scholarly journals Responsiveness and Adaptability of Healthcare Facilities in Emergency Scenarios: COVID-19 Experience

Author(s):  
Marta Łukasik ◽  
Anna Porębska

The COVID-19 pandemic revealed many vulnerabilities of the contemporary built environment along with limited preparedness and low efficiency in mitigating unexpected and unprecedented challenges. This article discusses the efficiency and responsiveness of basic hospital spatial layouts in three different scenarios: normal operation; the segregation of a large number of patients and still providing them with access to emergency healthcare, typical for a pandemic; and a sudden, extremely high number of admissions typical for compound disasters and terrorist attacks. A set of parameters and a method for general adaptability assessment (GAAT) that can be used as a tool in decision-making processes as well as evaluation of both existing facilities and the new models for resilient hospitals resulting from the experience of the pandemic are proposed. The paper emphasizes why factors among which adaptability, convertibility, and scalability should be at the very core of hospital development and management strategies. It also discusses new models of adaptable healthcare facilities that enable day-to-day operations to continue alongside a pandemic, and other emergency scenarios.

Author(s):  
I. Barsukova ◽  
I. Bagretsova

Development of a system for the delivery of emergency care in a hospital inevitably raises questions of its availability and quality. And, if the leading pathological syndrome which is a reason for hospitalization and posing a threat to the patient's life deserves priority attention, then the accompanying pathology often stays in the background. At the same time the accompanying pathology related to the field of dermatovenerology poses epidemiological threat. The aim of the study was to improve the organization of health care for patients with concomitant pathology related to dermatovenerology in an emergency hospital. Development of new models and principles of the organization of medical and diagnostic process, introduction of methods of express diagnostics is required; importance of a dermatovenerologist becomes obvious, it will increase the availability and quality of care for patients with dermatovenereological pathology in an emergency hospital.


2020 ◽  
Vol 41 (S1) ◽  
pp. s151-s152
Author(s):  
Lauren Epstein ◽  
Alicia Shugart ◽  
David Ham ◽  
Snigdha Vallabhaneni ◽  
Richard Brooks ◽  
...  

Background: Carbapenemase-producing carbapenem-resistant Acinetobacter baumannii (CP-CRAB) are a public health threat due to potential for widespread dissemination and limited treatment options. We describe CDC consultations for CP-CRAB to better understand transmission and identify prevention opportunities. Methods: We defined CP-CRAB as CRAB isolates with a molecular test detecting KPC, NDM, VIM, or IMP carbapenemases or a plasmid-mediated oxacillinase (OXA-23, OXA-24/40, OXA-48, OXA-58, OXA-235/237). We reviewed the CDC database of CP-CRAB consultations with health departments from January 1, 2017, through June 1, 2019. Consultations were grouped into 3 categories: multifacility clusters, single-facility clusters, and single cases. We reviewed the size, setting, environmental culturing results, and identified infection control gaps for each consultation. Results: We identified 29 consultations involving 294 patients across 19 states. Among 9 multifacility clusters, the median number of patients was 12 (range, 2–87) and the median number of facilities was 2 (range, 2–6). Among 9 single-facility clusters, the median number of patients was 5 (range, 2–50). The most common carbapenemase was OXA-23 (Table 1). Moreover, 16 consultations involved short-stay acute-care hospitals, and 6 clusters involved ICUs and/or burn units. Also, 8 consultations involved skilled nursing facilities. Environmental sampling was performed in 3 consultations; CP-CRAB was recovered from surfaces of portable, shared equipment (3 consultations), inside patient rooms (3 consultations) and nursing stations (2 consultations). Lapses in environmental cleaning and interfacility communication were common across consultations. Among 11 consultations for single CP-CRAB cases, contact screening was performed in 7 consultations and no additional CP-CRAB was identified. All 4 patients with NDM-producing CRAB reported recent international travel. Conclusions: Consultations for clusters of oxacillinase-producing CP-CRAB were most often requested in hospitals and skilled nursing facilities. Healthcare facilities and public health authorities should be vigilant for possible spread of CP-CRAB via shared equipment and the potential for CP-CRAB spread to connected healthcare facilities.Funding: NoneDisclosures: None


2007 ◽  
Vol 28 (7) ◽  
pp. 845-852 ◽  
Author(s):  
G. W. Coombs ◽  
H. Van Gessel ◽  
J. C. Pearson ◽  
M.-R. Godsell ◽  
F. G. O'Brien ◽  
...  

