Towards cost effective emergency medical dispatching in the UK

1995 ◽  
Vol 2 (3) ◽  
pp. 116???122 ◽  
Author(s):  
E. GLUCKSMAN
Keyword(s):  
Cost Effective ◽  
Emergency Medical ◽  
The Uk ◽  
Emergency Medical Dispatching

Exploring the Benefits of Early Contractor Involvement (ECI) and the Mechanism for Automated 5D BIM Quantification Process in Offsite Modular Construction

2016 ◽  
Author(s):  
Tochukwu Moses ◽  
David Heesom ◽  
David Oloke ◽  
Martin Crouch
Keyword(s):  
Effective Means ◽  
Cost Effective ◽  
Modular Construction ◽  
Automated Quantification ◽  
Building Information ◽  
Project Risks ◽  
Value Add ◽  
The Uk ◽  
The Impact ◽  
Level 2

The UK Construction Industry through its Government Construction Strategy has recently been mandated to implement Level 2 Building Information Modelling (BIM) on public sector projects. This move, along with other initiatives is key to driving a requirement for 25% cost reduction (establishing the most cost-effective means) on. Other key deliverables within the strategy include reduction in overall project time, early contractor involvement, improved sustainability and enhanced product quality. Collaboration and integrated project delivery is central to the level 2 implementation strategy yet the key protocols or standards relative to cost within BIM processes is not well defined. As offsite construction becomes more prolific within the UK construction sector, this construction approach coupled with BIM, particularly 5D automated quantification process, and early contractor involvement provides significant opportunities for the sector to meet government targets. Early contractor involvement is supported by both the industry and the successive Governments as a credible means to avoid and manage project risks, encourage innovation and value add, making cost and project time predictable, and improving outcomes. The contractor is seen as an expert in construction and could be counter intuitive to exclude such valuable expertise from the pre-construction phase especially with the BIM intent of äóÖbuild it twiceäó», once virtually and once physically. In particular when offsite construction is used, the contractoräó»s construction expertise should be leveraged for the virtual build in BIM-designed projects to ensure a fully streamlined process. Building in a layer of automated costing through 5D BIM will bring about a more robust method of quantification and can help to deliver the 25% reduction in overall cost of a project. Using a literature review and a case study, this paper will look into the benefits of Early Contractor Involvement (ECI) and the impact of 5D BIM on the offsite construction process.

scholarly journals Sheep scab spatial distribution: the roles of transmission pathways

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Emily Joanne Nixon ◽  
Ellen Brooks-Pollock ◽  
Richard Wall
Keyword(s):  
Disease Transmission ◽  
Movement Control ◽  
Cost Effective ◽  
Infected Sheep ◽  
Disease Spread ◽  
Psoroptes Ovis ◽  
Long Distance ◽  
Sheep Scab ◽  
The Uk ◽  
The Impact

Abstract Background Ovine psoroptic mange (sheep scab) is a highly pathogenic contagious infection caused by the mite Psoroptes ovis. Following 21 years in which scab was eradicated in the UK, it was inadvertently reintroduced in 1972 and, despite the implementation of a range of control methods, its prevalence increased steadily thereafter. Recent reports of resistance to macrocyclic lactone treatments may further exacerbate control problems. A better understanding of the factors that facilitate its transmission are required to allow improved management of this disease. Transmission of infection occurs within and between contiguous sheep farms via infected sheep-to-sheep or sheep–environment contact and through long-distance movements of infected sheep, such as through markets. Methods A stochastic metapopulation model was used to investigate the impact of different transmission routes on the spatial pattern of outbreaks. A range of model scenarios were considered following the initial infection of a cluster of highly connected contiguous farms. Results Scab spreads between clusters of neighbouring contiguous farms after introduction but when long-distance movements are excluded, infection then self-limits spatially at boundaries where farm connectivity is low. Inclusion of long-distance movements is required to generate the national patterns of disease spread observed. Conclusions Preventing the movement of scab infested sheep through sales and markets is essential for any national management programme. If effective movement control can be implemented, regional control in geographic areas where farm densities are high would allow more focussed cost-effective scab management. Graphical Abstract

scholarly journals Innovation Pathways in the NHS: An Introductory Review

2021 ◽  
Author(s):  
Anmol Arora ◽  
Andrew Wright ◽  
Mark Cheng ◽  
Zahra Khwaja ◽  
Matthew Seah
Keyword(s):  
Health Care ◽  
National Health ◽  
Health Care Professionals ◽  
New Technologies ◽  
Care Delivery ◽  
Cost Effective ◽  
Care Models ◽  
Set Up ◽  
The Uk ◽  
Introductory Review

