Search results for: hospital emergencies.

Authors: Nouha Mhimdi, Wahiba Ben Abdessalem Karaa, Henda Ben Ghezala

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Many methods are used to collect data like questionnaires, surveys, focus group interviews. Or the collection of poor-quality data resulting, for example, from poorly designed questionnaires, the absence of good translators or interpreters, and the incorrect recording of data allow conclusions to be drawn that are not supported by the data or to focus only on the average effect of the program or policy. There are several solutions to avoid or minimize the most frequent errors, including obtaining expert advice on the design or adaptation of data collection instruments; or use technologies allowing better "anonymity" in the responses. In this context, and to overcome the aforementioned problems, we suggest in this paper an approach to achieve the collection of relevant data, by carrying out a large-scale questionnaire-based survey. We have been able to collect good quality, consistent and practical data on hospital emergencies to improve emergency services in hospitals, especially in the case of epidemics or pandemics.

Keywords: Data collection, survey, database, data analysis, hospital emergencies.

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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: M. K. Holst, P. H. Kirkegaard, L. D. Christoffersen

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Present paper presents a parametric performancebased design model for optimizing hospital design. The design model operates with geometric input parameters defining the functional requirements of the hospital and input parameters in terms of performance objectives defining the design requirements and preferences of the hospital with respect to performances. The design model takes point of departure in the hospital functionalities as a set of defined parameters and rules describing the design requirements and preferences.

Keywords: Architectural Layout Design, Hospital Design, Parametric design, Performance-based models.

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Authors: Shamsuddin Ahmed, Francis Amagoh

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This paper presents a case study that uses processoriented simulation to identify bottlenecks in the service delivery system in an emergency department of a hospital in the United Arab Emirates. Using results of the simulation, response surface models were developed to explain patient waiting time and the total time patients spend in the hospital system. Results of the study could be used as a service improvement tool to help hospital management in improving patient throughput and service quality in the hospital system.

Keywords: Simulation, Hospital Service, Resource Utilization, United Arab Emirates.

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Authors: Somayeh Abedian, Pirhossein Kolivand, Hamid Reza Lornejad, Amin Karampour, Ebrahim Keshavarz Safari

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For emergency and relief service providers such as pre-hospital emergencies, quick arrival at the scene of an accident or any EMS mission is one of the most important requirements of effective service delivery. EMS Response time (the interval between the time of the call and the time of arrival on scene) is a critical factor in determining the quality of pre-hospital Emergency Medical Services (EMS). This is especially important for heart attack, stroke, or accident patients that seconds are vital in saving their lives. Location-based e-services can be broadly defined as any service that provides information pertinent to the current location of an active mobile handset or precise address of landline phone call at a specific time window, regardless of the underlying delivery technology used to convey the information. According to research, one of the effective methods of meeting this goal is determining the location of the caller via the cooperation of landline and mobile phone operators in the country. The follow-up of the Communications Regulatory Authority (CRA) organization has resulted in the receipt of two separate secured electronic web services. Thus, to ensure human privacy, a secure technical architecture was required for launching the services in the pre-hospital EMS information management system. In addition, to quicken medics’ arrival at the patient's bedside, rescue vehicles should make use of an intelligent transportation system to estimate road traffic using a GPS-based mobile navigation system independent of the Internet. This paper seeks to illustrate the architecture of the practical national model used by the Iranian EMS organization.

Keywords: response time, geographic location inquiry service, location-based services, emergency medical services information system

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Authors: Mai Ali

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Advancing beyond the junior stage of a paediatrician’s career is a crucial step where they accumulate essential skills and knowledge. This process prepares them for the challenges they will encounter throughout their profession, particularly in dealing with paediatric emergencies. This can be especially demanding for trainees specializing in fields like endocrinology, particularly in the management of Diabetic Ketoacidosis (DKA) in the UK. In different societal contexts, junior doctors, whether specializing in paediatrics or other medical fields, are generally expected to possess a fundamental level of knowledge and skills necessary for managing DKA emergencies. These physicians consistently concurred in recognizing prevalent problems in the healthcare facilities they examined. Such issues include the lack of established guidelines for DKA treatment and the inadequate availability of comprehensive training opportunities. The abstract underscores the critical importance of junior paediatricians acquiring expertise in managing paediatric emergencies, with a specific focus on DKA. Commonly, issues like the lack of standardized protocols and training deficiencies are recurring themes across healthcare facilities. This research proposal aims to conduct a thematic analysis of the proficiency of paediatric trainees in the United Kingdom when handling DKA in various clinical contexts. The primary goal is to assess their competency and suggest effective strategies for comprehensive DKA training improvement.

