www.haciric.org www.haciric.org HaCIRIC 11 - Global health infrastructure – Global health infrastructure HaCIRIC11 HaCIRIC International Conference 2011 challenges for the next decade 26 - 28 September, Manchester, UK HaCIRIC Partners Global health infrastructure – challenges for the next decade Delivering innovation, demonstrating the benefits | Conference Proceedings Proceedings Conference Conference Proceedings | 4th Annual Conference of the Health and Care Infrastructure Research and Innovation Centre 26 - 28 September, Manchester, UK Manchester, 26 - 28 September, HaCIRIC Tanaka Building Imperial College Business School South Kensington Campus London SW7 2AZ T: +44 (0)20 7594 3084 E: [email protected] www.haciric.org 90946.003 B5 4pp Proceedings cover (spreads with spine) r3.indd 1 12/09/2011 17:10 PROCEEDINGS HaCIRIC INTERNATIONAL CONFERENCE 2011 Global health infrastructure – challenges for the next decade. Delivering innovation, demonstrating the benefits. Manchester, UK September 26-28, 2011 Proceedings | HaCIRIC International Conference 2011 CONFERENCE ORGANISATION COMMITTEE James Barlow Jack O’Sullivan Bora Trimçev SCIENTIFIC COMMITTEE Sepideh Arkani, University of Reading, UK Phil Astley, University College London, UK Steffen Bayer, Imperial College London, UK Jane Carthey, Centre for Health Assets Australasia, Australia Rachel Cooper, University of Lancaster, UK Geert Dewulf, University of Twente, The Netherlands Jonathan Erskine, Durham University, UK Chris Harty, University of Reading, UK Jane Hendy, Imperial College London, UK Mike Kagioglou, University of Salford, UK Jun Lu, Loughborough University, UK Sameedha Mahadkar, Loughborough University, UK Grant Mills, Loughborough University, UK Andrew Price, Loughborough University, UK Stelios Sapountzis, University of Salford, UK Shariful Shikder, Loughborough University, UK Derek Thomson, Loughborough University, UK The Copyright remains with the original authors of the paper 1 Proceedings | HaCIRIC International Conference 2011 PREFACE Since HaCIRIC started in 2006, we have expanded the scale of our activities and depth of our knowledge of healthcare infrastructure challenges. We are now established as an international centre of expertise and research. But the world around us has not stood still. Our future programme is responding to the changing global context for delivering healthcare. The UK is no different from all major developed countries in its need to meet an expanding demand for healthcare while simultaneously controlling rising costs and improving quality and safety. Business as usual will not be an option for governments and healthcare organisations. The solutions may require system redesign, involving new combinations of technology, services and infrastructure. Four steps are likely to be particularly important in the years to come: shifting care patterns between different healthcare settings, rethinking the use of technological and physical infrastructure to support that change, developing new organisational and funding models to make it work, and encouraging change by generating rigorous and accessible evidence to demonstrate the changes that really do work. The right combinations of technology, people and infrastructure may be hard to identify and will involve difficult implementation challenges. The political environment – how to accommodate diverse stakeholders to optimise outcomes – will add another layer of complexity. And today’s preference for ‘local solutions’ can mean that decision-makers may lack expertise in tackling tricky issues, as well as leading to increased fragmentation of the system. HaCIRIC’s work is therefore essential – unless the key questions are researched, with solutions properly modelled and the learning effectively disseminated, health systems may not be able to accomplish the innovations that are needed. From a standing start, in a field where research was largely uncoordinated and almost entirely conducted in disciplinary silos, HaCIRIC has developed a programme focused on a series of healthcare infrastructure challenges. A research and practice community has begun to develop around HaCIRIC. Our annual conference forms an important part of this process. By bringing together our growing community of researchers we are able to share and discuss findings from the most up-to-date work in our field. The growth in the size of delegate numbers since 2008 has been impressive. Our first annual conference was held at Imperial College London in April 2008. This was attended by fifty researchers and representatives from industry and the government. The 2009 conference was held in Brighton and attended by ninety delegates. Last year’s conference in Edinburgh and this year’s conference have over one hundred attendees