Hospital Buildings Research Articles

Radiofrequency Technologies of Local Positioning in Healthcare

Introduction. Localization of objects position in closed space plays an important role in many areas of human activity, including medicine. Using indoor-positioning technologies as a part of telemedicine systems allows one to improve the quality of medical care and to reduce mortality of patients. Therefore, indoor-positioning technologies contribute to achieve the goals outlined in the Russian Federation government`s program "Healthcare development". Aim. To study the applicability of modern radiofrequency technologies for localization of patients inside a hospital building. Materials and methods. Scientific sources devoted to indoor-positioning based on radiofrequency technologies were analyzed. The methods used included: - bibliographic retrieval; - selection and verification of sources based on their relevance; - analysis of sources by methods of deconstruction and comparative analysis . Results. The result of the analysis indicated that radiofrequency positioning technologies allow one to locate objects using radio waves properties. The disadvantage of the technology is the penetration of radio signal through walls and floors. Given this, it is necessary to use complex algorithms to detect an object with accuracy to a specific room. Despite this disadvantage, radiofrequency technologies can be used for positioning in medical facilities since they are easy in deployment and service. Also, they are used in ready-made commercial solutions. ZigBee technology is an exception because it does not allow one to track moving objects in real-time. Conclusion. Based on the study it was concluded that BLE technology is the most suitable for indoor-positioning in medical facilities. It is energy-efficient, it has sufficiently fast data transfer rate, good communication radius and a large range of ready-made communication equipment. It is also worth noting that most wireless medical sensors exchange data via the BLE interface.

Efficacy of Radiant Catalytic Ionization in Reduction of Enterococcus spp., Clostridioides difficile and Staphylococcus aureus in Indoor Air

(1) Background: An aerogenic way is one of main rout of spreading microorganisms (including antibiotic resistant), that cause healthcare-associated infections. The source of microorganisms in the air can be patients, personnel, visitors, outdoor air, hospital surfaces and equipment, and even sink drains. (2) Methods: The standardized suspensions (0.5 McFarland) of the examined strains (Enterococcus spp., Clostridioides difficile, Staphylococcus aureus) were nebulized in sterile chamber. Then the Induct 750 (ActivTek) device, generating RCI (radiant catalytic ionization) phenomenon, was used for 20 min. Next, the number of bacteria in the air was calculated using collision method. The percentage of reduction coefficient (R) was calculated. (3) Results: In case of enterococci, the R value was >90% and there are no statistically significant differences among tested strains. For C. difficile strains the R value range from 64–95%. The R value calculated for hypervirulent, antibiotic resistant CDI PCR 27 strain was statistically significantly lower than for other examined strains. For S. aureus non-MRSA the R value was 99.87% and for S. aurues MRSA the R value was 95.61%. (4) Conclusions: The obtained results indicate that the use of RCI may contribute to reducing the occurrence of dangerous pathogens in the air, and perhaps transmission and persistence in the hospital buildings environment.

Sustainability and Energy Efficiency: BIM 6D. Study of the BIM Methodology Applied to Hospital Buildings. Value of Interior Lighting and Daylight in Energy Simulation

One of the least used aspects of BIM (Building Information Modeling) is the ability to obtain the energy model of the building using the BIM methodology known as BIM 6D. This digital information model allows simulating the real energy behavior of the building and the improvement in the building’s lighting systems, both natural and artificial, in particular daylighting. In this way, the BIM 6D simulation allows us to make design and operation decisions for the building, not only for new buildings that must be, in accordance with current legislation, NZEB (Nearly Zero-Energy Building) but also for the rehabilitation of existing buildings. Particularly in buildings for sanitary use, BIM 6D allows an exhaustive analysis of the energy impact of said rehabilitation, guiding it towards an improvement in energy and light efficiency, which in turn provides greater quality and comfort in the use of the sustainable building. This subject of study is especially important in public buildings for hospital use. Buildings where energy efficiency and comfort, oriented towards optimal and efficient lighting, are two fundamental criteria highly appreciated by patients and citizens in general. Once the energy model of the building has been obtained, it is possible to study and identify possible alternatives to improve energy efficiency and improve lighting, as well as to analyze the possibilities of incorporating other more efficient forms of renewable energy, such as the use of daylight. In this work we can see how applying a set of simulated improvement actions in BIM 6D achieves an energy saving of 50% in general and up to 13% only by acting on lighting systems, allowing the decarbonization of buildings with high energy consumption, such as hospitals, and in turn, will lead to an improvement in the energy certification of these buildings; thus achieving a better and higher quality of habitability, using more efficient forms of lighting and transforming buildings into more sustainable spaces.

