Search results for: Hospital Design

Authors: C. Ardil

Abstract:

In this paper, a new MCDMA approach, the permanent analytics process is proposed to assess the immovable valuation criteria and their significance in the placement of the healthcare facility. Five decision factors are considered for the value and selection of immovables. In the multiple factor selection problems, the priority vector of the criteria used to compare several immovables is first determined using the permanent analytics method, a mathematical model for the multiple criteria decisionmaking process. Then, to demonstrate the viability and efficacy of the suggested approach, twenty potential candidate locations were evaluated using the hospital site selection problem's decision criteria. The ranking accuracy of estimation was evaluated using composite programming, which took into account both the permanent analytics process and the weighted multiplicative model. 

Keywords: Hospital Facility Location Selection, Permanent Analytics Process, Multiple Criteria Decision Making (MCDM)

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Authors: Mahmoud A. El-Banna

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The need to increase the efficiency of health care systems is becoming an obligation, and one of area of improvement is the discharge process. The objective of this work is to minimize the patients discharge time (for insured patients) to be less than 50 minutes by using six sigma approach, this improvement will also: lead to an increase in customer satisfaction, increase the number of admissions and turnover on the rooms, increase hospital profitability.Three different departments were considered in this study: Female, Male, and Paediatrics. Six Sigma approach coupled with simulation has been applied to reduce the patients discharge time for pediatrics, female, and male departments at hospital. Upon applying these recommendations at hospital: 60%, 80%, and 22% of insured female, male, and pediatrics patients respectively will have discharge time less than the upper specification time i.e. 50 min.

Keywords: Discharge Time, Healthcare, Hospitals, Patients, Process Improvement, Six Sigma, Simulation

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Authors: Nareelux Suwannobol, Supap Chobkhayan

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The aim of this study was to investigate the pregnancy outcomes of teenage mothers at DanKhunThot hospital, Nakhon Ratchasima, Thailand. A retrospective descriptive study was conducted in 573 of teenage pregnant from charts reviewed from 1st October 2010-31st March, 2012. Data were analyzed by frequency distribution, mean and Standard Deviation. The results shown several problems and negatives outcomes of pregnancy in teenager such as not attended prenatal care, Low birth weight infants, death fetus in utero and other complications. The results of this study can be utilized in the development of prenatal, perinatal and post natal care services, especially in DanKhunthot Hospital contexts. Moreover, the results were present to the District Health Care committees in order to enhance health care service system for teenage pregnancy of DanKhunthot District in further.

Keywords: Teenage mothers, Pregnancy outcome, Neonatal outcomes, Maternal outcomes.

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Authors: Miyoun Won, Youngkyung Choi

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In the meantime, there were lots of hardware solutions like products or urban facilities for crime prevention in the public design area. Meanwhile, people have growing interest in public design so by making a village; community design in public design is getting active by the society. The system for crime prevention is actively done by the citizens who created the community. Regarding the social situation, in this project, we saw it as a kind of community design practices and researched about 'how does community design influence Crime prevention?' The purpose of this study is to propose the community design as a way of preventing the crime in the city. First, we found out about the definition, elements and methods of community design by reviewing the theory. And then, this study analyzed the case that was enforced in Seoul and organize the elements and methods of community design. This study can be refer to Public Design based on civil participation and make the community design area contribute to expand the way of solving social problems.

Keywords: Public Design, Sustainable Community Design, Crime Prevention, Participatory Design.

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Authors: D.O. Omondi, M.K. Walingo, G.M. Mbagaya, L.O.A. Othuon

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This study applied the Theory of Planned Behavior model in predicting dietary behavior among Type 2 diabetics in a Kenyan environment. The study was conducted for three months within the diabetic clinic at Kisii Hospital in Nyanza Province in Kenya and adopted sequential mixed methods design combing both qualitative and quantitative phases. Qualitative data was analyzed using grounded theory analysis method. Structural equation modeling using maximum likelihood was used to analyze quantitative data. The results based on the common fit indices revealed that the theory of planned behavior fitted the data acceptably well among the Type 2 diabetes and within dietary behavior {χ2 = 223.3, df = 77, p = .02, χ2/df = 2.9, n=237; TLI = .93; CFI =.91; RMSEA (90CI) = .090(.039, .146)}. This implies that the Theory of Planned Behavior holds and forms a framework for promoting dietary practice among Type 2 diabetics.

