Purpose Interventions are essential for the management of built heritage because they extend the lifespan of buildings and enable them to be enjoyed by multiple generations.International organisations and institutions...Purpose Interventions are essential for the management of built heritage because they extend the lifespan of buildings and enable them to be enjoyed by multiple generations.International organisations and institutions,such as UNESCO and ICOMOS,have adopted doctrinal documents over time,stimulating best practices in built heritage management worldwide.Although these documents are often referenced in academic work,they are seldom systematically researched.Which interventions are referenced or omitted?Are they defned?What trends are noted in the understanding of best practices as interventions?Design/methodology/approach This research consists of a systematic content analysis of nine international doctrinal documents,which were selected from nearly seventy international doctrinal documents—mainly adopted by UNESCO and ICOMOS.The main aim is to reveal and compare the concepts used for reference interventions and further use the defnitions to reveal and discuss the relationships between them.The trends of these interventions being used were determined based on the frequency of mentions per intervention term in the selected documents.Findings Regarding the defnition of the intervention concepts,there are three main fndings.First,instead of being treated as a single concept,‘conservation’has been presented as an umbrella concept for other interventions and thus has been the most popular concept since the frst version(1992)of the New Zealand Charter was implemented.In contrast,‘preservation’remains a single concept,among the highest scales,to maintain the integrity of built heritage,including use.Second,‘repair’was found to play a paradoxical role between‘restoration’and‘reconstruction’,which created divergent opinions in the documents.Third,since the notions of‘use’have expanded from the functions of monuments(International Charter for the Conservation and Restoration of Monuments and Sites:The Venice Charter,1964)to the‘associations of places’(The Burra Charter:The Australia ICOMOS Charter for Places of Cultural Signifcance,with associated Guidelines and Code on the Ethics of Co-existence,1999;The Burra Charter:The Australia ICOMOS Charter for Places of Cultural Signifcance,2013),which include activities,traditional habits,accessibility,etc.,the complexity of mentioning diferent forms of‘use’has led to some(re)interventions,such as‘adaptation’,‘adaptive reuse’,and‘rehabilitation’,being put into grey areas and used interchangeably.Originality This research advances the current understanding of intervention concepts and their relationships,as well as diferences and similarities in defnitions.展开更多
Background Delays in first case on-time starts(FCOTS)can lead to inefficiencies in the operating room(OR),dissatisfaction among patients with their providers and staff,and increased facility costs.While the literature...Background Delays in first case on-time starts(FCOTS)can lead to inefficiencies in the operating room(OR),dissatisfaction among patients with their providers and staff,and increased facility costs.While the literature has established standards for improving main OR efficiency,further research is needed in labour and delivery(L&D)units.Therefore,we aimed to identify the barriers to ontime case starts in L&D ORs and to develop interventions to reduce OR case delays.Methods This quality improvement study was conducted at a safety-net hospital,where the average FCOTS was 12%before our initiative.Starting in November 2022,a multidisciplinary team was formed,including representatives from quality,obstetrics,anaesthesiology,nursing and scheduling.We developed failure modes and effects analysis,process mapping and interventions using the Institute for Healthcare Improvement Model for Improvement,testing them through rapid Plan-Do-StudyAct cycles.We used Montgomery rules with statistical process control charts to measure statistically significant changes in both outcome and process measures.Results Contributors to the delays at the patient,provider and systems levels were identified.Interventions targeting structure,process,team members and patient engagement were implemented from December 2022 through December 2023.A 41%increase in the average percentage of on-time first cases compared with the baseline(12%)was observed,based on data collected from August 2022 through November 2022 to postintervention(53%),and this improvement was sustained for 4 months.Additionally,a 69%decrease in the average case delay in minutes from baseline(178 min)was noted 6 months after project initiation(55 min).Conclusions Interventions at the patient,provider and systems levels were identified and implemented,effectively increasing OR on-time case starts on L&D.These can be used in other L&D units to improve FCOTS.展开更多
文摘Purpose Interventions are essential for the management of built heritage because they extend the lifespan of buildings and enable them to be enjoyed by multiple generations.International organisations and institutions,such as UNESCO and ICOMOS,have adopted doctrinal documents over time,stimulating best practices in built heritage management worldwide.Although these documents are often referenced in academic work,they are seldom systematically researched.Which interventions are referenced or omitted?Are they defned?What trends are noted in the understanding of best practices as interventions?Design/methodology/approach This research consists of a systematic content analysis of nine international doctrinal documents,which were selected from nearly seventy international doctrinal documents—mainly adopted by UNESCO and ICOMOS.The main aim is to reveal and compare the concepts used for reference interventions and further use the defnitions to reveal and discuss the relationships between them.The trends of these interventions being used were determined based on the frequency of mentions per intervention term in the selected documents.Findings Regarding the defnition of the intervention concepts,there are three main fndings.First,instead of being treated as a single concept,‘conservation’has been presented as an umbrella concept for other interventions and thus has been the most popular concept since the frst version(1992)of the New Zealand Charter was implemented.In contrast,‘preservation’remains a single concept,among the highest scales,to maintain the integrity of built heritage,including use.Second,‘repair’was found to play a paradoxical role between‘restoration’and‘reconstruction’,which created divergent opinions in the documents.Third,since the notions of‘use’have expanded from the functions of monuments(International Charter for the Conservation and Restoration of Monuments and Sites:The Venice Charter,1964)to the‘associations of places’(The Burra Charter:The Australia ICOMOS Charter for Places of Cultural Signifcance,with associated Guidelines and Code on the Ethics of Co-existence,1999;The Burra Charter:The Australia ICOMOS Charter for Places of Cultural Signifcance,2013),which include activities,traditional habits,accessibility,etc.,the complexity of mentioning diferent forms of‘use’has led to some(re)interventions,such as‘adaptation’,‘adaptive reuse’,and‘rehabilitation’,being put into grey areas and used interchangeably.Originality This research advances the current understanding of intervention concepts and their relationships,as well as diferences and similarities in defnitions.
文摘Background Delays in first case on-time starts(FCOTS)can lead to inefficiencies in the operating room(OR),dissatisfaction among patients with their providers and staff,and increased facility costs.While the literature has established standards for improving main OR efficiency,further research is needed in labour and delivery(L&D)units.Therefore,we aimed to identify the barriers to ontime case starts in L&D ORs and to develop interventions to reduce OR case delays.Methods This quality improvement study was conducted at a safety-net hospital,where the average FCOTS was 12%before our initiative.Starting in November 2022,a multidisciplinary team was formed,including representatives from quality,obstetrics,anaesthesiology,nursing and scheduling.We developed failure modes and effects analysis,process mapping and interventions using the Institute for Healthcare Improvement Model for Improvement,testing them through rapid Plan-Do-StudyAct cycles.We used Montgomery rules with statistical process control charts to measure statistically significant changes in both outcome and process measures.Results Contributors to the delays at the patient,provider and systems levels were identified.Interventions targeting structure,process,team members and patient engagement were implemented from December 2022 through December 2023.A 41%increase in the average percentage of on-time first cases compared with the baseline(12%)was observed,based on data collected from August 2022 through November 2022 to postintervention(53%),and this improvement was sustained for 4 months.Additionally,a 69%decrease in the average case delay in minutes from baseline(178 min)was noted 6 months after project initiation(55 min).Conclusions Interventions at the patient,provider and systems levels were identified and implemented,effectively increasing OR on-time case starts on L&D.These can be used in other L&D units to improve FCOTS.
