The ever increasing number of natural hazards is affecting health and stretching healthcare facilities to their limits. Many healthcare facilities could not perform as were expected due to physical damage and inappropriate social performance. This themed issue aims to support decision makers, engineers and planners (in less exposed countries and countries with financial, awareness and expertise constraints but are at high risk) to identify the vulnerability of their existing facilities and ensure that new facilities are resilient enough to cope with the multiple adversities they face. The key
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The effective management of risk is critical to the success of any construction project and the importance of risk management has grown as projects have become more complex and competition has increased. Contractors have traditionally used financial mark-ups to cover the risk associated with construction projects but as competition increases and margins have become tighter they can no longer rely on this strategy and must improve their ability to manage risk. This paper presents the results of a survey conducted to evaluate the impact of global risk factors on cost performance of construction projects in Mozambique. The survey reported upon forms part of a larger study that aims to develop a fuzzy logic decision framework for contractors to better manage global risk factors affecting the cost performance of construction projects. Major global risk factors affecting cost performance were identified through an extensive literature review followed by a workshop and a questionnaire survey of construction contractors in Mozambique. The findings of the questionnaire form the basis for the repertory grid interviews aimed at eliciting relevant knowledge so as to develop a knowledge-based decision support system. There are several approaches to categorising risks permeating construction projects. This paper groups risks into three main categories, namely organisation-specific, global and Acts of God. It focuses on global risk factors because they are ill-defined, less understood by contractors and difficult to model, assess and manage although they have huge impact on cost performance. Generally, contractors, especially in developing countries, have insufficient experience and knowledge to manage them effectively. The surveyed contractors identified the following global risk factors as having significant impact: project size, project location, project complexity, estimator bias, market conditions, level of competition, fraudulent practices, construction, economic and political risk factors. The findings stress the need to depart from traditional approaches and to explore new directions in order to equip contractors with effective risk management tools.
The Nigerian healthcare system is divided into the primary, secondary and tertiary levels of care, which are under the three tiers of government (local, state and federal) with some overlapping of responsibilities. The Federal Ministry of Health (FMOH) develops policies and physical structures, and supervises the operations of the healthcare system. The Primary Health Care (PHC) level has been identified as the appropriate setting to tackle 90 - 95% of major causes of morbidity and mortality because of its proximity to over 80% of the populace. At the PHC level, the services provided include integrated preventive, promotive and community development activities. However, the implementation of PHC in Nigeria has lacked impact and sustainability, thus leading to the research discussed in this paper which is aimed at proposing an innovative procurement system for sustaining PHC facilities in Nigeria. The proposed system is focused at developing and encouraging a new market for investment in primary care and community-based facilities and services. It is a form of Public-Private Partnership (PPP) that enjoys national support but with local control. One of the central objectives is the idea of bringing together all the various local stakeholders, interests and users that comprise the local health economy. The arrangement is expected to offer considerable social and economic benefits while satisfying the fundamental philosophy of PHC.
This paper was accepted for publication in the journal Journal of Financial Management of Property and Construction and the definitive published version is available at http://dx.doi.org/10.1108/JFMPC-06-2015-0019 ; Purpose - This paper identifies costs related to dementia care provision and explores how purposeful built environment investments can help control these costs and improve Quality of Life and clinical outcomes. Design/methodology/approach - This research adopts a multi-method approach where the findings of a literature review drove the analysis of data obtained from the 115 pilot projects funded by the Department of Health England's National Dementia Capital Investment Programme. Findings - Under the UK government's new productivity challenge, it is fundamental to identify actions that provide Value for Money in order to prioritise policy and practice. This paper identifies healthcare spaces (e.g. bathroom) where the impact of the built environment on healthcare costs are most evident, and building elements (e.g. lighting) to which these costs can be directly associated. The paper advocates the development of evidence and decision support tools capable of: linking built environment interventions to the healthcare costs; and helping the health and social care sectors to develop effective and efficient capital investment strategies. Research limitations/implications - Further work needs to develop more systematic ways of rationalising pro-active and timely built environment interventions capable of mitigating dementia (and elderly) care cost escalation. Originality/value - This research takes an innovative view on capital investment for care environments and suggests that appropriate built environment interventions can have a profound impact on costs associated with dementia care provision.
