Hospital Construction Project Research Articles

Comprehensive Enhancement and Renovation Strategies for Old Hospitals in Urban Central Areas: A Case Study of Huiai Hospital in Guangzhou

The renovation project of Huiai Hospital in Guangzhou serves as a typical example of comprehensive updating, overall planning, and phased construction for old urban hospitals. It addresses representative and complex issues encountered in the renovation of outdated hospitals. By analyzing cases of renovation in urban center old hospitals, this study identifies the constraints faced in hospital renovation, summarizes the complex issues in the construction of old hospitals, and proposes targeted renovation strategies. These strategies include vertical and horizontal development, establishing transportation interfaces, reorganizing planning structures, integrating regional characteristics, and coexisting of old and new elements. These insights provide a reference for future related hospital construction projects

Developing a cost-predictive model for hospital construction projects

ABSTRACT Hospital construction projects require the integration of innovative technologies, making them complex and challenging to estimate accurately. Without reliable guidelines, lists of considerations, or predictive models, decision-makers may choose an unsuitable contractor, leading to cost overruns and project delays. This research used quantitative and qualitative methods, including expert opinions and focus groups, to address this issue and identify critical factors affecting cost estimation in hospital construction. Using multi-regression analysis, historical data was analyzed to establish a cost-predictive model. The study identified 24 factors that determine the most critical criteria affecting the cost estimation of hospital construction. This model can evaluate the estimated direct cost provided to decision-makers in the early stages of the project with over 95% accuracy. The research results can assist professionals in the construction industry in better estimating and managing the costs of hospital construction projects, reducing risks, and improving project outcomes. Key findings indicate that specific components such as site and electrical works show average percentage errors of 8.02% and 5.11%, respectively, highlighting areas prone to cost estimation inaccuracies. This insight directs focus on improving accuracy in these critical sectors, thus further refining cost management strategies for hospital construction projects.

A transformer-based deep learning model for early prediction of lymph node metastasis in locally advanced gastric cancer after neoadjuvant chemotherapy using pretreatment CT images

Early prediction of lymph node status after neoadjuvant chemotherapy (NAC) facilitates promptly optimization of treatment strategies. This study aimed to develop and validate a deep learning network (DLN) using baseline computed tomography images to predict lymph node metastasis (LNM) after NAC in patients with locally advanced gastric cancer (LAGC). A total of 1205 LAGC patients were retrospectively recruited from three hospitals between January 2013 and March 2023, constituting a training cohort, an internal validation cohort, and two external validation cohorts. A transformer-based DLN was developed using 3D tumor images to predict LNM after NAC. A clinical model was constructed through multivariate logistic regression analysis as a baseline for subsequent comparisons. The performance of the models was evaluated through discrimination, calibration, and clinical applicability. Furthermore, Kaplan-Meier survival analysis was conducted to assess overall survival (OS) of LAGC patients at two follow-up centers. The DLN outperformed the clinical model and demonstrated a robust performance for predicting LNM in the training and validation cohorts, with areas under the curve (AUCs) of 0.804 (95% confidence interval [CI], 0.752-0.849), 0.748 (95% CI, 0.660-0.830), 0.788 (95% CI, 0.735-0.835), and 0.766 (95% CI, 0.717-0.814), respectively. Decision curve analysis exhibited a high net clinical benefit of the DLN. Moreover, the DLN was significantly associated with the OS of LAGC patients [Center 1: hazard ratio (HR), 1.789, P<0.001; Center 2:HR, 1.776, P=0.013]. The transformer-based DLN provides early and effective prediction of LNM and survival outcomes in LAGC patients receiving NAC, with promise to guide individualized therapy. Future prospective multicenter studies are warranted to further validate our model. National Natural Science Foundation of China (NO. 82373432, 82171923, 82202142), Project Funded by China Postdoctoral Science Foundation (NO. 2022M720857), Regional Innovation and Development Joint Fund of National Natural Science Foundation of China (NO. U22A20345), National Science Fund for Distinguished Young Scholars of China (NO. 81925023), Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application (NO. 2022B1212010011), High-level Hospital Construction Project (NO. DFJHBF202105), Natural Science Foundation of Guangdong Province for Distinguished Young Scholars (NO. 2024B1515020091).