Keywords: Dietary practice, Kenya, Theory of PlannedBehavior, Type 2 diabetes, Mixed Methods Design.

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Authors: Mudafara S Bengleil

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Estimation of the magnitude and causes of poisoning was the objective of the current study. A retrospective study of medical records of all poisoning children admitted to Benghazi Children Hospital in Libya from January 2008 up to December 2010. Number of children admitted was 244; the age ranged from less than one to 13 years old. Most of cases were admitted with mild symptom and the majority of them were boys. Only few cases admitted to intensive care unit and there was no mortality recorded through the period of study. Age group 1 to 3 years (50.8%) had the highest frequency of admission and the peak of admission was during summer. The most common cause of admission was due to ingestion of medication (53.69%), House hold product exposure (26.64%) was the second causes of admission while, 19.67% of admissions were due to Food poisoning. Almost all admitted cases were accidental and medicines were the most consumed substances in addition, improper storage of toxic agents were the first risk factor of poisoning. Present results indicated that, children poisoning seems to be a common pediatric care problem which need to control and prevent.

Keywords: Children, hospital, poisoning.

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Authors: Trevor Kroeger, Hayden Williams, Edward Holzinger, David Coleman, Brian Haberman

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The network connectivity of medical devices is increasing at a rapid rate. Many medical devices, such as vital sign monitors, share information via wireless or wired connections. However, these connectivity options suffer from a variety of well-known limitations. Wireless connectivity, especially in the unlicensed radio frequency bands, can be disrupted. Such disruption could be due to benign reasons, such as a crowded spectrum, or to malicious intent. While wired connections are less susceptible to interference, they inhibit the mobility of the medical devices, which could be critical in a variety of scenarios. This work explores the application of Light Fidelity (Li-Fi) communication to enhance the security, performance, and mobility of medical devices in connected healthcare scenarios. A simple bridge for connected devices serves as an avenue to connect traditional medical devices to the Li-Fi network. This bridge was utilized to conduct bandwidth tests on a small Li-Fi network installed into a Mock-ICU setting with a backend enterprise network similar to that of a hospital. Mobile and stationary tests were conducted to replicate various different situations that might occur within a hospital setting. Results show that in room Li-Fi connectivity provides reasonable bandwidth and latency within a hospital like setting.

Keywords: Hospital, light fidelity, Li-Fi, medical devices, security.

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Authors: Mourtou Efstratia, Abdel-Badeeh M. Salem, Pavlidis George

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Hierarchical high-level PNs (HHPNs) with time versions are a useful tool to model systems in a variety of application domains, ranging from logistics to complex workflows. This paper addresses an application domain which is receiving more and more attention: procedure that arranges the final inpatient charge in payment-s office and their management. We shall prove that Petri net based analysis is able to improve the delays during the procedure, in order that inpatient charges could be more reliable and on time.

Keywords: eHealth, Petri-Nets, Hospital Services, InpatientCharges, Workflow Modeling.

