Getting to zero: evidence-based healthcare risk management is key.

In this article we call for a new approach to patient safety improvement, one based on the emerging field of evidence-based healthcare risk management (EBHRM). We explore EBHRM in the broader context of the evidence-based healthcare movement, assess the benefits and challenges that might arise in adopting an evidence-based approach, and make recommendations for meeting those challenges and realizing the benefits of a more scientific approach.

Non-reflective boundary conditions for non-uniform mean velocity inlet and outlet flows

The numerical solution of problems in unbounded physical space requires a truncation of the computational domain to a reasonable size. As a result, the conditions on the artificial boundaries are generally unknown. Assumptions like constant pressure or velocities are only valid in the far field and lead to spurious reflections if applied on the boundaries of the truncated domain. A number of attempts have been made over the past decades to design conditions that prevent such reflections. One approach is based on characteristics. The standard analysis assumes a spatially uniform mean flow field but this is often impractical. In the present paper we show how to extend the formulation to the more general case of a non-uniform mean velocity field. A number of test cases are provided and our results compare favourably with other boundary conditions. In principle the present approach can be extended to include non-uniformities in all variables.

Transient flows in enclosures: A generalised approach for modelling the effects of geometry, heat gains and wind

Transient flows in a confined ventilated space induced by a buoyancy source of time-varying strength and an external wind are examined. The space considered has varying cross-sectional area with height. A generalised theoretical model is proposed to investigate the flow dynamics following the activation of an external wind and an internal source of buoyancy. To investigate the effect of geometry, we vary the angle of the wall inclination of a particular geometry in which a point source of constant buoyancy is activated in the absence of wind. Counter-intuitively the ventilation is worse and lower airflow rates are established for geometries of increasing cross-sectional areas with height. We investigate the effect of the source buoyancy strength by comparing two cases: (1) when the buoyancy input is constant and (2) when the buoyancy input gradually increases over time so that after a finite time the total buoyancy inputs for (1) and (2) are identical. The rate at which the source heat gains are introduced has a significant role on the flow behaviour as we find that, in case (2), a warmer layer and a more pronounced overshoot are obtained than in case (1). The effect of assisting and opposing wind on the transient ventilation of an enclosure of constant cross-sectional area with height and constant heat gains is examined. A Froude number Fr is used to define the relative strengths of the buoyancy-induced and wind-induced velocities and five different transient states and their associated critical Fr are identified. © 2010 Elsevier Ltd.

The effect of floor heat source area on the induced airflow in a room

We examine the role of heat source geometry in determining rates of airflow and thermal stratification in natural displacement ventilation flows. We modify existing models to account for heat sources of finite (non-zero) area, such as formed by a sun patch warming the floor of a room. Our model allows for predictions of the steady stratification and ventilation flow rates that develop in a room due to a circular heat source at floor level. We compare our theoretical predictions with predictions for the limiting cases of a point source of heat (yielding a stratified interior), and a uniformly heated floor (yielding a mixed interior). Our theory shows a smooth transition between these two limits, which themselves result in extremes of ventilation, as the ratio of the heat source radius to the room height increases. Our model for the transition from displacement to mixing ventilation is compared to previous work and demonstrates that the transition can occur for smaller sources than previously thought, particularly for rooms with large floor area compared to ceiling height. © 2009 Elsevier Ltd.

Ventilation effectiveness measures based on heat removal: Part 2. Application to natural ventilation flows

The three effectiveness measures based on the ability of a flow to flush buoyancy from a ventilated space proposed by Coffey and Hunt [Ventilation effectiveness measures based on heat removal-part 1. Definitions. Building and Environment, in press, doi:10.1016/j.buildenv.2006.03.016.] are applied to assess and compare two fundamental natural ventilation flows. We focus on the limiting cases of passive displacement and passive mixing ventilation flows during transient conditions. These transient flows occur when, for example, heat is purged from a building at night. Whilst it is widely recognised that mixing flows are less efficient at purging heat than displacement flows, our results indicate that, when a particular zone of a room is considered, displacement ventilation can result in lower effectiveness than mixing ventilation. When a room is considered as a whole, displacement ventilation yields higher effectiveness than mixing ventilation and we quantify these differences in terms of the geometry of the space and opening area. The proposed theoretical predictions are compared with effectiveness deduced from measurements made during laboratory experiments and show good agreement. © 2006 Elsevier Ltd. All rights reserved.

