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1 – 10 of over 1000Ilkay Cankurtaran and M. Halis Gunel
Cancer has become a priority among today’s health problems. Therefore, providing facilities that ensure high-quality cancer treatment has become an essential design problem…
Abstract
Purpose
Cancer has become a priority among today’s health problems. Therefore, providing facilities that ensure high-quality cancer treatment has become an essential design problem. Additionally, a considerable number of studies have introduced the ‘healing environment concept’ as a substantial input for healthcare buildings. The purpose of this paper is to present a design guide for cancer treatment services that is compatible with the healing environment concept.
Design/methodology/approach
In this context, studies on the healing environment have been analyzed, and the legislation of some selected countries has been assessed. Then, all the filtered data are used to form the design guideline for chemotherapy department, radiation oncology department and inpatient care services under a new series of analysis criteria.
Findings
The resulting principles are revealed according to the criteria of general settlement principles, internal function relations, medical necessities, user experience, interior design, social interaction/privacy, safety, landscape design and outdoor relations by the help of proposed plans, diagrams and schematic drawings.
Originality/value
This research constitutes the first and yet only study in its field that aims to increase efficiency and user satisfaction and provide better patient-centered care while providing a design guide on health-care architecture.
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Riikka Kyrö, Antti Peltokorpi and Lauri Luoma-Halkola
The fast advancement of medical technology and processes poses challenges to hospital construction and management. The purpose of this paper is to provide a structured approach to…
Abstract
Purpose
The fast advancement of medical technology and processes poses challenges to hospital construction and management. The purpose of this paper is to provide a structured approach to advancing adaptability in hospital retrofits, proposing the preferable timing and scope of different adaptability strategies.
Design/methodology/approach
A qualitative research approach was chosen, with 28 semi-structured interviews designers, project managers, clients and healthcare professionals as the primary research data.
Findings
This paper presents a model for planning for the future in hospital retrofits. The model includes 11 different adaptability strategies, categorized based on the level of adaptability. Furthermore, each strategy is linked to an open building system level, indicating the appropriate timing. Based on the findings, generality strategies in the tertiary building system level are the most effective forms of adaptability, as they are easy to implement and answer to non-specific changes in hospital operations.
Research limitations/implications
The findings contribute to existing knowledge on adaptability in buildings, and provide practical guidance particularly for designers. A new type of service offering, an adaptability roadmap detailing the scope and timing of adaptability, is suggested.
Originality/value
The paper contributes to the existing research by detailing different approaches and knowledge related to adaptability and its strategies in hospital retrofits. More specifically, the three-fold categorization of adaptability is linked to both timing and intrusiveness in a novel way.
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Marziyeh Faghiholislam, Hamidreza Azemati, Hadi Keshmiri and Somayeh Pourbagher
The most common reaction to an acute physical illness is anxiety, which may be followed by depression. In patients with chronic diseases, the prevalence of anxiety disorders and…
Abstract
Purpose
The most common reaction to an acute physical illness is anxiety, which may be followed by depression. In patients with chronic diseases, the prevalence of anxiety disorders and depression is almost twice as high as in other diseases. This study aims to extract prominent components in the design of treatment spaces on reducing hospitalized patients’ depression from both experts and patients/users’ point of views. A final model is also presented based on the findings.
Design/methodology/approach
This research used an exploratory mixed method. The effective components were extracted through the administration of two Likert-scale researcher-made questionnaires in two phases. Q factor analysis was conducted to reach the components. A total of 205 patients were admitted to Namazi Hospital in Shiraz, and 20 architecture and psychology experts participated in the survey. Final modeling of the data was done through path analysis.
Findings
Six factors were found to be effective by experts in reducing depression in therapeutic spaces: nature-oriented space, targeted social space, diverse space, visual comfort, logical process and safe space. On the part of patients, seven components were deemed to be effective: visual perception, naturalism, functionalism, physical security, logical process, psychological safety and diversity. Also, four main cycles were extracted from the final model with the direct effect of diversity and the other five cycles were mediated by naturalism.
