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Ismael, Zhiman Khairi, and Kadhim Fathel Khalil. "Space Performance Assessment of a Relocatable Health Facility: Mosul Hospital as a Case Study." Buildings 12, no. 10 (September 26, 2022): 1539. http://dx.doi.org/10.3390/buildings12101539.
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Relocatable buildings are commonly spread around as an alternative method of construction. To consider it a successful practice, it should perform its function similarly to a traditional way. Assessing a building after its operation determines the rate of its success and decides the possibility of repeating its type. This study aimed to provide a comprehensive knowledge base related to space evaluation of the building through spatial assessment. This study investigated the functional efficiency and dimensional requirements of a relocatable hospital in Mosul, in the south of Iraq. This study compared the dimensional requirements of eight hospital departments to the standard, followed by functional efficacy analysis based on space syntax theory and compared the results to examples used in standards books. The results showed that departments in the relocatable buildings have good plan integration. We concluded that hospitals constructed with containers could achieve functional efficiency.
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Golbazi, Maryam, and Can B. Aktas. "LEED CERTIFICATION AND PATIENT WELLBEING IN GREEN HEALTHCARE FACILITIES." Journal of Green Building 15, no. 4 (September 1, 2020): 3–18. http://dx.doi.org/10.3992/jgb.15.4.3.
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ABSTRACT Beyond resource efficiencies, green buildings aim to create healthy indoor environments for building occupants. In terms of improving occupant well-being, a unique case emerges for healthcare facilities, whose patients may be at a vulnerable state. In the U.S., the Leadership in Energy and Environmental Design (LEED) rating system has become the most widely recognized certification system for green buildings, including green healthcare facilities and buildings. Hospitals with high total scores in the LEED rating system are green buildings but may not necessarily be the optimal green healthcare environment from a patient’s wellbeing perspective. Certified health-care facilities were analyzed in terms of their credit valuation to assess whether health-care facilities prioritize specific criteria that influence patient wellbeing and recovery time. Analysis of results indicate hospitals may be valuing the level of certification more than those credits that were deemed relevant for patient wellbeing and rate of recovery, either due to lack of information or due to economic constraints. To consolidate the previous results and to compare the performance of LEED certified green hospitals to the national average, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was analyzed for patients’ perspectives on the healthcare facility. Results indicate higher satisfaction in green hospitals’ overall patient care performance as well as a greater tendency to recommend green hospitals to others compared to the national average. No statistical significance was found for hospital cleanliness and quietness between green hospitals and the national average. HIGHLIGHTS
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Rockstroh, Kurt, David Sykes, and Mandy Kachur. "Acoustic comfort in health care facilities: Perspective of FGI-Facility Guidelines Institute." Journal of the Acoustical Society of America 151, no. 4 (April 2022): A70—A71. http://dx.doi.org/10.1121/10.0010689.
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Acoustic comfort is a welcome concept for the design and management of healthcare facilities, potentially providing methods to address acoustic environment deficiencies revealed by experience and by the Affordable Care Act’s CAHPS® Hospital Survey, on which the noise question historically performs worst yielding public disclosure and financial penalties to hospitals. One possible vehicle for introducing quantified acoustic comfort into buildings is the healthcare design guidelines published by the Facility Guidelines Institute (FGI), which are adopted as building code in a majority of the United States, provide reference standards for the Leadership in Energy and Environmental Design (LEED) Rating System and the International Green Construction Code, and are cited in 87 countries. For acceptance into the FGI guidelines, “acoustic comfort” requires a formal definition accepted by standards organizations and clinical research, which is free from conflicts of interest based on research conducted by recognized third-party organizations on the physiological and psychological effects of noise on humans, particularly those with compromised health, like patients in hospitals and skilled nursing facilities. FGI encourages proposals from the public, particularly valuing advice from members of professional societies, and relies on the research community to provide evidence-based support for all acoustics topics.
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Polka, N. S., V. M. Makhniuk, V. V. Chorna, V. M. Podolian, and S. T. Yurchenko. "Hygienic assessment of new architectural and planning solutions of buildings of psychiatric health care facilities." Medicni perspektivi 27, no. 3 (September 30, 2022): 135–41. http://dx.doi.org/10.26641/2307-0404.2022.3.265960.
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Aim: to conduct a hygienic assessment of new architectural and planning solutions of psychiatric health care facility buildings in Ukraine and give a comparative description of the sanitary standards of the latter in the EU. The study was conducted based on the analysis of State Building Norms (SBN) B.2.2-10:2019 “Buildings and structures. Health care facilities” (draft, final revision), scientific sources of domestic and foreign scientists. A survey of the chief physicians of psychiatric hospitals of Ukraine concerning safe sanitary and hygienic, anti-epidemic conditions for the functioning of psychiatric health care facilities was conducted. We consider it necessary to present more carefully architectural and planning solutions in the relevant section of SBN B.2.2-10:2019 (draft, final revision) or to use the opportunity specified in the introduction to these Norms, and to supplement them with the Manual on the design of psychiatric health care facilities, taking into account the experience of the European Union. To create an appropriate “therapeutic environment” in new domestic mental health care facilities, it is necessary to implement European requirements in the design of these facilities with the involvement of multidisciplinary groups: (from architects to nurses, from construction contractors to patients) and supplement SBN B.2.2-10:2019 “Buildings and structures. Health care Facilities” of Ukraine with a guide for designing facilities of a new type of “Mental Health Centers” as in the Republic of Poland. We have developed and sent to the chief physicians of psychiatric hospitals of Ukraine «Questionnaire for scientific sanitary and epidemiological assessment of the conditions of placement of a psychiatric health care facility”. Based on the analysis of the block of questions on sanitary and antiepidemic and sanitary and hygienic parameters that characterize the buildings of domestic psychiatric hospitals, the location of medical structures and auxiliary units on the land plot, i.e. the design of buildings is determined. In particular, 50% of psychiatric hospitals are housed in combined buildings, 25% have a pavilion system (separate buildings), 12.5% each have a centralized system (all in one building) and a block system. The number of stories of psychiatric hospitals up to 2 is 50%, up to 3 – 37.5% and up to 5 stories in those which have been under construction since 1960 – 12.5%. Analysis of the questionnaire block on the conditions of stay, treatment, rehabilitation of the mentally ill revealed the possibility of organizing occupational therapy in 12.5% of psychiatric hospitals, where special workshops are equipped and patients can acquire professional skills. Physiotherapy rooms are equipped in 50% of psychiatric hospitals. Low provision of patients with furniture was revealed: 25% of patients partially have proper desk, 75% do not have it; 50% are provided with proper chairs; 62.8% use proper bedside tables and 25% – closets for storing personal clothes.
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Hwang, Cho, and Moon. "Feasibility Study on Energy Audit and Data Driven Analysis Procedure for Building Energy Efficiency: Bench-Marking in Korean Hospital Buildings." Energies 12, no. 15 (August 3, 2019): 3006. http://dx.doi.org/10.3390/en12153006.
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Growths in population, increasing demand for health care services and comfort levels, together with patients on the rise in time spent inside hospitals, assure the upward trend that energy demand will continue in the future. Since the hospital buildings operate 24 hours, 365 days a year for the treatment and restoration of patients, they are approximately 2–3 times more energy-intensive than normal buildings. For this reason, energy efficiency in hospitals is one of the prime objectives for energy policy at regional, national and international levels. This study aims to find how meaningful energy performance, reflecting good energy management and energy conservation measures (ECMs), can be operated for hospital buildings, a category encompassing complex buildings with different systems and large gaps between them. Energy audit allows us to obtain knowledge from the healthcare facility, in order to define and tune data driven analysis rules. The use of benchmarking in the energy audit of healthcare facilities enables immediate comparison between hospitals. Data driven energy analysis also allows ascertaining their expected energy consumption and estimating the possible savings margin by using the building energy flow chart. In the 2015–2017 periods, bench-marking of four public hospitals in Seoul were audited for the energy consumption related to weather conditions, total area, bed numbers, employee numbers, and analyzed for building energy flow by zones, energy sources, systems and equipment. This is a practice-based learning in a hospital project. The results reveal that the average annual energy consumption of a hospital under normal conditions, and energy efficiency factors are divided into energy baselines, energy consumption goals for energy saving and energy usage trends for setting ECMs, respectively. The indicator dependent on the area of inpatients (number of beds) proved to be the most suitable as a reference to quantify the energy consumption of a hospital.
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Wahyuningrum, Sri Hartuti, and Mustika K. Wardhani. "EFFICIENCY OF INPATIENT LAYOUT IN PRIVATE HOSPITAL (Case Study: Bhakti Asih Hospital, Brebes Central Java)." MODUL 20, no. 01 (March 29, 2020): 1–9. http://dx.doi.org/10.14710/mdl.20.01.2020.1-9.
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In the context of hospital building, inpatient care has large portion in comparasion of the other facility areas within hospitals related to efficiency, such as outpatient services, emergency room, diagnostic and especially inpatient function group services. Even though inpatient care group do not have specific requirements for detailed design and building equipment, it requires efficiency considerations related to correlation with room layout. It is expected that by considering the level of efficiency of service to patients, design can fulfill technical requirements of health and medical aspects. Regarding designs for district-level private hospitals, demand optimization of placement and layout of inpatient care became main topic in this research. This is related to the value of investment in building area development and types of services provided according to inpatient services class. The method used is comparative study of two (2) private hospital design to find the mind factors that most influence of optimization of inpatient layout. The results of study can be used as a guide in architectural design process for designing hospital buildings especially related to design efficiency of inpatient layout so that the building can function sustainability because of optimal service.
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Aalto, Leena, Sanna Lappalainen, Heidi Salonen, and Kari Reijula. "Usability evaluation (IEQ survey) in hospital buildings." International Journal of Workplace Health Management 10, no. 3 (June 5, 2017): 265–82. http://dx.doi.org/10.1108/ijwhm-03-2016-0014.
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Purpose As hospital operations are undergoing major changes, comprehensive methods are needed for evaluating the indoor environment quality (IEQ) and usability of workspaces in hospital buildings. The purpose of this paper is to present a framework of the characteristics that have an impact on the usability of work environments for hospital renovations, and to use this framework to illustrate the usability evaluation process in the real environment. Design/methodology/approach The usability of workspaces in hospital environments was evaluated in two hospitals, as an extension of the IEQ survey. The evaluation method was usability walk-through. The main aim was to determine the usability characteristics of hospital facility workspaces that support health, safety, good indoor air quality, and work flow. Findings The facilities and workspaces were evaluated by means of four main themes: orientation, layout solution, working conditions, and spaces for patients. The most significant usability flaws were cramped spaces, noise/acoustic problems, faulty ergonomics, and insufficient ventilation. Due to rooms being cramped, all furnishing directly caused functionality and safety problems in these spaces. Originality/value The paper proposes a framework that links different design characteristics to the usability of hospital workspaces that need renovation.
