Paul R. Harper

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Using average number of patients expected in a year, average length of stay and a target occupancy level to calculate the number of critical care beds needed is mathematically incorrect because of nonlinearity and variability in the factors that control length of stay. For a target occupancy in excess of 80%, this simple calculation will typically(More)
BACKGROUND There is an urgent need to consider the skill-mix of the dental team to meet the oral health needs and demands of the population in general, and older people in particular. As people live longer and retain their teeth there will be a progressive change in both the volume and type of dental care required, and the demand for care. Operational(More)
Radical thinking about the design of industrial processes over the last century has greatly improved the quality and efficiency of manufacturing and services. Similar methods to deliver higher quality health care at lower cost would be extremely valuable. In health care, however, we must also consider how patients feel about the processes and the extent to(More)
It has long been recognised that the structure of social networks plays an important role in the dynamics of disease propagation. The spread of HIV results from a complex network of social interactions and other factors related to culture, sexual behaviour, demography, geography and disease characteristics, as well as the availability, accessibility and(More)
In 1998, the Department of Health (England) commissioned the first phase of national evidence-based guidelines for preventing healthcare associated infections. These focused on developing a set of standard principles for preventing infections in hospitals together with guidelines for preventing hospital-acquired infections (HAI) associated with the use of(More)
Within a health care setting, it is often desirable from both clinical and operational perspective to capture the uncertainty and variability amongst a patient population, for example to predict individual patient outcomes, risks or resource needs. Homogeneity brings the benefits of increased certainty in individual patient needs and resource utilisation,(More)