Keywords: DKA management, junior paediatricians, level of competence, standardized protocols.

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Authors: Mai Miyabe, Taku Fukushima, Takashi Yoshino, Aguri Shigeno

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The need for multilingual communication in Japan has increased due to an increase in the number of foreigners in the country. When people communicate in their nonnative language, the differences in language prevent mutual understanding among the communicating individuals. In the medical field, communication between the hospital staff and patients is a serious problem. Currently, medical translators accompany patients to medical care facilities, and the demand for medical translators is increasing. However, medical translators cannot necessarily provide support, especially in cases in which round-the-clock support is required or in case of emergencies. The medical field has high expectations from information technology. Hence, a system that supports accurate multilingual communication is required. Despite recent advances in machine translation technology, it is very difficult to obtain highly accurate translations. We have developed a support system called M3 for multilingual medical reception. M3 provides support functions that aid foreign patients in the following respects: conversation, questionnaires, reception procedures, and hospital navigation; it also has a Q&A function. Users can operate M3 using a touch screen and receive text-based support. In addition, M3 uses accurate translation tools called parallel texts to facilitate reliable communication through conversations between the hospital staff and the patients. However, if there is no parallel text that expresses what users want to communicate, the users cannot communicate. In this study, we have developed a circulating support environment for multilingual medical communication using parallel texts. The proposed environment can circulate necessary parallel texts through the following procedure: (1) a user provides feedback about the necessary parallel texts, following which (2) these parallel texts are created and evaluated.

Keywords: multilingual medical communication, parallel texts.

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Authors: R. Tandlich, S. Hoossein, K. A. Tagwira, M. M. Marais, T. A. Ludwig, R. P. Chidziva, M. N. Munodawafa, W. M. Wrench

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Response to the public health-related emergencies is analysed here for a rural university in South Africa. The structure of the designated emergency plan covers all the phases of the disaster management cycle. The plan contains elements of the vulnerability model and the technocratic model of emergency management. The response structures are vertically and horizontally integrated, while the planning contains elements of scenario-based and functional planning. The available number of medical professionals at the Rhodes University, along with the medical insurance rates, makes the staff and students potentially more medically vulnerable than the South African population. The main improvements of the emergency management are required in the tornado response and the information dissemination during health emergencies. The latter should involve the increased use of social media and e-mails, following the Taylor model of communication. Infrastructure must be improved in the telecommunication sector in the face of unpredictable electricity outages.

Keywords: Public health, Rural university, Taylor model of communication.

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Authors: Hsiu-Pi Lin, Wen-Chen Huang, Hui-Fang Chen, Yan-Pin Ke

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Corporate Social Responsibility (CSR) has become a new trend of business governance. Few research studies on CSR published in Taiwanese academia, especially for medical settings, we were interested in probing the relationship of CSR and financial performance in medical settings in Taiwan. The results illustrate that: (1) a time delay effect exists with a lag between CSR effort and its performance in the hospital foundation, (2) input into the internal domains of CSR will be helpful to improve employee productivity in the hospital foundation, and (3) input into the external domains of CSR will be helpful in improving financial performance in the hospital foundation. This study overviews CSR in the medical industry in Taiwan and the relationship of CSR and financial performance. Discussions of possible implications from the study results are applied to consult the CSR concept that will be transferred into a business strategy for the organization manager.

Keywords: Corporate Social Responsibility (CSR), financialperformance, hospital foundation,

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Authors: Emmanouel Koumoulas, Aikaterini Rokkou, Marios Moschakis

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Theagenio" in Thessaloniki exists and works for three centuries now as a hospital. Since 1975, it has been operating as an Integrated Special Cancer Hospital and since 1985 it has been integrated into the National Health System. "Theagenio" Cancer Hospital is located at the central web of Thessaloniki residential complex and consists of two buildings, the "Symeonidio Research Center", which was completed in 1962 and the Nursing Ward, a project that was later completed in 1975. This paper examines the design of the Hospital Unit according to the requirements of the energy design of buildings. Initially, the energy characteristics of the Hospital are recorded, followed by a detailed presentation of the electromechanical installations. After the existing situation has been captured and with the help of the software TEE-KENAK, different scenarios for the energy upgrading of the buildings have been studied. Proposals for upgrading concern both the shell, e.g. installation of external thermal insulation, replacement of frames, addition of shading systems, etc. as well as electromechanical installations, e.g. use of ceiling fans, improvements in heating and cooling systems, interventions in lighting, etc. The simulation calculates the future energy status of the buildings and presents the economic benefits of the proposed interventions with reference to the environmental profits that arise.