Objective.To describe the control of an outbreak of infection and colonization with the New York/Japan methicillin-resistantStaphylococcus aureus(MRSA) clone in multiple healthcare facilities, and to demonstrate the importance of making an MRSA management policy involving molecular typing of MRSA into a statewide public health responsibility.Setting.A range of healthcare facilities, including 2 metropolitan teaching hospitals and a regional hospital, as well as several community hospitals and long-term care facilities in a nonmetropolitan healthcare region.Interventions.A comprehensive, statewide MRSA epidemiological investigation and management policy.Results.In May 2005, there were 3 isolates referred to the Western Australian Gram-Positive Bacteria Typing and Research Unit that were identified as the New York/Japan MRSA clone, a pandemic MRSA clone with the ability to spread and replace existing clones in a region. Subsequent investigation identified 28 additional cases of infection and/or colonization dating from 2002 onward, including 1 involving a colonized healthcare worker (HCW) who had previously been hospitalized overseas. Of the 31 isolates detected, 25 were linked epidemiologically and via molecular typing to the isolate recovered from the colonized HCW. Four isolates appeared to have been introduced separately from overseas. Although the isolate from the single remaining case patient was genetically indistinct from the isolates that spread within Western Australia, no specific epidemiological link could be established. The application of standard outbreak management strategies reduced further spread.Conclusions.The elimination of the New/York Japan MRSA clone in a healthcare region demonstrates the importance of incorporating MRSA management policy into statewide public health programs. The mainstays of such programs should include a comprehensive and effective outbreak identification and management policy (including pre-employment screening of HCWs, where applicable) and MRSA clone identification by multilocus sequence typing.


Plants ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 2747
Author(s):  
Thomas Armand ◽  
Luâna Korn ◽  
Elodie Pichon ◽  
Marlène Souquet ◽  
Mélissandre Barbet ◽  
...  

Neonicotinoids are widely used to protect fields against aphid-borne viral diseases. The recent ban of these chemical compounds in the European Union has strongly impacted rapeseed and sugar beet growing practices. The poor sustainability of other insecticide families and the low efficiency of prophylactic methods to control aphid populations and pathogen introduction strengthen the need to characterize the efficiency of new plant protection products targeting aphids. In this study, the impact of Movento® (Bayer S.A.S., Leverkusen, Germany), a tetrameric acid derivative of spirotetramat, on Myzus persicae and on viral transmission was analyzed under different growing temperatures. The results show (i) the high efficiency of Movento® to protect rapeseed and sugar beet plants against the establishment of aphid colonies, (ii) the impact of temperature on the persistence of the Movento® aphicid properties and (iii) a decrease of approximately 10% of the viral transmission on treated plants. These observations suggest a beneficial effect of Movento® on the sanitary quality of treated crops by directly reducing primary infections and indirectly altering, through aphid mortality, secondary infections on which the spread of disease within field depends. These data constitute important elements for the future development of management strategies to protect crops against aphid-transmitted viruses.


2021 ◽  
Vol 9 ◽  
Author(s):  
Sanjana Fatema Chowdhury ◽  
Syed Muktadir Al Sium ◽  
Saeed Anwar

The ongoing coronavirus disease 2019 (COVID-19) pandemic has disrupted every aspect of our life. The need to provide high-level care for an enormous number of patients with COVID-19 infection during this pandemic has impacted resourcing for and restricted the routine care of all non-COVID-19 conditions. Since the beginning of the pandemic, the people living with rare disorders, who represent a marginalized group of the population even in a normal world, have not received enough attention that they deserve. Due to the pandemic situation, they have experienced (and experiencing) an extreme inadequacy of regular clinical services, counseling, and therapies they need, which have made their life more vulnerable and feel more marginalized. Besides, the clinicians, researchers, and scientists working on rare genetic diseases face extra challenges due to the pandemic. Many ongoing research projects and clinical trials for rare and genetic diseases were stalled to avoid patients' and research staff's transmission to COVID-19. Still, with all the odds, telehealth and virtual consultations for rare disease patients have shown hope. The clinical, organizational, and economic challenges faced by institutions, patients, their families, and the caregivers during the pandemic indicate the importance of ensuring continuity of care in managing rare diseases, including adequate diagnostics and priority management strategies for emergencies. In this review, we endeavored to shed light on the issues the rare disease community faces during the pandemic and the adaptations that could help the rare disease community to better sustain in the coming days.


Author(s):  
Osvaldo Augusto Vasconcelos de Oliveira Lopes Da Silva ◽  
José Machado Moita Neto ◽  
Marcos Antônio Tavares Lira

The expansion of Brazilian higher education institutions (HEIs) organized in multicampi structures brought a significant complexity to the academic and administrative management. In this context, environmental management strategies become quite relevant, especially when considering the low effectiveness of the Brazilian Labeling Program (BLP) for the classification of buildings in practice. The main objective of the present paper is to evaluate the BLP efficacy as applied to HEI buildings, aiming to develop a new environmental labeling model for multicampi HEIs. For this purpose, the BLP was applied to the labeling of Instituto Federal de Educação, Ciência e Tecnologia do Piauí (IFPI), employing data obtained from electricity bills between 2016 and 2018. The energy diagnosis was performed considering distinct indicators,performance indexes, levels and rankings of relative energy efficiency, from which energy efficiency labels could be developed. The results allow the verification of the low efficiency of the BLP, especially in the environmental labeling of HEIs. From the detailed analysis of bills, it is possible to develop environmental labels inspired by the BLP, resulting in a different approach. A novel type-II environmental labeling methodology is then introduced based on the breakdown of electricity bills and statistical methods.


