Search results

Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

Recently, there has been a shift toward the embodied energy assessment of buildings. However, the impact of material service life on the life-cycle embodied energy has received little attention. We aimed to address this knowledge gap, particularly in the context of the UAE and investigated the embodied energy associated with the use of concrete and other materials commonly used in residential buildings in the hot desert climate of the UAE.

Using input–output based hybrid analysis, we quantified the life-cycle embodied energy of a villa in the UAE with over 50 years of building life using the average, minimum, and maximum material service life values. Mathematical calculations were performed using MS Excel, and a detailed bill of quantities with >170 building materials and components of the villa were used for investigation.

For the base case, the initial embodied energy was 57% (7390.5 GJ), whereas the recurrent embodied energy was 43% (5,690 GJ) of the life-cycle embodied energy based on average material service life values. The proportion of the recurrent embodied energy with minimum material service life values was increased to 68% of the life-cycle embodied energy, while it dropped to 15% with maximum material service life values.

The findings provide new data to guide building construction in the UAE and show that recurrent embodied energy contributes significantly to life-cycle energy demand. Further, the study of material service life variations provides deeper insights into future building material specifications and management considerations for building maintenance.