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Xuan, Xiaodong. "Study of indoor environmental quality and occupant overall comfort and productivity in LEED- and non-LEED–certified healthcare settings." Indoor and Built Environment 27, no. 4 (December 19, 2016): 544–60. http://dx.doi.org/10.1177/1420326x16684007.
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The study combined quantitative and qualitative approaches, in terms of both staff perception and facility manager perspective, to evaluate the effectiveness of indoor environmental quality (IEQ) of LEED–certified facilities and relationship between IEQ and occupant comfort and productivity in healthcare settings in the USA climate zones 2 and 3. A multiple-methods approach combining a questionnaire survey and semi-structured interview was tested for effective post-occupancy evaluation. The study compared one non-LEED healthcare facility with five LEED certified healthcare buildings and examined which variable(s) had significant relationship with comfort and productivity by surveying 249 occupants and interviewing six facility managers in six healthcare settings. The results showed that five LEED–certified healthcare settings were superior to one non-LEED facility in most of building performance factors. Building design, temperature comfort, image presented to visitors, use of space, control over noise and ability to meet occupants’ needs were significant predictors for overall comfort. Lighting overall, temperature comfort and image presented to visitors had a significant positive relationship with perceived productivity. Only one non-LEED hospital was selected and some buildings had small response rate, the results should be interpreted with caution.
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Berte, Erica, and Vijaya Narapareddy. "Building a Culture of Innovation in a Health-Care Organization." Entrepreneurship Education and Pedagogy 1, no. 4 (September 11, 2018): 330–48. http://dx.doi.org/10.1177/2515127418794151.
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Columbus Regional Health (CRH, hereafter), a nonprofit organization in Columbus, Indiana, evolved from a traditional local hospital to an award-winning regional health-care provider through innovation. As CRH began implementing innovation processes, the city of Columbus was hit by a natural disaster that flooded the hospital's flagship facility forcing it to close its operations and relocate its critical patients to other hospitals in the area. As a result of the closure, CRH's leadership faced daunting challenges, including whether or not to continue paying its employees, how to continue to provide care for its patients and the community, and funding the cost of repairs and renovations to CRH facilities estimated at $180 million. The management's response to these challenges and how a culture of innovation emerged from that can teach us several important lessons. Pertinent questions are as follows: (a) How can we evaluate the innovation process undertaken by CRH? and (b) What was the impact of the organization innovation and flood crisis on shaping CRH's culture?
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Ehab, Toka, Nermine Hany, and Gihan Mosaad. "Nanotechnology applications in interior design of hospitals to enhance thermal comfort and decrease the infection spread for the occupants." F1000Research 13 (April 23, 2024): 342. http://dx.doi.org/10.12688/f1000research.143569.1.
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Background In healthcare facilities, the significance of sensitive architecture cannot be overstated. In regions facing challenges such as Egypt, the healthcare sector is grappling with deteriorating conditions. The design of hospitals is crucial for addressing the needs of patients with varying illnesses and for creating an environment that fosters psychological well-being. The interior design process, especially the selection of materials, plays a pivotal role in ensuring a hygienic and safe environment within healthcare facilities. Walls, floors, ceilings, and furniture materials are key elements that contribute to the overall design. A study was conducted to investigate the application of nano materials in healthcare facility interior design in Egypt. Methods The study involved first a literature review on nano technology and its application in healthcare interior spaces. It culminated in a framework and guidelines for nano materials in different hospital zones. The analytical part of the study analysed successful international examples, leading to a checklist of nanomaterials categorized by hospital zones. The third part involved a base case study in Alexandria, Egypt, simulating the impact of nano coatings on air temperature, radiant temperature, and relative humidity using the DesignBuilder software. Results The results demonstrated a positive impact on patient health and thermal comfort with nano materials. The use of nano coatings in interior design finishes resulted in decreases in air temperature, radiant temperature, and relative humidity. There was an average decrease of 12.3%-16.7% in air temperature, 3%-4.2% in radiant temperature, and 7%-12% in relative humidity throughout the year. Conclusions The study highlighted the effectiveness of nano technology in enhancing the interior finishes of healthcare buildings, leading to improved patient health, thermal comfort, and decreased infection spread rate. We provide valuable recommendations for optimizing material selection in existing hospital buildings in emphasizing potential benefits of nano materials in healthcare facility design.
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Fauzan, Fauzan, Khin Thu Zar Htay, Zawil Huda, Hafiz Oktaufik, and Geby Aryo Agista. "Effect of tsunami load on the elementary school building of the 23/24 Padang, Indonesia." E3S Web of Conferences 331 (2021): 07016. http://dx.doi.org/10.1051/e3sconf/202133107016.
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West Sumatra Province is one of the provinces in Indonesia that is vulnerable to natural disasters, especially earthquakes and tsunamis. Padang city, as the capital city of West Sumatra, is an area that is included in an area with a high level of vulnerability (High Risk Zone) to tsunamis. Therefore, the construction of public buildings such as hospitals, government offices, and school buildings must have certain technical engineering that is able to anticipate the damage and collapse of buildings due to the earthquake and tsunami. One of the public buildings as an educational facility in Padang city is the Elementary School building of the 23/24 (SD 23/24 Padang), located close to the beach. Based on the evaluation results of the Detail Engineering Design (DED) documents, it is found that this building was designed without taking into account the tsunami loads. Therefore, a building assessment should be carried out to check the capacity of the building to resist the working loads, including the tsunami loads, and to investigate the effect of the tsunami loads on the SD 23/24 Padang building. In this study, the building was analyzed using ETABS v.18 software based on the new Indonesian Seismic Code, SNI 1726-2019 for seismic load and FEMA P646-2019 for calculating tsunami loads. The results show that the SD 23/24 Padang building is strong against earthquake loads, but it doesn’t have enough capacity when tsunami loads are applied, in which there are several structural elements (columns/beams) that do not have sufficient capacity to withstand the combined earthquake and tsunami loads. The effect of tsunami loads on the building structure is also discussed in this paper.
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Ivanovich, Vaulin Vladimir, and Singeev Sergey Aleksandrovich. "Improving the safety of hospital complexes in modern conditions." International Journal of Human and Health Sciences (IJHHS) 5, no. 4 (July 20, 2021): 412. http://dx.doi.org/10.31344/ijhhs.v5i4.350.
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Background: The article presents the results of a study of ensuring fire safety in medical and preventive institutions (LPI) on the example of the central city hospital.Objectives: Research is aimed at improving the fire safety of hospital complexes and hospitals in modern conditions.Materials and Methods: The study used the methods of system analysis of scientific research and statistical data on ensuring fire safety, methods of structural analysis of the practice of ensuring fire safety of hospital complexes, mathematical methods for calculating the evacuation of people from a building and the spread of a fire in a building, methods for calculating the economic efficiency of means of support fire safety.Results and Discussion: Based on the analysis of fire statistics in healthcare facilities in Russia, it is concluded that it is advisable to improve the fire safety of hospitals and hospital complexes in modern conditions. The point of view is expressed that along with the fact that fire safety in hospitals is observed, the analysis indicates the existing problems in the practice of implementation.Conclusion: In order to increase the level of fire safety, it is possible to introduce: a modern fire alarm system; video of control systems and monitoring of safety of objects on the territory of the medical facility; installation of automatic fire extinguishing systems in fire-hazardous premises; installation of additional emergency lighting and reflectors indicating the direction of evacuation in case of fire and smoke; carrying out organizational and practical measures to ensure the safety of patients in a medical institution in an emergency situation (ES), namely, it is proposed to develop a memo of actions for patients in the hospital complex on inpatient treatment in case of an emergency with a list in the instruction log; provision of medical facilities with individual rescue equipment and provision of hospitals and hospital complexes with highrise buildings with modern evacuation means.International Journal of Human and Health Sciences Vol. 05 No. 04 October’21 Page: 412-417
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Ramadhani, Glabella Ersyara, Ahmad Farkhan, and Leny Pramesti. "THE DESIGN APPLICATION OF PHYSICAL OUTCOME’S THEORY ON THE HOSPITAL OF MOTHER AND CHILD IN SURAKARTA." ARSITEKTURA 16, no. 1 (April 30, 2018): 39. http://dx.doi.org/10.20961/arst.v16i1.17236.
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<em>Women and Children Hospital is an useful healthcare facility to improve the health of Indonesian people especially for women, mothers and children. The lack of adequate health facilities in Indonesia for mothers and children, especially in the city of Solo, makes the number of health cases concerning them are still poorly handled and thorough. Therefore, it needs a special health facility that handles the problem, namely Women and Children Hospital with concept that can solve the problem. The appropriate theory for solving the problem is the Physical Outcome Theory (derived from the concept of Healing Environment).That theory serves to help patients in the hospital, to feel comfortable and safe to be treated in it. The research method used is applied research, through the exploration of initial ideas and data collection which then concluded to be a guide in the design analysis. The results of Physical Outcome Theory implementation in buildings, realized through the processing siteplan design, building facade, interiors, and exteriors.</em>
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Sihombing, Alfies, Yeni Nuraeni, and Wiwin Triyunarti. "BANGUNAN GEDUNG RUMAH SAKIT DI KABUPATEN CIANJUR DI LIHAT DARI UNDANG-UNDANG NO 44 TAHUN 2009 TENTANG RUMAH SAKIT DAN UNDANG-UNDANG NO 28 TAHUN 2002 TENTANG BANGUNANGEDUNG." Pakuan Justice Journal of Law (PAJOUL) 3, no. 1 (August 4, 2022): 15–23. http://dx.doi.org/10.33751/pajoul.v3i1.5831.
