scholarly journals Why hospital design matters: A narrative review of built environments research relevant to stroke care

2021 ◽  
pp. 174749302110424
Author(s):  
Julie Bernhardt ◽  
Ruby Lipson-Smith ◽  
Aaron Davis ◽  
Marcus White ◽  
Heidi Zeeman ◽  
...  
Keyword(s):  
Built Environment ◽  
Building Design ◽  
Stroke Care ◽  
Healthcare Services ◽  
Evidence Base ◽  
Narrative Review ◽  
Built Environments ◽  
Healthcare Facilities ◽  
Hospital Design ◽  
Living Labs

Healthcare facilities are among the most expensive buildings to construct, maintain, and operate. How building design can best support healthcare services, staff, and patients is important to consider. In this narrative review, we outline why the healthcare environment matters and describe areas of research focus and current built environment evidence that supports healthcare in general and stroke care in particular. Ward configuration, corridor design, and staff station placements can all impact care provision, staff and patient behavior. Contrary to many new ward design approaches, single-bed rooms are neither uniformly favored, nor strongly evidence-based, for people with stroke. Green spaces are important both for staff (helping to reduce stress and errors), patients and relatives, although access to, and awareness of, these and other communal spaces is often poor. Built environment research specific to stroke is limited but increasing, and we highlight emerging collaborative multistakeholder partnerships (Living Labs) contributing to this evidence base. We believe that involving engaged and informed clinicians in design and research will help shape better hospitals of the future.

Immersive virtual environments versus physical built environments: A benchmarking study for building design and user-built environment explorations

2015 ◽  
Vol 54 ◽  
pp. 116-126 ◽  
Author(s):  
Arsalan Heydarian ◽  
Joao P. Carneiro ◽  
David Gerber ◽  
Burcin Becerik-Gerber ◽  
Timothy Hayes ◽  
...  
Keyword(s):  
Built Environment ◽  
Virtual Environments ◽  
Building Design ◽  
Built Environments ◽  
Immersive Virtual Environments

Application of Theory in Studies of Healthcare Built Environment Research

2020 ◽  
Vol 13 (3) ◽  
pp. 154-170 ◽  
Author(s):  
Michelle M. Shannon ◽  
S. Nordin ◽  
J. Bernhardt ◽  
M. Elf
Keyword(s):  
Built Environment ◽  
Research Question ◽  
Healthcare Setting ◽  
Evidence Base ◽  
Environment Design ◽  
Healthcare Facilities ◽  
Review Team ◽  
Theory Application ◽  
The Right ◽  
The Impact

We aimed to examine the nature and extent of theory application in studies of built environment attributes and impact on adults in healthcare facilities. Many varied theories are described when providing the rationale for research into built environments in healthcare. Uncertainty exists around the right theory to frame a research question, alignment with measurement tools, and whether healthcare setting makes a difference. This poses challenges to researchers seeking to build the evidence base for built environment design that benefits patients and staff. Our multidisciplinary review team scoped the literature to determine how theories are used to inform research investigating the impact of the built environment of healthcare on adults. When researchers recorded theory at development of the study question, in data collection, and in data analysis/interpretation, we called this explicitly theory-based application. Synthesis occurred using a narrative approach. Overall, we found 17 diverse theories named in studies. Explicitly theory-based use occurred with eight theories, comprising 47% of all theories used. Five theories were named more frequently in studies out of all theories identified. In 20% of studies, theory was not used explicitly during the research inquiry. We argue that researchers must continue to strive toward explicit use of theories, similar to development of other health interventions that employ multifactorial components.

scholarly journals Simulating the effects of redesigned street-scale built environments on access/egress pedestrian flows to metro stations

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Yanan Liu ◽  
Dujuan Yang ◽  
Harry J. P. Timmermans ◽  
Bauke de Vries
Keyword(s):  
Built Environment ◽  
Route Choice ◽  
Local Area ◽  
Destination Choice ◽  
Built Environments ◽  
Renewal Processes ◽  
City Center ◽  
Metro Station ◽  
Route Choice Behavior ◽  
The City