The present demand for economically viable construction projects in the Saudi Public Sector is coupled with the need to maximise the efficient use of Saudi Arabian natural resources. The aim of this paper is to investigate sustainability in Saudi Arabia in terms of strategies, policies, barriers and enablers associated with its implementation and as perceived by key decision makers. It also endeavours to define sustainable construction principles as currently being applied in the country. The data used in this study were obtained through a review of related literature, reinforced with information distilled from interviews conducted with people working in or possessing significant experience of the Saudi Public Sector. The findings show that the Saudi government has made significant efforts towards protecting the environment by enacting a number of regulations and policies and by joining a number of global conventions over the past few years. However, the lack of consideration paid to sustainable construction principles during the conceptual phase of design has resulted undesirable consumption rates of materials, water and energy during the construction, operating and maintenance phases of projects. Moreover, there currently appears to be are lack of awareness, regulation, policies, information and leaderships with regard to implementation of sustainable construction. Several relevant principles for sustainable construction in terms of environmental, economic and social have been elaborated upon; and enablers that could accelerate its understanding and implementation in the country have been highlighted.
Assessment of urban sustainability can be considered as a means to an end as it is often intended to guide decision-making in a way that contributes to sustainable urban development. The contribution of assessment mechanisms towards the achievement of this goal depends to a large extent on the level of use and adoption of sustainability assessment tools amongst the diversity of users. Since the development of a Sustainable Development Strategy in 1998, the UK Government has given sustainable development prominence on the policy agenda, with similar emphasis being reflected at EU legislation level. Investigation of the barriers and incentives to sustainability assessment can supplement this increasing prominence of sustainability in decision-making processes and the equally increasing need for sustainability assessment. A review of the literature on the subject suggests that although much has been written on barriers and incentives to sustainability, very little work has been done on factors that hinder or encourage uptake of sustainability assessment tools. Against this background, the aim of this paper is to investigate and identify the barriers and incentives to sustainability assessment and the adoption of assessment tools. This should provide a starting point for assessing the potential impact of various approaches and incentives to overcome the barriers to sustainability assessment. Four broad sets of barriers and incentives are identified as perceptual, institutional; economic; and technological factors. The paper further discusses some of the enablers associated with the various policies and legislative instruments at the political hierarchies of: the EU; the UK (including the devolved governments); and local government levels. The paper concludes by suggesting that the identified barriers and incentives should be given due consideration during the development of any sustainability assessment tool.
This paper describes work initiated by the government in Tanzania aimed at benchmarking labour productivity amongst building contractors, and to thereby establish a construction labour productivity performance related data base and stimulate competitive performance. A clear need for performance improvement for construction industries in African developing countries is set out. Labour productivity has been identified as a critical issue in performance improvement and arguments have been put forward to justify the concentration of efforts to improve labour productivity at site level. Productivity benchmarks were established by observing site output using the activity sampling technique. The proposed benchmark is an asymptotic upper productivity figure which can be used for establishing a continuous productivity improvement programme. The project concepts used are then compared with Total Quality Management (TQM) and benchmarking concepts.
In England and Wales the responsibility for the provision and maintenance of water supply and sewerage facilities was transferred to the private sector with the sale (privatisation) of the government-owned Regional Water Authorities to create nine English and one Welsh public limited companies (PLCs). Prior to privatisation, the Regional Water Authorities held an agreement whereby the various English Local Authorities were responsible as agents to the Water Authorities for the provision and maintenance of sewerage facilities within their districts. These agency agreements were transferred to the PLCs but these could be subject to far reaching review in the future. There are also 28 existing small private water supply companies with no involvement in sewerage matters.
This is an Open Access Article. It is published by Emerald under the Creative Commons Attribution 3.0 Unported Licence (CC BY). Full details of this licence are available at: http://creativecommons.org/licenses/by/3.0/ ; Purpose: Recent research outcomes suggest that the number of natural hazards, both environmental and geophysical, will increase due to the effect of global warming. Various approaches have been investigated to reduce environmental degradation and to improve the physical resilience to natural hazards. However, most of these approaches are fragmented and when combined with cultural barriers they often result into less efficient assessment tools. The aim of this study is to: explore the challenges associated with the integration of resilience and sustainability; and propose a workable solution that ensures resilient and sustainable buildings. Design/methodology/approach: The primary source of information used to develop this paper has been research publications, policy papers, reports and tool guidelines. A set of questions were developed to guide the review which was complemented with information distilled from the HFA 2005-2015 to develop an integration process to evaluate ten international sustainability appraisal tools. Findings The major finding of this research is that, from a technical point of view, resilience and sustainability could be integrated. However, it requires a long and thorough process with a multi-disciplinary stakeholder team including technical, strategic, social and political parties. A combination of incentives and policies would support this process and help people work toward the integration. The Japanese model demonstrates a successful case in engaging stakeholders in the process which led to the development of a comprehensive appraisal tool, CASBEE®, where resilience and sustainability are integrated. Practical implications Although data have been sought through literature review (i.e. secondary data), the research is expected to have significant impact as it provides a clear theoretical foundation and methods for those wishing to integrate resilience within current sustainability appraisal tools or develop new tools. Originality/value: This paper provides original concepts that are required to reduce fragmentation in the way resilience and sustainability are addressed. It sets up new research agenda which has the potential to have a strong impact due the fact that sustainability and resilience are getting higher on the political priority scale.