Keywords: Energy consumption in hospitals, energy saving interventions, energy upgrading, hospital facilities.

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Authors: G. Cossu, A. Esposito, G. Picco, C. Scrizzi, A. Tartaglia, E. Tresso

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A collaboration among the Hospital S. Giovanni Battista of Turin, the Politecnico of Turin, and the MUST company is described. The content of the collaboration has been and is the use of ICT-s, e-learning, and blended learning for the internal professional education, training, and keeping up to date of the personnel of the hospital. A platform for the delivery of the teaching materials has been built, including an evaluation and self-evaluation tool. The first on line courses have been developed and delivered and many more are in preparation. The first results of the monitoring of the efficacy of the online education have been positive.

Keywords: E-learning, blended learning, on line education, ICT.

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Authors: Burak Köken, Hatice D. Arslan, Bilgehan Y. Çakmak

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Analyzing the relation networks between the hospital buildings which have complex structure and distinctive spatial relationships is quite difficult. The hospital buildings which require specialty in spatial relationship solutions during design and selfinnovation through the developing technology should survive and keep giving service even after the disasters such as earthquakes. In this study, a hospital building where the load-bearing system was strengthened because of the insufficient earthquake performance and the construction of an additional building was required to meet the increasing need for space was discussed and a comparative spatial evaluation of the hospital building was made with regard to its status before the change and after the change. For this reason, spatial organizations of the building before change and after the change were analyzed by means of Space Syntax method and the effects of the change on space organization parameters were searched by applying an analytical procedure. Using Depthmap UCL software, Connectivity, Visual Mean Depth, Beta and Visual Integration analyses were conducted. Based on the data obtained after the analyses, it was seen that the relationships between spaces of the building increased after the change and the building has become more explicit and understandable for the occupants. Furthermore, it was determined according to findings of the analysis that the increase in depth causes difficulty in perceiving the spaces and the changes considering this problem generally ease spatial use.

Keywords: Architecture, hospital building, space syntax, strengthening.

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Authors: W. Astiata, N. Elmesrati, N. Elmesrati, A. Abo Reyana

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The aim of this study is to survey the incidence, prevalence, types and associated impairments of CP in children at the Tripoli children hospital (T.C.H). The study covered all the cases the hospital had diagnosed in the period between (1.1.2009) and (31.12.2010), during which 38 cases of ages between 2 months to 3 years were diagnosed in the mentioned period. The incidence of CP was (17.42 per one thousand) out of (2143) of different neurological cases and came with a result of 23 cases of spastic CP which represented about (60.53%) out of the total number of cases, and the most associated impairment is convulsion. Medical information was collected from the patients’ files at the registration department from the neurology department. The data has been collected by a questionnaire, which had been set to finely organize the patient’s files.

Keywords: Physiotherapy, Rehabilitation, Libya, Cerebral Palsy, hospital, survey.

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Authors: E. Bakkaloğlu, N. Torunbalcı

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Earthquakes are inevitable natural disasters in Turkey. Therefore, buildings must be prepared for this natural hazard. Especially in hospital buildings, earthquake resistance is an essential point because hospitals are one of the first places where people come after earthquake. Although hospital buildings are more suitable for horizontal architecture, it is necessary to construct and expand multi-story hospital buildings due to difficulties in finding suitable places as a result of excessive urbanization, difficulties in obtaining appropriate size land and decrease in suitable places and increase in land values. In Turkey, using seismic isolators in public hospitals, which are placed in first degree earthquake zone and have more than 100 beds, is made obligatory by general instruction. As a result of this decision, it may sometimes be necessary to construct seismic isolated multi-story hospital buildings in cities where those problems are experienced. Although there is widespread use of seismic isolators in Japan, there are few multi-story buildings in which seismic isolators are used in Turkey. As it is known, base isolation systems are the most effective methods of earthquake resistance, as the number of floors increases, the center of gravity moves away from the base in multi-story buildings, increasing the overturning effect and limiting use of these systems. In this context, it is aimed to investigate structural systems of multi-story buildings which are built using seismic isolation methods in the world. In addition to this, a working principle is suggested for the disseminating seismic isolator used in multi-story hospital buildings. The results to be obtained from the study will guide architects who design multi-story hospital buildings in their architectural designs, and engineers in terms of structural system design.