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Authors: Napisporn Memongkol, Runchana Sinthavalai, Nattapong Seneeratanaprayune Weerawat Ounsaneha, Chanisada Choosuk

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The objective of this research is to develop the performance indicators (PIs) in operational level for the Pre-hospital Emergency Medical Service (EMS) system employing in Thailand. This research started with ascertaining the current pre-hospital care system. The team analyzed the strategies of Narerthorn, a government unit under the ministry of public health, and the existing PIs of the pre-hospital care. Afterwards, the current National Strategic Plan of EMS development (2008-2012) of the Emergency Medical Institute of Thailand (EMIT) was considered using strategic analysis to developed Strategy Map (SM) and identified the Success Factors (SFs). The analysis results from strategy map and SFs were used to develop the Performance Indicators (PIs). To verify the set of PIs, the team has interviewed with the relevant practitioners for the possibilities to implement the PIs. To this paper, it was to ascertain that all the developed PIs support the objectives of the strategic plan. Nevertheless, the results showed that the operational level PIs suited only with the first dimension of National Strategic Plan (infrastructure and information technology development). Besides, the SF was the infrastructure development (to contribute the EMS system to people throughout with standard and efficiency both in normally and disaster conditions). Finally, twenty-nine indicators were developed from the analysis results of SM and SFs.

Keywords: Emergency Medical Service, Performance Indicator, Success Factor, Thailand

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Authors: Nasir Baba Ahmed, Nicolas Daclin, Marc Olivaux, Gilles Dusserre

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The Mobile field hospital is critical in terms of managing emergencies in crisis. It is a sub-section of the main hospitals and the health sector, tasked with delivering responsive, immediate, and efficient medical services during a crisis. With the aim to prevent further crisis, the assessment of the cyber assets follows different methods, to distinguish its strengths and weaknesses, and in turn achieve cyber resiliency. The work focuses on assessments of cyber resilience in field hospitals with trends growing in both the field hospital and the health sector in general. This creates opportunities for the adverse attackers and the response improvement objectives for attaining cyber resilience, as the assessments allow users and stakeholders to know the level of risks with regards to its cyber assets. Thus, the purpose is to show the possible threat vectors which open up opportunities, with contrast to current trends in the assessment of the mobile field hospitals’ cyber assets.

Keywords: Assessment framework, cyber resilience, cyber security, Mobile Field Hospital.

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Authors: Tulika Bhattacharyya, Suhita C. Chatterjee

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West Bengal, one of the most rapidly ageing states in India, has inadequate structure for elder care. Therefore, there is an urgent need to improve elder care which involves focusing on different care settings where the elderly exists, like - Homes, Hospitals and Long-Term Care facilities (e.g. - Old Age Homes, Hospices). The study explores various elder care settings, with the intention to develop an understanding about them, and thereby generate comprehensive information about the entire spectrum of elder care in Kolkata. Empirical data are collected from the elderly and their caregivers in different settings. The tools for data collection are narratives, in-depth interviews and focus group discussions, along with field observations. Mixed method design is adopted to analyze the complexities of elder care in different set ups. The major challenges of elder care in private Homes are: architecturally inadequate housing conditions, paucity of financial support and scarcity of skilled caregivers. While the key factors preventing the Hospital and Long-Term Care Facilities from providing elder care services are inadequate policies and set governmental standards for elder care for the hospitalized elderly in various departments of the Hospital and the elderly residing in different kinds of Long Term Care Facilities. The limitations in each care setting results in considerable neglect and abuse of the elderly. The major challenges in elder care in West Bengal are lack of continuum between different care settings/ peripheral location of private Homes within public health framework and inadequate state Palliative policy- including narcotic regulations. The study suggests remedial measures to improve the capacity to deliver elder care in different settings.

Keywords: Elder care settings, family caregiver, home care, geriatric hospital care, long term care facility.

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Authors: T. Thulare, M. Herselman, A. Botha

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Poor system use, including inappropriate design of health information systems, causes difficulties in communication with patients and increased time spent by healthcare professionals in recording the necessary health information for medical records. System features like pop-up reminders, complex menus, and poor user interfaces can make medical records far more time consuming than paper cards as well as affect decision-making processes. Although errors associated with health information and their real and likely effect on the quality of care and patient safety have been documented for many years, more research is needed to measure the occurrence of these errors and determine the causes to implement solutions. Therefore, the purpose of this paper is to identify data integrity challenges in hospital information systems through a scoping review and based on the results provide recommendations on how to manage these. Only 34 papers were found to be most suitable out of 297 publications initially identified in the field. The results indicated that human and computerized systems are the most common challenges associated with data integrity and factors such as policy, environment, health workforce, and lack of awareness attribute to these challenges but if measures are taken the data integrity challenges can be managed.