Green hospital - A necessity and not option

Green hospital - A necessity and not option - JMRA- Print ISSN No: - 2394-2762 Online ISSN No:- 2394-2770 Article DOI No:- 10.18231/j.jmra.2020.010, Journal of Management Research and Analysis-J Manag Res Anal

Long-term, continuous air quality monitoring in a cross-sectional study of three UK non-domestic buildings

Long-term, continuous air quality monitoring has been carried out alongside seasonal passive sampling within a case study a hospital, school and office building, representing a cross-section of the UK non-domestic sector. This approach aimed at adopting state of the art sensor technology to provide a greater understanding of the variations in indoor air quality over time and how these variations relate to both building operation and occupant behavior. The results highlight how the relationship between indoor and outdoor air evolves considerably on both short and long-term basis, with varying behaviors then seen across different sources of pollutants. The mechanically ventilated hospital and school buildings demonstrate the effectiveness of particulate filters, with very low internal concentrations of PM2.5. However, high ventilation rates, combined with the absence of any filtration of NO2, resulted in the hospital having the highest indoor concentrations of NO2 and the highest associated indoor-outdoor ratio. Morning and evening traffic related peaks in NO2 can be observed indoors, with their penetration dependent upon the delivered ventilation rates. This demonstrates the impact of adopting high ventilation rates during peak traffic, and the consequences of CO2 based demand-controlled ventilation systems in polluted urban areas without full filtration. The naturally ventilated office then demonstrates significant seasonal variations, with increased ventilation openings resulting in indoor NO2 concentrations in the summer exceeding those in the winter, despite significant reductions in ambient levels. Conversely, concentrations of indoor pollutants are seen to reduce with increasing ventilation rates, demonstrating the complex balance between the dilution of indoor pollutants and penetration of outdoor sources. Despite significant reductions from the winter to the summer (21.6–11.2 μg/m3), all formaldehyde measurements in the naturally ventilated office exceeded guideline values, indicating improved guidance and product labelling schemes may be required to achieve these guideline concentrations and reduce associated health risks.

Evaluation of hospital disaster preparedness by a multi-criteria decision making approach: The case of Turkish hospitals

Considering the unexpected emergence of natural and man-made disasters over the world and Turkey, the importance of preparedness of hospitals, which are the first reference points for people to get healthcare services, becomes clear. Determining the level of disaster preparedness of hospitals is an important and necessary issue. This is because identifying hospitals with low level of preparedness is crucial for disaster preparedness planning. In this study, a hybrid fuzzy decision making model was proposed to evaluate the disaster preparedness of hospitals. This model was developed using fuzzy analytic hierarchy process (FAHP)-fuzzy decision making trial and evaluation laboratory (FDEMATEL)-technique for order preference by similarity to ideal solutions (TOPSIS) techniques and aimed to determine a ranking for hospital disaster preparedness. FAHP is used to determine weights of six main criteria (including hospital buildings, equipment, communication, transportation, personnel, flexibility) and a total of thirty-six sub-criteria regarding disaster preparedness. At the same time, FDEMATEL is applied to uncover the interdependence between criteria and sub-criteria. Finally, TOPSIS is used to obtain ranking of hospitals. To provide inputs for TOPSIS implementation, some key performance indicators are established and related data is gathered by the aid of experts from the assessed hospitals. A case study considering 4 hospitals from the Turkish healthcare sector was used to demonstrate the proposed approach. The results evidenced that Personnel is the most important factor (global weight = 0.280) when evaluating the hospital preparedness while Flexibility has the greatest prominence (c + r = 23.09).

Structural Racism in American Psychiatry and APA: Part 1

Structural Racism in American Psychiatry and APA: Part 1

The Study of Quality Control Management that Influence the Implementation of Technical Standards for Class C Hospital Buildings in Tangerang Districs

Based on research issues regarding the implementation of hospital building technical standards that are often ignored, especially from the quality control process so that there is no improvement in quality, the research problems that will be resolved are analyzing the understanding and indicators regarding; quality control management, and the application of technical standards in class C hospital buildings. This study examines the main aspects of quality control management, quality control circles, and PDCA Cycles (plans, actions, checks, actions) as a program in the implementation of factors that affect quality control management. Applying the technical standard of class C hospital buildings was assessed based on the provisions of the ministry of health. As a consideration of this research examines the portrait of the project under study, which is a case study of Class C Hospital in Tangerang Districts and highlights relevant research results in the past 10 years. Qualitative methods sourced from secondary data will be used to study understanding and indicators in discussing research problems. In the results of this study it can be concluded that the factors of quality control management can hinder the application of hospital building technical standards so that it can affect the quality of the building which has an impact on the comfort and safety of building users. This research produces answers to research problems that will provide recommendations for improvement for service users so that it can have a positive impact on the implementation of the project.