from eleven countries around the world. Our 2011 conference received over sixty papers from around the world. Twenty one were offered a platform presentation. The papers and address a number of themes, from managing change to simulation modelling, from finance in healthcare and infrastructure design. These proceedings are the result of the hard work of many people. We would like to thank all the authors who submitted abstracts and papers to the conference. We also very much appreciate the help provided by the referees. On behalf of HaCIRIC, we would like to welcome you to our 2011 international conference. James Barlow and Colin Gray 2 Proceedings | HaCIRIC International Conference 2011 TABLE OF CONTENTS PHD WORKSHOP PAPERS A CASE STUDY OF CHANGES IN HEALTHCARE SERVICE UTILISATION FOLLOWING THE INTRODUCTION OF A TECHNOLOGICAL INNOVATION ............ 5 Tiago Cravo Oliveira AN EXAMINATION OF DIFFERENT MECHANISMS AIMED AT FACILITATING KNOWLDEGE TRANSFER ACROSS PROFESSIONAL AND ORGANISATIONAL BOUNDARIES IN HEALTHCARE .........................................................................................20 Linda Pomeroy APPLYING THE REAL OPTIONS THEORY FOR IDENTIFYING FLEXIBILITY IN PROJECT DELIVERY OF HEALTH ORGANISATIONS ....................................................34 Maartje van Reedt Dortland, Geert Dewulf and Hans Voordijk REAL ESTATE ADDED VALUE AND DECISION-MAKING IN HOSPITAL INFRASTRUCTURE ................................................................................................................52 Johan van der Zwart BEYOND SCORING: FACILITATING ENHANCED EVALUATION OF THE DESIGN QUALITY OF NHS HEALTHCARE BUILDINGS ................................................................68 Dennis O’Keeffee, Derek Thomson and Andrew Dainty CONFERENCE PAPERS PLANNING FOR MAJOR SERVICE AND INFRASTRUCTURE TRANSITIONS: AN INTERNATIONAL COMPARATIVE STUDY OF UK, US AND CANADIAN HOSPITALS ...................................................................................................................................................83 Danielle Tucker, Jane Hendy and James Barlow CONSENSUAL POLITICS IN HEALTHCARE: THE NATIONAL EHEALTH PROJECT OF SLOVENIA ........................................................................................................................84 Kyriakos Hatzaras EXPLORING THE CONCEPT AND REALITY OF EVIDENCE–BASED IMPLEMENTATION ............................................................................................................. 100 Julie Reed and Derek Bell DISRUPTIVE INNOVATION IN STROKE DIAGNOSIS IN REMOTE LOCATIONS: FIELD-BASED ULTRASOUND ............................................................................................ 122 James Barlow, Steffen Bayer, Henry Feldman, Stan Finkelstein, Evin Jacobson and Shane Reti WHAT ARE THE POTENTIAL BROADER IMPLICATIONS AND VALUE FROM THE USE OF ELECTRONIC HEALTH RECORDS .................................................................... 136 Georgios Xydopoulos and Lampros Stergioulas BUSINESS STRATEGY FORMATION IN AN INTEGRATED AREA AND HEALTHCARE DELIVERY PROJECT ............................................................................... 147 Hendrik Cramer, Geert Dewulf and Hans Voordijk FLEXIBLE AND ADAPTABLE HOSPITALS – AUSTRALIAN CASE STUDIES ............. 160 Jane Carthey and Vivien Chow 3 Proceedings | HaCIRIC International Conference 2011 A LEAN WAY OF DESIGN AND PRODUCTION FOR HEALTHCARE CONSTRUCTION PROJECTS ............................................................................................................................. 176 Sergio Kemmer, Lauri Koskela, Stylianos Sapountzis and Ricardo Codinhoto EVIDENCE-BASED DESIGN AT A TIME OF AUSTERITY: DO BUILDING STANDARDS AND TOOLS REFLECT THE REALITY OF DESIGNING FOR DEMENTIA, THE ELDERLY, CHILDREN AND REFURBISHMENT OR RECONFIGURATION? ....................................................................................................... 190 Michael Phiri, Grant Mills, Ching-Lan Chang, Andrew Price and Simon Austin DEVELOPING ACCURATE COSTING SYSTEMS ............................................................ 212 Chris Chapman and Anja Kern HELPING DECISION MAKERS NAVIGATE THE EVIDENCE AROUND HEALTH FINANCING .......................................................................................................................... 213 Christina Pagel, Martin Utley, Gayatri Kembhavi, Nouria Brikci, Anni-mariaPulkki- Brannstrom, Xavier Dutoit and Jolene Skordis-Worral INTEGRATED DECISION SUPPORT: A NEW APPROACH TO THE DESIGN OF HOSPITAL FACILITIES TO OPTIMISE LOW CARBON PERFORMANCE .................. 244 Matthew Bacon, Duane Passman and Karen Hicks MODELLING INNOVATIVE DIAGNOSTIC TOOLS FOR TUBERCULOSIS IN DEVELOPING COUNTRIES TO FACILITATE EFFECTIVE UPTAKE.