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ABSTRAK Rumah Sakit merupakan sarana publik dibidang kesehatan yang sangat dibutuhkan masyarakat. Sebagai sarana publik dibidang kesehatan, maka diperlukan sumber daya manusia, alat kesehatan bahkan sarana yang menunjang dalam pelayanan kesehatan tersebut. Sebagai sarana publik maka Rumah Sakit pun harus mempunyai gedung yang kemanfaatan disesuaikan dengan fungsinya. Bangunan gedung Rumah Sakit harus memenuhi persayaratan administratif dan persayaratan tehnis. Persyaratan administratif akan terbit ketika persyaratan tehnis dipenuhi. Salah satunya adalah sertifikat laik fungsi. Berdasarkan peraturan gedung bisa dimanfaatkan sesuai fungsi apabila SLF sudah terbit. SLF ini adalah keandalan bangunan gedung yang menjadi syarat secara tehnis. Kegagalan bangunan gedung disesuaikan dengan permasalahan yang ditemukan dilapangan, dengan begitu sanksi dapat diturunkan sesuai dengan permasalahan yang muncul. Kata kunci, Rumah Sakit, bangunan Gedung, Sertifikat Laik Fungsi ABSTRACT The hospital is a public facility in the health sector that is needed by the community. As a public facility in the health sector, human resources, medical equipment, and even facilities that support the health service are needed. As a public facility, the hospital must also have a building whose benefits are adjusted to its function. Hospital buildings must meet administrative and technical requirements. Administrative requirements will be issued when the technical requirements are met. One of them is a function-worthy certificate. Based on building regulations, it can be used according to its function when the SLF has been issued. This SLF is the reliability of the building which is a technical requirement. The failure of the building is adjusted to the problems found in the field, so sanctions can be lowered according to the problems that arise. Keywords, Hospital, Building, Function-worthy Certificate
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Lavy, Sarel, and Manish K. Dixit. "Wall Finish Selection in Hospital Design: A Survey of Facility Managers." HERD: Health Environments Research & Design Journal 5, no. 2 (January 2012): 80–98. http://dx.doi.org/10.1177/193758671200500207.
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Objective: This paper seeks to analyze healthcare facility managers' perceptions regarding the materials used for interior wall finishes and the criteria used to select them. It also examines differences in wall finish materials and the selection process in three major hospital spaces: emergency, surgery, and in-patient units. These findings are compared with healthcare designers' perceptions on similar issues, as currently documented in the literature. Background: Hospital design and the materials used for hospital construction have a considerable effect on the environment and health of patients. A 2002 survey revealed which characteristics healthcare facility designers consider when selecting materials for healthcare facilities; however, no similar study has examined the views of facility managers on building finish selection. Methods: A 22-question survey questionnaire was distributed to 210 facility managers of metropolitan, for-profit hospitals in Texas; IRB approval was obtained. Respondents were asked to rank 10 interior wall finish materials and 11 selection criteria for wall finishes. Data from 48 complete questionnaires were analyzed using descriptive statistics and nonparametric statistical analysis methods. Results: The study found no statistically significant differences in terms of wall finish materials or the characteristics for material selection in the three major spaces studied. It identified facility managers' four most-preferred wall finish materials and the five-most preferred characteristics, with a statistical confidence level of greater than 95%. Conclusions: The paper underscores the importance of incorporating all perspectives: facility designers and facility managers should work together toward achieving common organizational goals.
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Tjitradi, Ireneus Ezra, Arviansyah Arviansyah, and Ireneus Ezra Tjitradi. "Hospital Location Selection Targeting Indonesian NHI Patients for a Sustainable Business." AFEBI Management and Business Review 6, no. 1 (August 19, 2021): 12. http://dx.doi.org/10.47312/ambr.v6i1.416.
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Finding an optimal location is a strategic decision, and an error of location judgment causes problems in the process and directly affects cost and profitability. Currently, Indonesian National Health Insurance (BPJS) program has high coverage growth in Indonesia; however, building hospitals targeting BPJS patients have faced some challenges and may lead to an unprofitable business. Therefore, location selection is a crucial aspect of a hospital’s operation, highly relates to profitability, and impacts business performance. Moreover, being profitable is not enough for businesses to survive in the long run; they have to be sustainable. The purpose of this study is to develop a reference for a location selection for healthcare management when building hospitals targeting BPJS patients. This paper utilizes the EGSEE framework for a sustainable business to evaluate comprehensive hospital location selection sub-factors. The study employs a systematic literature review and a modified Delphi method to examine the experts’ judgment. Finally, the Analytic Hierarchy Process is applied to develop the evaluation method. The result, social factor has the highest priority with a total weight of 42%, followed by economic factor (38%), and environment factor (20%). Besides hospital targeting BPJS patients have a sustainable business by being social, hospitals also contribute to increase the welfare of people living near the facility.
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Awang, Nuratiqah Aisyah, Shirley Jin Lin Chua, Azlan Shah Ali, Cheong Peng Au-Yong, Amaramalar Selvi Naicker, and Brenda Saria Yuliawiratman. "Persons with disability perception of facilities management service quality: hospital buildings in Malaysia." International Journal of Health Care Quality Assurance 34, no. 3/4 (October 4, 2021): 125–39. http://dx.doi.org/10.1108/ijhcqa-08-2020-0165.
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PurposeThis study aims to discover the perception of persons with disabilities (PWDs) towards facilities management (FM) service quality at hospital buildings in Malaysia.Design/methodology/approachA questionnaire survey was conducted with 99 respondents in selected hospitals in Selangor, Malaysia.FindingsThis study aims to discover the perception of PWDs towards FM service quality, and it has found a gap for improvement. The area that requires the highest attention includes the importance of (1) assurance on accessibility despite maintenance activity being conducted (2) criticality of facilities maintenance itself, (3) assurance on comfort and safety, (4) reliable medium to ask for assistance or giving feedback, (5) signage that is clearly seen and easily understood and (6) staff responsiveness.Research limitations/implicationsThis instrument is validated by PWDs under the physical disability category only, specifically in the hospital context. Future research is recommended to identify the FM service quality aspect for different categories of disability (sensory, mental or intellectual impairment).Practical implicationsThe findings provide evidence for FM to consider PWDs' perceptions in FM strategy development. Even FM provides a healthcare support system. FM service quality partly reflects healthcare service quality.Social implicationsAccommodating the need of PWDs through the improvement of FM service quality aspect will partly fulfil the right of PWDs for equality of access to healthcare.Originality/valueThis SERVQUAL tools can be improvised and used to measure the perception of PWDs on FM service quality systematically and holistically. Understanding the service quality aspect is important for a facility manager to precisely measure and prioritise what is truly important to the building users with special needs and try to accommodate this need in the management activity.
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Chaloeytoy, Kittiwoot, Atima Dubsok, and Suthirat Kittipongvises. "Evaluating Thermal Comfort in Ward Areas of the Public Hospital in the Tropical Climates." E3S Web of Conferences 530 (2024): 05009. http://dx.doi.org/10.1051/e3sconf/202453005009.
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Thermal comfort in hospitals is a crucial element to provide appropriate indoor air quality for health and well-being. However, the airconditioning system usually has deficiencies to meet target criteria for the relevant thermal environmental factors. Therefore, this study aimed to evaluate thermal comfort in ward areas of the newly built public hospital in Thailand during the operation phase to examine how the building maintain comfort. The measurement equipment was installed for 24 hours in ward areas for collecting data and evaluating thermal comfort using the predicted mean vote (PMV) model. The results indicated that achieving thermal comfort could be found among inpatients and medical staff, with differential considerations on personal factors. As a few studies in hospitals in Thailand has been done, the results from this study can act as evidence to develop building performance assessments and operation strategies to optimally enhance health and well-being of the occupants in a public healthcare facility in Thailand and tropical regions.
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Sieveking, Nicholas, William Bellet, and Ronald C. Marston. "Employees' Views of Their Work Experience in Private Hospitals." Health Services Management Research 6, no. 2 (May 1993): 129–38. http://dx.doi.org/10.1177/095148489300600207.
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Employees in 10 private for-profit hospitals responded to questionnaires regarding their work experiences, hospital facilities, and employer. Replicated results identified themes of employee opinions, including: Supervision, The Employer, Role Significance, Hospital Image, Competitiveness, Benefits, Cohesiveness, and Work Load. Only scores on the Role Significance scale differed between clinical and non-clinical respondents, with the former scoring higher. Survey methodology can be used to define an organization's culture from the employee's viewpoint. Their perception of this culture helps determine their behavior at work and their conveying the image of their facility in the community. The recent emphasis on quality improvement and ‘bottom-up’ management presents a particularly well-suited opportunity for the effective use of surveys. Quality improvement efforts involve employee groups which empower workers as active diagnosticians, internal consultants, and decision makers. Survey defined ‘action levers’ portray avenues along which such constructive efforts might be directed. Also, surveys identify themes through which management can evaluate organizational performance overall and department by department, building in means by which those responsible for units of the hospital can be accountable for achieving measurable results.
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Brambilla, Andrea, Tian-zhi Sun, Waleed Elshazly, Ahmed Ghazy, Paul Barach, Göran Lindahl, and Stefano Capolongo. "Flexibility during the COVID-19 Pandemic Response: Healthcare Facility Assessment Tools for Resilient Evaluation." International Journal of Environmental Research and Public Health 18, no. 21 (October 31, 2021): 11478. http://dx.doi.org/10.3390/ijerph182111478.
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Healthcare facilities are facing huge challenges due to the outbreak of COVID-19. Around the world, national healthcare contingency plans have struggled to cope with the population health impact of COVID-19, with healthcare facilities and critical care systems buckling under the extraordinary pressures. COVID-19 has starkly highlighted the lack of reliable operational tools for assessing the level sof flexibility of a hospital building to support strategic and agile decision making. The aim of this study was to modify, improve and test an existing assessment tool for evaluating hospital facilities flexibility and resilience. We followed a five-step process for collecting data by (i) doing a literature review about flexibility principles and strategies, (ii) reviewing healthcare design guidelines, (iii) examining international healthcare facilities case studies, (iv) conducting a critical review and optimization of the existing tool, and (v) assessing the usability of the evaluation tool. The new version of the OFAT framework (Optimized Flexibility Assessment Tool) is composed of nine evaluation parameters and subdivided into measurable variables with scores ranging from 0 to 10. The pilot testing of case studies enabled the assessment and verification the OFAT validity and reliability in support of decision makers in addressing flexibility of hospital design and/or operations. Healthcare buildings need to be designed and built based on principles of flexibility to accommodate current healthcare operations, adapting to time-sensitive physical transformations and responding to contemporary and future public health emergencies.
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Gola, Marco, Marta Dell’Ovo, Stefano Scalone, and Stefano Capolongo. "Adaptive Reuse of Social and Healthcare Structures: The Case Study as a Research Strategy." Sustainability 14, no. 8 (April 14, 2022): 4712. http://dx.doi.org/10.3390/su14084712.
