Potentials and current shortcomings in the cooperation between German centers for rare diseases and primary care physicians: results from the project TRANSLATE-NAMSE

Background The TRANSLATE-NAMSE project with the strengthening of the centers for rare diseases with their affiliation to the European Reference Networks was a major step towards the implementation of the German National Plan of Action for People with Rare Diseases establishing better care structures. As primary care physicians, general practitioners and pediatricians play a central role in the diagnosis of patients with rare disease, as it is usually them referring to specialists and rare disease centers. Therefore, the interface management between primary care physicians and the centers for rare diseases is of particular importance. Methods In a mixed-method-approach an anonymous postal survey of 1,500 randomly selected primary care physicians in Germany was conducted with focus on (1) knowledge about a center for rare diseases and how it works, (2) in case of cooperation, satisfaction with the services provided by centers, and (3) expectations and needs they have with regard to the centers. In addition, in-depth telephone interviews were conducted with physicians who had already referred patients to a center. Results In total, 248 physicians responded to the survey, and 15 primary care physicians were interviewed. We observed a wide lack of knowledge about the existence of (45.6% confirmed to know at least one center) about how to access rare disease centers (50.4% of those who know a center confirmed knowledge) and what the center specializes in. In case of cooperation the evaluation was mostly positive. Conclusion To improve medical care, the interplay between primary care physicians and rare disease centers needs to be strengthened. (1) To improve the communication, the objectives and functioning of the rare disease centers should become more visible. (2) Other projects dealing with the analysis and improvement of interface management between centers and primary care physicians, as described in the National Plan of Action for People with Rare Diseases, need to be implemented immediately. (3) If the project is evaluated positively, the structures of TRANSLATE-NAMSE should be introduced nationwide into the German health care system to ensure comprehensive, quality-assured care for people with rare diseases with special consideration of the key role of primary care physicians—also taking into account the financial expenditures of this new care model.

A Novel Development of TRIZ-Analogic Construction Interface Problem Identification and Solutions Framework

One of the critical factors of project success is the interface management. Past project interface management mainly relies on knowledge and experience of the project managers. The existing studies of project interface management also mainly focused on the definition and the classification of project interfaces. There is no workable and flexible framework for construction interface problem identification and solutions. This study conducted an analogic study of contradiction matrix at Theory of Inventive Problem Solving (TRIZ) to develop such a framework. This research collected around six hundred interface management cases from civil works and building projects. For comparison, this research defined an experimental group (TRIZ case) and a control group (experience-oriented solution case) based on the concept of clinical experiments in medical science to evaluate and improve the rationality of the matrix. Subsequently, based upon the theory of information retrieval (IR), this research conducted statistical evaluation and TRIZ features remedies to develop generalized construction interface problem identification and solutions. For solving project management interface problems, the TRIZ-analogic construction interface problem identification and solutions framework provides a systematic approach to develop more robust solutions for interface problems in construction engineering rather than just simply relying on intuitive experience.

A framework to measure collaboration in a construction project

Collaboration amongst stakeholders in a construction project plays a significant role in managing and completing a project successfully. It specifically helps in interface management amongst the stakeholders. Among the various aspects of collaboration, there are two key factors that predominant. Firstly, the psychological factors that define a person as a natural collaborator, and secondly, the project-level enablers that determine a collaborative project. Therefore, in this study, two inductive theories are developed- one for psychological factors and another for project-level enablers of collaboration. This study aims to identify the key psychological factors and project enablers associated with collaboration and develop a conceptual framework to measure collaboration in a construction project. The workflow of the conceptual framework is developed in the first part of the research, and the input requirements are quantified. Robust hypothesis testing methodology is adopted to identify the key psychological factors and project enablers. Hypotheses testing yields three specific psychological factors for defining a person as a natural collaborator, and six enablers are essential for facilitating project collaboration. These results are used as input parameters in the derived conceptual framework to measure the level of collaboration in a construction project.