Keywords: Earthquake, energy absorbing systems, hospital, seismic isolation systems.

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Authors: Temitope O. Tokosi

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Healthcare is a human right. The sensitivity of health issues has necessitated the introduction of Enterprise Content Management (ECM) at district hospitals in the Western Cape Province of South Africa. The objective is understanding clinicians’ perception of ECM at their workplace. It is a descriptive case study design of constructivist paradigm. It employed a phenomenological data analysis method using a pattern matching deductive based analytical procedure. Purposive and s4nowball sampling techniques were applied in selecting participants. Clinicians expressed concerns and frustrations using ECM such as, non-integration with other hospital systems. Inadequate access points to ECM. Incorrect labelling of notes and bar-coding causes more time wasted in finding information. System features and/or functions (such as search and edit) are not possible. Hospital management and clinicians are not constantly interacting and discussing. Information turnaround time is unacceptably lengthy. Resolving these problems would involve a positive working relationship between hospital management and clinicians. In addition, prioritising the problems faced by clinicians in relation to relevance can ensure problem-solving in order to meet clinicians’ expectations and hospitals’ objective. Clinicians’ perception should invoke attention from hospital management with regards technology use. The study’s results can be generalised across clinician groupings exposed to ECM at various district hospitals because of professional and hospital homogeneity.

Keywords: Clinician, electronic content management, hospital, perception, technology.

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Authors: Elham Rastegari, Amirmasood Rahmani, Saeed Setayeshi

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The hospital and the health-care center of a community, as a place for people-s life-care and health-care settings, must provide more and better services for patients or residents. After Establishing Electronic Medical Record (EMR) system -which is a necessity- in the hospital, providing pervasive services is a further step. Our objective in this paper is to use pervasive computing in a case study of healthcare, based on EMR database that coordinates application services over network to form a service environment for medical and health-care. Our method also categorizes the hospital spaces into 3 spaces: Public spaces, Private spaces and Isolated spaces. Although, there are many projects about using pervasive computing in healthcare, but all of them concentrate on the disease recognition, designing smart cloths, or provide services only for patient. The proposed method is implemented in a hospital. The obtained results show that it is suitable for our purpose.

Keywords: Pervasive computing, RFID, Health-care.

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Authors: Niwatchai Namwichisirikul

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Due to the emergence of “Humanized Healthcare" introduced by Professor Dr. Prawase Wasi in 2003[1], the development of this paradigm tends to be widely implemented. The organizations included Healthcare Accreditation Institute (public organization), National Health Foundation, Mahidol University in cooperation with Thai Health Promotion Foundation, and National Health Security Office (Thailand) have selected the hospitals or infirmaries that are qualified for humanized healthcare since 2008- 2010 and 35 of them are chosen to be the outstandingly navigating organizations for the development of humanized healthcare, humanized healthcare award [2]. The research aims to study the current issue, characteristics and patterns of hospital administration contributing to humanized healthcare system in Thailand. The selected case studies are from four hospitals including Dansai Crown Prince Hospital, Leoi; Ubolrattana Hospital, Khon Kaen; Kapho Hospital, Pattani; and Prathai Hospital, Nakhonrachasima. The methodology is in-depth interviewing with 10 staffs working as hospital executive directors, and representatives from leader groups including directors, multidisciplinary hospital committees, personnel development committees, physicians and nurses in each hospital. (Total=40) In addition, focus group discussions between hospital staffs and general people (including patients and their relatives, the community leader, and other people) are held by means of setting 4 groups including 8 people within each group. (Total=128) The observation on the working in each hospital is also implemented. The findings of the study reveal that there are five important aspects found in each hospital including (1) the quality improvement under the mental and spiritual development policy from the chief executives and lead teams, leaders as Role model and they have visionary leadership; (2) the participation hospital administration system focusing on learning process and stakeholder- needs, spiritual human resource management and development; (3) the relationship among people especially staffs, team work skills, mutual understanding, effective communication and personal inner-development; (4) organization culture relevant to the awareness of patients- rights as well as the participation policy including spiritual growth achieving to the same goals, sharing vision, developing public mind, and caring; and (5) healing structures or environment providing warmth and convenience for hospital staffs, patients and their relatives and visitors.