Research limitations/implications
A total of 15 interviews with architects and psychologists, who were available at the time of the study, were conducted in January 2018. The only general question during interviews was “In your opinion, what factors are effective in reducing the level of depression of patients in the design of treatment spaces?” This may have limited the range of factors that could be surveyed in the study. After collecting the effective factors from the aforementioned expert’s points of view, the questionnaire of experts was designed (Appendix). The expert questionnaires were distributed and edited in two stages in January 2019 among 20 architect experts who were available at the time of the study. The one-year interval between designing and administering the questionnaires occurred because of the limitations posed by the COVID-19 pandemic situation. However, the interval did not pose methodological obstacles for the study.
Originality/value
Evidence-based investigation of the effectiveness of proper design components of therapeutic spaces in reducing the symptoms of patients with chronic secondary depression has received little attention in the literature. Using a “conceptual model,” the present study brought the issue into its focus so as to find effective components in the design of treatment spaces that can alleviate depression symptoms in chronically hospitalized patients.
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Sunil Chopra and Canan Savaskan
Addresses how flow times and capacity calculations can be made for a service process such as the Bariatric Surgery Center at a clinic. Highlights how these calculations can be…
Abstract
Addresses how flow times and capacity calculations can be made for a service process such as the Bariatric Surgery Center at a clinic. Highlights how these calculations can be made for a service process just as in any manufacturing setting. Discusses the notions of critical paths and bottlenecks and what factors affect both time and capacity. Also, discusses the relative profitability of two types of bariatric surgery, the goal being to link product profitability to the process.
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Amanda Aykanian and Emmy Tiderington
Studies have shown positive housing retention and quality of life outcomes in moving on initiatives (MOIs). However, less is known about how movers’ health service use changes…
Abstract
Purpose
Studies have shown positive housing retention and quality of life outcomes in moving on initiatives (MOIs). However, less is known about how movers’ health service use changes post-move. This paper aims to explore physical and mental health service use over time for participants in New York City’s MOI program.
Design/methodology/approach
This paper uses data collected at baseline, 12-months post move and 24-months post move to explore patterns in mental and physical health service use and their association with mental and physical health status for participants (N = 41). Health status was measured with the Medical Outcomes Study Short Form Survey Instrument.
Findings
Three mental health service use patterns emerged: service use at all time points, inconsistent service use across time points and no service use at any time point. Significant group differences in mental health were found at baseline and 12 months. Two physical health service use patterns emerged: service use at all three time points and inconsistent service use across time points. Significant group differences were found in mental health at 12 and 24 months.
Originality/value
This study showed that physical and mental health service use varied slightly over time for participants, with the majority of service use being for outpatient/non-acute care. The findings also point to possible relationships between service use and mental health status. Positive and negative implications of these findings are framed within the broader context of PSH and MOI goals.
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Marco Gola, Gaetano Settimo and Stefano Capolongo
Several countries have carried out air quality monitoring in professional workplaces where chemicals are used. Health-care spaces have been less investigated. This paper aims to…
Abstract
Purpose
Several countries have carried out air quality monitoring in professional workplaces where chemicals are used. Health-care spaces have been less investigated. This paper aims to define a protocol, as developed by a research group, for inpatient rooms to understand the state of the art and to suggest design and management strategies for improving process quality.
Design/methodology/approach
Starting from the ISO-16000 standard and guidelines for monitoring activities, a protocol is defined for a one year investigation, with passive samplers. Through data analysis of the investigations and analysis of the cleaning and finishing products, heating, ventilation and air conditioning and maintenance activities, etc., it is possible to highlight the potential influences of chemical pollution.
Findings
A methodology is defined for understanding the chemical pollution and the possible factors related to construction materials, cleaning products and maintenance activities.
Research limitations/implications
The paper analyzes only a limited number of case studies because the monitoring activity is still in progress.
Practical implications
The investigation offers a starting point for a wide tool for the definition of design, maintenance and management strategies in health-care facilities.
Social implications
The research project, aimed at improving the knowledge of indoor air quality (IAQ) in inpatient rooms, is a starting point for a supporting tool for future regulations concerning health-care facilities.
