.2 vs 17.3% P=0.92), or respiratory morbidity and mortality until discharge. The CPAP group required a greater number of doses of surfactant (1.5 vs 1.0, P=0.02). When CPAP was applied to the routine group, it was installed within a median time of 30 min. We found that CPAP applied less than 15 min after birth was not able to reduce the need for ventilator support and was associated with a higher number of doses of surfactant when compared to CPAP applied as clinically indicated within a median time of 30 min.

Examining the side effects of sucrose for pain relief in preterm infants: a case-control study

Sucrose solution is recommended as relevant pain relief management in neonates during acute painful procedures; however, only a few studies have analyzed the potentially adverse effects of sucrose administration to preterm neonates. The goal of this study was to examine the potential side effects of sucrose for pain relief in preterm infants, assessing feeding and weight gain during hospitalization and their feeding patterns postdischarge. The study sample consisted of 43 preterm neonates divided into two groups: a sucrose group (SG, n=18) and a control group (CG, n=25) in which no sucrose was administered. The SG received 0.5 mL/kg 25% oral sucrose for 2 min prior to all acute painful procedures during three consecutive days. A prospective review of medical charts was performed for all samples. The study was done prior to implementation of the institutional sucrose guidelines as a routine service, and followed all ethical requirements. There were no statistically significant differences between groups in terms of weight gain, length of stay with orogastric tubes, and parenteral feeding. Postdischarge, infant nutritional intake included feeding human milk to 67% of the SG and 74% of the CG. There were no statistically significant differences between groups regarding human milk feeding patterns postdischarge. Neonate feeding patterns and weight gain were unaffected following the short-term use of sucrose for pain relief.

Histidine-tryptophan-ketoglutarate solution decreases mortality and morbidity in high-risk patients with severe pulmonary arterial hypertension associated with complex congenital heart disease: an 11-year experience from a single institution

Cardioplegic reperfusion during a long term ischemic period interrupts cardiac surgery and also increases cellular edema due to repeated solution administration. We reviewed the clinical experiences on myocardial protection of a single perfusion with histidine-tryptophan-ketoglutarate (HTK) for high-risk patients with severe pulmonary arterial hypertension associated with complex congenital heart disease. This retrospective study included 101 high-risk patients undergoing arterial switch operation between March 2001 and July 2012. We divided the cohort into two groups: HTK group, myocardial protection was carried out with one single perfusion with HTK solution; and St group, myocardial protection with conventional St. Thomas' crystalloid cardioplegic solution. The duration of cardiopulmonary bypass did not differ between the two groups. The mortality, morbidity, ICU stay, post-operative hospitalization time, and number of transfusions in HTK group were lower than those in St group (P<0.05). Univariate and multivariate analysis showed that HTK is a statistically significant independent predictor of decreased early mortality and morbidity (P<0.05). In conclusion, HTK solution seems to be an effective and safe alternative to St. Thomas' solution for cardioplegic reperfusion in high-risk patients with complex congenital heart disease.

Asleep or not asleep? Evaluation of the Quality of Patients’ Sleep in Critical Care Nursing

Sleep is important for the recovery of a critically ill patient, as lack of sleep is known to influence negatively a person’s cardiovascular system, mood, orientation, and metabolic and immune function and thus, it may prolong patients’ intensive care unit (ICU) and hospital stay. Intubated and mechanically ventilated patients suffer from fragmented and light sleep. However, it is not known well how non-intubated patients sleep. The evaluation of the patients’ sleep may be compromised by their fatigue and still position with no indication if they are asleep or not. The purpose of this study was to evaluate ICU patients’ sleep evaluation methods, the quality of non-intubated patients’ sleep, and the sleep evaluations performed by ICU nurses. The aims were to develop recommendations of patients’ sleep evaluation for ICU nurses and to provide a description of the quality of non-intubated patients’ sleep. The literature review of ICU patients’ sleep evaluation methods was extended to the end of 2014. The evaluation of the quality of patients’ sleep was conducted with four data: A) the nurses’ narrative documentations of the quality of patients’ sleep (n=114), B) the nurses’ sleep evaluations (n=21) with a structured observation instrument C) the patients’ self-evaluations (n=114) with the Richards-Campbell Sleep Questionnaire, and D) polysomnographic evaluations of the quality of patients’ sleep (n=21). The correspondence of data A with data C (collected 4–8/2011), and data B with data D (collected 5–8/2009) were analysed. Content analysis was used for the nurses’ documentations and statistical analyses for all the other data. The quality of non-intubated patients’ sleep varied between individuals. In many patients, sleep was light, awakenings were frequent, and the amount of sleep was insufficient as compared to sleep in healthy people. However, some patients were able to sleep well. The patients evaluated the quality of their sleep on average neither high nor low. Sleep depth was evaluated to be the worst and the speed of falling asleep the best aspect of sleep, on a scale 0 (poor sleep) to 100 (good sleep). Nursing care was mostly performed while the patients were awake, and thus the disturbing effect was low. The instruments available for nurses to evaluate the quality of patients’ sleep were limited and measured mainly the quantity of sleep. Nurses’ structured observatory evaluations of the quality of patients’ sleep were correct for approximately two thirds of the cases, and only regarding total sleep time. Nurses’ narrative documentations of the patients’ sleep corresponded with patients’ self-evaluations in just over half of the cases. However, nurses documented several dimensions of sleep that are not included in the present sleep evaluation instruments. They could be classified according to the components of the nursing process: needs assessment, sleep assessment, intervention, and effect of intervention. Valid, more comprehensive sleep evaluation methods for nurses are needed to evaluate, document, improve and study patients’ quality of sleep.

Sustainable Development – the Key to Competitiveness CSR as an added value to Alstom’s corporate performance

Corporate social responsibility or CSR is today a widely recognized concept which is receiving in- creasing popularity extremely rapidly, especially in the business world. The pressure on companies to carry out their business practices in ethical manners, which promote the wellbeing of the environment and society, is coming from all directions and all stakeholders. Alstom, a French multinational conglomerate operating in the rail transport and energy industry, is no exception to this norm. This company, which will be used as the case example in this thesis, is being brought to bay in terms of engaging in CSR practices and practicing business with high ethics. It is surely not a negatively conceived phenomenon that CSR is being put on a pedestal – quite the opposite. Instead of corporations practicing CSR only to meet their stakeholder requirements through practicing window dressing, many corporations actually strive to benefit from the practice of corporate social business. In addition to bringing benefit to externals a corporation such as Alstom itself can benefit from being involved in CSR. The purpose of this thesis is to evaluate the current strategic values and the future perspectives of CSR at Alstom and moreover the added value which the practice of CSR could bring Alstom as a business. A set of perspectives from a futures studies viewpoint is looked at, with critical examination of the company’s current corporate practices as well as the CSR related studies and theories written for corporations. Through this, some solutions and practices will be suggested to Alstom in order for it to fully utilize the potential of corporate social business and the value it can bring in the most probable futures that the company is expected to face. By utilizing the Soft Systems Methodology (SSM), a method mainly used in organizations to solve problematic issues in management and policy contexts, a process is developed to see what improvements could be of help in improving Alstom and its way towards involving CSR in its business practices even more than it currently does. Alstom is already deeply involved in the practicing of CSR and its vision has a strong emphasis on this popular concept of today. In order to stay in the game and to use CSR as a competitive advantage to the company, Alstom ought to embed corporate social practices even deeper in its organizational culture by using them as a tool to reduce risk and costs, increasing employee commitment and customer loyalty and to attract socially responsible investors, just to name a few. CSR as a concept is seen to have great potential in the future, an opportunity Alstom will not miss.