Keywords: Data integrity, data integrity challenges, hospital information systems, South Africa.

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Authors: Lucy Ampaw-Asiedu, Terri R. Norton

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In the wake of recent disasters happening around the world such as earthquake in Italy (January, 2017); hurricanes in the United States (US) (September 2016 and September 2017); and compounding disasters in Haiti (September 2010 and September 2016); to our best knowledge, never has the world seen the need to work on preemptive rather than reactionary measures to salvage this situation than now. Tornadoes are natural hazards that mostly affect mid-western and central states in the US. Tornadoes, like all natural hazards such as hurricanes, earthquakes, floods and others, are very destructive and result in massive destruction to homes, cause billions of dollars in damage and claims many lives. Healthcare facilities in general are vulnerable to disasters, and therefore, the safety of patients, health workers and those who come in to seek shelter should be a priority. The focus of this study is to assess disaster management measures instituted by healthcare facilities. Thus, the sole aim of the study is to examine the vulnerabilities and the design of safe spaces in healthcare facilities in Central US. Objectives that guide the study are to primarily identify the impacts of tornadoes in hospitals and to assess the structural design or specifications of safe spaces. St. John’s Regional Medical Center, now Mercy Hospital in Joplin, is used as a case study. Preliminary results show that the lateral base shear of the proposed design to be 684.24 ton (1508.49kip) for the safe space. Findings from this work will be used to make recommendations about the design of safe spaces for health care facilities in Central US.

Keywords: Disaster management, safe spaces, structural design, tornado, vulnerability.

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Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support operational decisions in Emergency Medical Service (EMS) systems regarding the assignment of medical emergency requests to Emergency Departments (ED). This problem is called “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of a first phase of review of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a mission. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the travelling time and to free-up the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs also considering the expected time performance in the subsequent phases of the process, such as the case mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to compare different hospital selection policies. The model was implemented with the AnyLogic software and finally validated on a realistic case. The hospital selection policy that returned the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, based on a retrospective estimation of the TTP, and a dynamic approach, focused on a predictive estimation of the TTP which is determined with a constantly updated Winters forecasting model. Findings reveal that considering the minimization of TTP is the best hospital selection policy. It allows to significantly reducing service throughput times in the ED with a negligible increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms on TTP estimation, than a retrospective approach. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: Emergency medical services, hospital selection, discrete event simulation, forecast model.

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Authors: Wei-Wen Liu, Feng-Chuan Pan, Pei-Chi Wen, Sen-Ji Chen, Su-Hui Lin

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Nurses in an Armed Force Hospital (AFH) expose to stronger stress than those in a civil hospital, especially in an emergency department (ED). Ironically, stresses of these nurses received few if any attention in academic research in the past. This study collects 227 samples from the emergency departments of four armed force hospitals in central and southern Taiwan. The research indicates that the top five stressors are a massive casualty event, delayed physician support, overloads of routine work, overloads of assignments, and annoying paper work. Excessive work loading was found to be the primary source of stress. Nurses who were perceived to have greater stress levels were more inclined to deploy emotion-oriented approaches and more likely to seek job rotations. Professional stressors and problem-oriented approaches were positively correlated. Unlike other local studies, this study concludes that the excessive work-loading is more stressful in an AFH.

Keywords: Emergency nurse, Job stressor, Coping behavior, Armed force hospital.

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Authors: Niloofar Khedri, Masoud Rahgozar, MahmoudReza Hashemi

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Design patterns describe good solutions to common and reoccurring problems in program design. Applying design patterns in software design and implementation have significant effects on software quality metrics such as flexibility, usability, reusability, scalability and robustness. There is no standard rule for using design patterns. There are some situations that a pattern is applied for a specific problem and this pattern uses another pattern. In this paper, we study the effect of using chain of patterns on software quality metrics.

