Determination of Business Intelligence and Analytics-Based Healthcare Facility Management Key Performance Indicators

The use of digital technologies such as Internet of Things (IoT) and smart meters induces a huge data stack in facility management (FM). However, the use of data analysis techniques has remained limited to converting available data into information within activities performed in FM. In this context, business intelligence and analytics (BI&A) techniques can provide a promising opportunity to elaborate facility performance and discover measurable new FM key performance indicators (KPIs) since existing KPIs are too crude to discover actual performance of facilities. Beside this, there is no comprehensive study that covers BI&A activities and their importance level for healthcare FM. Therefore, this study aims to identify healthcare FM KPIs and their importance levels for the Turkish healthcare FM industry with the use of the AHP integrated PROMETHEE method. As a result of the study, ninety-eight healthcare FM KPIs, which are categorized under six categories, were found. The comparison of the findings with the literature review showed that there are some similarities and differences between countries’ FM healthcare ranks. Within this context, differences between countries can be related to the consideration of limited FM KPIs in the existing studies. Therefore, the proposed FM KPIs under this study are very comprehensive and detailed to measure and discover healthcare FM performance. This study can help professionals perform more detailed building performance analyses in FM. Additionally, findings from this study will pave the way for new developments in FM software and effective use of available data to enable lean FM processes in healthcare facilities.

ANT Perspective of Healthcare Big Data for Service Delivery in South Africa

In South Africa, there has been for many years challenges in how healthcare big data are accessed, used, and managed by facilities, particularly the small health facilities. The challenges arise from inaccuracy and inconsistency of patients' data and have impact on diagnoses, medications, and treatments, which consequently contributes to fatalities in South Africa, particularly in the rural areas of the country. The problem of inaccuracy and inconsistency of patients' data is often caused by lack of or poor analysis (or analytics) of data. Thus, the objective of this research was to understand the factors that influence the use and management of patients' big data for healthcare service delivery. The qualitative methods were applied, and a South African healthcare facility was used as a case in the study. Actor network theory (ANT) was employed as a lens to guide the analysis of the qualitative data. Based on the findings from the analysis, a model was developed, which is intended to guide analytics of big data for healthcare purposes, towards improving service delivery in the country.

Nationwide Acute Stroke Care Quality and Disparity in Korea: Focusing on the Type of Healthcare Facilities and the Socioeconomic Status of Patients

Background: The quality ofstroke care has a significantimpact onmortality and complications. The purpose ofthisstudy wasto investigate the difference in the quality of acute stroke treatment according to the type of healthcare facility and the socioeconomic status of patients.Methods: Thisstudy used Health Insurance Review and Assessment Service’s Healthcare Quality Assessment for Stroke 2013 data and included 10,399 cases from 201 healthcare facilities. Quality of care was categorized from grade 1 (best group) to grade 5 (worst group) according to performance scores using 10 processindicators.Results: The mean performance score was 91.5. Only 31% of all patients received treatment at grade 1 hospitals while 10% received treatment at grade 3 or lower hospitals. The difference in performance score by the type of healthcare facility existed (tertiary hospitals: 94.3, general hospitals: 88.7).Ofthe 159 general hospitals, 66 hospitals provided grade 3 orlower quality care.NHI patients used more tertiary hospitalsthan MA patients(51% vs. 38%), and MA patientswere more likely to use general hospitals providing grade 3 or lower quality care (11% vs. 21%).Conclusions: This study showed that some general hospitals provided low quality stroke care, and MA patients were more likely to use those hospitals. In order to increase the quality and equity of stroke treatment, a strategy to gather patients at healthcare facilitiesthat provide appropriate medicalservices will be needed.

Off-Label Use of Medicines in Children Attending a Secondary Healthcare Facility in Federal Capital Territory

Before a new drug is approved for marketing in any country, it must have undergone three phases of clinical trials designed to assess its efficacy and safety when used according to an approved recommendation. After a drug has been tested and approved by the regulatory authorities, the drug is usually given a ‘label’ or ‘license’ which is a report describing the drug intended use and dosage. This study aimed at evaluating the use of medicines outside the terms stated in the label. The study was conducted using a data collection form to obtain information from patients’ case file. Data were analysed using Statistical Package for Social Sciences. The case notes of 449 patients were included in the study. The ages of the patients ranged from 4 days to 16 years. Females constituted 51.7% (232) and males 48.3% (217). A total of 1866 drugs were administered to patients, of which 469 (25.13%) were off-label prescriptions. The highest category of off-label drug was indication (45%). This study has revealed a considerable prevalence of off-label use of medicines, there is however need for proper pharmaceutical care to be emplaced in healthcare facilities so as to minimize off-label drug use and prevent adverse effect of drugs as a result of inappropriate use of medicines.