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The regeneration and reuse of abandoned healthcare facilities represent one of the most complex issues in the broader field of disused public architectural heritage and its valorization. The leading causes of an elevated quantity of abandoned hospitals are the lack of resilience of these structures, as well as the evolution of the regulatory framework used to increase the quality standards of the National Health System and the constant changes caused by medical discoveries. In addition, the transfer to a new building typically does not involve consideration of the future of the dismissed facility with a lack of a strategic view for its regeneration, thus causing its progressive degradation. Although their large dimensions and unbuilt areas make recovery plans complex, the re-functionalization of these facilities represents an excellent opportunity for social and economic development, as several case studies demonstrate. This paper selects some useful examples of the reconversion and reuse of disused social and healthcare buildings through an accurate comparison that highlights the importance of the topic and the possible actions to be taken into consideration. Although this research focuses on a limited number of case studies, the paper gives rise to some strategies that can be applied to several current cases of disused buildings that could be used to support Decision Makers (DMs) from different countries.
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Garcia, Erin P., and Erin Epson. "Developing a Public Health Model for Regional Infection Prevention Collaboration Among Healthcare Facility Networks." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s187. http://dx.doi.org/10.1017/ice.2020.725.
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Background: Antimicrobial resistance (AR), including Clostridioides difficile infection (CDI), can spread across the healthcare continuum when patients move between facilities. In 2015, the CDC recommended that healthcare facilities (HCFs) and local public health departments (LPH) coordinate their efforts to prevent the spread of AR and CDI. Accordingly, the California Department of Public Health (CDPH) Healthcare-Associated Infections (HAI) Program developed a model for implementing regionally based AR/CDI prevention collaboratives within HCF networks. Methods: The CDPH HAI Program began identifying regions in California with high AR/CDI incidence or risk for AR/CDI emergence using NHSN data. During 2015–2019, we organized AR/CDI prevention collaboratives in these regions. We recruited HCFs for participation by presenting at local professional organization meetings and engaging skilled nursing facility corporate leadership. HAI Program infection preventionists conducted onsite infection prevention assessments at each participating HCF. HAI Program and LPH staff convened quarterly in-person learning and discussion sessions focused on infection prevention and antimicrobial stewardship best practices. Participating HCFs committed to facility-tailored process improvement plans and conducted self-assessments to evaluate infection prevention practice changes at the conclusion of the collaborative. For CDI-focused collaboratives, we used data reported to CDPH via NHSN to assess changes in hospital- and community-onset CDI incidence among participating hospitals before and after the collaboratives. Results: Since 2015, 205 HCFs in 15 LPH jurisdictions have participated in 6 regional AR/CDI prevention collaboratives. Participating HCFs reported improved implementation of AR/CDI prevention strategies. For CDI-focused collaboratives, hospital-onset CDI incidence decreased by ~3% per month among participating hospitals. The collaboratives created forums for communication and relationship building, which previously did not exist among LPH and the HCF networks. We used our experience and feedback from partners to develop an HAI Program AR Prevention Collaborative Tool Kit to help LPHs and healthcare organizations develop and implement regional AR/CDI prevention collaboratives in other at-risk or high AR/CDI prevalence areas in California. The tool kit includes materials developed for each of our collaboratives, which may be adapted to meet local needs. Conclusions: Regionally coordinated AR/CDI prevention initiatives among LPHs and HCFs can contribute to increased AR awareness, improved AR prevention practices, and decreased AR/CDI incidence. The effectiveness of regional AR/CDI prevention collaboratives may be the result of concurrent efforts to improve AR prevention practices both within individual HCFs and across patient sharing networks.Funding: NoneDisclosures: None
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Mandal, Sakti. "Hospital Location Allocation in Murshidabad District by GIS-Based MCA and Analytical Hierarchy Process." Journal of Geography, Environment and Earth Science International 27, no. 3 (March 30, 2023): 1–18. http://dx.doi.org/10.9734/jgeesi/2023/v27i3671.
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Hospitals are one of the most important infrastructural objects. The increasing population, especially in developing countries, amplifies the demand for new hospitals. Identifying the best locations for new hospitals is an important issue due to the fact that selecting suitable locations will help the government to optimize the allocation of medical resources, simplify social contradictions and control the health care development in rural and urban areas.
The district Murshidabad is situated in the bank of Padma and Bhagirathi River. Only 135 primary health centers are there, which provide very basic health services and they are randomly located in the district. No emergency health supporting facilities are present in those health centers and some of them are not opened for 24 hours in a day. Even the block primary health center is also very poor to take admissions of serious patients. Most of the times these health centers ask patient-parties to shift the patient Murshidabad medical college hospital. This is a very tuff job for emergency patients. Sometimes, patient-parties fail to shift the patient to a good hospital for very limited ambulance facility.
To solve the problem, it is very necessary to establish new hospitals or improve the services provided by the existing health centers. And as hospitals are one of the most important health services needed for the whole society, so they must be located in a rational manner so that we can maximize the accessibility of healthcare.
In this paper, we built site suitability analysis for selecting the optimal site for building new hospitals based on using MCA, AHP and Pair wise comparison method.GIS tool and techniques are employed to analyze the list of identified criteria in hospital site selection. These criterion are Population density, Distance from existing health centers, Proximity to road, Distance from railway track, Distance from river, Distance from industrial zones, Proximity to settlement, Proximity to educational institutions, Proximity to rail stations.
The results shows that though suitable areas are scattered over the entire region but most of the suitable areas are situated in the northern part of Murshidabad as national highway andrailway enhance the accessibility of the region. And also the result shows that the southernpart some area is very unsuitable for building new hospital. And it is also true that someexisting hospitals were not built in the suitable place.
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Vargas, Natalia, Sarah Brinkman, and Laura Grangaard. "Measuring Implementation of Antibiotic Stewardship in Critical Access Hospitals Using the NHSN Annual Facility Survey." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s436. http://dx.doi.org/10.1017/ice.2020.1101.
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Background: Critical access hospitals (CAHs) serving rural communities have numerous limitations regarding resources, infrastructure, and staffing to support antibiotic stewardship programs (ASPs) and related quality improvement activities. The Federal Office of Rural Health Policy (FORHP) established the Medicare Beneficiary Quality Improvement Project (MBQIP) to provide CAHs with specialized technical assistance in quality improvement data collection and reporting to drive improvements in the quality of care and to reduce barriers to establishing ASPs. In 2016, FORHP developed an antibiotic stewardship process measure in partnership with the CDC to assess progress on implementing ASPs and to optimize hospital quality improvement practices related to antibiotic use. This is the first measure to be successfully implemented and reported at a national level to improve the judicious use of antibiotics in hospitals. Methods: A process measure was developed to assess adherence to the 7 core elements of a successful hospital ASP (ie, leadership, accountability, drug expertise, action, tracking, reporting, and education), as defined by CDC guidelines. Implementation was accomplished through CAH participation in the NHSN Annual Facility Survey (AFS). Responses were analyzed to assess fidelity to each core element, to identify trends, and to benchmark measure reporting among 1,350 CAHs across the United States. Responses were mapped to 7 core element categories, and the total number of positive responses were matched to each core element for a specific survey year to track progress. Overall, the measure assessed progress in meeting all 7 core elements, as well as program robustness in the number of actions implemented and the amount of data tracked and reported at each hospital. NHSN reports were generated to tailor technical assistance activities and to assist hospitals with measure uptake and reporting. Results: CAH participation in the NHSN significantly increased from 2014 to 2018 (83% response rate). From 2014 through 2018, reporting of the new antibiotic stewardship measure consistently increased. CAHs that met all core elements increased from 18% (2014) to 73% (2018). Performance-based benchmarks enabled hospital comparisons and the establishment of reporting goals. Conclusions: This study highlights viable approaches to measuring antibiotic stewardship at a national level to drive improvements in care at hospitals of any size. The implementation of the antibiotic stewardship measure across CAHs demonstrates the impact of federal programs like MBQIP for hospitals that are building capacity for quality improvement. For the first time, CAHs were able to measure and compare their implementation of ASPs to other hospitals at the state and national level.Funding: NoneDisclosures: None
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Harris, Debra D. "Return on investment of a LEED platinum hospital: the influence of healthcare facility environments on healthcare employees and organizational effectiveness." Journal of Hospital Administration 3, no. 6 (September 17, 2014): 37. http://dx.doi.org/10.5430/jha.v3n6p37.
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Objective: The purpose of this research study was to link hospital environments to the quality of care and the associated cost of care by examining the relationship among hospital environments and healthcare employee engagement, turnover, illness and injury. Methods: This study used a multi-method research design and quantitative analysis of data sets from participating hospitals. Data included employee survey responses and human resource employee data provided by the hospital system. All statistical tests used an alpha level of .05. The analysis of the survey and human resource employee data tested for significant differences among employees at the participating hospitals; and used correlations and regression analysis to determine the direction and strength of the relationships where significant differences were evident. Results: Results from the survey indicated that perceptions of the built environment affect employee engagement and health and well-being up to 14%. Turnover and injury reductions were significant and resulted in substantial cost differences; $2.17M cost reduction based on the facility replaced and annual cost avoidance of $2.24M when compared to the two newer hospitals that were not Leadership in Energy and Environmental Design (LEED) certified. Conclusions: This study demonstrates that the quality of the hospital environment has social, environmental, and cost implications that aligns with the intention of sustainable design as defined by the United States Green Building Council (USGBC). Developing a built environment that supports productivity, efficiency, safety, and engagement contributes to the prosperity of the healthcare organization.
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Setola, Nicoletta, Eletta Naldi, Maria Vittoria Arnetoli, Luca Marzi, and Roberto Bologna. "Hospital responses to COVID-19: evidence from case studies to support future healthcare design research." Facilities 40, no. 1/2 (November 3, 2021): 131–45. http://dx.doi.org/10.1108/f-03-2021-0023.
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Purpose The Covid-19 pandemic has placed health-care systems and their facilities throughout the world under immense pressure. The pandemic has highlighted the crucial role of health-care facilities design in looking beyond the ongoing crisis and considering how hospitals can better prepare for unexpected future health situations. This study aims to investigate how hospitals reacted to the crisis in terms of their physical spaces, which architectural features permitted the necessary transformations, and how this data can inform hospital design research in the future. Design/methodology/approach The research adopted a qualitative and multi-method approach to case studies. Data was collected directly (field survey and interviews) and indirectly (literature, periodicals, specialised websites, webinars, conferences and forums), and a strengths, weaknesses, opportunities, threats analysis supported the data evaluation. Findings Hospitals’ responses to the crisis were guided by a host of variables depending on the specific intervention context and risk scenario. Some key issues emerged as particularly meaningful to drive future research in hospital design, namely, architectural typology, layout and spatial proximities, technological systems, the quality of care spaces, the role of public spaces, facility management tools to drive the transformation, territorial health care networks and new technologies. Originality/value The paper suggests that the current crisis can be transformed into an opportunity, in terms of research and innovation, to rethink and improve the quality and efficiency of health-care spaces, restoring their crucial role of promoting health by design.