AbstractHealthcare as an industry is recognised as one of the most innovative. Despite heavy regulation, there is substantial scope for new technologies and care models to not only boost patient outcomes but to do so at reduced cost to healthcare systems and consumers. Promoting innovation within national health systems such as the National Health Service (NHS) in the United Kingdom (UK) has been set as a key target for health care professionals and policy makers. However, while the UK has a world-class biomedical research industry, several reports in the last twenty years have highlighted the difficulties faced by the NHS in encouraging and adopting innovations, with the journey from idea to implementation of health technology often taking years and being very expensive, with a high failure rate. This has led to the establishment of several innovation pathways within and around the NHS, to encourage the invention, development and implementation of cost-effective technologies that improve health care delivery. These pathways span local, regional and national health infrastructure. They operate at different stages of the innovation pipeline, with their scope and work defined by location, technology area or industry sector, based on the specific problem identified when they were set up. In this introductory review, we outline each of the major innovation pathways operating at local, regional and national levels across the NHS, including their history, governance, operating procedures and areas of expertise. The extent to which innovation pathways address current challenges faced by innovators is discussed, as well as areas for improvement and future study.

scholarly journals Cost-effectiveness of a domestic violence and abuse training and support programme in primary care in the real world: updated modelling based on an MRC phase IV observational pragmatic implementation study

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e021256 ◽  
Author(s):  
Estela Capelas Barbosa ◽  
Talitha Irene Verhoef ◽  
Steve Morris ◽  
Francesca Solmi ◽  
Medina Johnson ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health Service ◽  
Cost Effective ◽  
Uncertainty Interval ◽  
The Uk ◽  
The Cost ◽  
Training And Support ◽  
Domestic Violence And Abuse ◽  
Service Perspective ◽  
Health Service Perspective

ObjectivesTo evaluate the cost-effectiveness of the implementation of the Identification and Referral to Improve Safety (IRIS) programme using up-to-date real-world information on costs and effectiveness from routine clinical practice. A Markov model was constructed to estimate mean costs and quality-adjusted life-years (QALYs) of IRIS versus usual care per woman registered at a general practice from a societal and health service perspective with a 10-year time horizon.Design and settingCost–utility analysis in UK general practices, including data from six sites which have been running IRIS for at least 2 years across England.ParticipantsBased on the Markov model, which uses health states to represent possible outcomes of the intervention, we stipulated a hypothetical cohort of 10 000 women aged 16 years or older.InterventionsThe IRIS trial was a randomised controlled trial that tested the effectiveness of a primary care training and support intervention to improve the response to women experiencing domestic violence and abuse, and found it to be cost-effective. As a result, the IRIS programme has been implemented across the UK, generating data on costs and effectiveness outside a trial context.ResultsThe IRIS programme saved £14 per woman aged 16 years or older registered in general practice (95% uncertainty interval −£151 to £37) and produced QALY gains of 0.001 per woman (95% uncertainty interval −0.005 to 0.006). The incremental net monetary benefit was positive both from a societal and National Health Service perspective (£42 and £22, respectively) and the IRIS programme was cost-effective in 61% of simulations using real-life data when the cost-effectiveness threshold was £20 000 per QALY gained as advised by National Institute for Health and Care Excellence.ConclusionThe IRIS programme is likely to be cost-effective and cost-saving from a societal perspective in the UK and cost-effective from a health service perspective, although there is considerable uncertainty surrounding these results, reflected in the large uncertainty intervals.

scholarly journals case study in distributed team science in research using electronic health records

2018 ◽  
Vol 3 (3) ◽  
Author(s):  
Jiao Song ◽  
Elizabeth Elliot ◽  
Andrew D Morris ◽  
Joannes J Kerssens ◽  
Ashley Akbari ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Oral Anticoagulants ◽  
Cost Effective ◽  
Study Cohort ◽  
Team Science ◽  
Data Types ◽  
Health Records ◽  
Distributed Team ◽  
Electronic Health ◽  
The Uk

IntroductionDue to various regulatory barriers, it is increasingly difficult to move pseudonymised routine health data across platforms and among jurisdictions. To tackle this challenge, we summarized five approaches considered to support a scientific research project focused on the risk of the new non-vitamin K Target Specific Oral Anticoagulants (TSOACs) and collaborated between the Farr institute in Wales and Scotland. ApproachIn Wales, routinely collected health records held in the Secure Anonymous Information Linkage (SAIL) Databank were used to identify the study cohort. In Scotland, data was extracted from national dataset resources administered by the eData Research & Innovation Service (eDRIS) and stored in the Scottish National Data Safe Haven. We adopted a federated data and multiple analysts approach, but arranged simultaneous accesses for Welsh and Scottish analysts to generate study cohorts separately by implementing the same algorithm. Our study cohort across two countries was boosted to 6,829 patients towards risk analysis. Source datasets and data types applied to generate cohorts were reviewed and compared by analysts based on both sites to ensure the consistency and harmonised output.  DiscussionThis project used a fusion of two approaches among five considered. The approach we adopted is a simple, yet efficient and cost-effective method to ensure consistency in analysis and coherence with multiple governance systems. It has limitations and potentials of extending and scaling. It can also be considered as an initialisation of a developing infrastructure to support a distributed team science approach to research using Electronic Health Records (EHRs) across the UK and more widely. KeywordsTeam science, cross-jurisdictional data linkage, electronic health records

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