Successful Disinfection of a New Healthcare Facility Contaminated with Pseudomonas aeruginosa

Contamination of water use points in health establishments is a frequent and concerning problem. Maintenance and disinfection of water systems can be inefficient. Sterilizing filters are commonly used at selected taps. We report diagnostic and corrective approaches that have succeeded in making a contaminated health facility sustainably compatible with its activity without restriction in taps use. The zones contaminated with pseudomonas as well as those, along the water networks, at risk of biofilm development were identified. Corrective measures on the network and various types of decontamination were carried out. At the end of this work, the bacterial load in the water significantly decreased and 219 out of 223 controls were negative for P. aeruginosa over 3 years of follow-up. Four positive results were linked to three taps not used for care which were satisfactorily treated locally. Errors at the design and setup phases of health facilities may result in resistant bacterial contamination. P. aeruginosa contamination of newly built healthcare facilities is an underreported problem. Guidelines on design, disinfection, and monitoring procedures of water networks of healthcare facilities should be adapted consequently and would certainly improve the offered care limiting patients’ risk and avoid many unwanted financial situations for the providers.

Awareness about Workplace Harassment among Female Nursing Students and Nursing Staff of a Teaching Hospital in Lahore

Background: Harassment of working women is a common social and human rights problem and healthcare settings are no exception. This unacceptable situation has many avoidable determinants that need preventive measures to ensure, safe and secure working environment for nurses. Objectives: To assess the knowledge and understanding among female nursing students and nursing staff about workplace harassment in a tertiary healthcare facility. Methods: It was a cross-sectional study conducted at Tertiary care hospital Lahore from July to September 2018. Convenient sampling technique was used to collect data. Verbal informed consent of voluntary participants was taken. Anonymity and confidentiality was assured. SPSS version 21 was used for data analysis. The participants (n=80) comprised of senior female nurses students (62.5%) and senior nursing staff (37.5%), aged 18 to 46 years. Results: Awareness about common harassment forms was adequate (81.3%). Adverse effects included mental health problems (83.8%) and low self-esteem (72.5%). A large percentage of nurses (62.5%) intended to report such personal incident to institutional head and 72.5% were willing to accompany victims for such reporting. 77.5% desired arranging informative sessions and holding counseling for victims (78.8%) at workplace. Only 22.5% had vague idea about official protective legal frameworks. Conclusions: Workplace harassment of female workers is quite prevalent but under-reported phenomena in Pakistan. All organizations and institutions must have a harassment policy to protect the females.

Factors influencing the place of delivery in the rural region of Labrousse, Hati

Objectives The objective of this study is to determine factors that influence the place of delivery in the rural region of Labrousse, Haiti Design This study employed a cross-sectional survey design to collect data using an anonymous interview guide comprising structured questions and made up of two parts: 1- Identification of personal and socio-cultural parameters. 2-Identification of the reasons for the place of the last childbirth. Setting The study was conducted fromSeptember to November 2017 in Notre-Dame of Lourdes of Labrousse community health center and the area catered to by it. Labrousse is a rural community located in the 3rd communal section of Miragoâne about 19 kilometers from the main road, in the department of Nippes. Participants The survey included 92 women aged 13–46 years, live in the area who had at least one birth in the last 1–3 years by the time of data collection. Results 75% of women gave birth to their last child at home. 76% of home births were assisted by a matron or traditional practitioner. age, religion, level of education of mothers and fathers, distance between home and health facility, availability of transportation and prenatal follow-up are significant factors (P <0.05) that influence the choice of delivery place. Conclusion Acting on the factors influencing the delivery place in Labrousse would make it possible to bridge this gap between the number of home births and the number of births in healthcare facility.

Traumatic Dental Injuries: A Survey of Knowledge and Attitudes Among Family Physicians in Turkey

Background/Aim: Individuals exposed to trauma are most often brought or directed to the nearest healthcare facility by their relatives. In Turkey, most widely available healthcare services are provided by family physicians at primary care Family Health Centers and patients expect receiving treatment for TDI from medical doctors when they do not immediate access to a dentist. The aim of this study was to investigate the knowledge and attitude about traumatic dental injuries among family physicians working at family health centersin Turkey. Material and methods: A total of 110 family physicians participated in the study. Participants were family physicians who attended a meeting organized by Elazığ Provincial Directorate of Health. A self-administered questionnaire consisting of 16 multiple choice questions assessing both demographic data, knowledge and attitude about traumatic dental injuries was distributed to family physicians during the meeting.Results: The results obtained from 86 fully responded questionnaire forms, %75 of family physicians didn't receive any education on TDI. 86% of Family physicians feel that they don't have adequate knowledge about TDI. 53.5% of the family physicians reported that they have come across patients with TDI at least once at their practice. 39.5% of the physicians did not know the importance of extra-oral time. Sterile sponge was selected as the best transport media for avulsed tooth by 22.6% of the participants. Regarding physicians’ attitude, 75% think that education should be provided in medical schools about TDI.Conclusions: This study revealed that the majority of family physicians lack the knowledge needed to manage avulsion and crown fracture cases. Hence, educational programs are necessary during and after medical training for family physicians to provide proper management for traumatic dental injuries.