Evaluating critical criteria for green hospital buildings

Greening building is an increasingly important concern and a challenge in construction industry. The purpose of this paper is to evaluate the weights of criteria for green hospital buildings that provides decision-makers the priorities strategy in greening process. AHP was applied in this study to establish the hierarchy structure and evaluate the weight of criteria for green hospital buildings. The result indicated that sustainable site, energy saving, and water efficiency are the top three criteria. In the overall ranking, the top three significant sub-criteria are design of layout, greening of site, and energy saving for façade. The contribution of this study is to help decision-makers understand the relatively important of criteria to make decision for green hospital projects for sustainable development.

Contents of the final disinfection of an ambulance after transporting a patient with a coronavirus infection standard operating procedure

The standard operating procedure (SOP) defines the procedure for the final disinfection of an ambulance after the transportation of a patient to an emergency room of the main hospital building.

Penggunaan Atrium pada Bangunan Rumah Sakit Bertingkat dan Pengaruhnya terhadap Keselamatan Jiwa terhadap Bahaya Kebakaran

The use of atrium in hospital buildings accelerating the patient's healing process and reduce the impression of stress on hospital buildings. However, the presence of the atrium can also pose a fire hazard because it can be a means of spreading smoke quickly. This study determines the effect of atriums in hospital buildings on the level of life safety in the event of a fire. The study was conducted at two hospitals in Bandung and Jakarta, Indonesia. The level of life safety is assessed through the difference between the time needed for the evacuation, referred to as RSET, and the time taken by smoke to cause a critical condition for occupants, called ASET, where RSET must be shorter than ASET. The analysis carried out on two physical configurations: open and closed atrium, and the results of this study showed that with an open atrium, the smoke quickly covered the evacuation route before the evacuation process completed, or ASET<RSET. The fire room door must be closed, and the smoke-barrier must be installed around the atrium to prevent the spread of smoke into patient rooms, thus fulfill the ASET<RSET criteria.

Feature Extraction from Building Submetering Networks Using Deep Learning

The understanding of the nature and structure of energy use in large buildings is vital for defining novel energy and climate change strategies. The advances on metering technology and low-cost devices make it possible to form a submetering network, which measures the main supply and other intermediate points providing information of the behavior of different areas. However, an analysis by means of classical techniques can lead to wrong conclusions if the load is not balanced. This paper proposes the use of a deep convolutional autoencoder to reconstruct the whole consumption measured by the submeters using the learnt features in order to analyze the behavior of different building areas. The display of weights and information of the latent space provided by the autoencoder allows us to obtain precise details of the influence of each area in the whole building consumption and its dependence on external factors such as temperature. A submetering network is deployed in the León University Hospital building in order to test the proposed methodology. The results show different correlations between environmental variables and building areas and indicate that areas can be grouped depending on their function in the building performance. Furthermore, this approach is able to provide discernible results in the presence of large differences with respect to the consumption ranges of the different areas, unlike conventional approaches where the influence of smaller areas is usually hidden.

Conserving Modern Architectural Heritage: Review on First Numune Hospitals of Turkey