Keywords: Hospital administration, Humanized healthcare.

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Authors: A. Teke, O. Timur

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Hospitals represent approximately 6% of total energy consumption in the utility buildings sector. Heating, Ventilation and Air Conditioning (HVAC) systems are the major part of electrical energy consumption at the hospitals. The air-conditioning system is responsible for around 70% of total electricity consumption. Electric motors and lighting systems in a hospital represent approximately 19% and 21% of the total energy consumption, respectively. In this paper, profiles of hospital energy end-use consumption and an overview of energy saving areas at the hospitals are presented.

Keywords: Energy efficiency, energy saving, healthcare energy consumption, hospital.

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Authors: Suken Nayak, Aditya Kambli, Bharati Ingale, Gauri Shukla

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The technological concepts such as wireless hospital and portable cardiac telemetry system require the development of physiological signal acquisition devices to be easily integrated into the hospital database. In this paper we present the low cost, portable wireless ECG acquisition hardware that transmits ECG signals to a dedicated computer.The front end of the system obtains and processes incoming signals, which are then transmitted via a microcontroller and wireless Bluetooth module. A monitoring purpose Bluetooth based end user application integrated with patient database management module is developed for the computers. The system will act as a continuous event recorder, which can be used to follow up patients who have been resuscitatedfrom cardiac arrest, ventricular tachycardia but also for diagnostic purposes for patients with arrhythmia symptoms. In addition, cardiac information can be saved into the patient-s database of the hospital.

Keywords: ECG, Bluetooth communication, monitoring application, patient database

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Authors: Anders S. Kristensen, Dewan Ahsan, Saqib Mehmood, Shakeel Ahmed

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Traffic accidents are a result of the convergence of hazards, malfunctioning of vehicles and human negligence that have adverse economic and health impacts and effects. Unfortunately, avoiding them completely is very difficult, but with quick response to rescue and first aid, the mortality rate of inflicted persons can be reduced significantly. Smart and innovative technologies can play a pivotal role to respond faster to traffic crash emergencies comparing conventional means of transportation. For instance, Rescue Emergency Drone (RED) can provide faster and real-time crash site risk assessment to emergency medical services, thereby helping them to quickly and accurately assess a situation, dispatch the right equipment and assist bystanders to treat inflicted person properly. To conduct a research in this regard, the case of a traffic roundabout that is prone to frequent traffic accidents on the outskirts of Esbjerg, a town located on western coast of Denmark is hypothetically considered. Along with manual calculations, Emergency Disaster Management Simulation (EDMSIM) has been used to verify the response time of RED from a fire station of the town to the presumed crash site. The results of the study demonstrate the robustness of RED into emergency services to help save lives. 

Keywords: Automated external defibrillator, medical emergency, fire and rescue services, response time, unmanned aerial system.

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Authors: Lina Al-Qatawneh, Abdallah Abdallah, Salam Zalloum

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In managing healthcare logistics, cost is not the only factor to be considered. The level of items- criticality used in patient care services plays an important role as well. A stock-out incident of a high critical item could threaten a patient's life. In this paper, the DMAIC (Define-Measure-Analyze-Improve-Control) methodology is used to drive improvement projects based on customer driven critical to quality characteristics at a Jordanian hospital. This paper shows how the application of Six Sigma improves the performance of the case hospital logistics system by reducing the number of stock-out incidents.

Keywords: Criticality level, Healthcare, Logistics, and Six Sigma.

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Authors: G. Gürsel, K. H. Gülkesen, N. Zayim, A. Arifoğlu, O. Saka

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User satisfaction is one of the most used success indicators in the research of information system (IS). Literature shows user expectations have great influence on user satisfaction. Both expectation and satisfaction of users are important for Hospital Information Systems (HIS). Education, IS experience, age, attitude towards change, business title, sex and working unit of the hospital, are examined as the potential determinant of the medical users’ expectations. Data about medical user expectations are collected by the “Expectation Questionnaire” developed for this study. Expectation data are used for calculating the Expectation Meeting Ratio (EMR) with the evaluation framework also developed for this study. The internal consistencies of the answers to the questionnaire are measured by Cronbach´s Alpha coefficient. The multivariate analysis of medical user’s EMRs of HIS is performed by forward stepwise binary logistic regression analysis. Education and business title is appeared to be the determinants of expectations from HIS.

