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Planning and budgeting for healthcare facilities necessitate precise estimation and a thoughtful analysis of the required area for each department, as well as extensive knowledge of the most important elements that can influence the design and provide an appropriate environment for staff and patients. A gross conversion factor is influential in calculating the entire area of a department. However, there is no precise standard indicating how this factor should be calculated. To address this problem, quality function deployment (QFD) has been implemented. The intensive care unit (ICU) is one of the highly equipped departments that should be properly planned; therefore, it was selected for application. The five steps of the QFD are used to identify and rank the most important and efficient design features. Only the top factors are considered in calculating the required area for the ICU department. This approach presents a unique method for estimating the gross square area based on calculating the gross conversion factor. To demonstrate the proposed approach's efficacy, it was applied to two Egyptian public hospitals. The results reveal that 15–16% of the total space of both hospitals can be reduced from the total department space. Moreover, an outstanding reduction in ICU design and preparation expenses has been achieved. The design reduces the required budget for a project while maintaining the same construction material quality and accommodating extra beds. Additionally, the QFD proves its ability to redesign the ICU department while reducing costs. [ABSTRACT FROM AUTHOR]

Urban management and planning during public health emergencies, such as the COVID-19 pandemic, are critical. This article examines hospital site selection in Yinzhou, Ningbo, China, using geographical data analysis. It evaluates travel costs and referral patterns between hospitals and community health facilities to establish a sustainable hierarchical diagnosis and treatment system. The results reveal that existing medical facilities, particularly in rural areas, are inadequate during public health emergencies. The article proposes considering total transportation costs in allocating the sites of new hospitals and suggests adopting a 'permanent + temporary' facility planning approach to ease financial burdens. Addressing these issues can mitigate the inequitable distribution of urban and rural medical resources. This article was published open access under a CC BY licence: https://creativecommons.org/licenses/by/4.0/. [ABSTRACT FROM AUTHOR]

Abstract Planning and budgeting for healthcare facilities necessitate precise estimation and a thoughtful analysis of the required area for each department, as well as extensive knowledge of the most important elements that can influence the design and provide an appropriate environment for staff and patients. A gross conversion factor is influential in calculating the entire area of a department. However, there is no precise standard indicating how this factor should be calculated. To address this problem, quality function deployment (QFD) has been implemented. The intensive care unit (ICU) is one of the highly equipped departments that should be properly planned; therefore, it was selected for application. The five steps of the QFD are used to identify and rank the most important and efficient design features. Only the top factors are considered in calculating the required area for the ICU department. This approach presents a unique method for estimating the gross square area based on calculating the gross conversion factor. To demonstrate the proposed approach’s efficacy, it was applied to two Egyptian public hospitals. The results reveal that 15–16% of the total space of both hospitals can be reduced from the total department space. Moreover, an outstanding reduction in ICU design and preparation expenses has been achieved. The design reduces the required budget for a project while maintaining the same construction material quality and accommodating extra beds. Additionally, the QFD proves its ability to redesign the ICU department while reducing costs.

Objective: The study aims to investigate what design practitioners and healthcare facility managers deem as important benchmarking metrics worldwide, investigating country differences in benchmarking usage and which metrics are prioritized. Background: Benchmarking is a regular practice in the healthcare sector, both for clinical and managerial aspects to compare, measure, and improve standardized processes. However, limited knowledge is available about benchmarking procedures in hospital planning, design, and construction. Methods: A web-based survey was designed, revised, and pilot-tested in five countries; it was adjusted according to local experts' suggestions and submitted globally via SoSci multilingual platform to persons involved in hospital design, research, construction, and facility management. It was composed of closed questions on 5-point Likert-type scale ranking frequency or importance and open-ended questions divided into six sections. Two hundred and eighty full responses have been collected. Statistical analysis was performed via PowerBI and R-Studio, while qualitative analysis was performed via MAXQDA. Results: The findings reported allow for both specific insights per each country or category as well as enabling general considerations of a practice that is becoming always more international with 30%–50% of respondents working in the international context. The evaluation of the survey highlights the most important benchmarks, among others. For example, for respondents from the top five countries (Sweden, Spain, Germany, Italy, and the United States), the most important metric for benchmark comparability is whether the project was new construction, new construction attached to an existing hospital, or interior renovation. Construction date, client type (public vs. private), and country of location were also generally rated as the most important metrics by respondents. Other metrics that were consistently rated as important globally included inpatient unit layout, walking distances, number of floors, and whether all patient rooms are private. Space-related metrics are considered very important elements in the design and planning of healthcare facilities worldwide. Regarding cost-related metrics, all countries consider the ratio construction cost per building gross area as the most important. Conclusions: Benchmarking emerges as a relevant tool for hospital design and planning as it can support efficiency, standardization, and confidence; currently, benchmarking is still underutilized due to the challenge of international comparison, access to data outside each specific company, and variation design metrics nationally. Benchmarking strategies should be further investigated to support knowledge exchange and to ensure reliable and comparable information globally. [ABSTRACT FROM AUTHOR]