AbstractIn urban renewal processes, metro line systems are widely used to accommodate the massive traffic needs and stimulate the redevelopment of the local area. The route choice of pedestrians, emanating from or going to the metro stations, is influenced by the street-scale built environment. Many renewal processes involve the improvement of the street-level built environment and thus influence pedestrian flows. To assess the effects of urban design on pedestrian flows, this article presents the results of a simulation model of pedestrian route choice behavior around Yingkoudao metro station in the city center of Tianjin, China. Simulated pedestrian flows based on 4 scenarios of changes in street-scale built environment characteristics are compared. Results indicate that the main streets are disproportionally more affected than smaller streets. The promotion of an intensified land use mix does not lead to a high increase in the number of pedestrians who choose the involved route when traveling from/to the metro station, assuming fixed destination choice.

scholarly journals DEEP SCOPE: A Framework for Safe Healthcare Design

2021 ◽  
Vol 18 (15) ◽  
pp. 7780
Author(s):  
Ellen Taylor ◽  
Sue Hignett
Keyword(s):  
Human Factor ◽  
Healthcare Facility ◽  
Built Environments ◽  
Facility Design ◽  
Healthcare Facilities ◽  
Healthcare Design ◽  
Accident Causation ◽  
Healthcare Facility Design

Thinking in patient safety has evolved over time from more simplistic accident causation models to more robust frameworks of work system design. Throughout this evolution, less consideration has been given to the role of the built environment in supporting safety. The aim of this paper is to theoretically explore how we think about harm as a systems problem by mitigating the risk of adverse events through proactive healthcare facility design. We review the evolution of thinking in safety as a safety science. Using falls as a case study topic, we use a previously published model (SCOPE: Safety as Complexity of the Organization, People, and Environment) to develop an expanded framework. The resulting theoretical model and matrix, DEEP SCOPE (DEsigning with Ergonomic Principles), provide a way to synthesize design interventions into a systems-based model for healthcare facility design using human factors/ergonomics (HF/E) design principles. The DEEP SCOPE matrix is proposed to highlight the design of safe healthcare facilities as an ergonomic problem of design that fits the environment to the user by understanding built environments that support the “human” factor.

The Psychological Supportive Design Features in Hospitals: Case of a Public Jordanian Hospital in Amman

2021 ◽  
pp. 193758672110295
Author(s):  
Nadine Al-Bqour ◽  
Shaher Rababeh ◽  
Rama Al-Rabady
Keyword(s):  
Interior Design ◽  
Public Hospital ◽  
Psychological Needs ◽  
Design Features ◽  
Healthcare Facilities ◽  
Hospital Design ◽  
Third World Country ◽  
Responsive Design ◽  
Healing Environments ◽  
Supportive Design

Purpose: The purpose of this study is to develop a practical framework that combines the psychological supportive design features in hospitals’ healing environments, also, to examine the implementation of these features in a Jordanian public hospital. Background: Positive psychological feelings are the hidden powerful treatment in hospitals. Although that Jordan represents a third-world country, it is counted as one of the most sought-after healthcare locations in the Middle East for its distinguished healthcare serveries (Private Hospitals Association, 2019). Nevertheless, the architectural and interior design of the healthcare facilities in Jordan usually ignores the inpatients’ psychological needs. Also, there is an absence of practicing a set of psychological supportive design features to guide the hospitals’ design in Jordan. Method: Design features are obtained from the main theories in the field of supportive healing environments. A large Jordanian public hospital was selected to be assessed in terms of these features within the developed practical framework. This study adopts a mixed methodology; data are collected using different methods, mainly literature review, site inventory, and inpatients’ questionnaire. Results: The studied hospital remains moderately considerable in terms of the psychologically supportive design features. However, the nature connectivity aspect is not satisfactorily considered in the studied hospital design. Conclusion: This study suggests a responsive design that fosters interaction and integration with surrounding nature in order to increase levels of connectivity with nature. The studied design features in this study could work as guiding principles for Jordanian hospitals’ designers.

scholarly journals Analysis of Annual Costs of Mobile Clinics in the Southern United States