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Gupta, S. D., Sandesh Kumar Sharma, Santosh Kumar, Neeraj Sharma, and Ashok Jain. "Self-assessment of Public Healthcare Facility in Conformity with Accreditation Guidelines for Quality Services." Journal of Health Management 25, no. 2 (June 2023): 156–61. http://dx.doi.org/10.1177/09720634231175750.
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There is a growing global concern for healthcare quality and patient safety and several countries have initiated accreditation and self assessment programmes for improved quality healthcare and patient safety. Both are based on the quality improvement framework and standards. Case studies have shown that: I) Accreditation certification of hospitals and healthcare facilities has been improved the quality of healthcare and related healthcare services. ii) Self-assessment by healthcare organisations has proved to be very useful tool for continuous and sustainable improvement in organization performance, quality of services, patient satisfaction over and above building the self-confidence of the care providers. In context of facility assessed it was carried out using a checklist specifically designed for this study with 318 items. The scoring pattern comprised total points and percent compliance for functional capacity of the hospital in comparison to prescribed norms. Assessment revealed maximum compliance in the categories of MIS and communication (100%). The facility lacked standard operating procedures, quality assurance system and fire safety system. Self-assessment as continuous feature will lay the basis for planning new interventions for impacting over all quality healthcare outcomes as well sustainability.
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Khairullah, Hilmi, Muhammad Ridha Alhamdani, and Jawas Dwijo Putro. "RUMAH SAKIT TIPE C DI KECAMATAN PONTIANAK UTARA." JMARS: Jurnal Mosaik Arsitektur 10, no. 2 (August 19, 2022): 500. http://dx.doi.org/10.26418/jmars.v10i2.57079.
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Health is a healthy state of a person who is not only physically but also socially, spiritually and mentally. In every area there must be a health service facility called a hospital. The construction of hospitals in Pontianak City is not so evenly distributed, especially in North Pontianak District. Type C general hospital is a hospital with a capacity of at least 100 inpatient beds, and related to the number of facilities and the ability of specialized medical services at least 4 (four) basic specialists. The approach used in planning a type C hospital is a healing environment approach, which is an approach that combines elements of nature, psychology, and the senses with considerations of site, actors and activities, size of space, architectural elements, structures, utilities. The purpose of this design is the design of a type C hospital that can meet the needs of health facilities in North Pontianak District and the design of a hospital building that is comfortable, safe, and can respond to the surrounding environment by combining natural, psychological, and sensory elements. The methodology used is data collection, data analysis and synthesis, and the design phase. The result of the design of a type C hospital is a hospital building that is comfortable, safe, and able to respond to the surrounding environment by combining natural, psychological, and sensory elements in North Pontianak District.
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Oh, Jeeheh, Maggie Makar, Christopher Fusco, Robert McCaffrey, Krishna Rao, Erin E. Ryan, Laraine Washer, et al. "A Generalizable, Data-Driven Approach to Predict Daily Risk ofClostridium difficileInfection at Two Large Academic Health Centers." Infection Control & Hospital Epidemiology 39, no. 4 (March 26, 2018): 425–33. http://dx.doi.org/10.1017/ice.2018.16.
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OBJECTIVEAn estimated 293,300 healthcare-associated cases ofClostridium difficileinfection (CDI) occur annually in the United States. To date, research has focused on developing risk prediction models for CDI that work well across institutions. However, this one-size-fits-all approach ignores important hospital-specific factors. We focus on a generalizable method for building facility-specific models. We demonstrate the applicability of the approach using electronic health records (EHR) from the University of Michigan Hospitals (UM) and the Massachusetts General Hospital (MGH).METHODSWe utilized EHR data from 191,014 adult admissions to UM and 65,718 adult admissions to MGH. We extracted patient demographics, admission details, patient history, and daily hospitalization details, resulting in 4,836 features from patients at UM and 1,837 from patients at MGH. We used L2 regularized logistic regression to learn the models, and we measured the discriminative performance of the models on held-out data from each hospital.RESULTSUsing the UM and MGH test data, the models achieved area under the receiver operating characteristic curve (AUROC) values of 0.82 (95% confidence interval [CI], 0.80–0.84) and 0.75 ( 95% CI, 0.73–0.78), respectively. Some predictive factors were shared between the 2 models, but many of the top predictive factors differed between facilities.CONCLUSIONA data-driven approach to building models for estimating daily patient risk for CDI was used to build institution-specific models at 2 large hospitals with different patient populations and EHR systems. In contrast to traditional approaches that focus on developing models that apply across hospitals, our generalizable approach yields risk-stratification models tailored to an institution. These hospital-specific models allow for earlier and more accurate identification of high-risk patients and better targeting of infection prevention strategies.Infect Control Hosp Epidemiol2018;39:425–433
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Alsuhaibani, Mohammed, Takaaki Kobayashi, Lorinda Sheeler, Alexandra Trannel, Stephanie Holley, Oluchi Abosi, Kyle Jenn, et al. "Bat Intrusions at a Tertiary Care Center, Iowa 2018–2020." Antimicrobial Stewardship & Healthcare Epidemiology 1, S1 (July 2021): s16. http://dx.doi.org/10.1017/ash.2021.29.
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Background: Bats are recognized as important vectors in disease transmission. Frequently, bats intrude into homes and buildings, increasing the risk to human health. We describe bat intrusions and exposure incidents in our hospital over a 3-year period. Methods: The University of Iowa Hospitals and Clinics (UIHC) is an 811-bed academic medical center in Iowa City, Iowa. Established in 1928, UIHC currently covers 209,031.84 m2 (~2,250,000 ft2) and contains 6 pavilions built between 1928 and 2017. We retrospectively obtained bat intrusion calls from the infection prevention and control program call database at UIHC during 2018–2020. We have also described the event management for intrusions potentially associated with patient exposures. Results: In total, 67 bat intrusions occurred during 2018–2020. The most frequent locations were hallways or lounges 28 (42%), nonclinical office spaces 19 (14%), and stairwells 8 (12%). Most bat intrusions (65%) occurred during the summer and fall (June–November). The number of events were 15 in 2018, 28 in 2019, and 24 in 2020. We observed that the number of intrusions increased with the age of each pavilion (Figure 1). Of 67 intrusions, 2 incidents (3%) were associated with potential exposure to patients. In the first incident, reported in 2019, the bat was captured in a patient care area and released before an investigation of exposures was completed and no rabies testing was available. Also, 10 patients were identified as having had potential exposure to the bat. Among them, 9 patients (90%) received rabies postexposure prophylaxis. In response to this serious event, we provided facility-wide education on our bat control policy, which includes the capture and safe handling of the bat, assessment of potential exposures, and potential need for rabies testing. We also implemented a bat exclusion project focused on the exterior of the oldest hospital buildings. The second event, 1 patient was identified to have potential exposure to the bat. The bat was captured, tested negative for rabies, no further action was needed. Conclusions: Bat intrusions can be an infection prevention and control challenge in facilities with older buildings. Hospitals may need animal intrusion surveillance systems, management protocols, and remediation efforts.Funding: NoDisclosures: None
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Lai, Joseph, and P. L. Yuen. "Performance evaluation for hospital facility management: literature review and a research methodology." Journal of Facility Management Education and Research 3, no. 1 (January 1, 2019): 38–43. http://dx.doi.org/10.22361/jfmer/96267.
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ABSTRACT Underpinning the quality of health services is a wide range of facilities services that require effective management. With the importance of such facilities management (FM) increasingly recognized, research on healthcare FM has grown, with many that attempted to develop some performance frameworks or key performance indicators (KPIs) for hospital FM. A credible scheme that is tailored for evaluating the holistic FM performance of hospital buildings, however, is yet to be seen. In order to establish such a performance evaluation scheme, a research project was initiated. A review of the literature germane to hospital FM and the groundwork completed by the research team, based on which the project was formulated, is reported in this paper. The research methodology of the project and the five stages of rigorous research work, including a multi-pronged approach to data collection, the method for processing the data with an analytic network process (ANP) and the steps for establishing the intended evaluation scheme, are also described.
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Goniewicz, Krzysztof, Patrycja Misztal-Okońska, Witold Pawłowski, Frederick M. Burkle, Robert Czerski, Attila J. Hertelendy, and Mariusz Goniewicz. "Evacuation from Healthcare Facilities in Poland: Legal Preparedness and Preparation." International Journal of Environmental Research and Public Health 17, no. 5 (March 9, 2020): 1779. http://dx.doi.org/10.3390/ijerph17051779.
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Medical facilities, while providing both essential and demanding health care to society’s most vulnerable populations, also belong to the most demanding category of risk to human life if and when a crisis event occurs within its walls. The development of a safe evacuation plan for these facilities is extremely complicated, as the evacuation of medical facilities is much more complex than for other critical infrastructure. In this category, the evacuated patients constitute a specific risk group requiring specialized medical care. Hospitalized persons may be dependent on life-saving measures, are unconscious or immobile, are significantly restricted in movement or mentally unbalanced, being dependent on the continued assistance of trained third parties. Additionally, the medical transport of evacuated patients becomes more difficult due to the limited capacity of ambulances and available health care facilities to transport them to, which are increasingly limited due to their overcrowded census. The study aimed to analyze the requirements which are placed on hospitals in Poland to ensure the safety of patients in case of an evacuation. The research method used in the paper was retrospective analysis and evaluation of the media and literature. We have found, that Polish law imposes an obligation on the administrator of a medical facility to ensure the safety of both patients and employees. The regulations cover issues of technical conditions to be met by buildings and their location, prevention, and fire protection requirements, and the determination of which staff is responsible for the evacuation. However, available documents fail to describe what the hospital evacuation process itself should entail under emergency evacuation. Taking into account the complexity of the hospital evacuation process, health care facilities should have a well-developed plan of action that must be implemented at least once a year in the form of facility-wide training. Evacuation drills should not be avoided. Only trained procedures offer the possibility of later analysis to identify and eliminate errors and provide the opportunity to acquire skill sets and habits which promote the behaviors expected in real-life emergencies.