Background: Various programmes and models for post-intensive care unit (ICU) follow-up services have been developed worldwide. In China, post-ICU follow-up remains in the exploratory stage and little is known regarding the appropriate form and challenges of implementation, which need to be further explored. Aim: This study aimed to explore and describe the barriers to and facilitators of post-ICU follow-up services from the perspective of critical care professionals. Design: This was a descriptive qualitative study. Semi-structured interviews were conducted with 21 health care workers whose units had offered ICU survivors different forms of follow-up services; the data were analysed by qualitative content analysis during August 2022 and December 2022. Setting: The study was conducted at 14 ICUs in 11 tertiary hospitals in Shanghai, China. Findings: Seventeen subthemes were extracted as barriers and facilitators in the follow-up of ICU survivors. In the initiating process, the barriers included the restriction of decision-making rights and scope of practice, indifferent attitude towards survivors and repeated work. The facilitators included admitted significance, the needs of ICU survivors, the conscientiousness of professionals and the pioneers and leadership support. In the implementation process, lack of confidence, lack of cooperation in medical consortium, distrusted relationships, restrictions of medical insurance, ageing problems and insufficient human resources acted as barriers, whereas lessons learned, positive feedback and digital support served as facilitators. Furthermore, recommendations and tips were identified for offering follow-up services. Conclusion: Medical personnel can better utilize available resources and develop strategies to overcome constraints by gaining insights into the abovementioned barriers and facilitators. The findings of this study can provide a useful reference for structured and systematic follow-ups to ameliorate post-intensive care syndrome in low- and middle-income countries. Relevance to Clinical Practice: Publicity and educational measures play a crucial role in enhancing the awareness of survivors and the consensus of health care professionals from medical consortium regarding impairments after critical care. Leadership and policy support can address numerous obstacles to guiding follow-up services. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed to extend original research and identify operational and space-related requirements for specialization from the perspectives of nursing behavior and process. Background: Studies related to the specialty of different nursing units have been widely conducted in nursing science, while few studies have explored the specialized requirements for the physical environments of nursing units in different departments. Method: Questionnaire survey data were collected from 125 nurses in 11 clinical departments, and nurse shadowing (approximately 68 hr) was conducted in four clinical departments. Results: The questionnaire survey showed that satisfaction with care activity, visibility, and physical environment within the existing nursing unit environment was rated differently among different departments of nursing units. However, nurses in different groups of age, education, work experience, and position indicated no statistically significant difference. Behavioral observations demonstrated that the spatial and temporal distributions of activities, spatial linkages, and communication patterns varied in distinct departments. Conclusion: This research found that nurses in different departments had different evaluations of satisfaction and environmental characteristics. It also explains the differences in nursing work behaviors and processes found in various departments and sheds light on specialized requirements from the behavior perspective. The findings could help optimize the design of efficient and satisfactory nursing units in different departments. [ABSTRACT FROM AUTHOR]

Copyright of Zeitschrift für Herz-, Thorax- und Gefaesschirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article examines the effort to restructure Catholic health care in the Diocese of Brooklyn during the 1960s. It looks specifically at the formation of the Catholic Medical Center of Brooklyn and Queens (CMC), an ambitious plan to unite diocesan-owned hospitals and forge the nation's first multi-institutional Catholic hospital system. Formally announced just two days before the federal government's new Medicare program launched, the plan reflected the optimism of the moment and reveals the enormous faith that Catholic health care providers placed in the promise of federal funding. But within a few short years, the system stood on the brink of collapse as administrative and financial challenges mounted. The CMC's complicated history reveals not only the internal struggle that the diocese faced in restructuring its hospitals, modernizing facilities, and creating a unified health care system but also the tensions inherent in 1960s health care reform and the limits of the public-private partnership it envisioned between the government and the voluntary health care sector. [ABSTRACT FROM AUTHOR]

