In the context of the built environment in the recent years the concept of maintenance has changed from corrective to preventive maintenance. There is evidence that preventive maintenance is much more efficient than corrective maintenance, since severe deteriorations that may represent danger to people are avoided, and also money is saved. To make periodic inspections of the buildings is useful to quantify the extent to which deteriorations are severe or not, in order to facilitate decision making and prioritize interventions. To this purpose many scales have been used and are used to assess the severity of damage and degradation of the building components. But it appears evident that there is not consensus among users and these scales are different between them, with different number of degrees and metrics for the measurement of the condition state. The main goal of this paper is to calculate which is the optimal metric (which is the optimal number of degrees) of a severity scale of damages in buildings, so the corresponding scale could be of widespread and of common use among professionals, avoiding the problems of comparison between different evaluators. The proposed methodology to calculate the optimal metric of a scale can be also extended to other scopes.

To make periodic inspections of the buildings is useful to quantify the extent to which deficiencies are severe or not, in order to facilitate decision making and prioritize interventions. In previous works by the authors is proposed a scale of gravity of damages in buildings, with the aim of being of widespread and of common use among professionals. This scale is applied through the direct assignment methodology (DA), based on the generic definitions of each degree. It is demonstrated and characterized the existence of certain level of variability among technicians, when assigning gravity values using DA methodology, due to the fuzzy condition of the attribute to be evaluated. The main goal of this paper is to propose a methodology to assign values of gravity, based on hazard for people of detachments from the façade, by using measurable parameters and mathematical functions. The final objective is to reduce the level of variability among inspectors when assessing the condition state of a building façade. The proposed methodology is named System of Evaluation of Façades (SEF). The methodology can be also extended to the assessment of other building systems as structures or roofs and other type of infrastructures.

Introduction: Our comprehensive stroke center provides community outreach and stroke education to patients, caregivers, and community members on the importance of calling 911 in the event of a stroke. However, approximately 1/3 of our center’s stroke alerts are walk-ins. With a walk-in stroke, rapid assessment is essential because the stroke response team has no information compared to information that otherwise would be provided by EMS. As such, our center developed a rapid assessment by the emergency triage nurse or technician, who can then activate a stroke alert. Methods: The change to rapid stroke assessment and stroke alert activation by triage nurses and technicians (rather than waiting for an emergency physician to assess and activate a stroke alert) was made in March 2018. Cases from one year prior to the intervention were compared to cases from the year after implementation. Differences in turnaround times (door to stroke alert activation, door to needle [DTN]) were calculated. Results: In the period before implementation, there were 1200 stroke alerts, of which 420 arrived via triage (35%). Median door to stroke alert was 0 min. Of those who arrived through triage, 8 received IV alteplase (8/420=2%). For those patients, median DTN was 39 min. In contrast, after implementation, there were 1401 stroke alerts, of which 342 arrived via triage (24%). Median door to stroke alert was 2 min. Of those, 15 received IV alteplase (15/342=4%), with a median DTN of 32 min. Discussion: A nursing driven initiative at Emergency Department triage was effective at improving stroke treatment rate and decreasing DTN for IV alteplase for walk-in stroke patients.