Research on Contract Risk Management of Hospital Construction Project based on Fuzzy Analytic Hierarchy Process

With Covid-2019 outbreak in December 2019, the number of medical infrastructure projects in infrastructure projects has increased. Although contract management is an important link of medical infrastructure project management but there is little quantitative research on the risk analysis. in this paper, firstly, three first-level risk indicators of contract risk management evaluation system are extracted by combing literature: contract drafting, contract signing and contract performance. Then, taking the contract management of a 3A hospital in Chengdu as an example, 12 second-level risk indicators are determined by fault tree method. Then, by experts scoring and statistically analyzing the risk points of 100 construction project contracts signed by the hospital from 2016 to 2020, the weight of secondary risk indicators is determined and the risk matrix is established. Then, the evaluation matrix of contract risk management evaluation system is established by 10 experts. Finally, the evaluation index system of contract risk management is obtained by combining the risk matrix with the evaluation matrix through fuzzy analytic hierarchy process, and the maximum membership degree method is adopted to complete the risk assessment. The research results show that there are high risks in the contract drafting stage and medium risks in the contract signing and contract performance stages in the contract management of a Grade A hospital in Chengdu. The author puts forward reasonable suggestions to improve the contract management level of hospital construction projects.

The Relationship of Attitudes to Compliance with the Use of Personal Protective Equipment in the Construction Project of Hermina Hospital, Madiun City

The construction industry is a dynamic field with potential hazards that can affect project quality and performance. Proper implementation of Occupational Safety and Health (OHS) management is essential in construction projects. The use of personal protective equipment (PPE) is an important aspect of OHS, but compliance among construction workers is still lacking. This study aims to determine the relationship between attitude and compliance with the use of PPE on the Hermina Hospital construction project in Madiun City. This study was a cross-sectional study, and data were collected using a questionnaire. This study involved 93 construction workers. The results showed that 62% of construction workers in Ethiopia did not use PPE while working, mainly due to lack of availability (41.1%), lack of orientation on the use of PPE (21.3%), discomfort (16.3%), and lack of perceived importance (1.3%). In Indonesia, approximately 60% of workers have experienced head injuries due to not wearing a safety helmet, 90% have experienced facial injuries due to not wearing a face shield, 77% have experienced foot injuries due to not wearing safety shoes, and 66% have experienced eye injuries due to not using eye protection. The low compliance with PPE use among construction workers is a significant concern, as this increases the risk of occupational injuries and accidents. Factors such as availability, training, comfort, and perceived importance of PPE should be addressed to improve compliance. Employers and policy makers need to prioritize the implementation of effective OHS management in construction projects to protect workers' health and safety.

Implementation of Value Engineering in Bandung Islamic University Hospital Building Construction

Infrastructure development in Indonesia has increased sharply every year. Construction projects are starting to appear at a fairly high frequency in each region. However, in the process of project development, the quality, time, and cost aspects are not always optimal. Therefore, Value Engineering analysis is needed to get optimal results. This Value Engineering analysis is able to identify components that can be saved and determine alternatives to replace these components without reducing the quality or quality of work. The case study in this research is the Bandung Islamic University Hospital Construction Project. The Value Engineering analysis carried out on this project is a change in the work of the upper structure, such as slab, column and beam from conventional to precast concrete. In addition to Value Engineering analysis, this research also analyzed greenhouse gas emissions using Life Cycle Assessment analysis. The results showed savings of Rp 3,180,685,659.81 or 8.19% of the initial project cost. Meanwhile, the existing greenhouse gas emissions amounted to 9556.01 kgCO2e and for alternative work amounted to 72896.49 kgCO2e.

Associations of proton pump inhibitors with susceptibility to influenza, pneumonia, and COVID-19: Evidence from a large population-based cohort study.