Purpose: The new Italian National Recovery and Resilience Plan (NRRP) has prioritised a new healthcare model that will establish the additional community healthcare facilities (CHFs). The paper proposes a methodology for supporting decision-making on location of the future facilities according to new parameters that consider how proximity to healthcare benefits communities. Rethinking the spatial parameters for locating future CHFs, focusing on fragile areas, creates a novel decision support system. Design/methodology/approach: The methodology is based on multifactor analysis and on geographic information system (GIS) mapping to simulate the potential and risks associated with the proposed location of CHFs, focusing on territorial contexts of metropolitan cities, medium-sized cities, and Inner Areas, characterized by different fragilities. This method aims to innovate urban planning practices by updating the practice of per-capita urban planning standards and promoting implementation of the 15-minute city model. Findings: The method defines new spatial parameters useful to inform the appropriate location of CHFs in Italy's Inner Areas. This offers a new integrated approach to spatial design mixing urban planning and healthcare dimensions. Originality/value: The methodology will bring about an integrated urban planning approach, which guides both transformative urban choices and health services' implementation according to the needs of communities. [ABSTRACT FROM AUTHOR]

Abstract Background Effects of demographic change, such as declining birth rates and increasing individual life expectancy, require health system adjustments offering age- and needs-based care. In addition, healthcare factors can also influence health services demand. Methods The official German hospital statistics database with odd-numbered years between 1995 and 2011 was analysed. This is a national comprehensive database of all general hospital inpatient services delivered. Official data from hospital statistics were linked at the district level with demographic and socio-economic data as well as population figures from the official regional statistics. Panel data regression, modelling case numbers per hospital, was performed for 13 diagnosis groups that characterised the patient structure. Socio-demographic variables included age, sex, household income, and healthcare factors included bed capacity, personnel and hospital characteristics. Results The median number of annual treatments per hospital increased from 6 015 (5th and 95th percentile [670; 24 812]) in 1995 to 7 817 in 2011 (5th and 95th percentile [301; 33 651]). We developed models characterising the patient structure of health care in Germany, considering both socio-demographic and hospital factors. Demographic factors influenced case numbers across all major diagnosis groups. For example, the age groups 65–74 and 75 + influenced cerebrovascular disease case numbers (p

The regionalization of care for ST elevation myocardial infarction (STEMI) may unintentionally concentrate patients with non-ST elevation myocardial infarction (NSTEMI) into percutaneous coronary intervention (PCI) capable hospitals. This could lead to benefits such as increased access to PCI-capable hospitals, but could cause harms such as crowding in some hospitals with decreased patient volume and revenue in others. We set out to assess whether STEMI regionalization programs concentrated patients with NSTEMI at STEMI-receiving hospitals.

Background: Effects of demographic change, such as declining birth rates and increasing individual life expectancy, require health system adjustments offering age- and needs-based care. In addition, healthcare factors can also influence health services demand. Methods: The official German hospital statistics database with odd-numbered years between 1995 and 2011 was analysed. This is a national comprehensive database of all general hospital inpatient services delivered. Official data from hospital statistics were linked at the district level with demographic and socio-economic data as well as population figures from the official regional statistics. Panel data regression, modelling case numbers per hospital, was performed for 13 diagnosis groups that characterised the patient structure. Socio-demographic variables included age, sex, household income, and healthcare factors included bed capacity, personnel and hospital characteristics. Results: The median number of annual treatments per hospital increased from 6 015 (5th and 95th percentile [670; 24 812]) in 1995 to 7 817 in 2011 (5th and 95th percentile [301; 33 651]). We developed models characterising the patient structure of health care in Germany, considering both socio-demographic and hospital factors. Demographic factors influenced case numbers across all major diagnosis groups. For example, the age groups 65–74 and 75 + influenced cerebrovascular disease case numbers (p < 0.001). Other important factors included human and material resources of hospitals or the household income of patients. Distinct differences between the models for the individual diagnosis groups were observed. Conclusions: Hospital planning should not only consider demographic change but also hospital infrastructure and socio-economic factors. [ABSTRACT FROM AUTHOR]

Implementing large-scale nursing continuing development programs for bedside staff can be operationally challenging. The aim of this project was to establish a sustainable simulation education program that is incorporated into staff nurses' work schedules and provides provisions to accommodate patient assignment coverage. This article describes the planning, implementation, and evaluation of a simulation programthat was successfully delivered to 89%of nurses employed on four inpatient units at an academic medical center. [ABSTRACT FROM AUTHOR]