Purpose The new political approaches followed after the establishment of republic transformed the basic characteristics of many different dynamics in Turkey ranging from education and industry to art and architecture. The arrangements related to health services hold an important place among these fields and the great transformations seen in healthcare services necessitated the construction of hospital buildings with contemporary architectural qualities. In this framework, new hospital buildings known as “Numune” (Sample) Hospitals were established in Ankara, Diyarbakir, Erzurum and Sivas cities in 1924 to be good examples for further hospital buildings. In this context, the historical evolutions, architectural characteristics and current situations of these Numune hospitals are examined in this study together with an analysis of all the changes and interventions they were exposed to from past to present. This study aims to clarify the historical importance of Numune hospitals in question, address the changes they have undergone to date, criticize the interventions in the context of architectural history and conservation disciplines, and put forward various suggestions related to such disciplines. The search of the ways to provide the interrelationship of these buildings with the rapidly evolving current world by referring to the contemporary methods of different disciplines, constitutes one other basic aim of this study. The applications of the public authority of health services; namely the -Ministry of Health- and the other efficient dynamics related with the conservation of these buildings are also critically evaluated with respect to their roles on the sustaining of the architectural and historial values of these buildings. Design/Methodology/Approach The problems in preserving the original characteristics and showing respect to the historical values of these buildings are discussed by using the instruments and concepts of architectural history and conservation disciplines. Besides, some strategies are proposed for the preservation of these buildings with an awareness of the current conditions of health services in Turkey, and the possibility of the conflict between today’s conservation practices and health facility standards. Findings Taking into account contemporary approaches and the advanced conservation techniques being employed today, this study indicates that it is possible to make use of these structures by transforming their functions and maintaining their authentic values through proper applications. It is also expressed that a well-defined framework regarding that which structures are to be conserved according to which criteria could not be created, and that the decision-making mechanism focused solely on the conservation of the oldest structures. Practical Implications Some refunctioning and remediation strategies are presented for conserving the historical values of these Numune hospitals, while also improving their conditions as far as possible. Social Implications The concepts of heritage and value should be defined in a broader contextual framework and conservation principles should be revised according to these definitions. Originality/Value Considering these buildings serve as cultural bridges extending from the Ottoman era to the present and have important places in the historical development of healthcare facility architecture in Turkey, they hold symbolic values within the context of Turkish architectural history and heritage.

Audit Awal Energi Listrik RS Kartika Husada Tambun

Energy evaluation is an important means for an organization to be more competitive in the global era. IKE or the intensity of electricity consumption is a term used to evaluate energy consumption in a system (building). IKE value is obtained by comparing the total use of electrical energy in building area. The evaluation process is done by collecting historical data from Kartika Husada Tambun hospital building., such as data of building area, data of the use of electricity, and the budget spent of electricity needs. From the calculation results, IKE value of the Kartika Husada Tambun Hospital in 2016 was 160,73 kWh / m2/ year, the IKE value in 2017 was 166,04 kWh / m2/ year, and 2018 was 142,79 kWh / m2/ year. This result is in the efficient category because it does not pass the IKE standard for electricity for a hospital building of 380 kWh / m2 per year. For cost savings the author recommends the application of energy-saving technology

Energy efficiency improvement of solar water heating systems – An IoT based commissioning methodology

This paper studies a mechanism to investigate and to improve the energy efficiency of a solar water heating system (SWH) in a hospital building located in Singapore. We utilize the data collected from Internet-of-Things (IoT) to gain information on different environmental and operational aspects of the considered system, that determine opportunities for improving the efficiency of various sub-systems of the SWH, and develop control strategies for efficient operation of the overall system. Through the data collected by IoT, such as water flow, heat pump and water pump operational schedule, availability of solar, and electricity consumption, we perform a comprehensive energy audit to analyze the efficiency of sub-systems and the performance of overall system as well. Based on the insights obtained from data analysis, corresponding control strategies for various sub-systems are developed to improve the efficiency of the overall system and reduce the operational cost of the SWH. Finally, the effectiveness of the proposed control strategies is confirmed through experiment on the site of the considered SWH.

Non-intrusive cooling tower model validation: Results from a case study

A cooling tower (CT) model was built based on physical thermodynamics and heat and mass transfer principles using the effectiveness-NTU method for heat exchanger performance. The focus of the model was to use non-intrusive measurements and predict the exiting water temperature from the cooling tower given certain inputs. Compared with the existing models, the new model has two main advantages: (1) the model involves only the key important non-intrusive input variables and has an intuitive description of the CT operation; (2) it is modular and can be used as an input to other models to perform overall cooling plant optimization. The focus of the modeling was not to get the most accurate measurements, but rather to help in the aid of developing a system level cooling tower model which could be used as a part of an optimization framework for overall building energy consumption. The model still predicted the results accurately within 8% when compared with the results from field experiments. During steady-state operation, the results were even stronger with mean absolute percentage error within 5%. Model validation is performed at various ambient conditions and the results are supported with data from a hospital building in Alcorcon, Spain.