Adverse effects of proton pump inhibitors (PPIs) have raised wide concerns. The association of PPIs with influenza is unexplored, while that with pneumonia or COVID-19 remains controversial. Our study aims to evaluate whether PPI use increases the risks of these respiratory infections. The current study included 160,923 eligible participants at baseline who completed questionnaires on medication use, which included PPI or histamine-2 receptor antagonist (H2RA), from the UK Biobank. Cox proportional hazards regression and propensity score-matching analyses were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). Comparisons with H2RA users were tested. PPI use was associated with increased risks of developing influenza (HR 1.32, 95% CI 1.12-1.56) and pneumonia (hazard ratio [HR] 1.42, 95% confidence interval [CI] 1.26-1.59). In contrast, the risk of COVID-19 infection was not significant with regular PPI use (HR 1.08, 95% CI 0.99-1.17), while the risks of severe COVID-19 (HR 1.19. 95% CI 1.11-1.27) and mortality (HR 1.37. 95% CI 1.29-1.46) were increased. However, when compared with H2RA users, PPI users were associated with a higher risk of influenza (HR 1.74, 95% CI 1.19-2.54), but the risks with pneumonia or COVID-19-related outcomes were not evident. PPI users are associated with increased risks of influenza, pneumonia, as well as COVID-19 severity and mortality compared to non-users, while the effects on pneumonia or COVID-19-related outcomes under PPI use were attenuated when compared to the use of H2RAs. Appropriate use of PPIs based on comprehensive evaluation is required. This work is supported by the National Natural Science Foundation of China (82171698, 82170561, 81300279, 81741067, 82100238), the Program for High-level Foreign Expert Introduction of China (G2022030047L), the Natural Science Foundation for Distinguished Young Scholars of Guangdong Province (2021B1515020003), the Guangdong Basic and Applied Basic Research Foundation (2022A1515012081), the Foreign Distinguished Teacher Program of Guangdong Science and Technology Department (KD0120220129), the Climbing Program of Introduced Talents and High-level Hospital Construction Project of Guangdong Provincial People's Hospital (DFJH201923, DFJH201803, KJ012019099, KJ012021143, KY012021183), and in part by VA Clinical Merit and ASGE clinical research funds (FWL).

Key Points and Difficulties in the Management of a New Guangzhou 12th People’s Hospital Branch

During the 13th Five-Year Plan period, to improve medical and health services, the Guangzhou Municipal government invested billions in medical construction. During that time, Guangzhou was renewing its approval procedures for construction projects, and the COVID-19 outbreak changed the requirements of hospital construction. In addition to focusing more on spatial planning and layout, the integration of specialized departments, large-scale medical equipment, and numerous intelligent systems increased the complexity of hospital construction projects. The success of these projects often hinges on the quality of the management team. If a hospital construction project manager lacks experience and an understanding of the project’s key aspects, they may struggle with organization, management, and problem-solving, leading to rework, resource waste, and delays. This paper uses the construction of a new Guangzhou 12th People’s Hospital branch as an example to describe the key points and difficulties in each stage of project construction and proposes solutions for the management of similar projects in the future.

Evaluating the Alignment between Intended Project Durations and Standard Time Cost Models: A Comparative Analysis in Basic Hospital Construction Projects in Nepal

This study examines the congruence between the intended projected duration expressed in bidding documents for basic hospital construction projects and Nepal's time cost model specific to health building projects. Through a comparative analysis approach, data from bidding documents and the time cost model equation were analyzed to identify disparities or alignments. The findings reveal moderate to strong positive correlations between the intended project completion time and the time calculated from costs, with variations in correlation strength depending on the specific variables used for cost estimation. The study highlights the need for refining cost estimation methods, enhancing training and capacity building, regular calibration of time-cost models, and further research to improve project management practices in the Nepalese construction industry.

