Hospital Infrastructure Research Articles

Investigating How Budget Plan Contributes to Successful Implementation of Level Two Healthcare Infrastructure Projects in Kiminini Sub-County, Trans Nzoia County, Kenya

Healthcare is a critical pillar of long-term development. It is therefore up to nations and governments to ensure their healthcare systems are up to date to meet the growing needs of their populations. Developing healthcare infrastructure is critical to achieving this goal. The overall goal of this research was to investigate the influence of project planning on successful implementation of functional level two hospital infrastructure projects in Kiminini Sub-County. The specific objective was to investigate how cost and budget plan influences successful implementation of projects in Kiminini sub- County, Trans Nzoia County, Kenya. Kenya Health Policy 2014-2030 was the intervening variable. Explanatory research design that utilizes both qualitative and quantitative data collection methods was used. The target population included the County departments of health, public works, and finance, heads and staff of the sampled facilities, political and community representatives and contractors. Sample size was 100 respondents. Questionnaires and interview guides were used to collect primary data. Quantitative data was analysed using SPSS version 25. Qualitative data was analysed using content analysis method and presented in narrative form. According to study findings, while some projects were completed within budget, others failed to meet their objectives. Budget estimates and funding were planned though not all were implemented as planned due to delayed disbursement of funds and delay in approving the budgetary allocation for projects due to political differences. The study recommended better collaboration between County and National governments and County assembly, and political good will. The study concluded that planning, and cost and budget plan are crucial in implementation of successful projects. The study aimed at adding value to existing knowledge in the field of study and aiding in implementing successful healthcare infrastructure projects as envisioned in Kenya Vision 2030, and Kenya Health Policy 2014-2030.

Retrospective analysis of 261 autopsies of penetrating cardiac injuries with emphasis on sociodemographic factors

Penetrating cardiac injuries (PCIs) are highly lethal and several factors are related to its incidence and mortality. While most studies focus on characterizing patients who arrived at a medical facility alive and exploring the relationship between the degree of heart compromise and mortality, our study delved deeper into the topic. This study analyzed 261 autopsy reports from 2017 in Bogotá, Colombia, and characterized the factors surrounding PCI incidence and mortality while emphasizing the role of sociodemographic variables. Of these cases, 247 (94.6%) were males with a mean age of 29.19 ± 9.7 years. Weekends, holidays, and late hours had the highest incidence of PCIs. The victims' deaths occurred at the scene in 66 (25.3%) cases, and 65.1% of the victims died before receiving medical care. Upon admission, patients with vital signs were more likely to have been transported by taxi or a private vehicle. Two or more compromised cardiac chambers, increased time of transportation, trauma occurred in the city outskirts, and gunshot wounds were related to increased mortality. Our data is valuable for surgeons, health system managers, and policy analysts as we conducted a holistic assessment of the anatomical and sociodemographic factors that are closely associated with mortality following a PCI. Surgeons must recognize that PCIs can occur even when the entrance wound is outside the cardiac box. Reinforcing hospital infrastructure in the outskirts and improving the availability, accuracy, and response time of first responders may lead to improved patient mortality rates.

A Unified Approach to Sustainable Hospital Supply Chain Management in the Post-Pandemic Era

Sustainable Hospital Supply Chain Management (SHSCM) has become crucial in the post-pandemic era, balancing economic, environmental, and social dimensions of healthcare. This paper proposes an integrated approach to SHSCM, combining four core elements, particularly Hospital Infrastructure Development (HID), Collaboration and Information Flow (CIF), Forecasting and Planning Management (FPM), and Technology Supply Chain Application (TSCA). This approach addresses the complexities and challenges in healthcare supply chains, promoting resilience, efficiency, and sustainability. The authors present potential applications from two different healthcare systems scenarios to demonstrate the application and effectiveness of the proposed approach. The findings of this study suggest that the integration of HID, CIF, FPM, and TSCA provides a comprehensive and systematic way to enhance SHSCM, with implications for research and practice in this important field.