Copyright of Balikesir Health Sciences Journal / Balıkesir Sağlık Bilimleri Dergisi is the property of Balikesir Health Sciences Journal (BAUN Health Sci J) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The healthcare sector is growing in importance as people continue to age and pandemics complicate the boundary conditions of such systems. The number of innovative approaches to solve singular tasks and problems in this area is only slowly increasing. This is particularly evident when looking at medical technology planning, medical training and process simulation. In this paper a concept for versatile digital improvements to these problems by using state of the art development methods of Virtual Reality (VR) and Augmented Reality (AR) are presented. The programming and design of the software is done with the help of Unity Engine, which provides an open interface for docking with the developed framework for future work. The solutions were tested under domain specific environments and have shown good results and positive feedback. [ABSTRACT FROM AUTHOR]

Copyright of Gefaesschirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BackgroundDuring the fight against COVID-19, China’s public hospitals played the main role in taking on the most urgent, dangerous and arduous medical treatment and work. Therefore, in order to promote the high-quality development of hospitals, it is necessary to support some potential public hospitals to build and develop a “One Hospital with Multiple Campuses System” (OHMC) based on controlling the size of single hospitals, and to quickly convert their functions in the event of a severe epidemic.MethodsThe Cobb–Douglas production function and log-transformed production function were used to measure the appropriate hospital size for 22 public hospitals in a region of China.ResultsThe eight OHMC hospitals that planned to be build are basically qualified to handle the conditions and potential of multi-districts from the perspective of economy of scale. The OHMC hospitals in operation appear to have weakened incremental scale rewards, because they are in the process of development, but they are still higher than the overall level of single-campus hospitals.ConclusionThe expansion of hospital scale may bring the advantages of group development, but it may also bring about problems including rising hospital cost, increasing management and operation cost, inefficient allocation of medical resources and unbalanced development.

Although Temporary Hospitals (THs) usually present improvised structures, they are considered necessary solutions in extreme situations, such as critical moments of the COVID-19 pandemic. Timely planning of hospital resources is a challenging task for public health decision-makers and essential to caring for patients to ensure the healthcare system's sustainability. For this reason, we propose the integration of Discrete Event Simulation (DES), Response Surface Methodology (RSM), and Normalized Normal Constraint (NNC) for planning a TH in Brazil amid the COVID-19 pandemic. While DES is an outstanding process modelling approach, RSM and NNC are methods for planning and analysing experiments and generating a representative set of optimal solutions for decision-makers. This study defined the number of beds in the Short Stay Unit (SSU) that maximizes the number of patients attended and the patient conformity rate while minimizing the SSU daily cost. Moreover, two uncontrollable input factors are also considered: the number of patients arriving at the TH and the percentage of these patients who have COVID-19. We developed complete and evenly distributed Pareto frontiers considering controllable and uncontrollable factors, which decision-makers can use according to the metrics prioritization and the pandemic status. [ABSTRACT FROM AUTHOR]

Equipping rooms used for medical purposes, like e.g., intensive care units, is an expensive and time-consuming task. In order to avoid extensive subsequent adjustments due to inappropriate layout visualization or geometric conditions difficult to identify in 2D plans, it is of utmost importance to provide an optimal planning environment to future users such as physicians and nurses. In this paper we present the concept of a fully automatized pipeline, which is designed to visualize computer aided design (CAD) data using virtual reality (VR). The immersive VR experience results in improvement of efficiency in the decisionmaking process during the planning phase due to better spatial imagination. The pipeline was successfully tested with CAD data from existing Intensive Care Units. The results indicate that the pipeline can be a valuable tool in the field of spatial planning in healthcare, due to simple usage and fast conversion of CAD data. The next step will be the development of a plugin for CAD tools to allow for interactions with the CAD models in Virtual Reality, which is not yet possible without manual intervention. [ABSTRACT FROM AUTHOR]

Abstract Background Patient engagement (PE) in hospital planning and improvement is widespread, yet we lack evidence of its impact. We aimed to identify benefits and harms that could be used to assess the impact of hospital PE. Methods We interviewed hospital-affiliated persons involved in PE activities using a qualitative descriptive approach and inductive content analysis to derive themes. We interpreted themes by mapping to an existing framework of healthcare performance measures and reported themes with exemplar quotes. Results Participants included 38 patient/family advisors, PE managers and clinicians from 9 hospitals (2

