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Article
Publication date: 1 June 2011

Julie Eatock, Malcolm Clarke, Claire Picton and Terry Young

Accident and emergency (A&E) departments experience a secondary peak in patient length of stay (LoS) at around four hours, caused by the coping strategies used to meet the…

1620

Abstract

Purpose

Accident and emergency (A&E) departments experience a secondary peak in patient length of stay (LoS) at around four hours, caused by the coping strategies used to meet the operational standards imposed by government. The aim of this paper is to build a discrete‐event simulation model that captures the coping strategies and more accurately reflects the processes that occur within an A&E department.

Design/methodology/approach

A discrete‐event simulation (DES) model was used to capture the A&E process at a UK hospital and record the LoS for each patient. Input data on 4,150 arrivals over three one‐week periods and staffing levels was obtained from hospital records, while output data were compared with the corresponding records. Expert opinion was used to generate the pathways and model the decision‐making processes.

Findings

The authors were able to replicate accurately the LoS distribution for the hospital. The model was then applied to a second configuration that had been trialled there; again, the results also reflected the experiences of the hospital.

Practical implications

This demonstrates that the coping strategies, such as re‐prioritising patients based on current length of time in the department, employed in A&E departments have an impact on LoS of patients and therefore need to be considered when building predictive models if confidence in the results is to be justified.

Originality/value

As far as the authors are aware this is the first time that these coping strategies have been included within a simulation model, and therefore the first time that the peak around the four hours has been analysed so accurately using a model.

Details

Journal of Health Organization and Management, vol. 25 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 1 May 2006

Simon Pemberton, Carys Alty, Rose Boylan and Claire Stevens

The purpose of this article is to explore whether it is possible to analyse if Black and other racial minorities (BRM) groups in Liverpool are benefiting from processes of…

1022

Abstract

Purpose

The purpose of this article is to explore whether it is possible to analyse if Black and other racial minorities (BRM) groups in Liverpool are benefiting from processes of regeneration, and their impact on levels of BRM employment and economic activity.

Design/methodology/approach

The article draws on official social and economic statistics and on qualitative interview data to provide a case study analysis.

Findings

It is argued that local regeneration initiatives do not always reflect and address the needs of different BRM groups and that this has contributed to the underperformance of the Liverpool's BME population.

Research limitations/implications

There are important research implications from this piece. The work has demonstrated that the limited data collection practices of a number of agencies that operate at a local level, struggle to understand the broad and diverse range of BRM needs.

Practical implications

Addressing the needs of BRM groups is hampered by methods of community engagement with BRM groups. While some examples of good practice are starting to emerge, challenges remain in relation to sharing such practice and the co‐ordination of data collection.

Originality/value

The article provides an original overview of the information requirements to better understand how BRM groups can be supported through regeneration.

Details

International Journal of Sociology and Social Policy, vol. 26 no. 5/6
Type: Research Article
ISSN: 0144-333X

Keywords

Content available
Book part
Publication date: 27 May 2021

Nolwenn Bühler

Abstract

Details

When Reproduction Meets Ageing
Type: Book
ISBN: 978-1-83909-747-8

Article
Publication date: 1 August 1950

THE centenary celebration is that of the apparently prosaic public library acts ; it is not the centenary of libraries which are as old as civilization. That is a circumstance…

Abstract

THE centenary celebration is that of the apparently prosaic public library acts ; it is not the centenary of libraries which are as old as civilization. That is a circumstance which some may have overlooked in their pride and enthusiasm for the public library. But no real librarian of any type will fail to rejoice in the progress to which the celebration is witness. For that has been immense. We are to have a centenary history of the Public Library Movement—that is not its title—from the Library Association. We do not know if it will be available in London this month; we fear it will not. We do know its author, Mr. W. A. Munford, has spent many months in research for it and that he is a writer with a lucid and individual Style. We contemplate his task with a certain nervousness. Could anyone less than a Carlyle impart into the dry bones of municipal library history that Strew these hundred years, the bones by the wayside that mark out the way, the breath of the spirit that will make them live ? For even Edward Edwards, whose name should be much in the minds and perhaps on the lips of library lovers this month, could scarcely have foreseen the contemporary position ; nor perhaps could Carlyle who asked before our genesis why there should not be in every county town a county library as well as a county gaol. How remote the days when such a question was cogent seem to be now! It behoves us, indeed it honours us, to recall the work of Edwards, of Ewart, Brotherton, Thomas Greenwood, Nicholson, Peter Cowell, Crestadoro, Francis Barrett, Thomas Lyster, J. Y. M. MacAlister, James Duff Brown and, in a later day without mentioning the living, John Ballinger, Ernest A. Baker, L. Stanley Jast, and Potter Briscoe—the list is long. All served the movement we celebrate and all faced a community which had to be convinced. It still has, of course, but our people do now allow libraries a place, more or less respected, in the life of the people. Librarians no longer face the corpse‐cold incredulity of the so‐called educated classes, the indifference of the masses and the actively vicious hostility of local legislators. Except the illuminated few that existed. These were the men who had the faith that an informed people was a happier, more efficient one and that books in widest commonalty spread were the best means of producing such a people. These, with a succession of believing, enduring librarians, persisted in their Struggle with cynic and opponent and brought about the system and the technique we use, modified of course and extended to meet a changing world, but essentially the same. Three names we may especially honour this September, Edward Edwards, who was the sower of the seed; MacAlister, who gained us our Royal Charter ; and John Ballinger, who was the person who most influenced the introduction of the liberating Libraries Act of 1919.

Details

New Library World, vol. 53 no. 2
Type: Research Article
ISSN: 0307-4803

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