2020 ◽  
Vol 11 ◽  
pp. 215013272098062
Author(s):  
Sharon Attipoe-Dorcoo ◽  
Rigoberto Delgado ◽  
Dejian Lai ◽  
Aditi Gupta ◽  
Stephen Linder
Keyword(s):  
Primary Care ◽  
Healthcare Services ◽  
Medicare Beneficiaries ◽  
Mobile Clinic ◽  
Efficient Manner ◽  
Healthcare Facilities ◽  
Capital Costs ◽  
At Risk Populations ◽  
Mobile Clinics ◽  
The Cost

Introduction Mobile clinics provide an efficient manner for delivering healthcare services to at-risk populations, and there is a need to understand their economics. This study analyzes the costs of operating selected mobile clinic programs representing service categories in dental, dental/preventive, preventive care, primary care/preventive, and mammography/primary care/preventive. Methods The methodology included a self-reported survey of 96 mobile clinic programs operating in Texas, North Carolina, Georgia, and Florida; these states did not expand Medicaid and have a large proportion of uninsured individuals. Data were collected over an 8-month period from November 2016 to July 2017. The cost analyses were conducted in 2018, and were analyzed from the provider perspective. The average annual estimated costs; as well the costs per patient in each mobile clinic program within different service delivery types were assessed. Costs reported in the study survey were classified into recurrent direct costs and capital costs. Results Results indicate that mean operating costs range from about $300 000 to $2.5 million with costs increasing from mammography/primary care/preventive delivery to dental/preventive. The majority of mobile clinics provided dental care followed by dental/preventive. The cost per patient visit for all mobile clinic service types ranged from $65 to $529, and appears to be considerably less than those reported in the literature for fixed clinic services. Conclusion The overall costs of all delivery types in mobile clinics were lower than the costs of providing care to Medicare beneficiaries in federally funded health centers, making mobile clinics a sound economic complement to stationary healthcare facilities.

scholarly journals Hospital Construction Cost Affecting Their Lifecycle: An Italian Overview

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 888
Author(s):  
Leopoldo Sdino ◽  
Andrea Brambilla ◽  
Marta Dell’Ovo ◽  
Benedetta Sdino ◽  
Stefano Capolongo
Keyword(s):  
Healthcare Services ◽  
Construction Cost ◽  
Design Stage ◽  
Quality Healthcare ◽  
Healthcare Facilities ◽  
Early Design Stage ◽  
Hospital Facility ◽  
Italian Context ◽  
The Cost ◽  
Cost Components

The need for 24/7 operation, and the increasing requests of high-quality healthcare services contribute to framing healthcare facilities as a complex topic, also due to the changing and challenging environment and huge impact on the community. Due to its complexity, it is difficult to properly estimate the construction cost in a preliminary phase where easy-to-use parameters are often necessary. Therefore, this paper aims to provide an overview of the issue with reference to the Italian context and proposes an estimation framework for analyzing hospital facilities’ construction cost. First, contributions from literature reviews and 14 case studies were analyzed to identify specific cost components. Then, a questionnaire was administered to construction companies and experts in the field to obtain data coming from practical and real cases. The results obtained from all of the contributions are an overview of the construction cost components. Starting from the data collected and analyzed, a preliminary estimation tool is proposed to identify the minimum and maximum variation in the cost when programming the construction of a hospital, starting from the feasibility phase or the early design stage. The framework involves different factors, such as the number of beds, complexity, typology, localization, technology degree and the type of maintenance and management techniques. This study explores the several elements that compose the cost of a hospital facility and highlights future developments including maintenance and management costs during hospital facilities’ lifecycle.

Racial Disparities in Incidence of Legionnaires’ Disease and Social Determinants of Health: A Narrative Review

2021 ◽  
pp. 003335492110267
Author(s):  
Candis M. Hunter ◽  
Simone W. Salandy ◽  
Jessica C. Smith ◽  
Chris Edens ◽  
Brian Hubbard
Keyword(s):  
Health Care ◽  
Built Environment ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Health Care Access ◽  
Narrative Review ◽  
Economic Stability ◽  
Care Access ◽  
Legionnaires Disease ◽  
Access And Quality