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Gunawan, Abdi, Yudi Purnomo, and Uray Fery Andi. "PERANCANGAN RUMAH SAKIT IBU DAN ANAK DI KABUPATEN SINTANG." JMARS: Jurnal Mosaik Arsitektur 10, no. 1 (February 19, 2022): 146. http://dx.doi.org/10.26418/jmars.v10i1.52621.
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Health is the most important factor in people's lives, especially the health of mothers and children. The increasing number of births and deaths and the increasing number of residents in Sintang Regency as the 3rd largest Regency in West Kalimantan Province, thus requires a health facility that accommodates services for mothers and children. One type of service is the Mother and Child Hospital (RSIA). The design of this hospital is planned in Sintang District, Sintang Regency. This location was taken based on the issue of the importance of RSIA development, and 2019 Central Statistics Agency (BPS) data which shows that health facilities such as hospitals are not evenly distributed in Sintang Regency in Sintang District. The design method used includes: ideas, data collection, analysis, and the design phase, as well as the results of the design of the maternal and child hospital. This design consists of a linear building that follows the shape of the land. Zoning space is divided and adapts to narrow land forms. Orientation, placement and circulation are regulated based on existing regulations and analysis, so that there is a need for circulation paths as needed, and on the facade of the building it is planned to use several window openings that are used as natural lighting and ventilation in the room.
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Nur, Khilda Wildana, Andi Annisa Amalia, and Siti Fuadillah Alhumairah Amin. "Evaluasi Adaptasi Arsitektur terhadap Pandemi Covid-19 pada Bangunan Fasilitas Kesehatan di Makassar." ARSITEKTURA 20, no. 1 (April 30, 2022): 115. http://dx.doi.org/10.20961/arst.v20i1.55995.
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<p class="Abstract"><em>Architecture responds to the Pandemic with a unified and massive form, while the Covid-19 demands buildings that are completely void. This research was conducted at the healthcare facility building at Khadijah Hospital in Makassar which is expected to be a representative building for mapping the transmission of Covid-19 in public facilities. This study aims to examine adaptation strategies from the architectural realm in healthcare facilities combined with studies on COVID-19 mitigation and Muhammadiyah mediation in applying Islamic concepts. This research is descriptive exploratory to the object of research. The data collection method was obtained from the results of observations, interviews, and literature studies which were then analyzed using synchronic reading and diachronic reading methods, aligning all available information so that conclusions were obtained from all references. This study results that adaptation is more likely to regulate circulation, limit the number of people, and reduce furniture. Providing additional rooms such as green open spaces, and special cabin for patients and visitors are not fully accommodated because health care facility considers the cost and construction time. Another result is that the form of architectural adaptation raises the potential for design based on natural interventions such as the healing environment approach and biophilic design.</em></p>
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Bulakh, I. V. "Common Features of Architectural Design of the Medical Purpose Building." Science & Technique 18, no. 4 (August 13, 2019): 311–18. http://dx.doi.org/10.21122/2227-1031-2019-18-4-311-318.
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The paper considers principal features and specific character of architectural design for health care institutions. Main designing stages, missions and complexities for every successive designing step have been revealed in the paper. The paper presents specific features, main stages and design approaches to designing of modern health care facilities, comfortable architectural environment of health institutions, which have been formed on the basis of the analysis of advanced international experience in the field of designing healthcare facilities. The proposed approaches are based on modern experience in designing medical buildings over the past decade in the developed countries. A special attention has been paid to obsolete methods for architecture-planning organization of healthcare facilities and modern approaches to arrangement of engineering and other systems which significantly influence on economical efficiency, quality, comfort and effectiveness of architectural environment in healthcare institutions. Every healthcare facility, every separate department are considered as unique in their essence, for this reason it is not so easy to reflect modern technological solutions and architectural tendencies. The paper contains an attempt to attract attention of architects to the complexity in designing of a building to be constructed, to find ways which will help to reach its step-by-step solution. It has been noted as well that there is a necessity to arrange interaction between an architect and a medical technologist. Modern medical departments and hospitals have been recently designed and built in the Ukraine, but they are in increasingly short number. These facilities have been constructed due to decision makers who, in spite of diverse difficulties, lack of information and specialists, lack of proper funding, etc., are trying to do their best in order to reach the modern level of desingning and construction of hospitals. So-called “typical” medical projects of 70-ies and 80-ies continue to be implemented up to now. This is certainly due to inadequate funding, but such economy has at the end rather high cost.
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Ariani, Madelina, Bella Donna, Happy Pangaribuan, Gde Yogadhita, and Hendro Wartatmo. "Hospital Preparedness in Facing the COVID-19 Pandemic Based on the Command System: A Study in Jakarta and Yogyakarta, Indonesia." Prehospital and Disaster Medicine 38, S1 (May 2023): s163. http://dx.doi.org/10.1017/s1049023x23004235.
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Introduction:Hospitals have had Hospital Disaster Plans (HDP), however, when the COVID-19 pandemic attacked, several hospitals neglected the HDP. They seem to find it difficult to operationalize HDP. The hospital’s problems were also increasingly complex because they must also think about how to break the internal transmission chain and how to deal with the surge in COVID-19 patients besides building a clear incident command system (ICS). This study aimed to carry out documentation and analyze hospital preparedness in dealing with COVID-19 based on the ICS.Method:This study was documentation research using a qualitative approach. All hospital preparations in "high case" areas in Jakarta and Yogyakarta from April to June 2020 were documented, followed by interviews and document observations. Furthermore, data were analyzed according to the ICS management functions; commander, secretary, operational, logistics, planning, and financial administration.Results:Since the COVID-19 pandemic, hospitals had developed a separate COVID-19 handling system from the existing HDP documents. The analysis showed the division of tasks and functions of each field in the COVID-19 Task Force already existed, but it had not been described in detail. The communication and procedure flow within the internal and external COVID-19 task force were generally only verbal. In conclusion, related to the readiness to face the surge in COVID-19 patients, the hospitals have not made any plans or supervision for handling COVID-19.Conclusion:Hospital preparedness in the face of the COVID-19 pandemic based on the Command System has not been maximized. The existing HDP only includes planning for natural disaster management. Furthermore, every health facility established the COVID-19 Task Force. However, the principle of division of tasks, communication, and planning flow in the Task Force still needs to be improved.
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Veligotska, Y., and S. Gordiienko. "THE FEATURES OF MODERN INTERIORS FORMATION OF MEDICAL INSTITUTIONS." Municipal economy of cities 6, no. 159 (November 27, 2020): 56–61. http://dx.doi.org/10.33042/2522-1809-2020-6-159-56-61.
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The interior design of hospitals space takes an important role in improving well-being during medical stays. In Today in Ukraine, the development of medical institutions, and especially their interior spaces, is given insufficient attention, and they, with their outdated and unattractive appearance, can cause discomfort to most patients, employees and visitors. Based on this, the general objectives of the study were to analyze the practical experience of interior design of medical institutions and identify important aspects and features of interior design. The article examines the design features of health care facilities from the perspective of the patient, visitor and employee. Analysis of the practical experience of interior design in modern hospitals around the world has revealed the main trends in design solutions. Analyzing the different designs of medical facilities around the world, it was found that the architectural styles for healthcare buildings are extremely diverse. From small specialized hospitals to huge medical complexes that help thousands of patients every day, each facility uses a unique combination of design details. On the basis of this analysis the general approaches of design concerning their formation are revealed. Some of them are based on the orientation and comfortable movement of all subjects of the hospital. Others are based on the fact that the technicality and conciseness of the design - a guarantee of quality medical care. Another approach when the design is based on natural integration and environmental friendliness, which creates a comfortable feeling in the hospital. Based on this, important aspects of the design of medical institutions were identified, including: aesthetic, environmental, functional, psychological and practical aspects. The main features of the interior of medical institutions are identified, which include the following important design elements: noise background, aesthetic and compositional solutions, lighting (natural, artificial), natural communication, ergonomics, comfortable workplaces, accents, visual landmarks. This article defines that the interior design of medical institutions is a set of measures to ensure the proper level of hospitals, which will significantly improve the well-being of patients, optimize the work of employees and create a comfortable environment for all subjects of these institutions.
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Aliabadi, Amir A., Steven N. Rogak, Karen H. Bartlett, and Sheldon I. Green. "Preventing Airborne Disease Transmission: Review of Methods for Ventilation Design in Health Care Facilities." Advances in Preventive Medicine 2011 (2011): 1–21. http://dx.doi.org/10.4061/2011/124064.
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Health care facility ventilation design greatly affects disease transmission by aerosols. The desire to control infection in hospitals and at the same time to reduce their carbon footprint motivates the use of unconventional solutions for building design and associated control measures. This paper considers indoor sources and types of infectious aerosols, and pathogen viability and infectivity behaviors in response to environmental conditions. Aerosol dispersion, heat and mass transfer, deposition in the respiratory tract, and infection mechanisms are discussed, with an emphasis on experimental and modeling approaches. Key building design parameters are described that include types of ventilation systems (mixing, displacement, natural and hybrid), air exchange rate, temperature and relative humidity, air flow distribution structure, occupancy, engineered disinfection of air (filtration and UV radiation), and architectural programming (source and activity management) for health care facilities. The paper describes major findings and suggests future research needs in methods for ventilation design of health care facilities to prevent airborne infection risk.
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Duffy, Kerry, Adam Pearson, and Mark Waters. "Moving a hospital - a once in a lifetime experience." Australian Health Review 25, no. 2 (2002): 155. http://dx.doi.org/10.1071/ah020155.
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It is a hugely complex task to move a 525-bed acute tertiary health facility to a new building whilst continuing to provide services to the public - a task that was undertaken at Brisbane's Princess Alexandra Hospital in March/April 2001. There were complex issues to manage, ranging from clinical unit interdependence across a split campus to the development of detailed plans for transferring telephone extensions/personal computers in a "live environment". The success of the Princess Alexandra exercise is shown by there having been no adverse effects on patients, the lack of negative media attention and the occurrence of only two staff injuries during the move. Meticulous planning and good communication with staff and stakeholders (other hospitals, general practitioners)supported this success. The decision to reduce clinical services where possible during the shift was helpful.Understanding the complexity and richness of the information technology, the work environment and the humanelements on campus was also critical to success. One major error was the initial decision to schedule the move within weeks of receiving practical completion of the new building. It became all too clear in November 2000 that further time was required to commission the building. The Transition was therefore rescheduled from January to March 2001. This decision was critical to the success of the move.