Deep learning for colorectal cancer detection in contrast-enhanced CT without bowel preparation: a retrospective, multicentre study

Contrast-enhanced CT scans provide a means to detect unsuspected colorectal cancer. However, colorectal cancers in contrast-enhanced CT without bowel preparation may elude detection by radiologists. We aimed to develop a deep learning (DL) model for accurate detection of colorectal cancer, and evaluate whether it could improve the detection performance of radiologists. We developed a DL model using a manually annotated dataset (1196 cancer vs 1034 normal). The DL model was tested using an internal test set (98 vs 115), two external test sets (202 vs 265 in 1, and 252 vs 481 in 2), and a real-world test set (53 vs 1524). We compared the detection performance of the DL model with radiologists, and evaluated its capacity to enhance radiologists' detection performance. In the four test sets, the DL model had the area under the receiver operating characteristic curves (AUCs) ranging between 0.957 and 0.994. In both the internal test set and external test set 1, the DL model yielded higher accuracy than that of radiologists (97.2% vs 86.0%, p<0.0001; 94.9% vs 85.3%, p<0.0001), and significantly improved the accuracy of radiologists (93.4% vs 86.0%, p<0.0001; 93.6% vs 85.3%, p<0.0001). In the real-world test set, the DL model delivered sensitivity comparable to that of radiologists who had been informed about clinical indications for most cancer cases (94.3% vs 96.2%, p>0.99), and it detected 2 cases that had been missed by radiologists. The developed DL model can accurately detect colorectal cancer and improve radiologists' detection performance, showing its potential as an effective computer-aided detection tool. This study was supported by National Science Fund for Distinguished Young Scholars of China (No. 81925023); Regional Innovation and Development Joint Fund ofNational Natural Science Foundation of China(No.U22A20345);National Natural Science Foundation of China (No. 82072090 and No. 82371954); Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application (No. 2022B1212010011); High-level Hospital Construction Project (No. DFJHBF202105).

Material Planning for Upper Structure Work Based on the Material Requirement Planning (MIDR) Method in the Kasih Ibu Hospital Construction Project, Surakarta

Material Planning for Upper Structure Work Based on the Material Requirement Planning (MIDR) Method in the Kasih Ibu Hospital Construction Project, Surakarta

Analysis of Domestic Component Level (TKDN) and Company Benefit Weight (BMP) in Construction Projects

In the world of construction projects, good project management is required, including the use of domestic products. The government encourages the use of domestic products through the program to increase the use of domestic production (P3DN). The amount of domestic content in commodities, services, and the combination of products and services can be used to measure the use of domestic products. This quantity is called the Domestic Component Level (TKDN). Company Benefit Weight (BMP) is an award given to industrial companies that invest and produce in Indonesia. This research aims to calculate the amount of TKDN and BMP for the Muhammadiyah Ahmad Dahlan Kediri Hospital construction project. With reference to the Ministry of Industry of the Republic of Indonesia's Regulation No. 16 of 2011 regarding Provisions and Procedures for Calculating Domestic Component Levels, the research employs a descriptive quantitative methodology to compute and analyze Domestic Content Levels (TKDN). The results of analytical calculations show that the TKDN percentage is 69.65% and the BMP percentage is 3%. This research concluded that the total TKDN and BMP was 72.65%, thus meeting the minimum limit for the sum of TKDN and BMP of 40%.

Several factors affecting sick building syndrome complaints in construction office workers in Jakarta

Introduction: Sick building syndrome is a condition in which people who live or work inside a building experience sudden health and comfort impacts related to time spent inside the building, in the absence of a specific disease or cause that can be identified. This study aims to determine the picture of the risk of sick building syndrome in office workers and complaints of sick building syndrome. Methods: Data obtained from several respondents through axial sampling. Data collection was carried out by filling out questionnaires related to complaints of sick building syndrome that had been validated and observed. Results: Factors that influence complaints of sick building syndrome in office workers of hospital construction projects in Jakarta are room temperature, room humidity, habits of leaving the room during rest, and odor in the room. And complaints that often arise, including complaints of headaches, fatigue as many as 39 people, sore eyes, and dry cough and dizziness. Conclusion: Work environment factors that include room temperature, room humidity, and odors in the room as well as behavioral factors that include the habit of leaving the room are driving factors for the occurrence of sick building syndrome in office workers of hospital construction projects in Jakarta.