Development of EPAT: An assessment tool for pediatric hematology/oncology training programs.

In the absence of a standardized tool to assess the quality of pediatric hematology/oncology training programs, the Education Program Assessment Tool (EPAT) was conceptualized as a user-friendly and adaptable tool to evaluate and identify areas of opportunity, pinpoint needed modifications, and monitor progress for training programs around the world. The development of EPAT consisted of three main phases: operationalization, consensus, and piloting. After each phase, the tool was iteratively modified based on feedback to improve its relevance, usability, and clarity. The operationalization process led to the development of 10 domains with associated assessment questions. The two-step consensus phase included an internal consensus phase to validate the domains and a subsequent external consensus phase to refine the domains and overall function of the tool. EPAT domains for programmatic evaluation are hospital infrastructure, patient care, education infrastructure, program basics, clinical exposure, theory, research, evaluation, educational culture, and graduate impact. EPAT was piloted in five training programs in five countries, representing diverse medical training and patient care contexts for proper validation of the tool. Face validity was confirmed by a correlation between the perceived and calculated scores for each domain (r=0.78, p<.0001). EPAT was developed following a systematic approach, ultimately leading to a relevant tool to evaluate the different core elements of pediatric hematology/oncology training programs across the world. With EPAT, programs will have a tool to quantitatively evaluate their training, allowing for benchmarking with centers at the local, regional, and international level.

STUDY OF ELECTRICAL INSTALLATION PLANNING AT THE GENERAL HOSPITAL IN BENGKAYANG DISTRICT

The Regional General Hospital of Bengkayang Regency is planning the construction of a new building. The Bengkayang Regency General Hospital building will be planned to total 2 buildings, namely the Central Medical building and the IRNA building, where the Central Medical building has 4 floors with an area of 8024.62 m2 and the IRNA building has 3 floors with an area of 5945.55 m2 and several rooms to be built include: INFECTIOUS, IGD, Obstetric Installation, ICU, ICCU, HCU, Operating Room, and IRNA Room. To build the Regional General Hospital of Bengkayang Regency, it is necessary to plan electrical installations which are part of the initial stage of work. In planning this electrical installation, the need for electrical energy to serve the load must be in accordance with the Indonesian National Standard which refers to the Regulation of the Minister of Health of the Republic of Indonesia Number 24 of 2016 concerning technical requirements for hospital buildings and infrastructure and the General Regulation of Electrical Installations (PUIL) 2011. Research on the planning of this installation uses literature study methods and discriminatory analytics. At the planning stage, several calculations were carried out, namely calculating the need for lighting illumination, air conditioning capacity, conducting cross-sectional area, safety current rating, as well as making line diagrams and calculating cost budget details (RAB). Based on calculations and analysis, the amount of power to meet all electricity load needs is 624322 Watt and the total cost of all work is Rp. 5,623,488,000.00.

The Role of Latest Technology in Sustainable Hospital Supply Chain Management

The future of sustainable hospital supply chain management (SHSCM) hinges on the effective adoption and application of advanced technologies. As discussed previously, Hospital Infrastructure Development (HID), Collaboration &amp; Information Flow (CIF), and Forecasting &amp; Planning Management (FPM) are crucial for an effective and sustainable SCM. However, leveraging the latest Technology Supply Chain Applications (TSCA) could further enhance these efforts, ensuring not only sustainability but also a higher level of service efficiency and patient care.