Abstract Background Medical treatment quality has been shown to be better in high volume than in low volume hospitals. However, this relationship has not yet been confirmed in abdominal cancer in Switzerland and is relevant for referral of patients and healthcare planning. Thus, the present study investigates the association between hospital volumes for surgical resections of colon, gastric, rectal, and pancreatic carcinomas and outcomes. Methods This retrospective analysis is based on anonymized claims data of patients with mandatory health insurance at Helsana Group, a leading health insurance in Switzerland. Outcome parameters were length of hospital stay, mortality and cost during the inpatient stay as well as at 1-year follow-up. Hospital volume information was derived from the Quality Indicators dataset provided by the Swiss Federal Office of Public Health. The impact of hospital volume on the different treatment outcomes was statistically tested using generalized estimating equations (GEE) models, taking into account the non-independence of observations from the same hospital. Results The studies included 2′859 resections in patients aged 18 years and older who were hospitalized for abdominal cancer surgery between 2014 and 2018. Colon resections were the most common procedures (n = 1′690), followed by rectal resections (n = 709). For rectal, colon and pancreatic resections, an increase in the mean number of interventions per hospital and a reduction of low volume hospitals could be observed. For the relationship between hospital volume and outcomes, we did not observe a clear dose-response relationship, as no significantly better outcomes were observed in the higher-volume category than in the lower-volume category. Even though a positive “routine effect” cannot be excluded, our results suggest that even hospitals with low volumes are able to achieve comparable treatment outcomes to larger hospitals. Conclusion In summary, this study increases transparency on the relationship between hospital volume and treatment success. It shows that simple measures such as defining a minimum number of procedures only might not lead to the intended effects if other factors such as infrastructure, the operating team or aggregation level of the available data are not taken into account.

Objectives Smart hospitals involve the application of recent information and communications technology (ICT) innovations to medical services; however, the concept of a smart hospital has not been rigorously defined. In this study, we aimed to derive the definition and service types of smart hospitals and investigate cases of each type. Methods A literature review was conducted regarding the background and technical characteristics of smart hospitals. On this basis, we conducted a focus group interview with experts in hospital information systems, and ultimately derived eight smart hospital service types. Results Smart hospital services can be classified into the following types: services based on location recognition and tracking technology that measures and monitors the location information of an object based on short-range communication technology; high-speed communication network-based services based on new wireless communication technology; Internet of Things-based services that connect objects embedded with sensors and communication functions to the internet; mobile health services such as mobile phones, tablets, and wearables; artificial intelligence-based services for the diagnosis and prediction of diseases; robot services provided on behalf of humans in various medical fields; extended reality services that apply hyper-realistic immersive technology to medical practice; and telehealth using ICT. Conclusions Smart hospitals can influence health and medical policies and create new medical value by defining and quantitatively measuring detailed indicators based on data collected from existing hospitals. Simultaneously, appropriate government incentives, consolidated interdisciplinary research, and active participation by industry are required to foster and facilitate smart hospitals.

Planning problems in healthcare systems have received greater attention in the last decade, especially because of the concerns recently raised about the scattering of surgical interventions among a wide number of different facilities that can undermine the quality of the outcome due to the volume-outcome association. In this paper, an approach to plan the amount of surgical interventions that a facility has to perform to assure a low adjusted mortality rate is proposed. The approach explicitly takes into account the existing interaction among patients' choices and decision makers' planning decisions. The first objective of the proposed approach is to find a solution able to reach quality in health outcomes and patients' adherence. The second objective is to investigate the difference among solutions that are identified as optimal by either only one of the actors' perspective, i.e., decision makers and patients, or by considering both the perspectives simultaneously. Following these objectives, the proposed approach is applied to a case study on Italian colon cancer interventions performed in 2014. Results confirm a variation in the hospital planned volumes when considering patients' behaviour together with the policy maker plan, especially due to personal preferences and lack of information about hospital quality. [ABSTRACT FROM AUTHOR]

Abstract Background Patient engagement (PE) in health‐care planning and improvement is a growing practice. We lack evidence‐based guidance for PE, particularly in hospital settings. This study explored how to optimize PE in hospitals. Methods This study was based on qualitative interviews with individuals in various roles at hospitals with high PE capacity. We asked how patients were engaged, rationale for approaches chosen and solutions for key challenges. We identified themes using content analysis. Results Participants included 40 patient/family advisors, PE managers, clinicians and executives from 9 hospitals (2