Detail Engineering Design (DED) pada Struktur New Siloam Hospital Surabaya

The construction of health facilities is part of national development. Therefore, many health facility development projects, such as hospitals, continue to be carried out in various regions. One of them is the construction of the New Siloam Hospital in Surabaya. This article aims to understand the concept of detail engineering design on the building structure of New Siloam Hospital. Field surveys and data collection are the methods used to obtain information related to hospital construction projects. There are several differences between field data and work drawing data that has been created. Some of these differences include details on the reinforcement and casting volume. Therefore, it is necessary to carry out further evaluation of field data with work drawing data so that the project can proceed according to initial planning.

Toward Restorative Hospital Environment: Nature and Art in Finnish Hospitals.

This study explores the integration of nature and art in recent hospital construction projects in Finland, focusing on public hospitals. Interviews with 15 stakeholders, including hospital executives, workers, designers, artists, and architects, reveal the value placed on nature and nature-themed art in hospital settings. The research question presented was: How nature and art are incorporated in Finnish hospitals in order to achieve a restorative hospital environment? Findings highlight themes that appeared in different hospitals: (1) the desired atmosphere, (2) nature and multisensory experiences, (3) social support, and (4) sense of connection and belonging. Bringing nature inside the hospital, whether through natural elements or artworks, emerges as a promising approach. Despite positive outcomes, challenges such as cost and maintenance persist, indicating the need for further research to optimize these initiatives. Overall, incorporating nature and art in hospitals has the potential to enhance healing and well-being for patients, families, and healthcare workers.

Formation and maintenance of organizational culture in collaborative hospital construction projects

Literature defines the significance of organizational culture to the performance of projects, emphasized in collaborative contracts increasing the importance of relational management issues. We have studied the challenges emerging in projects and described preconditions for managing the formation and maintenance of organizational culture to increase the project performance. We applied qualitative research approach focusing on two hospital construction projects utilizing relational contract model.Shortening timeline, dynamism in emerging and departing project participants and the background organizational cultures of the participants set challenges for the management of the organizational culture. We propose specific managerial actions to separate formation and maintenance phases of the organizational culture in projects. We have specified managerial preconditions for cultural level of underlying assumptions like psychological safety, trust, and collaboration and getting rid of old habits and attitudes, focusing to form mindset of collaboration and best for the project in formation and maintenance phases.

Long-term risks of respiratory diseases in patients infected with SARS-CoV-2: a longitudinal, population-based cohort study