Keywords: Design Patterns, Design patterns' Relationship, Software quality Metrics, Software Engineering.

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Authors: Ö. Şenyiğit, A. Çolak

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It is of great importance for an architectural student to know the parameters through which he/she can conduct his/her design and makes his/her design effective in architectural education. Therefore; an empirical application study was carried out through the designing activity using the emulation model to support the design and design approaches of architectural students. During the investigation period, studies were done on the basic design elements and principles of the fall semester, and the emulation model, one of the designing methods that constitute the subject of the study, was fictionalized as three phased “recognition-interpretation-application”. As a result of the study, it was observed that when students were given a key method during the design process, their awareness increased and their aspects improved as well.

Keywords: Basic design, design education, design methods, emulation.

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Authors: R. Damaševičius

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System-level design based on high-level abstractions is becoming increasingly important in hardware and embedded system design. This paper analyzes meta-design techniques oriented at developing meta-programs and meta-models for well-understood domains. Meta-design techniques include meta-programming and meta-modeling. At the programming level of design process, metadesign means developing generic components that are usable in a wider context of application than original domain components. At the modeling level, meta-design means developing design patterns that describe general solutions to the common recurring design problems, and meta-models that describe the relationship between different types of design models and abstractions. The paper describes and evaluates the implementation of meta-design in hardware design domain using object-oriented and meta-programming techniques. The presented ideas are illustrated with a case study.

Keywords: Design patterns, meta-design, meta-modeling, metaprogramming.

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Authors: S. Choodoung, U. Smutkupt

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This study systemizes processes and methods in wooden furniture design that contains uniqueness in function and aesthetics. The study was done by research and analysis for designer-s consideration factors that affect function and production. Therefore, the study result indicates that such factors are design process (planning for design, product specifications, concept design, product architecture, industrial design, production), design evaluation as well as wooden furniture design dependent factors i.e. art (art style; furniture history, form), functionality (the strength and durability, area place, using), material (appropriate to function, wood mechanical properties), joints, cost, safety, and social responsibility. Specifically, all aforementioned factors affect good design. Resulting from direct experience gained through user-s usage, the designer must design the wooden furniture systemically and effectively. As a result, this study selected dinning armchair as a case study with all involving factors and all design process stated in this study.

Keywords: Furniture Design, Function Design, Aesthetic, Wooden Furniture.

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Authors: Armin Samarghandi, Amirreza Jafari, Mohamad Ghiasi

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Since individuals spend the majority of their time indoors, this immediately affects their productivity and health. An essential factor in occupational health and public health is the influence of indoor environmental quality (IEQ) in buildings on occupant welfare and productivity. Since then, empirical data have been equivocal, indicating either that the studies are inaccurate or that the research has just scratched the surface of green buildings in offices, accommodation, and hospital settings and not taken the aforementioned holistically. This study compared three green-certified buildings — a residential green building, a green hospital, and a green school — with conventional structures in Tehran, Iran by means of a questionnaire spread among those utilizing these buildings, and assessing their productivity and health rate as opposed to the time they resided, worked in conventional buildings. The results demonstrated higher scores pertaining to productivity, physical and mental wellness as a consequence of better indoor environmental quality (IEQ), natural lighting, design, and sustainability of these building against non-green buildings. In addition, ancillary matters — environmental, financial, intellectual, emotional, social, spiritual dimensions of participants — were indirectly evaluated, and the same results are produced.

Keywords: Green building, Iran, productivity, physical and mental health, Tehran.