Thermal stratification produced by plumes and jets in enclosed spaces

The airflow and thermal stratification produced by a localised heat source located at floor level in a closed room is of considerable practical interest and is commonly referred to as a 'filling box'. In rooms with low aspect ratios H/R ≲ 1 (room height H to characteristic horizontal dimension R) the thermal plume spreads laterally on reaching the ceiling and a descending horizontal 'front' forms separating a stably stratified, warm upper region from cooler air below. The stratification is well predicted for H/R ≲ 1 by the original filling box model of Baines and Turner (J. Fluid. Mech. 37 (1968) 51). This model represents a somewhat idealised situation of a plume rising from a point source of buoyancy alone-in particular the momentum flux at the source is zero. In practical situations, real sources of heating and cooling in a ventilation system often include initial fluxes of both buoyancy and momentum, e.g. where a heating system vents warm air into a space. This paper describes laboratory experiments to determine the dependence of the 'front' formation and stratification on the source momentum and buoyancy fluxes of a single source, and on the location and relative strengths of two sources from which momentum and buoyancy fluxes were supplied separately. For a single source with a non-zero input of momentum, the rate of descent of the front is more rapid than for the case of zero source momentum flux and increases with increasing momentum input. Increasing the source momentum flux effectively increases the height of the enclosure, and leads to enhanced overturning motions and finally to complete mixing for highly momentum-driven flows. Stratified flows may be maintained by reducing the aspect ratio of the enclosure. At these low aspect ratios different long-time behaviour is observed depending on the nature of the heat input. A constant heat flux always produces a stratified interior at large times. On the other hand, a constant temperature supply ultimately produces a well-mixed space at the supply temperature. For separate sources of momentum and buoyancy, the developing stratification is shown to be strongly dependent on the separation of the sources and their relative strengths. Even at small separation distances the stratification initially exhibits horizontal inhomogeneity with localised regions of warm fluid (from the buoyancy source) and cool fluid. This inhomogeneity is less pronounced as the strength of one source is increased relative to the other. Regardless of the strengths of the sources, a constant buoyancy flux source dominates after sufficiently large times, although the strength of the momentum source determines whether the enclosure is initially well mixed (strong momentum source) or stably stratified (weak momentum source). © 2001 Elsevier Science Ltd. All rights reserved.

Product life trade-offs: what if products fail early?

Increasing product life allows the embodied emissions in products to be spread across a longer period but can mean that opportunities to improve use-phase efficiency are foregone. In this paper, a model that evaluates this trade-off is presented and used to estimate the optimal product life for a range of metal-intensive products. Two strategies that have potential to save emissions are explored: (1) adding extra embodied emissions to make products more sturdy, increasing product life, and (2) increasing frequency of use, causing early product failure to take advantage of improvements in use-phase efficiency. These strategies are evaluated for two specific case studies (long-life washing machines and more frequent use of vehicles through car clubs) and for a range of embodied and use-phase intensive products under different use-phase improvement rate assumptions. Particular emphasis is placed on the fact that products often fail neither at their design life nor at their optimal life. Policy recommendations are then made regarding the targeting of these strategies according to product characteristics and the timing of typical product failure relative to optimal product life.

Strategies for modeling turbulent flows in electronics

Hybrid methods based on the Reynolds Averaged Navier Stokes (RANS) equations and the Large Eddy Simulation (LES) formulation are investigated to try and improve the accuracy of heat transfer and surface temperature predictions for electronics systems and components. Two relatively low Reynolds number flows are studied using hybrid RANS-LES, RANS-Implicit-LES (RANS-ILES) and non-linear LES models. Predictions using these methods are in good agreement with each other, even using different grid resolutions. © 2008 IEEE.

Mixed nonlinear LES for DES suitable flows

It is shown that a new mixed nonlinear/eddy viscosity LES model reproduces profiles better than a number of competing nonlinear and mixed models for plane channel flow. The objective is an LES method that produces a fully resolved turbulent boundary layer and could be applied to a variety of aerospace problems that are currently studied with RANS, RANS-LES, or DES methods that lack a true turbulent boundary layer. There are two components to the new model. One an eddy viscosity based upon the advected subgrid scale energy and a relatively small coefficient. Second, filtered nonlinear terms based upon the Leray regularization. Coefficients for the eddy viscosity and nonlinear terms come from LES tests in decaying, isotropic turbulence. Using these coefficients, the velocity profile matches measurements data at Reτ ≈ 1000 exactly. Profiles of the components of kinetic energy have the same shape as in the experiment, but the magnitudes differ by about 25%. None of the competing LES gets the shape correct. This method does not require extra operations at the transition between the boundary layer and the interior flow.

Computation of transient and steady turbulent isothermal flows with an impinging rectangular jet

The computation of both transient and steady turbulent incompressible isothermal flows is studied. The flow is very complex, having streamline curvature, large vortex structures and stagnation resulting from an impinging rectangular jet. For transient computations, the standard k-ε model is adopted. For steady flows, the k-ε, high and low Reynolds number k-l and mixing length models are tried. Zonal approaches combining the above turbulence models are also investigated. None of the models are found to give satisfactory agreement with velocity measurements.