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Ma, Jing, Lawrence Lessner, Judith Schreiber, and David O. Carpenter. "Association between Residential Proximity to PERC Dry Cleaning Establishments and Kidney Cancer in New York City." Journal of Environmental and Public Health 2009 (2009): 1–7. http://dx.doi.org/10.1155/2009/183920.
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Perchloroethylene (PERC) is commonly used as a dry cleaning solvent and is believed to be a human carcinogen, with occupational exposure resulting in elevated rates of kidney cancer. Living near a dry cleaning facility using PERC has been demonstrated to increase the risk of PERC exposure throughout the building where the dry cleaning is conducted, and in nearby buildings. We designed this study to test the hypothesis that living in an area where there are many PERC dry cleaners increases PERC exposure and the risk of kidney cancer. We matched the diagnosis of kidney cancer from hospitalization discharge data in New York City for the years 1994–2004 by zip code of patient residence to the zip code density of dry cleaners using PERC, as a surrogate for residential exposure. We controlled for age, race, gender, and median household income. We found a significant association between the density of PERC dry cleaning establishments and the rate of hospital discharges that include a diagnosis of kidney cancer among persons 45 years of age and older living in New York City. The rate ratio increased by 10 to 27% for the populations in zip codes with higher density of PERC dry cleaners. Because our exposure assessment is inexact, we are likely underestimating the real association between exposure to PERC and rates of kidney cancer. Our results support the hypothesis that living near a dry cleaning facility using PERC increases the risk of PERC exposure and of developing kidney cancer. To our knowledge, this study is the first to demonstrate an association between residential PERC exposure and cancer risk.
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Scanlon, Molly, Ellen Taylor, and Kirsten Waltz. "Evaluating Efficacy of a COVID-19 Alternative Care Site Preparedness Assessment Tool for Catastrophic Healthcare Surge Capacity during Pandemic Response." Healthcare 11, no. 3 (January 21, 2023): 324. http://dx.doi.org/10.3390/healthcare11030324.
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During the COVID-19 pandemic, implementing catastrophic healthcare surge capacity required a network of facility infrastructure beyond the immediate hospital to triage the rapidly growing numbers of infected individuals and treat emerging disease cases. Providing regional continuity-of-care requires an assessment of buildings for alternative care sites (ACS) to extend healthcare operations into non-healthcare settings. The American Institute of Architects (AIA) appointed a COVID-19 ACS Task Force involving architects, engineers, public health, and healthcare professionals to conduct a charrette (i.e., intensive workshop) to establish guidance during the alert phase of the pandemic. The task force developed an ACS Preparedness Assessment Tool (PAT) for healthcare teams to assist with their rapid evaluation of building sites for establishing healthcare operations in non-healthcare settings. The tool was quickly updated (V2.0) and then translated into multiple languages. Subsequently, the authors of this manuscript reviewed the efficacy of the PAT V2.0 in the context of reported case studies from healthcare teams who developed a COVID-19 ACS in community settings. In summary, policy makers should re-examine the role of the built environment during emergency pandemic response and its impact on patients and health professionals. An updated ACS PAT tool should be established as part of the public health preparedness for implementing catastrophic healthcare surge capacity.
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Sherman, Jules P., Laura C. Hedli, Alexandria I. Kristensen-Cabrera, Steven S. Lipman, Doug Schwandt, Henry C. Lee, Lillian Sie, Louis P. Halamek, and Naola S. Austin. "Understanding the Heterogeneity of Labor and Delivery Units: Using Design Thinking Methodology to Assess Environmental Factors that Contribute to Safety in Childbirth." American Journal of Perinatology 37, no. 06 (April 23, 2019): 638–46. http://dx.doi.org/10.1055/s-0039-1685494.
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Abstract Objective There is limited research exploring the relationship between design and patient safety outcomes, especially in maternal and neonatal care. We employed design thinking methodology to understand how the design of labor and delivery units impacts safety and identified spaces and systems where improvements are needed. Study Design Site visits were conducted at 10 labor and delivery units in California. A multidisciplinary team collected data through observations, measurements, and clinician interviews. In parallel, research was conducted regarding current standards and codes for building new hospitals. Results Designs of labor and delivery units are heterogeneous, lacking in consistency regarding environmental factors that may impact safety and outcomes. Building codes do not take into consideration workflow, human factors, and patient and clinician experience. Attitude of hospital staff may contribute to improving safety through design. Three areas in need of improvement and actionable through design emerged: (1) blood availability for hemorrhage management, (2) appropriate space for neonatal resuscitation, and (3) restocking and organization methods of equipment and supplies. Conclusion Design thinking could be implemented at various stages of health care facility building projects and during retrofits of existing units. Through this approach, we may be able to improve hospital systems and environmental factors.
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Brambilla, Andrea, Jan Marvin Apel, Inga Schmidt-Ross, Maddalena Buffoli, and Stefano Capolongo. "Testing of a Multiple Criteria Assessment Tool for Healthcare Facilities Quality and Sustainability: The Case of German Hospitals." Sustainability 14, no. 24 (December 14, 2022): 16742. http://dx.doi.org/10.3390/su142416742.
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Background: Hospital facilities are an essential part of healthcare systems, making the assessment of their quality and sustainability pivotal. Most existing evaluation tools lack a holistic and validated approach, while predominantly excluding the built environment. The Italian hospital evaluation tool SustHealth v2 addresses the shortcoming of existing applications through its structured and more integrated approach; there is the need for further testing it. Methods: The study aims to test for the first time in an international case study the multicriteria assessment tool previously developed and validated. The tool assesses social, environmental, and organisational qualities in hospitals with an online survey containing 199 closed questions sent to German hospitals. A total of 14 full replies have been collected and the resulting data analysed through descriptive statistics and heat maps identifying patterns in ownership and size. Results: Within the sample, higher scores are reported in Social Quality, while lower in Environmental and Organisational Quality. Respondents performed well in the sustainability dimensions of health promotion, waste management, and patient safety. Improvements can be achieved in energy management, facility management, and technological innovation criteria. Private hospitals slightly outperform both public and non-profit clinics. The findings presented in this study suggest a non-linear relationship between sustainability and hospital size since the highest scores were obtained by either small or large facilities. Conclusion: The study highlighted strengths and limitation of SustHealth v2. Further testing and comparison are encouraged in different context.
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Haynes, Michele, Timothy O'Rourke, Daphne Nash, Bernard Baffour, Sue York, Carys Chainey, Georgia Betros, and Paul Memmott. "Aboriginal and Torres Strait Islander preferences for healthcare settings: effective use of design images in survey research." Australian Health Review 44, no. 2 (2020): 222. http://dx.doi.org/10.1071/ah18196.
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Objective The aim of this study was to develop an effective digital survey instrument incorporating images to investigate Aboriginal and Torres Strait Islander preferences for health clinics and hospitals, design of healthcare settings and the differences between inner regional and remote locations. Methods Design-related constructs developed from qualitative interviews informed the construction of healthcare setting images. These images were embedded in an online survey instrument to elicit data on design preferences and an area-based recruitment strategy ensured participation by Indigenous Australians from three Queensland locations. Logistic regression analyses were used to estimate the odds of preference for a healthcare setting design by location. Results Statistical analysis of data from 602 participants showed a preference for health care at an Aboriginal and Torres Strait Islander clinic. The odds of preference for an in-patient room with a two- versus single-bed design was greater for participants with less education, and lower for participants with a long-term health problem. Conclusions The multidisciplinary approach to developing an online survey instrument with images and the willingness of Indigenous people of all ages to engage with the images demonstrated the effectiveness of this method in providing robust evidence for the design of culturally appropriate healthcare spaces for Indigenous users. What is known about the topic? Evidence-based research influences the design of healthcare buildings, yet the field currently provides negligible evidence on cross-cultural perceptions or experiences of conventional modern hospitals and clinics. Although recent healthcare buildings show signs of acknowledging Indigenous users, general principles in the Australian Health Facility Guidelines give limited specific information about how cultural requirements may translate into architectural design. What does this paper add? The multidisciplinary approach to research design has enabled the development of healthcare design-related constructs from consultation with Indigenous people, the presentation of these constructs as images and the inclusion of these images for comparison and selection in a digital survey instrument. Combined with a culturally appropriate recruitment strategy, this survey provides evidence from a large sample of the Indigenous population. Selected results from analyses of survey responses show the capacity of the methodological approach to address broader questions about Indigenous preferences for healthcare settings by location, age and sex. What are the implications for practitioners? A focus on individual preferences related to healthcare clinics and the combined significance of design and setting can give practitioners a better understanding of Aboriginal and Torres Strait Islander people’s preferences and suggest ways to reduce the incidence of poor engagement with healthcare services.
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Lino, Bartholomew, Arie Eisenman, Richard Schuster, Carlos Giloni, Masad Bharoum, Moshe Daniel, and Cham Dallas. "The Second Lebanon War Experience at Western Galilee Hospital." Disaster Medicine and Public Health Preparedness 10, no. 1 (July 21, 2015): 152–56. http://dx.doi.org/10.1017/dmp.2015.80.
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AbstractThe summer of 2006 in northern Israel served as the battleground for the second war against Hezbollah based along Israel’s border with southern Lebanon. Western Galilee Hospital (WGH), which is located only 6 miles from the Lebanese border, served as a major medical center in the vicinity of the fighting. The hospital was directly impacted by Hezbollah with a Katyusha rocket, which struck the ophthalmology department on the 4th floor. WGH was able to utilize a 450-bed underground facility that maintained full hospital functionality throughout the conflict. In a major feat of rapid evacuation, the entire hospital population was relocated under the cover of darkness to these bunkers in just over 1 hour, thus emptying the building prior to the missile impact. Over half of the patients presenting during the conflict did not incur physical injury but qualified as acute stress disorder patients. The particulars of this evacuation remain unique owing to the extraordinary circumstances, but many of the principles employed in this maneuver may serve as a template for other hospitals requiring emergency evacuation. Hospital functionality drastically changed to accommodate the operational reality of war, and many of these tactics warrant closer investigation for possible implementation in other conflict zones. (Disaster Med Public Health Preparedness. 2016;10:152–156)
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van der Voordt, Theo J. M. "Adding value by health care real estate: parameters, priorities, and interventions." Journal of Corporate Real Estate 18, no. 2 (May 9, 2016): 145–59. http://dx.doi.org/10.1108/jcre-11-2015-0037.