Author(s):  
Nermin Kişi

Although major steps have been taken to increase inclusive representation of women in the workforce, there is a significant gender gap in achieving leadership roles in both developed and developing regions. In particular, many women around the world face serious challenges that prevent them from moving to leadership positions. Women's empowerment approaches are needed in order to have equal access to resources, to participate in decision-making processes, and to support career advancement. Within this context, interim management strategies can be considered as one of the empowering opportunities for women leadership. The purpose of this chapter is to explore the role of interim management on women leaders' empowerment. This is the first attempt that evaluates the notion of interim management as part of empowerment of women's leadership. It is expected to add value to literature on women in leadership positions and corporate decision-making.


2020 ◽  
Vol 29 (7) ◽  
pp. 586-594
Author(s):  
Kedar S Mate ◽  
Jeffrey Rakover ◽  
Kay Cordiner ◽  
Amy Noble ◽  
Noura Hassan

BackgroundHealthcare cost management strategies are limited in number and resource intensive. Budget constraints in the National Health Service Scotland (NHS Scotland) apply pressure on regional health boards to improve efficiency while preserving quality.MethodsWe developed a technical method to assist health systems to reduce operating costs, called continuous value management (CVM). Derived from lean accounting and employing quality improvement (QI) methods, the approach allows for management to reduce or repurpose resources to improve efficiency. The primary outcome measure was the cost per patient admitted to the ward in British pounds (£).InterventionsThe first step of CVM is developing a standard care model. Teams then track system performance weekly using a tool called the ‘box score’, and improve performance using QI methods with results displayed on a visual management board. A 29-bed inpatient respiratory ward in a mid-sized hospital in NHS Scotland pilot tested the method.ResultsWe included 5806 patients between October 2016 and May 2018. During the 18-month pilot, the ward realised a 21.8% reduction in cost per patient admitted to the ward (from an initial average level of £807.70 to £631.50 as a new average applying Shewhart control chart rules, p<0.0001), and agency nursing spend decreased by 30.8%. The ward realised a 28.9% increase in the number of patients admitted to the ward per week. Other quality measures (eg, staff satisfaction) were sustained or improved.ConclusionCVM methods reduced the cost of care while improving quality. Most of the reduction came by way of reduced bank nursing spend. Work is under way to further test CVM and understand leadership behaviours supporting scale-up.


Author(s):  
Nermin Kişi

Although major steps have been taken to increase inclusive representation of women in the workforce, there is a significant gender gap in achieving leadership roles in both developed and developing regions. In particular, many women around the world face serious challenges that prevent them from moving to leadership positions. Women's empowerment approaches are needed in order to have equal access to resources, to participate in decision-making processes, and to support career advancement. Within this context, interim management strategies can be considered as one of the empowering opportunities for women leadership. The purpose of this chapter is to explore the role of interim management on women leaders' empowerment. This is the first attempt that evaluates the notion of interim management as part of empowerment of women's leadership. It is expected to add value to literature on women in leadership positions and corporate decision-making.


2020 ◽  
Vol 33 (1) ◽  
pp. 49 ◽  
Author(s):  
Joana Tendais Almeida ◽  
Ana Luísa Esteves ◽  
Filipa Martins ◽  
Isabel Palma

Introduction: Statins are among the most effective drugs in lowering cholesterol levels and, consequently, in reducing cardiovascular mortality and morbidity. Although generally well tolerated, they have adverse effects that may reduce patient adherence to therapy. The objective of this evidence-based review is to summarize the evidence on the effectiveness of alternative management strategies in patients with intolerance to statins.Material and Methods: A literature search including clinical practice guidelines, systematic reviews and meta-analyses was conducted, in January 2017, in major international databases, and considered articles published in the last 10 years. The search was complemented with research papers published over the past three years and found in the PubMed database. The level of evidence and strength of recommendation were determined using the scale Strength of Recommendation Taxonomy - SORT.Results: We included eight guidelines, six systematic reviews and one research paper.Discussion: The strategies proposed by the different studies vary according to the severity of symptoms of intolerance including maintenance of the statin therapy (dose reduction, addition of a statin of equal or lower intensity or alternate days’ uptake) and lipid-lowering therapy with other drugs (ezetimibe monotherapy or association with statin tolerated dose). Supplementation with coenzyme Q10 or vitamin D, in order to improve adherence to treatment with statins, is not recommended.Conclusion: This review highlights some alternatives to address patients’ intolerance to statins; however, these are mostly based on recommendations with low to moderate evidence. Therefore, further research with randomized studies involving greater number of patients is required, in order to obtain a more robust recommendation.


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