Keywords: Evaluation, Fuzzy Logic, Hospital Information System, User Expectation.

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Authors: P. Prudtikul, S. Pathomsiri

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Most, if not all, public hospitals in Thailand have encountered a common problem regarding the increasing demand for medical services. The increasing number of patients causes so much strain on the hospital-s services, over-crowded, overloaded working hours, staff fatigue, medical error and long waiting time. This research studied the characteristics of operational processes of the medical care services at the medicine department in a large public university hospital. The research focuses on details regarding methods, procedures, processes, resources, and time management in overall processes. The simulation model is used as a tool to analyze the impact of various improvement strategies.

Keywords: Patient flow, medicine department, simulation, outpatient department.

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Authors: A. Sherif, A. El Zafarany, R. Arafa

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Hospitals, everywhere, are considered heavy energy consumers. Hospital Intensive Care Unit spaces pose a special challenge, where design guidelines requires the provision of external windows for daylighting and external view. Window protection strategies could be employed to reduce energy loads without detriment effect on comfort or health care. This paper addresses the effectiveness of using various window strategies on the annual cooling, heating and lighting energy use of a typical Hospital Intensive Unit space. Series of experiments were performed using the EnergyPlus simulation software for a typical Intensive Care Unit (ICU) space in Cairo, located in the Egyptian desert. This study concluded that the use of shading systems is more effective in conserving energy in comparison with glazing of different types, in the Cairo ICUs. The highest energy savings in the West and South orientations were accomplished by external perforated solar screens, followed by overhangs positioned at a protection angle of 45°.

Keywords: Energy, Hospital, Intensive Care Units, Shading.

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Authors: M. Farzadkia, S. Jorfi

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Hospital waste is a category of waste consisting of infectious and non-infectious waste, which pose environmental and health risks. Therefore, special planning and management is required, due to the potential hazards of them. The lack of valid and comprehensive information regarding the generation and management of hospital waste in Iran is one of the most important problems in this field. This research aimed to evaluate hospital waste management efficiency in Karaj city, Iran. The four greatest hospitals in Karaj city had been selected in this cross-sectional study. Site observations and interviews with employees were implemented. The data was gathered based on the hospital waste management questionnaire which was designed by World Health Organization for developing countries. Collected Data had been analyzed using SPSS software. The average of solid waste which was generated per bed was 2.78 kg, which included 90% of domestic waste and 10% of infectious waste. Based on the quantitative analysis of general and infectious waste in these hospitals, the highest contributors of general waste were consisting of food waste (37.39%), while textile (28.06%) were the highest contributors of the infectious waste. According to the information contained in the questionnaires, the main defects of waste management in these hospitals were; inadequate staff in waste management sector, poorly disinfection of solid waste containers and temporary storage locations, and a lack of proper infectious waste treatment. According to the results of this research, waste management in these hospitals were far from optimum conditions. In order to improve the existing conditions, mentioned problems must be solved quickly, and planning for continuous monitoring in the waste management field in these hospitals should be established.

Keywords: Waste management, hospital wastes, solid wastes, Iran.

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Authors: Angela–M. Paleologou, Aphrodite Dellaporta

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Erroneous computer entry problems [here: 'e'errors] in hospital labs threaten the patients-–health carers- relationship, undermining the health system credibility. Are e-errors random, and do lab professionals make them accidentally, or may they be traced through meaningful determinants? Theories on internal causality of mistakes compel to seek specific causal ascriptions of hospital lab eerrors instead of accepting some inescapability. Undeniably, 'To Err is Human'. But in view of rapid global health organizational changes, e-errors are too expensive to lack in-depth considerations. Yet, that efunction might supposedly be entrenched in the health carers- job description remains under dispute – at least for Hellenic labs, where e-use falls behind generalized(able) appreciation and application. In this study: i) an empirical basis of a truly high annual cost of e-errors at about €498,000.00 per rural Hellenic hospital was established, hence interest in exploring the issue was sufficiently substantiated; ii) a sample of 270 lab-expert nurses, technicians and doctors were assessed on several personality, burnout and e-error measures, and iii) the hypothesis that the Hardiness vs Alienation personality construct disposition explains resistance vs proclivity to e-errors was tested and verified: Hardiness operates as a resilience source in the encounter of high pressures experienced in the hospital lab, whereas its 'opposite', i.e., Alienation, functions as a predictor, not only of making e-errors, but also of leading to burn-out. Implications for apt interventions are discussed.