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Purpose Because of the transition of the Dutch health care sector from a governmentally steered domain towards regulated market forces, health care organisations have become fully responsible for their real estate. This paper aims to explore if/how Dutch health care organisations adopt the concept of adding value by corporate and public real estate, which values are prioritised and how these values are implemented in daily practice. Design/methodology/approach Literature study and a meta-analysis of six student theses (1 × BSc, 1 × MSc, 3 × post-MSc and 1 × PhD) on adding value by health care facilities were conducted, using document analysis and semi-structured interviews with CEOs, project leaders, real estate managers and facility managers. All respondents work in Dutch hospitals, assisted living facilities for the elderly, or mental health care facilities. The interviews were jointly prepared by the students, and the author of this paper being their supervisor. Findings End-user satisfaction, enhancing productivity and stimulating innovation are highly prioritised. Which values are prioritised depends on the organisational objectives, target group, available budget, position in the life cycle of design, construction and use and external context, in particular governmental policy and competition with other health care suppliers. The operationalisation into concrete design choices and strategic management of buildings-in-use is still underdeveloped. Research limitations/implications The interviews lasted 1-1.5 hours, which is rather limited to get a complete picture. Although much work has been done to operationalise the added value of corporate real estate and building-related facilities, there is still a lack of a widely agreed taxonomy of added values and how to measure and manage these values. Ongoing international collaboration between researchers and practitioners aims to contribute to a common framework and to develop standardised measurement methods. Practical implications The insights can support decision-makers in value-adding real estate and facilities management value by public and corporate real estate. The listings of prioritised values and related interventions can be used as a frame of reference to improve the current design and management of health care real estate. Social implications A clear insight in value-adding management of corporate real estate may result in a better fit among real estate, organisational objectives and end-user needs. Originality/value The findings link the added value theory to corporate real estate management in Dutch health care practice.
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Ahmed, Abdulsalam, Hafiz T. A. Khan, and Muili Lawal. "Effective Hospital Care Delivery Model for Older People in Nigeria with Multimorbidity: Recommendations for Practice." Healthcare 10, no. 7 (July 7, 2022): 1268. http://dx.doi.org/10.3390/healthcare10071268.
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The importance of developing an effective action-based model of care for multimorbid patients has become common knowledge, but it remains unclear why researchers in Nigeria have not paid attention to the issue. Hence, this study assessed the quality of health services using the Donabedian model and aimed to recommend an effective hospital care delivery model for older people in Nigeria with multimorbidity. A cross-sectional study using face-to-face data was conducted between October 2021 and February 2022. The reported data were collated, checked, coded, and entered into JISC online survey software and then exported to IBM Statistical Package for Social Science (SPSS) version 27 for analysis, sourced from the University of West London, London, United Kingdom. The data were collected from the outpatient department of four high-volume public secondary hospitals in Niger State (the largest hospital in the three senatorial zones and that of the state capital). Systematic random sampling was used to select 734 patients with two or more chronic diseases (multimorbidity) aged 60 years and above who presented for routine ambulatory outpatient and consented to participate in the study. A Service Availability and Readiness Assessment (SARA) tool was used to assess the structure, and the process quality was assessed by the patients’ experiences as they navigated the care pathway, whereas the outcome was measured using the patients’ overall satisfaction. Using Spearman’s correlation, no statistically significant association was observed between satisfaction level with the healthcare that was received and the five domains of health facility readiness (Total score Basic Amenities, Total score Basic Equipment, Total score infection control, Total score diagnostic capacity, Total score essential drugs), and the general facility readiness. Finally, the process component superseded the structure as the determinant of the quality of healthcare among multimorbid patients in Niger State. The emphasis of the process should be on improving access to quality of care, improving patient–physician relationships and timing, reducing the financial burden of medical care, and building confidence and trust in medical care. Therefore, these factors should be incorporated into designing the healthcare model for multimorbid patients in Nigeria.
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Kihungi, Loyce, Mary Ndinda, Samantha Dolan, Evelyn Wesangula, Linus Ndegwa, George Owiso, John Lynch, Lauren Frisbie, and Peter Rabinowitz. "Improvement of Infection Prevention and Control Practices Using Quality Improvement Approach in Two Model Hospitals in Kenya." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s286—s287. http://dx.doi.org/10.1017/ice.2020.859.
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Background: Little is known about how best to implement infection prevention and control programs in low-resource settings. The quality improvement approach using plan-do-study-act (PDSA) cycles provides a framework for data-driven infection prevention and control implementation. We used quality improvement techniques and training to improve infection prevention and control practices in 2 model hospitals in Kenya. Methods: The 2 hospitals were chosen by the Kenya Ministry of Health for capacity building on infection prevention and control. At each site, the project team (the University of Washington International Training for Education and Training in Health, Ministry of Health, and Centers for Disease Control) conducted infection prevention and control training to infection prevention and control committee members. Infection prevention and control quality improvement activities were introduced in a staggered manner, focusing on hand hygiene and waste management practices. For hand hygiene, the project team’s technical assistance focused on facility hand hygiene infrastructure, hand hygiene practice adherence, hand hygiene supply quantification, and monitoring and evaluation using WHO hand hygiene audit tools. Waste management technical assistance focused on availability of policy, guidelines, equipment and supplies, waste segregation, waste quantification, and monitoring and evaluation using a data collection tool customized based on previously published tools. Regular interactive video conference sessions between the project team and the sites that included didactic sessions and sharing of data provided ongoing mentorship and feedback on quality improvement implementation, data interpretation, and data use. Results: Hand hygiene data collection began in April 2018. In hospital A, hand hygiene compliance increased from a baseline of 3% to 51% over 9 months. In Hospital B, hand hygiene compliance rates increased from 23% at baseline to 44% after 9 months. Waste management data collection began in November 2018. At hospital A, waste segregation compliance scores increased from 73% at baseline to 80% over 6 months, whereas hospital B, waste segregation compliance went from 44% to 80% over 6 months. Conclusions: A quality improvement approach appears to be a feasible means of infection prevention and control program strengthening in low resource settings.Funding: NoneDisclosures: None
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Alhussain, Haitham, Vemparala Priyatha, Musa Bin Bashir, Saba Ijaz, Umar Farooq, Wondimagegn Tibebu Tilahun, Abrham Warkineh Azale, et al. "Analysing Health Professionals' Adherence to National Guidelines and Comparing Diabetes Care in Specialized Care Centres and Hospitals." American Journal of Internal Medicine 12, no. 1 (March 13, 2024): 1–10. http://dx.doi.org/10.11648/j.ajim.20241201.11.
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The socioeconomic impact of diabetes treatment includes significant costs for diagnosis, treatments, hospitalizations, and associated social challenges. According to the International diabetic federation (IDF) guidelines, effective management entails a holistic strategy including nutritious diet, avoiding carbonated beverages, quitting smoking, and routine exercising. Targeted weight loss is critical, comprising antidiabetic medications, a specific food plan, and lifestyle changes to attain a 7-8% glycated hemoglobin level. Proper medicine and footwear use reduces ulcer risks and further complications. The IDF emphasizes detailed treatment plans and sequential screenings. Diabetes management is obligatory, focusing glycaemic control, lifestyle changes, and risk assessment. A study examines treatment programs, medical behaviour, and factors impacting diabetic care reception. This study examined diabetes mellitus treatment in medical facilities by conducting health information reviews in outpatient clinics with a sample size of 400 records. Java applets detected problems, indicating 95% confidence in therapy. Cross-sectional studies in Peshawar hospitals included 250 patients, whereas specialized diabetic treatment centers evaluated 150 patients. Documented care differed; public hospitals had lower foot inspection rates (16.4%) than specialized care (14%). Statistical analysis, such as the Chung test and binary logistic regression, was used to assess variable relationships. Smoking was common (86%), and 59.8% relied on oral anti-diabetic medications. Less than 30% follow up examinations were recorded in public hospitals which showed discrepancies in documentation. Diabetes management can be improved, particularly through better screening procedures. Discrepancies between provided and documented care underscore the need for higher documentation standards. Private clinics demonstrated comparatively better care, possibly influenced by consultation fees, facility availability, and a comfortable environment—attributes lacking in public hospitals in Pakistan.
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Pace, Lydia E., Jean Marie Vianney Dusengimana, Jean Paul Balinda, Origene Benewe, Vestine Rugema, Cyprien Shyirambere, Jean Bosco Bigirimana, et al. "Integrating breast cancer screening into a cervical cancer screening program in three rural districts in Rwanda." Journal of Clinical Oncology 38, no. 15_suppl (May 20, 2020): 2025. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.2025.
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2025 Background: In low-income countries where mammography is not widely available, optimal strategies to facilitate earlier breast cancer detection are not known. We previously conducted a cluster randomized clinical trial of clinician trainings in Burera District in rural Rwanda to facilitate earlier diagnosis among symptomatic women; 1.3% of women evaluated at intervention health centers (HCs) were diagnosed with cancer. Early stage breast cancer incidence was higher in intervention areas. Subsequently, Rwanda Biomedical Centre, Rwanda’s national health implementation agency, adapted the program in 3 other districts, offering screening clinical breast exams (CBE) to all women aged 30-50 years receiving cervical cancer screening and any other woman requesting CBE. A navigator facilitated patient tracking. We sought to examine patient volume, service provision and cancer detection rate in the adapted program. Methods: We abstracted data from weekly HC reports, facility registries, and the referral hospital’s electronic medical record to determine numbers of patients seen, referrals made, biopsies, and cancer diagnoses from July 2018-December 2019. Results: CBE was performed at 17,239 visits in Rwamagana, Rubavu and Kirehe Districts (total population 1.34 million) over 18, 17 and 7 months of program implementation respectively. At 722 visits (4.2%), CBE was abnormal. 571 patients were referred to district hospitals (DH); their average age was 35 years. Of those referred, 388 (68.0%) were seen at DH; 32% were not. Of those seen, 142 (36.6%) were referred to a referral facility; 121 of those referred (85.2%) actually went to the referral facility. Eighty-eight were recommended to have biopsies, 83 (94.3%) had biopsies, and 29 (34.9% of those biopsied; 0.17% of HC visits) were diagnosed with breast cancer. Conclusions: Integrating CBE screening into organized cervical cancer screening in rural Rwandan HCs led to a large number of patients receiving CBE. As expected, patients were young and the cancer detection rate was much lower than in a trial focused on symptomatic women. Even with navigation efforts, loss-to-follow-up was high. Analyses of stage, outcomes, patient and provider experience and cost are planned to characterize CBE screening’s benefits and harms in Rwanda. However, these findings suggest building health system capacity to facilitate referrals and retain patients in care are needed prior to further screening scaleup. In the interim, early diagnosis programs targeting symptomatic women may be more efficient and feasible.