Objectives Racial and socioeconomic disparities in the incidence of Legionnaires’ disease have been documented for the past 2 decades; however, the social determinants of health (SDH) that contribute to these disparities are not well studied. The objective of this narrative review was to characterize SDH to inform efforts to reduce disparities in the incidence of Legionnaires’ disease. Methods We conducted a narrative review of articles published from January 1979 through October 2019 that focused on disparities in the incidence of Legionnaires’ disease and pneumonia (inclusive of bacterial pneumonia and/or community-acquired pneumonia) among adults and children (excluding articles that were limited to people aged <18 years). We identified 220 articles, of which 19 met our criteria: original research, published in English, and examined Legionnaires’ disease or pneumonia, health disparities, and SDH. We organized findings using the Healthy People 2030 SDH domains: economic stability, education access and quality, social and community context, health care access and quality, and neighborhood and built environment. Results Of the 19 articles reviewed, multiple articles examined disparities in incidence of Legionnaires’ disease and pneumonia related to economic stability/income (n = 13) and comorbidities (n = 10), and fewer articles incorporated SDH variables related to education (n = 3), social support (none), health care access (n = 1), and neighborhood and built environment (n = 6) in their analyses. Conclusions Neighborhood and built-environment factors such as housing, drinking water infrastructure, and pollutant exposures represent critical partnership and research opportunities. More research that incorporates SDH and multilevel, cross-sector interventions is needed to address disparities in Legionnaires’ disease incidence.

Building back smarter—part one: the case for more modular facilities in the NHS

2021 ◽  
Vol 27 (9) ◽  
pp. 1-9
Author(s):  
Isobel Clough
Keyword(s):  
Service Delivery ◽  
Physical Space ◽  
Cost Effective ◽  
Healthcare Services ◽  
Business Case ◽  
Care Quality ◽  
Healthcare Facilities ◽  
Building Maintenance ◽  
Cost Implications ◽  
The Cost

The NHS is facing an unprecedented backlog in both patient care and building maintenance, with severe implications for service delivery, finance and population wellbeing. This article is the first in a series discussing modular healthcare facilities as a potential solution to these issues, providing flexible and cost-effective spaces to allow services to increase capacity without sacrificing care quality. The first of three instalments, this paper will outline the problems facing the NHS estate, many of which have been exacerbated to critical levels by the COVID-19 pandemic, and what this means for service delivery. It will then make the case for modular infrastructure, outlining the potential benefits for healthcare services, staff and patients alike. Using modern methods of construction, this approach to creating physical space in healthcare can provide greater flexibility and a reduced impact on the environment. The next two articles in this series will go on to provide detailed case studies of successful modular implementation in NHS trusts, an analysis of the cost implications and guidance on the commissioning process and building a business case.

MEASURING SPATIAL HEALTHCARE FACILITIES ACCESSIBILITY USING TWO-STEP FLOATING CATCHMENT ANALYSIS (2SFCA) (Case Study: Cianjur Regency, Indonesia)

2021 ◽  
pp. 11
Author(s):  
Muhamad Iqbal Januadi Putra ◽  
Nabila Dety Novia Utami
Keyword(s):  
Travel Time ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Spatial Accessibility ◽  
Healthcare Facilities ◽  
Spatial Disparities ◽  
Time Threshold

The presence of healthcare facilities is quite essential to provide good healthcare services in a particular area, however, the existence of healthcare facilities is not evenly distributed in Cianjur Regency. This condition leads to the disparities of healthcare facilities across the Cianjur Regency. In this paper, we aim to measure and map the spatial disparities of healthcare facilities using a Two-Step Floating Catchment Analysis (2SFCA). This method can calculate the magnitude of spatial accessibility for healthcare facilities by formulating the travel time threshold and the quality of healthcare facilities across the study area. This research shows the result that the spatial accessibility of healthcare facilities in the Cianjur Regency is not evenly distributed across the districts. The spatial accessibility value resulted from 2SFCA is ranging from 0- 3.97. A low value indicates low spatial accessibility, while a higher value shows good accessibility. The majority of districts in the Cianjur Regency have the spatial accessibility value 0-0.5 (86%). Meanwhile, only a few have the higher value; value 0.5-0.99 as much as 6.6%, 0.99-1.49 as 3.3%, and 3.48-3.97 has a percentage of 3.3%. Also, this analysis results in the cluster of good spatial accessibility in healthcare facilities, namely the Pagelaran District and Cipanas District. Interestingly, the downtown of Cianjur Regency has lower spatial accessibility compared to both areas.

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