Background: Patient engagement (PE) in hospital planning and improvement is widespread, yet we lack evidence of its impact. We aimed to identify benefits and harms that could be used to assess the impact of hospital PE. Methods: We interviewed hospital-affiliated persons involved in PE activities using a qualitative descriptive approach and inductive content analysis to derive themes. We interpreted themes by mapping to an existing framework of healthcare performance measures and reported themes with exemplar quotes. Results: Participants included 38 patient/family advisors, PE managers and clinicians from 9 hospitals (2 < 100 beds, 4 100 + beds, 3 teaching). Benefits of PE activities included 9 impacts on the capacity of hospitals. PE activities involved patient/family advisors and clinicians/staff in developing and spreading new PE processes across hospital units or departments, and those involved became more adept and engaged. PE had beneficial effects on hospital structures/resources, clinician staff functions and processes, patient experience and patient outcomes. A total of 14 beneficial impacts of PE were identified across these domains. Few unintended or harmful impacts were identified: overextended patient/family advisors, patient/family advisor turnover and clinician frustration if PE slowed the pace of planning and improvement. Conclusions: The 23 self reported impacts were captured in a Framework of Impacts of Patient/Family Engagement on Hospital Planning and Improvement, which can be used by decision-makers to assess and allocate resources to hospital PE, and as the basis for ongoing research on the impacts of hospital PE and how to measure it. [ABSTRACT FROM AUTHOR]

Improving access to healthcare for people experiencing homelessness can be achieved via outreach clinics. Involving medical students in homeless healthcare projects leads to increased understanding of the social determinants of health and positive changes in student perception of this vulnerable patient group. Projects such as this can increase the social accountability of medical schools, with the potential to have a positive effect on health in the local community. Third-year medical students on GP placement were given the opportunity to design and deliver temporary clinics to the homeless population in Corby with the support of Public Health Northamptonshire. The study aimed to evaluate this educational intervention by exploring the students' motivation, experience and ideas on sustainability of the project via a focus group. Humanitarianism and the opportunity to meet patients face-to-face during the pandemic were motivating factors for joining the project. Students felt the educational experience was valuable, providing exposure to a patient group not often encountered in medical school. They gained an understanding of some of the challenges faced by this population. Some said this project forced them to address their unconscious biases and cited that to be a reason why projects like this should be mandatory. The learning experience made students consider funding and the organisation of healthcare. This study found that hands-on learning can provide educational and rewarding experiences for medical students. Positive experiences in the GP setting may impact career choices and allow them consider leadership and public health. [ABSTRACT FROM AUTHOR]

The article discusses a partnership created by a large healthcare organization and a baccalaureate nursing program in the Northeast to provide COVID-19 vaccinations to the community amidst nursing shortage in the U.S. Topics covered include the benefits of academic and clinical partnerships and the steps taken to deliver vaccinations in a timely fashion.