Keywords: Hospital lab, personality hardiness/alienation, e-errors' cost, burnout.

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Authors: Tahvilian R., Siahi Shadbad MR., Hamishehkar H., Aghababa Gharehbagh V.

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Nowadays pharmaceutical care departments located in hospitals are amongst the important pillars of the healthcare system. The aim of this study was to evaluate quality of hospital drugstores affiliated with Kermanshah University of Medical Sciences. In this cross-sectional study a validated questionnaire was used. The questionnaire was filled in by the one of the researchers in all seventeen hospital drugstores located in the teaching and nonteaching hospitals affiliated with Kermanshah University of Medical Sciences. The results shows that in observed hospitals,24% of pharmacy environments, 25% of pharmacy store and storage conditions, 49% of storage procedure, 25% of ordering drugs and supplies, 73% of receiving supplies (proper procedure are fallowed for receiving supplies), 35% of receiving supplies (prompt action taken if deterioration of drugs received is suspected), 23.35% of drugs delivery to patients and finally 0% of stock cards are used for proper inventory control have full compliance with standards.

Keywords: Hospital pharmacy standards, Kermanshah, pharmacy management

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Authors: Ibrahim A. Alkali

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There is no reservation on the outstanding contribution of patient families in restoration of hospitalised patients, hence their consideration as essential component of hospital ward regimen. The psychological and emotional support a patient requires has been found to be solely provided by the patient’s family. However, consideration of their presence as one of the major functional requirements of an inpatient setting design have always been a source of disquiet, especially in developing countries where policies, norms and protocols of healthcare administration have no consideration for the patients’ family. This have been a major challenge to the hospital ward facilities, a concern for the hospital administration and patient management. The study therefore is aimed at obtaining a consensus opinion on the best approach for family integration in the design of an inpatient setting.  A one day visioning charrette involving Architects, Nurses, Medical Doctors, Healthcare assistants and representatives from the Patient families was conducted with the aim of arriving at a consensus opinion on practical design approach for sustainable family integration. Patient’s family are found to be decisive character of hospital ward regimen that cannot be undermined. However, several challenges that impede family integration were identified and subsequently a recommendation for an ideal approach. This will serve as a guide to both architects and hospital management in implementing much desired Patient and Family Centred Care.

Keywords: Caregiving, Inpatient setting, Integration, Patient Families.

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Authors: C. A. Gilkeson, C. J. Noakes, P. A. Sleigh, M. A. I. Khan, M. A. Camargo-Valero

Abstract:

Understanding how airborne pathogens are transported through hospital wards is essential for determining the infection risk to patients and healthcare workers. This study utilizes Computational Fluid Dynamics (CFD) simulations to explore possible pathogen transport within a six-bed partitioned Nightingalestyle hospital ward. Grid independence of a ward model was addressed using the Grid Convergence Index (GCI) from solutions obtained using three fullystructured grids. Pathogens were simulated using source terms in conjunction with a scalar transport equation and a RANS turbulence model. Errors were found to be less than 4% in the calculation of air velocities but an average of 13% was seen in the scalar field. A parametric study of variations in the pathogen release point illustrated that its distribution is strongly influenced by the local velocity field and the degree of air mixing present.

Keywords: Natural, Ventilation, Pathogen, Transport

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Authors: Manisha Rathi, Thierry Chaussalet

Abstract:

Hospital staff and managers are under pressure and concerned for effective use and management of scarce resources. The hospital admissions require many decisions that have complex and uncertain consequences for hospital resource utilization and patient flow. It is challenging to predict risk of admissions and length of stay of a patient due to their vague nature. There is no method to capture the vague definition of admission of a patient. Also, current methods and tools used to predict patients at risk of admission fail to deal with uncertainty in unplanned admission, LOS, patients- characteristics. The main objective of this paper is to deal with uncertainty in health system variables, and handles uncertain relationship among variables. An introduction of machine learning techniques along with statistical methods like Regression methods can be a proposed solution approach to handle uncertainty in health system variables. A model that adapts fuzzy methods to handle uncertain data and uncertain relationships can be an efficient solution to capture the vague definition of admission of a patient.

Keywords: Admission, Fuzzy, Regression, Uncertainty

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