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Authors: Chiung-Hui Chen

Abstract:

With the approaching of digital era, various interactive service platforms and systems support human beings- needs in lives by different contents and measures. Design strategies have gradually turned from function-based to user-oriented, and are often customized. In other words, how designers include users- value reaction in creation becomes the goal. Creative design service of interior design requires positive interaction and communication to allow users to obtain full design information, recognize the style and process of personal needs, develop creative service design, lower communication time and cost and satisfy users- sense of achievement. Thus, by constructing a co-design method, based on the communication between interior designers and users, this study recognizes users- real needs and provides the measure of co-design for designers and users.

Keywords: Co-Design, Customized, Design Service, Interactive Genetic Algorithm, Interior Design.

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Authors: S. Kurien, S. Satpathy, S. K. Gupta, S. K. Arya, D. K. Sharma

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Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: Adverse events, health care technology, public sector hospital, reporting systems.

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Authors: G. Sokhansefat, M. Delavar, M. Banedj-Schafii

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Recently research on human wayfinding has focused mainly on mental representations rather than processes of wayfinding. The objective of this paper is to demonstrate the rationality behind applying multi-agent simulation paradigm to the modeling of rescuer team wayfinding in order to develop computational theory of perceptual wayfinding in crisis situations using image schemata and affordances, which explains how people find a specific destination in an unfamiliar building such as a hospital. The hypothesis of this paper is that successful navigation is possible if the agents are able to make the correct decision through well-defined cues in critical cases, so the design of the building signage is evaluated through the multi-agent-based simulation. In addition, a special case of wayfinding in a building, finding one-s way through three hospitals, is used to demonstrate the model. Thereby, total rescue time for rescue operation during building fire is computed. This paper discuses the computed rescue time for various signage localization and provides experimental result for optimization of building signage design. Therefore the most appropriate signage design resulted in the shortest total rescue time in various situations.

Keywords: Multi-Agent system (MAS), Spatial Cognition, Wayfinding, Indoor Environment, Geospatial Information System (GIS).

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Authors: L. Korpinen, T. Kava, I. Salmi

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This study aimed to describe the operating model of obstructive sleep apnea. Due to the large number of patients, the role of nurses in the diagnosis and treatment of sleep apnea was important. Pulmonary physicians met only a minority of the patients. The sleep apnea study in 2018 included about 800 patients, of which about 28% were normal and 180 patients were classified as severe (apnea-hypopnea index [AHI] over 30). The operating model has proven to be workable and appropriate. The patients understand well that they may not be referred to a pulmonary doctor. However, specialized medical follow-up on professional drivers continues every year.

Keywords: Sleep, apnea patient, operating model, hospital.

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Authors: Nouf Saad Alnassar, Susan Grant, Ray Holland

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This research study examines cases of Saudi Arabian universities and female academics for work environment issues within the context of design management applications. The study proposes use of design research, ergonomics and systems design thinking to develop the university design which facilitates removal of physical and cognitive barriers for female academics. Review of literature demonstrates that macro and micro ergonomic combined with design management and system design strategies can significantly improve the workplace design for female academics. The university design model would be prepared based on the analyses of primary data obtained from archived documents, participants' observation logs, photo audits, focus groups and semi-structured interviews of currently employed female academics in the selected case universities.

Keywords: Design management, workplace design, university design, ergonomics.

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Authors: Delly C. Lestari, Linosefa, Ardiana Kusumaningrum, Andi Yasmon, Anis Karuniawati

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The objective of this study is to determine the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) harboring mecA genes from screening isolates among intensive care unit (ICU) patients. All MRSA screening isolates from ICU’s patients of Cipto Mangunkusumo Hospital during 2011 and 2014 were included in this study. Identification and susceptibility test was performed using Vitek2 system (Biomereux®). PCR was conducted to characterize the SCCmec of S. aureus harboring the mecA gene on each isolate. Patient’s history of illness was traced through medical record. 24 isolates from 327 screening isolates were MRSA positive (7.3%). From PCR, we found 17 (70.8%) isolates carrying SCCmec type I, 3 (12.5%) isolates carrying SCCmec type III, and 2 (8.3%) isolates carrying SCCmec type IV. In conclusion, SCCmec type I is the most prevalent MRSA colonization among ICU patients in Cipto Mangunkusumo Hospital.