Background: Medical treatment quality has been shown to be better in high volume than in low volume hospitals. However, this relationship has not yet been confirmed in abdominal cancer in Switzerland and is relevant for referral of patients and healthcare planning. Thus, the present study investigates the association between hospital volumes for surgical resections of colon, gastric, rectal, and pancreatic carcinomas and outcomes.Methods: This retrospective analysis is based on anonymized claims data of patients with mandatory health insurance at Helsana Group, a leading health insurance in Switzerland. Outcome parameters were length of hospital stay, mortality and cost during the inpatient stay as well as at 1-year follow-up. Hospital volume information was derived from the Quality Indicators dataset provided by the Swiss Federal Office of Public Health. The impact of hospital volume on the different treatment outcomes was statistically tested using generalized estimating equations (GEE) models, taking into account the non-independence of observations from the same hospital.Results: The studies included 2'859 resections in patients aged 18 years and older who were hospitalized for abdominal cancer surgery between 2014 and 2018. Colon resections were the most common procedures (n = 1'690), followed by rectal resections (n = 709). For rectal, colon and pancreatic resections, an increase in the mean number of interventions per hospital and a reduction of low volume hospitals could be observed. For the relationship between hospital volume and outcomes, we did not observe a clear dose-response relationship, as no significantly better outcomes were observed in the higher-volume category than in the lower-volume category. Even though a positive "routine effect" cannot be excluded, our results suggest that even hospitals with low volumes are able to achieve comparable treatment outcomes to larger hospitals.Conclusion: In summary, this study increases transparency on the relationship between hospital volume and treatment success. It shows that simple measures such as defining a minimum number of procedures only might not lead to the intended effects if other factors such as infrastructure, the operating team or aggregation level of the available data are not taken into account. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Road traffic crashes (RTCs) annually cause about 1.35 million deaths and 20-50 million injuries. Hospitals have the main role in responding to road traffic injuries (RTIs) and decreasing the number of disabilities and deaths. This study aimed to assess the preparedness of selected Iranian hospitals in responding to road traffic crashes with mass casualties. MATERIAL AND METHODS: This cross-sectional study was carried out among 13 hospitals in four provinces including Tehran, Alborz, West Azerbaijan, and Hamedan in 2019. the valid and reliable questionnaire of hospital preparedness assessment in RTIs was used for data collection (Kappa coefficient = 0.89; CVR: 0.98; CVI: 0.97). Using SPSS 16, the level of hospital preparedness was categorized into three parts as weak (less than 34%), moderate (34-66%), and high (more than 66%). RESULTS: Preparedness of the selected hospitals was at a moderate level (= 65.25%). Although the level of preparedness in the aspects of command and control (72.7%), safety and security (71.54%), infrastructure and medical equipment (74.12%), and coordination (71.15%) was satisfactory, hospitals were weak in the training and exercise aspect (48.46%). The level of access to specific equipment needed for responding to trauma injuries was high (79.56%). CONCLUSIONS: Based on the findings, a response plan is required to make hospitals more prepared to respond to road traffic injuries. The plan may include training and development, as well as health facilities preparedness in terms of structure, equipment, and human resources. In addition, assessing the effectiveness of all response plans requires exercise and practice. [ABSTRACT FROM AUTHOR]

Background: Patient and family engagement (PE) in healthcare planning and improvement achieves beneficial outcomes and is widely advocated, but a lack of resources is a critical barrier. Little prior research studied how organizations support engagement specifically in hospitals.Objective: We explored what constitutes hospital capacity for engagement.Methods: We conducted descriptive qualitative interviews and complied with criteria for rigour and reporting in qualitative research. We interviewed patient/family advisors, engagement managers, clinicians and executives at hospitals with high engagement activity, asking them to describe essential resources or processes. We used content analysis and constant comparison to identify themes and corresponding quotes and interpreted findings by mapping themes to two existing frameworks of PE capacity not specific to hospitals.Results: We interviewed 40 patient/family advisors, patient engagement managers, clinicians and corporate executives from nine hospitals (two < 100 beds, four 100 + beds, three teaching). Four over-arching themes about capacity considered essential included resources, training, organizational commitment and staff support. Views were similar across participant and hospital groups. Resources included funding and people dedicated to PE and technology to enable communication and collaboration. Training encompassed initial orientation and project-specific training for patient/family advisors and orientation for new staff and training for existing staff on how to engage with patient/family advisors. Organizational commitment included endorsement from the CEO and Board, commitment from staff and continuous evaluation and improvement. Staff support included words and actions that conveyed value for the role and input of patient/family advisors. The blended, non-hospital-specific framework captured all themes. Hospitals of all types varied in the availability of funding dedicated to PE. In particular, reimbursement of expenses and compensation for time and contributions were not provided to patient/family advisors. In addition to skilled engagement managers, the role of clinician or staff champions was viewed as essential.Conclusion: The findings build on prior research that largely focused on PE in individual clinical care or research or in primary care planning and improvement. The findings closely aligned with existing frameworks of organizational capacity for PE not specific to hospital settings, which suggests that hospitals could use the blended framework to plan, evaluate and improve their PE programs. Further research is needed to yield greater insight into how to promote and enable compensation for patient/family advisors and the role of clinician or staff champions in supporting PE. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic has caused pronounced strain on global healthcare systems, forcing the streamlining of clinical activities and conservation of health resources. There is a pressing need for institutions to present discipline-specific strategies for the management of COVID-19 patients. We present the comprehensive considerations at the National University Hospital, Singapore from the surgeon’s and anesthetist’s perspectives in the performance of spinal surgery in COVID-19 patients. These are based on national guidelines and overarching principles of protection for the healthcare workers (HCWs) and efficiency in surgical planning. The workflow begins with the emergency department screening that has been adapted to the local epidemiology of COVID-19 in order to identify suspected/confirmed cases. If patient history cannot be obtained, demographic, clinical, and imaging data are used. Designated orthopedic “contaminated teams” are available 24/7 with an activation time of

