Justification for Research: the construction companies are facing barriers and challenges in BIM adoption as there is no clear guidance or best practice studies from which they can learn and build up their capacity for BIM use in order to increase productivity, efficiency, quality, and to attain competitive advantages in the global market and to achieve the targets in environmental sustainability. Purpose: this paper aims to explain a comprehensive and systemic evaluation and assessment of the relevant BIM technologies as part of the BIM adoption and implementation to demonstrate how efficiency gains have been achieved towards a lean architectural practice. Design/Methodology/Approach: The research is undertaken through a KTP (Knowledge transfer Partnership) project between the University of Salford and the John McCall Architects based in Liverpool, which is an SME (Small Medium Enterprise). The overall aim of KTP is to develop Lean Design Practice through the BIM adoption and implementation. The overall BIM implementation approach uses a socio-technical view in which it does not only consider the implementation of technology but also considers the socio-cultural environment that provides the context for its implementation. The technology adoption methodology within the BIM implementation approach is the action research oriented qualitative and quantitative research for discovery, comparison, and experimentation as the KTP project with JMA provides an environment for "learning by doing" Findings: research has proved that BIM technology adoption should be undertaken with a bottom-up approach rather than top-down approach for successful change management and dealing with the resistance to change. As a result of the BIM technology adoption, efficiency gains are achieved through the piloting projects and the design process is improved through the elimination of wastes and value generation. Originality/Value: successful BIM adoption needs an implementation strategy. However, at operational level, it is imperative that professional guidelines are required as part of the implementation strategy. This paper introduces a systematic approach for BIM technology adoption based on a case study implementation and it demonstrates a guideline at operational level for other SME companies of architectural practices.
ABSTRACT:Severe issues about data acquisition and management arise during the design creation and development due to complexity, uncertainty and ambiguity. BIM (Building Information Modelling) is a tool for a team based lean design approach towards improved architectural practice across the supply chain. However, moving from a CAD (Computer Aided Design) approach to BIM (Building Information Modelling) represents a fundamental change for individual disciplines and the construction industry as a whole. Although BIM has been implemented by large practices, it is not widely used by SMEs (Small and Medium Sized Enterprises). Purpose: This paper aims to present a systematic approach for BIM implementation for Architectural SMEs at the organizational level Design/Methodology/Approach: The research is undertaken through a KTP (Knowledge transfer Partnership) project between the University of Salford and John McCall Architects (JMA) a SME based in Liverpool. The overall aim of the KTP is to develop lean design practice through BIM adoption. The BIM implementation approach uses a socio-technical view which does not only consider the implementation of technology but also considers the socio-cultural environment that provides the context for its implementation. The action research oriented qualitative and quantitative research is used for discovery, comparison, and experimentation as it provides "learning by doing". Findings: The strategic approach to BIM adoption incorporated people, process and technology equally and led to capacity building through the improvements in process, technological infrastructure and upskilling of JMA staff to attain efficiency gains and competitive advantages. Originality/Value : This paper introduces a systematic approach for BIM adoption based on the action research philosophy and demonstrates a roadmap for BIM adoption at the operational level for SME companies.
BackgroundLittle is known about patient/family comfort voicing care concerns in real time, especially in the intensive care unit (ICU) where stakes are high and time is compressed. Experts advocate patient and family engagement in safety, which will require that patients/families be able to voice concerns. Data on patient/family attitudes and experiences regarding speaking up are sparse, and mostly include reporting events retrospectively, rather than pre-emptively, to try to prevent harm. We aimed to (1) assess patient/family comfort speaking up about common ICU concerns; (2) identify patient/family-perceived barriers to speaking up; and (3) explore factors associated with patient/family comfort speaking up.MethodsIn collaboration with patients/families, we developed a survey to evaluate speaking up attitudes and behaviours. We surveyed current ICU families in person at an urban US academic medical centre, supplemented with a larger national internet sample of individuals with prior ICU experience.Results105/125 (84%) of current families and 1050 internet panel participants with ICU history completed the surveys. Among the current ICU families, 50%–70% expressed hesitancy to voice concerns about possible mistakes, mismatched care goals, confusing/conflicting information and inadequate hand hygiene. Results among prior ICU participants were similar. Half of all respondents reported at least one barrier to voicing concerns, most commonly not wanting to be a ‘troublemaker’, ‘team is too busy’ or ‘I don’t know how’. Older, female participants and those with personal or family employment in healthcare were more likely to report comfort speaking up.ConclusionSpeaking up may be challenging for ICU patients/families. Patient/family education about how to speak up and assurance that raising concerns will not create ‘trouble’ may help promote open discussions about care concerns and possible errors in the ICU.
Electrocardiograms (ECGs) are frequently ordered in the pediatric emergency department (ED). Pediatric cardiologists are generally not asked to interpret every ECG; thus, ED patient management is often guided by the ED physicians' ECG interpretation. The objective of this study was to analyze the accuracy of ECG interpretation by ED physicians and a computer-generated interpretation and compare the two. A 12-month prospective study was performed in a pediatric ED. All patients (<22 years) who had an ECG in the ED were included. The ED physicians and the computer interpretation were compared to a reference standard. Each electrocardiographic diagnosis, as well as the ECG as a whole, was assigned to one of the following predetermined classes: I, normal sinus rhythm; II, minimal clinical significance; III, indeterminate clinical significance; IV, those of definite clinical significance. Both groups correctly interpreted all normal (class I) ECGs. The computer correctly interpreted approximately 75% of the class II and class III ECGs, whereas the ED physicians correctly interpreted 36% of both groups. For the class IV ECGs, both the computer and the ED physicians performed poorly, correctly interpreting just 14% and 28%, respectively. The computer proved to be more accurate than the ED physicians in interpreting ECGs of less than critical significance (classes II and III), but neither group was able to correctly interpret even a simple majority of the most significant abnormalities (class IV). We speculate that distributing the computer-generated interpretation to the ED physicians and formal review of all ED ECGs by a skilled interpreter may decrease the number of missed diagnoses.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.