Opportunity of the accommodation establishment development: a need for nature-based services and eco-friendly activity

PurposeThe purpose of this paper is to investigate the opportunities of development of the accommodation establishments by accepting the current shifting in travellers' needs and the possibilities of reducing the impact on nature.Design/methodology/approachThe Drucker's approach is used to investigate the opportunities of development for the accommodation establishments. The case study method is used to confirm the possibility to develop hospitality in a discovered way.FindingsAccommodation establishments located in the natural space can supply the nature-based accommodation services simultaneously providing the eco-friendly activities. On the other side, the accommodation establishment that is not located in the natural space can also accept the provision of nature-based accommodation services as an opportunity for development.Originality/valueThe current shift in the guests' needs prompts accommodation establishments to enlarge supplying of the nature-based services. However, if these services are supplied by hospitality facilities located in natural space, the threats to nature also grow. On the other hand, if the hospitality infrastructure is not located in natural space, hoteliers accept current needs of guests as threats to their business. The paper presents the possibility of solution of this contradiction and shows the opportunities for moving forward in the field of environmental sustainability in the hospitality industry.

Institutional Violence against Hospitalized Children: The Perception of Nursing Professionals

Objective: To understand the perception of the Nursing team about institutional violence against hospitalized children. Materials and method: A qualitative, descriptive and exploratory study, performed at a large-size public hospital in Salvador, Bahia, Brazil, with 17 Nursing professionals working in the Pediatrics unit, to whom semi-structured interviews were applied between March and May 2019. The collected data were categorized in the NVIVO12 software and submitted for content analysis. Results: The results are presented in four categories: The professionals’ lack of knowledge about institutional violence against hospitalized children; Recognition of institutional violence related to problems in the hospital infrastructure, Recognition of institutional violence in interpersonal relationships and Recognition of institutional violence in the care practices. Conclusions: It becomes necessary to apply policies to confront institutional violence, ranging from training the professionals to adapting the spaces and care practices to favor the children’s hospitalization environment.

Surgical Sealant with Integrated Shape-Morphing Dual Modality Ultrasound and Computed Tomography Sensors for Gastric Leak Detection.

Postoperative anastomotic leaks are the most feared complications after gastric surgery. For diagnostics clinicians mostly rely on clinical symptoms such as fever and tachycardia, often developing as a result of an already fully developed, i.e., symptomatic, surgical leak. A gastric fluid responsive, dual modality, electronic-free, leak sensor system integrable into surgical adhesive suture support materials is introduced. Leak sensors contain high atomic number carbonates embedded in a polyacrylamide matrix, that upon exposure to gastric fluid convert into gaseous carbon dioxide (CO2 ). CO2 bubbles remain entrapped in the hydrogel matrix, leading to a distinctly increased echogenic contrast detectable by a low-cost and portable ultrasound transducer, while the dissolution of the carbonate species and the resulting diffusion of the cation produces a markedly reduced contrast in computed tomography imaging. The sensing elements can be patterned into a variety of characteristic shapes and can be combined with nonreactive tantalum oxide reference elements, allowing the design of shape-morphing sensing elements visible to the naked eye as well as artificial intelligence-assisted automated detection. In summary, shape-morphing dual modality sensors for the early and robust detection of postoperative complications at deep tissue sites, opening new routes for postoperative patient surveillance using existing hospital infrastructure is reported.

'Into the fire': a focus group study of redeployed staff during the COVID-19 pandemic.

During the COVID-19 pandemic, redeployed staff whose services were temporarily suspended were offered a range of opportunities for work to support efforts to manage the impact of the pandemic. A new team, known as the Cygnets was established within an existing team SWAN, to provide non-specialist end of life and bereavement care during the COVID-19 pandemic. It is important to evaluate new services and one important component of this is understanding the perceptions of those staff who took on the new role. To evaluate the service from the perspectives of staff. A purposive sample of 14 NHS staff who had worked as Cygnets during the COVID-19 pandemic took part in three focus groups. The themes identified broadly followed the focus group schedule. Participants considered that overall, they had benefited greatly from the challenge of taking on the Cygnet role, and that this had been a learning experience. This was a rapid response to a need for increased provision of compassionate end-of-life care and was a beneficial experience for staff. More research is required into the broader value of the role within the hospital infrastructure.