Purpose: This paper reviews an area of interdisciplinary collaboration in the design of healthcare facilities that attempts to optimize hospital space-planning using automated statistical techniques from the discipline of Operations Research (OR). This review articulates Facility Layout Problems (FLPs) as a general class of OR problems. Furthermore, the review highlights limitations of these techniques, which necessitate an ethical and participatory engagement with computerized processes of healthcare architecture. Design/methodology/approach: An in-depth critical review was carried out, which revealed a number of common themes, collectively theorized as metamodeling processes, or models of models, through which various FLP modelling techniques can be challenged and debated in terms of their architectural viability, and ethical ramifications. Findings: This review provides a methodological basis for the further evaluation of computational models. It was found that most of the reviewed studies are functionally focused on flow efficiency and, in general, do not consider broader contextual, relational, social, or salutogenic design values. Originality/value: This review is the first on the subject written from an architectural perspective. It can be used by a broad range of readers as its critical review of past and present hospital layout modelling techniques discusses their capabilities and limitations. As such, it also enables them to consider ethical values while critiquing the epistemology of computational processes hidden beneath algorithmic outputs.

Abstract Regionalization has become a buzzword in US health care policy. Regionalization, however, has varied meanings, and definitions have lacked contextual information important to understanding its role in improving care. This concept review is a comprehensive primer and summation of 8 common core components of the national models of regionalization informed by text‐based analysis of the writing of involved organizations (professional, regulatory, and research) guided by semistructured interviews with organizational leaders. Further, this generalized model of regionalized care is applied to sepsis care, a novel discussion, drawing on existing small‐scale applications. This discussion highlights the fit of regionalization principles to the sepsis care model and the actualized and perceived potential benefits. The principal aim of this concept review is to outline regionalization in the United States and provide a roadmap and novel discussion of regionalized care integration for sepsis care.

Background: With the increasing prevalence of wildfire smoke in the Pacific Northwest, it is important to quantify health impacts to plan for adequate health services. The Rogue Valley region has historically faced some of the greatest wildfire threats in the state. Health impacts from smoke have been estimated in several recent studies that include Oregon's Rogue Valley, but the results between studies are conflicting., Objective: The objective is to critically examine impacts of wildfire smoke on health in the Rogue Valley area and translate the results to support hospital staffing decisions., Study Design: The study adopts a case-crossover approach., Methods: Apply a conditional Poisson regression to analyze time stratified counts while controlling for mean temperature., Results: Every 10 μ/m 3 increase in PM 2.5 is associated with a 2% increase in same-day hospital or emergency room admission rates for respiratory conditions during fire season after adjusting for temperature and time (OR = 1.020; 95% CI: 1.004-1.034); a 10 μ/m 3 increase in PM 2.5 lasting nine days is associated with a 4% increase in admission rates (OR = 1.041; 95% CI: 1.018-1.065). In other words, for each 10 μ/m 3 single day increase in pollution from smoke, an additional 0.26 respiratory patients would be expected in the area hospitals. With a single day increase from 10 μ/m 3 to 150 μ/m 3 , hospitals could expect an additional four patients., Conclusions: There are small but significant health impacts in the Rogue Valley. These impacts are smaller than some statewide estimates. We need further research to understand these differences., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background This study explored barriers and facilitators to integrating health evidence into spatial planning at local authority levels and examined the awareness and use of the Public Health England 'Spatial Planning for Health' resource. Methods A sequential exploratory mixed-methods design utilized in-depth semi-structured interviews followed by an online survey of public health, planning and other built environment professionals in England. Results Views from 19 individuals and 162 survey responses revealed high awareness and use of the Spatial Planning for Health resource, although public health professionals reported greater awareness and use than other professionals. Key barriers to evidence implementation included differences in interpretation and the use of 'evidence' between public health and planning professionals, lack of practical evidence to apply locally and lack of resource and staff capacity in local authorities. Key facilitators included integrating health into the design of local plans, articulating wider benefits to multiple stakeholders and simplifying presenting evidence (regarding language and accessibility). Conclusion The Spatial Planning for Health resource is a useful resource at local authority level. Further work is needed to maximize its use by built environment professionals. Public health teams need support, capacity and skills to ensure that local health and well-being priorities are integrated into local planning documents and decisions. [ABSTRACT FROM AUTHOR]