Originality/value
IAQ is an issue on which many governments are focusing. Several health-care researchers have reported studies that aim at improving users’ health. Most investigations are about biological and physical risks, but chemical risks have been less studied. The paper suggests some design and management strategies for inpatient room.
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Shitao Yang, Curtis P. McLaughlin, Robert W. Vaughan and John J. Aluise
Uses a professional services setting to study the concept offactory focus. The rapid growth in the US of ambulatory surgery centres(surgicentres) provides an evolving illustration…
Abstract
Uses a professional services setting to study the concept of factory focus. The rapid growth in the US of ambulatory surgery centres (surgicentres) provides an evolving illustration of focused factories in services. Because of the pressures of cost containment, most hospitals have segmented their surgical market, but have adapted their operations in a variety of ways. Some keep the inpatient and outpatient survery integrated in the same facility, while others choose a plant‐with‐a‐plant or a separate facility. Information concerning costs, organizational structure, achievement of the advantages and disadvantages of differentiation from inpatient surgery, service times, waiting times, customer services offered, and future plans were provided by 54 hospital‐owned ambulatory surgery centres. Despite a variety of structural arrangements, the responses were effectively classified by whether or not they shared operating rooms with inpatient surgery. Those who shared operating rooms reported significantly less achievement of the advantages and avoidance of the disadvantages of outpatient surgery. The shared facilities also reported longer waiting times, less patient contact and higher average facility charges, despite no significant differences in length of procedure nor volume of the seven most frequent procedures. Among the centre directors is the OR group, and 53 per cent favoured separation of the two surgical settings. All the directors with separated facilities favoured continued separation. The reasons given to justify integration emphasized economies of scale and safety, while those given for separation were customer‐service‐oriented.
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Gilbert Azuela, Daniel Sutton and Kirsten Van Kessel
Sensory modulation intervention involves using calming and grounding sensory stimuli to support coping with distress and intense emotions. Evaluating the impact of sensory…
Abstract
Purpose
Sensory modulation intervention involves using calming and grounding sensory stimuli to support coping with distress and intense emotions. Evaluating the impact of sensory modulation is challenging in inpatient settings due to the numerous variables influencing outcomes in ward environments. This study aims to determine the impact of sensory modulation across all organisational levels including service users, staff confidence and attitudes, ward climate and seclusion events.
Design/methodology/approach
Organisational case studies were conducted in two Aotearoa New Zealand inpatient mental health services, using qualitative and quantitative data to explore the effects of a sensory modulation programme.
Findings
Results showed that sensory modulation enhanced staff knowledge and confidence in fostering therapeutic relationships and reducing restrictive practices, positively impacted ward climate and provided service users with sensory strategies to use in everyday life.
Practical implications
The findings captured the complexity of implementation and impact of sensory modulation programmes at individual, group and organisational levels. It is important to recognise the influencing factors and impact of sensory modulation across all levels of service delivery.
Originality/value
Organisational case study methodology offered a unique approach to evaluating the impact of sensory modulation within inpatient mental health services. Data analysis suggests that in addition to managing acute service user distress, sensory modulation impacts broader staff, team and service level outcomes.
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Jean L. Freeman, Robert B. Fetter, Robert C. Newbold, Jean‐Marie Rodrigues and Daniel Gautier
Concern over the rising cost of medical care has caused many countries to investigate and implement different methods of cost containment, particularly for hospital services. In…
Abstract
Concern over the rising cost of medical care has caused many countries to investigate and implement different methods of cost containment, particularly for hospital services. In the United States, Medicare replaced its ‘cost‐based’ reimbursement system, in which hospital payments were based on the actual costs incurred in treating patients, with a system that pays hospitals a fixed price per case. Under this new system, all hospital discharges are classified into 467 Diagnosis Related Groups (DRGs) or types of cases based on the patient's age, sex, principal diagnosis, additional diagnoses (comorbidities and complications), surgical procedures performed, and the discharge status. During the first three years of the programme, the payment rate for each DRG is a function of a DRG weight (reflecting relative resource consumption), the hospital's historic costs of treating patients in that DRG, and a federally established rate adjusted for urban/rural differences and census region. In the fourth year the price will be based only on the DRG weight and the federally established rate.