In the post-pandemic era, growing apprehension exists regarding the potential sequelae of COVID-19. However, the risks of respiratory diseases following SARS-CoV-2 infection have not been comprehensively understood. This study aimed to investigate whether COVID-19 increases the long-term risk of respiratory illness in patients with COVID-19. In this longitudinal, population-based cohort study, we built three distinct cohorts age 37-73 years using the UK Biobank database; a COVID-19 group diagnosed in medical records between January 30th, 2020 and October 30th, 2022, and two control groups, a contemporary control group and a historical control group, with cutoff dates of October 30th, 2022 and October 30th, 2019, respectively. The follow-up period of all three groups was 2.7 years (the median (IQR) follow-up time was 0.8 years). Respiratory outcomes diagnosed in medical records included common chronic pulmonary diseases (asthma, bronchiectasis, chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), pulmonary vascular disease (PVD), and lung cancer. For the data analysis, we calculated hazard ratios (HRs) along with their 95% CIs using Cox regression models, following the application of inverse probability weights (IPTW). A total of 3 cohorts were included in this study; 112,311 individuals in the COVID-19 group with a mean age (±SDs) of 56.2 (8.1) years, 359,671 in the contemporary control group, and 370,979 in the historical control group. Compared with the contemporary control group, those infected with SARS-CoV-2 exhibited elevated risks for developing respiratory diseases. This includes asthma, with a HR of 1.49 and a 95% CI 1.28-1.74; bronchiectasis (1.30; 1.06-1.61); COPD (1.59; 1.41-1.81); ILD (1.81; 1.38-2.21); PVD (1.59; 1.39-1.82); and lung cancer (1.39; 1.13-1.71). With the severity of the acute phase of COVID-19, the risk of pre-described respiratory outcomes increases progressively. Besides, during the 24-months follow-up, we observed an increasing trend in the risks of asthma and bronchiectasis over time. Additionally, the HR of lung cancer for 0-6 month follow-up was 3.07 (CI 1.73-5.44), and the association of lung cancer with COVID-19 disease disappeared at 6-12 month follow-up (1.06; 0.43-2.64) and at 12-24 months (1.02; 0.45-2.34). Compared to those with one SARS-CoV-2 infection, reinfected patients were at a higher risk of asthma (3.0; 1.32-6.84), COPD (3.07; 1.42-6.65), ILD (3.61; 1.11-11.8), and lung cancer (3.20; 1.59-6.45). Similar findings were noted when comparing with a historical cohort serving as a control group, including asthma (1.31; 1.13-1.52); bronchiectasis (1.53; 1.23-1.89); COPD (1.41; 1.24-1.59); ILD (2.53; 2.05-3.13); PVD (2.30; 1.98-2.66); and lung cancer (2.23; 1.78-2.79). Our research suggests that patients with COVID-19 may have an increased risk of developing respiratory diseases, and the risk increases with the severity of infection and reinfection. Even during the 24-month follow-up, the risk of asthma and bronchiectasis continued to increase. Hence, implementing appropriate follow-up strategies for these individuals is crucial to monitor and manage potential long-term respiratory health issues. Additionally, the increased risk in lung cancer in the COVID-19 individuals was probably due to the diagnostic tests conducted and incidental diagnoses. The National Natural Science Foundation of China of China Regional Innovation and Development Joint Foundation; National Natural Science Foundation of China; Program for High-level Foreign Expert Introduction of China; Natural Science Foundation for Distinguished Young Scholars of Guangdong Province; Guangdong Basic and Applied Basic Research Foundation; Climbing Program of Introduced Talents and High-level Hospital Construction Project of Guangdong Provincial People's Hospital; VA Clinical Merit and ASGE clinical research funds.

Managing opportunism in stakeholder relationships: Case of a hospital construction project alliancing

Managing opportunism in stakeholder relationships: Case of a hospital construction project alliancing

Factors influencing cost overruns in publicly funded hospital projects

In the context of Vietnam's strong economic development and increasing demand for healthcare, enhancing healthcare infrastructure and addressing the issue of overcrowding in public hospitals has become a crucial government objective. This study focuses on identifying the factors influencing cost escalation in public hospital construction projects funded by public investment. The research applies a non-probability sampling method, using convenient sampling and Referral/Snowball sampling techniques. A total of 120 individuals participated in the study, including investors, project managers, design and construction contractors, subcontractors, and relevant suppliers. The study's findings have identified and ranked the ten most significant factors affecting cost escalation in public hospital projects. These factors include inadequate functional design, inadequate functional design, delay in disbursing public investment capital, unforeseeable events, design errors leading to repetitive construction, impact of exchange rate fluctuations on imported medical equipment, unfavorable weather conditions during construction, delay in providing adjusted contract prices or approving adjusted investment amounts, complex geological conditions, and use of estimated quantity estimates in bidding when design is incomplete. The results of this research contribute significantly to the management of construction costs in public hospitals, particularly in the context of public investment funding.

Influence of Occupational Health and Safety Risk On Human Resources on Project Continuity (Case Study: Muhammadiyah University Education Hospital Semarang)

This type of research uses a quantitative descriptive approach, namely describing and analyzing the problems found. Quantitative research is based on primary data and secondary data. This research aims to determine the positive influences between: (1). Employee performance influences work safety. (2). Worker awareness influences work safety. (3). Workers' health influences work safety. On the Semarang Muhammadiyah University Teaching Hospital Construction Project. The results of this research show that work safety has a positive and significant effect of 89.9% on employee performance, and worker health on project sustainability. With the help of SmartPLS3.0 software