Scoping Review: The Role of Personal Resilience and Personality Traits of Health Professionals In The Implementation of Interprofessional Collaboration Practice In Hospital

Health workers have a major role in increasing public satisfaction and assessing the quality of hospital health services. To answer and get this, hospitals must pass the accreditation stage through the hospital accreditation committee, namely by having criteria for the National Hospital Accreditation Standard is Interprofessional Collaboration (IPCP) but challenges between fellow professions and from themselves because there is still autonomy from each profession. Autonomy is also a coping method health professionals use to overcome challenges. The purpose is to examine the role of personal resilience and personality traits of health professionals in IPCP implementation in hospitals. A scoping review was conducted according to PRISMA guidelines for a scoping review. The study was performed on six databases (PubMed, Clinical Key, ProQuest, EBSCO, Scopus, and Science Direct) for relevant papers published between 2017 and 2021. Search terms included "Resilience AND Personality, "Health Professionals", "Interprofessional Collaboration Practice", AND "Hospital." Eight articles were included in this review. The study showed that personal resilience and personality traits determined the success of IPCP implementation in the hospital, which was influenced by education, training, management support, and hospital facilities and infrastructure. Conclusion: The role of each health professional's personal resilience and personality traits affects the quality of IPCP implementation in the hospital. Recommendation: IPCP can improve the quality of service in hospitals by facilitating health professional knowledge and skills about interprofessional collaboration, especially in implementing case management in hospitals.

10-year real-world data on acute myeloid leukemia: The paradigm of a public health center in Brazil.

e19022 Background: Acute myeloid leukemia (AML) is a heterogeneous disease with different predominant molecular pathways. The last few years have witnessed great advances in targeted therapy. There are several trials in developed countries evaluating clinical outcomes. Nevertheless, data from low and middle-income (LMIC) countries frequently describe inferior results. Methods: This was a retrospective single-center cohort conducted in a university hospital in Northeast Brazil. We have analyzed the outcomes of all 62 patients diagnosed with AML between 2007 and 2017. Patients were classified using the European LeukemiaNet 2017 model into favorable (n=8), intermediate (n=18), and adverse risk (n= 7). 29 were not otherwise classified because of the absence of cytogenetic and/or molecular tests. We used logistic regression for data analysis assessing death as the outcome. Survival measures were estimated using the Kaplan-Meier method. The impact of bone marrow transplant (BMT) on patients eligible for intensive treatment on overall survival (OS) was assessed using a Cox proportional hazards model. Results: The median OS (mOS) of the entire cohort was 7 months (CI: 3.14-10.85). Stratifying by the risk, the mOS was shorter in patients with unknown and adverse risk (3 and 5 months, respectively) than in favorable and intermediate risk (22 and 11 months, respectively, P = 0.05). 16 (38%) patients were submitted to allogeneic BMT. We found a survival advantage (hazard ratio, HR: 0.32, 95% CI: 0.15-0.71) – p=0.005) in transplant patients, with superior median overall survival (mOS) (49 months) when compared with the chemotherapy group (6 months) ( P = 0.003). A total of 48 (77%) patients died during the follow-up and most deaths (n=39, 81%) occurred during the first year of diagnosis. Univariate analysis of clinical and laboratory characteristics found no association with death. A multivariate model including AML origin, risk stratification, and alloBMT as predictor variables demonstrated the protective power of alloBMT (table). Conclusions: Inferior outcomes found in LMIC are the result of a multifactorial scenario that reflects the absence of proper diagnostic tools, hospital infrastructure, and the lack of more effective and less toxic therapies. We suggest that patients with inadequate risk assessment should undergo consolidation with alloBMT as this remains the primary curative intervention in the real-world setting of LMIC. [Table: see text]

Effect of Educational Tools on the use of Patient-Controlled Analgesia Devices.