Closed access. ; The wealth of any nation is ultimately based on its human resource or social capital. Education and training are the primary vehicles of developing this resource. Funding of formal construction craft skills training at trade institutions in Sub-Saharan Africa (SSA) is examined, using Zambia as a country case study. The data in the research were collected via semi-structured questionnaire interviews directed at government financed trades training schools offering construction programmes in Zambia. Results of the research show that formal construction craft skills training in Zambia has not been adequately funded over the years resulting in: ill-qualified low numbers of poorly remunerated teaching staff; poorly maintained infrastructure and workshop facilities not well equipped for teaching purposes; and out-dated curricula of construction craft programmes. A wide range of measures is required to improve funding for construction craft skills training. These include: increased training regulation and co-ordination by government, development of efficient and effective funding mechanisms that involve employers of crafts-persons, and training provision frameworks that encourage increased involvement of private training providers.
This is an Open Access Article. It is published by Taylor and Francis under the Creative Commons Attribution 4.0 Unported Licence (CC BY). Full details of this licence are available at: http://creativecommons.org/licenses/by/4.0/ ; Healthcare buildings play a significant role in delivering healthcare services and outcomes (e.g. quality, suitability, cleanliness, patient experience, value for money and risk mitigation). However, the current diffusion of responsibilities in England between central government and healthcare trusts has created gaps and weaknesses in the evidence base, knowledge, skills and tools for creating and assessing healthcare building design quality. How can a national healthcare building design quality improvement strategy be created? This question is explored in relation to policy, strategy and organizational issues. Four evaluation studies and four action research studies indicate the complexity and responsibilities in defining a design quality improvement strategy. It is found that the interdisciplinary development of national standards and tools requires centralized investment to facilitate nationwide learning and improvements in evidence and outcomes. In addition, the inevitable health policy changes made by successive governments require a sustainable and strategic response. The creation and maintenance of capacity and capabilities will require a dedicated team of professionals and a wide interdisciplinary network of long-term contributors who are motivated by a long-term desire to improve healthcare building design quality.
The increasing spectrum of environmental and social challenges instigated by the failure of development strategies, the continuous proliferation of unsustainable patterns of production and consumption coupled with the anticipated level of population stimulated the pursuit of a new path. Sustainable development has emerged as a possible remedy. Despite increasing efforts to marry the social and environmental challenges with economic growth, progress remains remote. Against this background, the paper aims to investigate the root cause of the current poor progress in terms of the practical application of the concept. The paper reinforces the drawbacks of the current societal conflict resolution mechanism: market and political arenas. As a possible solution, it suggest the urgent need for a shift to the third arena, which facilitates integration of public debates, scientific evidence and policy, and extensive use of innovative tools such as precautionary principle to ensure a high-quality decision-making process.
This is a conference paper. Made available by kind permission of the publisher. ; As the National Health Service (NHS) of England continues to face tighter cost saving and utilisation government set targets, finding the optimum between costs, patient waiting times, utilisation of resources, and user satisfaction is increasingly challenging. Patient scheduling is a subject which has been extensively covered in the literature, with many previous studies offering solutions to optimise the patient schedule for a given metric. However, few analyse a large range of metrics pertinent to the NHS. The tool presented in this paper provides a discrete-event simulation tool for analysing a range of patient schedules across nine metrics, including: patient waiting, clinic room utilisation, waiting room utilisation, staff hub utilisation, clinician utilisation, patient facing time, clinic over-run, post-clinic waiting, and post-clinic patients still being examined. This allows clinic managers to analyse a number of scheduling solutions to find the optimum schedule for their department by comparing the metrics and selecting their preferred schedule. Also provided is an analysis of the impact of variations in appointment durations and their impact on how a simulation tool provides results. This analysis highlights the need for multiple simulation runs to reduce the impact of non-representative results from the final schedule analysis.