Seismic resilience evaluation of base-isolated RC buildings using a loss-recovery approach

Seismic isolation systems, especially friction pendulum bearings (FPBs), are used as ideal seismic protection strategies in performance-based design. Furthermore, FPBs can increase the functionality of buildings by minimizing interruption of use of the facility (e.g., operational performance level) and reducing seismic demands on the structural and non-structural elements. The primary objective of this paper is to investigate the seismic resilience of reinforced concrete (RC) buildings, especially essential buildings in compliance with a loss-recovery approach. To this end, an analytical examination is conducted concerning a six-story RC building, which was mainly designed under the Uniform Building Code (UBC in International Conference of Building Officials, Whittier, CA, 1997) for a high-risk seismic zone. The incremental dynamic analyses of the fixed-base and base-isolated structures subjected to a set of near and far-fault ground motions are carried out for getting seismic fragility and functionality curves as well as the resilience of structures using a loss-recovery approach. The proposed methodology is employed to special buildings such as hospital buildings, with and without using the FPBs considering different seismic hazard scenarios that could occur within the investigated region. At the end of the paper, a parametric study is conducted by changing the building and pendulum parameters. The benefit of the suggested approach is found in terms of loss-recovery and seismic resilience that will be well recognized by the decision-maker for better planning to decrease seismic losses, rather than waiting for an earthquake and paying for it afterward.

Building for Change: Comparative Case Study of Hospital Architecture.

Objective:This study assesses how architectural design strategies impact the flexibility of hospitals to change over time.Background:Most hospitals are designed for highly specialized medical functions, which is often in conflict with the need to design the hospital facility to accommodate evolvement and change of functions over time. Architectural design strategies provide different approaches to the need to design for a specific medical program while planning for its future change.Methods:The study compares two hospital buildings with a very similar configuration and medical program but with significantly different architectural design strategies: One was designed for an unknown future medical function, and the second was designed for a specific medical function. The study analyses the two hospital buildings by their design strategy, planning, design process, and construction by phases and compares their change in practice over the last twelve years.Results:The design strategy to fit a specific function limited the hospital affordance to make changes during the design process, construction, and occupancy phases. Systematic design of system separation for an unknown function, in contradiction to a “tailor-made” approach in the design for a specific function, was found to support a variety of changing medical programs.Conclusions:Architectural design strategies developed in an early stage of the design process has a major impact on the future evolution of the hospital facility. The different results between the two projects also demonstrate the greater influence of healthcare policies, hospital organization culture, and infrastructure funding models on the architecture and flexibility of hospitals.

Post-earthquake hospital functionality evaluation: The case of Kumamoto Earthquake 2016

The Japanese Prefecture of Kumamoto experienced a series of strong earthquakes in April 2016 causing widespread damage and had a serious impact on local communities. The events caused over 3000 casualties and affected the continuity of healthcare services. Many hospitals had to be evacuated but the reasons for this evacuation are not clear. This research aims to investigate the impact of damage on the performance of the healthcare service through a survey of 118 healthcare facilities. The study connects earthquake metrics and the loss of healthcare service functionality and reveals the reasons for which facilities were totally or partially evacuated. Findings suggest that the reasons are mainly damage to buildings, critical systems, and medical equipment. It concludes by estimating that the stricken areas lost approximately 15% of their healthcare functionality. The study also concludes that the current building standards increased the performance of hospital buildings by approximately 10%; however, more attention is needed to protect architectural and critical systems.

Environmental Factors and Ventilation Affect Concentrations of Microorganisms in Hospital Wards of Southern Thailand.

Hospitals tend to have high density of occupancy. Poor indoor environmental quality in hospital buildings can exacerbate the health problems of patients and also harm visitors and staff. This study investigated the environmental characteristics and ventilation affecting the concentration of microorganisms in multiple-bed hospital wards. The measurements were accomplished by using a biosampler and an open plate method at four wards, different positions of electric fans, and different times. Data were analyzed by t-test and MANOVA. The results revealed that the concentrations of airborne bacteria were higher than the concentrations of fungi. There were significant differences in the concentrations of bacteria and fungi between sampling times and between hospital wards (p < 0.05), while no difference was observed by positions of electric fans. Correlations between the concentrations and other environmental parameters indicate that temperature, number of occupants, and humidity were physical factors associated with the concentrations of microorganisms. In addition, mostly, Gram-positive bacteria were observed. This indicates the conditions in buildings in the tropical climate, and regular housekeeping of all room areas is needed to prevent the growth of airborne contaminants and the related risks to patients, visitors, and staff.