In the literature, there are confusing data about educational tools and device use. Therefore, it is not clear which method is superior to the other. The aim of this study was to evaluate the effects of educational tools on patient-controlled analgesia (PCA) usage in patients undergoing hysterectomy. Ninety-six patients undergoing hysterectomy were enrolled in the study. Patients were randomly assigned to a group (verbal, brochure, or video) consisting of 32 patients each using the closed envelope method. After operations, all patients were sent to the ward and evaluated with numerical rating scale score for pain at 15th min., 2nd, 4th, 6th, 12th, 18th, 2nd, 4th, 6th, 12th, 18th, 24th hours. Given dose, the number of button presses, presence of nausea and vomiting, and static and dynamic pain scores were recorded. During visits, patients who had a pain score ≥4 were administered paracetamol 1 g IV. Ondansetron 8 mg IV was injected into patients who had nausea and vomiting. No significant differences were determined in resting and dynamic pain scores, number of button presses, and given doses between groups at 15th min., 2nd, 4th, 6th, 12th, 18th, 24th hours. In this study, education type did not affect PCA device use. We believe that whatever method the infrastructure of hospitals is suitable for, should be used for PCA device education.

Enhancing Sustainable Hospital Supply Chain Management through Collaboration and Information Flow in the Post-Pandemic Era

The importance of sustainability in Hospital Supply Chain Management (HSCM) has been increasingly recognized, particularly in the post-pandemic era. With growing demands for healthcare services, environmental concerns, and the pressing need for cost-effective solutions, hospitals must reconsider their supply chain strategies to ensure sustainability [1]. One critical aspect of achieving sustainable HSCM is fostering collaboration and information flow among stakeholders. Previously the author discussed about the Hospital Infrastructure Development (HID) which is one of the key elements that can contribute to sustainable HSCM [9]. This article will discuss another key element, the significance of "Collaboration &amp; Information Flow" in ensuring Hospital Supply Chain Management Sustainability.

Enhancing Sustainable Hospital Supply Chain Management through Collaboration and Information Flow in the Post-Pandemic Era

The importance of sustainability in Hospital Supply Chain Management (HSCM) has been increasingly recognized, particularly in the post-pandemic era. With growing demands for healthcare services, environmental concerns, and the pressing need for cost-effective solutions, hospitals must reconsider their supply chain strategies to ensure sustainability [1]. One critical aspect of achieving sustainable HSCM is fostering collaboration and information flow among stakeholders. Previously the author discussed about the Hospital Infrastructure Development (HID) which is one of the key elements that can contribute to sustainable HSCM [9]. This article will discuss another key element, the significance of "Collaboration &amp; Information Flow" in ensuring Hospital Supply Chain Management Sustainability.

Experiences on the Utility and Barriers of Telemedicine in Healthcare Delivery in Kenya.

Telemedicine is the provision of health services over a distance using information communication technology devices. Telemedicine is emerging as a promising component of healthcare care delivery worldwide, accelerated by the COVID-19 pandemic. This study assessed the factors promoting uptake, barriers, and opportunities for telemedicine among doctors in Kenya. Methodology. A semiquantitative, cross-sectional online survey was conducted among doctors in Kenya. During a month, between February and March 2021, 1,200 doctors were approached by email and WhatsApp, of whom 13% responded. Findings. A total of 157 interviewees participated in the study. The general usage of telemedicine was 50%. Seventy-three percent of doctors reported using a mix of in-person care and telemedicine. Fifty percent reported using telemedicine to support physician-to-physician consultations. Telemedicine had limited utility as a standalone clinical service. The inadequate information communication technology infrastructure was the most reported barrier to telemedicine, followed by a cultural resistance to using technology to deliver healthcare services. Other notable barriers were the high cost of initial setup limited skills among patients, limited skills among doctors, inadequate funding to support telemedicine services, weak legislative/policy framework, and lack of dedicated time for telemedicine services. The COVID-19 pandemic increased the uptake of telemedicine in Kenya. The most extensive use of telemedicine in Kenya supports physician-to-physician consultations. There is limited single use of telemedicine in providing direct clinical services to patients. However, telemedicine is regularly used in combination with in-person clinical services, allowing for continuity of clinical services beyond the physical hospital infrastructure. With the widespread adoption of digital technologies in Kenya, especially mobile telephone technologies, the growth opportunities for telemedicine services are immense. Numerous mobile applications will improve access capabilities for both service providers and users and bridge the gaps in care.