Keywords: MRSA, mecA genes, ICU, colonization.

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Authors: Jih-Rue Pan, Feng-Chuan Pan

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Today-s healthcare industries had become more patient-centric than profession-centric, from which the issues of quality of healthcare and the patient safety are the major concerns in the modern healthcare facilities. An unplanned extubation (UE) may be detrimental to the patient-s life, and thus is one of the major indexes of patient safety and healthcare quality. A high UE rate not only defeated the healthcare quality as well as the patient safety policy but also the nurses- morality, and job satisfaction. The UE problem in a psychiatric hospital is unique and may be a tough challenge for the healthcare professionals for the patients were mostly lacking communication capabilities. We reported with this essay a particular project that was organized to reduce the UE rate from the current 2.3% to a lower and satisfactory level in the long-term care units of a psychiatric hospital. The project was conducted between March 1st, 2011 and August 31st, 2011. Based on the error information gathered from varied units of the hospital, the team analyzed the root causes with possible solutions proposed to the meetings. Four solutions were then concluded with consensus and launched to the units in question. The UE rate was now reduced to a level of 0.17%. Experience from this project, the procedure and the tools adopted would be good reference to other hospitals.

Keywords: Unplanned extubation, patient safety, error information

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Authors: Pratap Sriram Sundar, Chandan Chowdhury, Sagar Kamarthi

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Nature has perfected her designs over 3.5 billion years of evolution. Research fields such as biomimicry, biomimetics, bionics, bio-inspired computing, and nature-inspired designs have explored nature-made artifacts and systems to understand nature’s mechanisms and intelligence. Learning from nature, the researchers have generated sustainable designs and innovation in a variety of fields such as energy, architecture, agriculture, transportation, communication, and medicine. Axiomatic design offers a method to judge if a design is good. This paper analyzes design aspects of one of the nature’s amazing object: chicken egg. The functional requirements (FRs) of components of the object are tabulated and mapped on to nature-chosen design parameters (DPs). The ‘independence axiom’ of the axiomatic design methodology is applied to analyze couplings and to evaluate if eggs’ design is good (i.e., uncoupled design) or bad (i.e., coupled design). The analysis revealed that eggs design is a good design, i.e., uncoupled design. This approach can be applied to any nature’s artifacts to judge whether their design is a good or a bad. This methodology is valuable for biomimicry studies. This approach can also be a very useful teaching design consideration of biology and bio-inspired innovation.

Keywords: Uncoupled design, axiomatic design, nature design, design evaluation.

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Authors: Mohammad Rajabalinejad

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Safety is often seen as a requirement or a performance indicator through the design process, and this does not always result in optimally safe products or systems. This paper suggests integrating the best safety practices with the design process to enrich the exploration experience for designers and add extra values for customers. For this purpose, the commonly practiced safety standards and design methods have been reviewed and their common blocks have been merged forming Safety Cube. Safety Cube combines common blocks for design, hazard identification, risk assessment and risk reduction through an integral approach. An example application presents the use of Safety Cube for design of machinery.

Keywords: Safety, safety cube, design, product, system, machinery.

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Authors: D. Barron, M. Zeegers

Abstract:

In this paper, we argue that Design research is basic to countries- national productivity and competition agendas at the same time that vagaries of research training presents as one of the barriers faced by Design Higher Degree by Research students in engaging those agendas. We argue that, given industry requirements for research-trained recruits, students have the right to expect that research training will provide the foundations of a successful career on an academic or research pathway or a professional pathway, but that universities have yet to address problems in their provision of research training for Design doctoral students. We suggest that to facilitate this, rigorous research conducted on the provision of Doctoral programs in Design would serve to inform future activities in Design research in productive ways.

Keywords: Design, Doctoral Design Education, Research Training

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