COVID-19- A Challenge for Urology Subspecialty in an overwhelmed public sector hospital: A Descriptive Review

Background: COVID-19 has brought unprecedented changes in every aspect of life throughout the world including the healthcare delivery system. After a grinding halt in surgical practice due to this pandemic, the conventional protocols needed a thorough overhaul before kick-starting formal services. This study discusses ways and procedure changes adopted at the Urology department to navigate this crisis and extend adequate urological care to patients at the same time. Aim: To share our experience of patient management in the era of the COVID-19 pandemic. Methods: It’s a descriptive review article based on patient management protocols and clinical audit in the era of COVID-19 pandemic at the Departmentof Urology, MTI, Lady Reading Hospital from 20th Marchto 20th June 2020. Clinical implication the benefit of this study is how to organize things and continue health care provision in a deadly pandemic. Furthermore, it will set a precedence that how to cope with such a pandemic in the future. Conclusion: All surgical patients should be screened for COVID-19, with preference given to PCR tests. All elective surgeries should be put on hold as a result of the limited availability of ventilators, manpower, and hospital beds. Only semi-elective, lifesaving and oncologic surgeries that cannot be delayed should be done with full PPEs provided to every personnel frequenting operating theaters during the procedure. Furthermore, more efforts are needed to lift the infrastructure of hospitals and make them capable to face problems of such proportions in the future. Keywords: COVID-19, Urology, Public sector hospital, Pandemic, Oncological surgeries

Sustainable Hospital Supply Chain Management through Hospital Infrastructure Development

Sustainability in Hospital Supply Chain Management (HSCM) is a critical consideration in the modern healthcare industry, given the growing concern for environmental conservation and resource optimization. Hospital Infrastructure Development (HID) is one of the key elements that can significantly contribute to sustainable HSCM. This article discusses the role of HID in enhancing the sustainability of HSCM and the various strategies that can be implemented.

Policies for Climate-Resilient Health Care Infrastructure—An Environmental Justice Priority

This Viewpoint discusses how bolstering the climate resilience of hospital infrastructure supports environmental justice goals.

Framework for cyber risk loss distribution of hospital infrastructure: Bond percolation on mixed random graphs approach.

Networks like those of healthcare infrastructure have been a primary target of cyberattacks for over a decade. From just a single cyberattack, a healthcare facility would expect to see millions of dollars in losses from legal fines, business interruption, and loss of revenue. As more medical devices become interconnected, more cyber vulnerabilities emerge, resulting in more potential exploitation that may disrupt patient care and give rise to catastrophic financial losses. In this paper, we propose a structural model of an aggregate loss distribution across multiple cyberattacks on a prototypical hospital network. Modeled as a mixed random graph, the hospital network consists of various patient-monitoring devices and medical imaging equipment as random nodes to account for the variable occupancy of patient rooms and availability of imaging equipment that are connected by bidirectional edges to fixed hospital and radiological information systems. Our framework accounts for the documented cyber vulnerabilities of a hospital's trusted internal network of its major medical assets. To our knowledge, there exist no other models of an aggregate loss distribution for cyber risk in this setting. We contextualize the problem in the probabilistic graph-theoretical framework using a percolation model and combinatorial techniques to compute the mean and variance of the loss distribution for a mixed random network with associated random costs that can be useful for healthcare administrators and cybersecurity professionals to improve cybersecurity management strategies. By characterizing this distribution, we allow for the further utility of pricing cyberrisk.