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Ransolin N, Saurin TA, Zani CM, Rapport F, Formoso CT, Clay-Williams R. The Built Environment Influence on Resilient Healthcare: A Systematic Literature Review of Design Knowledge. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2022; 15:329-350. [PMID: 35168374 DOI: 10.1177/19375867221077469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of this study was to develop built environment (BE) design knowledge to support resilient healthcare by systematically reviewing the evidence-based design (EBD) literature. BACKGROUND Although the EBD literature is vast, it has not made explicit its contribution to resilient healthcare, which is a key component of the highly complex health service. METHOD This review followed the steps recommended by the Preferred Reporting Items for Systematic reviews and Meta-Analyses method. After applying the inclusion and exclusion criteria, 43 journal papers were selected. The papers were analyzed in light of five guidelines for coping with complexity, allowing for the development of BE design knowledge that supports resilient healthcare. RESULTS The design knowledge compiled by the review was structured according to four levels of abstraction: five design-meta principles, corresponding to the five complexity guidelines, seven design principles, 21 design prescriptions, and 58 practical examples. The design knowledge emphasizes the interactions between the BE as physical infrastructure and the functions that it supports. CONCLUSIONS The design knowledge is expected to be useful not only to architects but also to those involved in the functional design of health services as they interact with the BE. Furthermore, our proposal provides a knowledge template that can be continuously updated based on the experience of practitioners and academic research.
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Affiliation(s)
- Natália Ransolin
- Construction Management and Infrastructure Post-Graduation Program (PPGCI), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Tarcisio Abreu Saurin
- Industrial Engineering and Transportation Department (DEPROT), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Carolina Melecardi Zani
- Bartlett School of Sustainable Construction (BSSC), University College London (UCL), United Kingdom
| | - Frances Rapport
- Australian Institute of Health Innovation (AIHI), Macquarie University, Sydney, New South Wales, Australia
| | - Carlos Torres Formoso
- Construction Management and Infrastructure Post-Graduation Program (PPGCI), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Robyn Clay-Williams
- Australian Institute of Health Innovation (AIHI), Macquarie University, Sydney, New South Wales, Australia
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Neumann J, Angrick C, Höhn C, Zajonz D, Ghanem M, Roth A, Neumuth T. Surgical workflow simulation for the design and assessment of operating room setups in orthopedic surgery. BMC Med Inform Decis Mak 2020; 20:145. [PMID: 32616031 PMCID: PMC7333415 DOI: 10.1186/s12911-020-1086-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 03/31/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The design and internal layout of modern operating rooms (OR) are influencing the surgical team's collaboration and communication, ergonomics, as well as intraoperative hygiene substantially. Yet, there is no objective method for the assessment and design of operating room setups for different surgical disciplines and intervention types available. The aim of this work is to establish an improved OR setup for common procedures in arthroplasty. METHODS With the help of computer simulation, a method for the design and assessment of enhanced OR setups was developed. New OR setups were designed, analyzed in a computer simulation environment and evaluated in the actual intraoperative setting. Thereby, a 3D graphical simulation representation enabled the strong involvement of clinical stakeholders in all phases of the design and decision-making process of the new setup alternatives. RESULTS The implementation of improved OR setups reduces the instrument handover time between the surgeon and the scrub nurse, the travel paths of the OR team as well as shortens the procedure duration. Additionally, the ergonomics of the OR staff were improved. CONCLUSION The developed simulation method was evaluated in the actual intraoperative setting and proved its benefit for the design and optimization of OR setups for different surgical intervention types. As a clinical result, enhanced setups for total knee arthroplasty and total hip arthroplasty surgeries were established in daily clinical routine and the OR efficiency was improved.
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Affiliation(s)
- Juliane Neumann
- Innovation Center Computer Assisted Surgery (ICCAS), Leipzig University, Semmelweisstr. 14, 04103, Leipzig, Germany.
| | - Christine Angrick
- Innovation Center Computer Assisted Surgery (ICCAS), Leipzig University, Semmelweisstr. 14, 04103, Leipzig, Germany
| | - Celina Höhn
- Innovation Center Computer Assisted Surgery (ICCAS), Leipzig University, Semmelweisstr. 14, 04103, Leipzig, Germany
- Department of Orthopaedic, Trauma and Plastic Surgery, Division of Endoprothetic Joint Surgery and General Orthopaedics, University of Leipzig Medical Center, Leipzig, Germany
| | - Dirk Zajonz
- Department of Orthopaedic, Trauma and Plastic Surgery, Division of Endoprothetic Joint Surgery and General Orthopaedics, University of Leipzig Medical Center, Leipzig, Germany
| | - Mohamed Ghanem
- Department of Orthopaedic, Trauma and Plastic Surgery, Division of Endoprothetic Joint Surgery and General Orthopaedics, University of Leipzig Medical Center, Leipzig, Germany
| | - Andreas Roth
- Department of Orthopaedic, Trauma and Plastic Surgery, Division of Endoprothetic Joint Surgery and General Orthopaedics, University of Leipzig Medical Center, Leipzig, Germany
| | - Thomas Neumuth
- Innovation Center Computer Assisted Surgery (ICCAS), Leipzig University, Semmelweisstr. 14, 04103, Leipzig, Germany
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Brunson JC, Laubenbacher RC. Applications of network analysis to routinely collected health care data: a systematic review. J Am Med Inform Assoc 2018; 25:210-221. [PMID: 29025116 PMCID: PMC6664849 DOI: 10.1093/jamia/ocx052] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 04/18/2017] [Accepted: 04/23/2017] [Indexed: 01/21/2023] Open
Abstract
Objective To survey network analyses of datasets collected in the course of routine operations in health care settings and identify driving questions, methods, needs, and potential for future research. Materials and Methods A search strategy was designed to find studies that applied network analysis to routinely collected health care datasets and was adapted to 3 bibliographic databases. The results were grouped according to a thematic analysis of their settings, objectives, data, and methods. Each group received a methodological synthesis. Results The search found 189 distinct studies reported before August 2016. We manually partitioned the sample into 4 groups, which investigated institutional exchange, physician collaboration, clinical co-occurrence, and workplace interaction networks. Several robust and ongoing research programs were discerned within (and sometimes across) the groups. Little interaction was observed between these programs, despite conceptual and methodological similarities. Discussion We use the literature sample to inform a discussion of good practice at this methodological interface, including the concordance of motivations, study design, data, and tools and the validation and standardization of techniques. We then highlight instances of positive feedback between methodological development and knowledge domains and assess the overall cohesion of the sample.
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Bae SH, Farasat A, Nikolaev A, Seo JY, Foltz-Ramos K, Fabry D, Castner J. Nursing teams: behind the charts. J Nurs Manag 2017; 25:354-365. [DOI: 10.1111/jonm.12473] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Sung-Heui Bae
- Ewha Womans University; College of Nursing; Seoul Korea
| | - Alireza Farasat
- University at Buffalo; Department of Industrial and Systems Engineering; Buffalo NY USA
| | - Alex Nikolaev
- University at Buffalo; Department of Industrial and Systems Engineering; Buffalo NY USA
| | - Jin Young Seo
- Hunter-Bellevue School of Nursing; Hunter College; CUNY; New York NY USA
| | | | - Donna Fabry
- University at Buffalo; School of Nursing; Buffalo NY USA
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Bae SH, Nikolaev A, Seo JY, Castner J. Health care provider social network analysis: A systematic review. Nurs Outlook 2015; 63:566-84. [DOI: 10.1016/j.outlook.2015.05.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Revised: 05/14/2015] [Accepted: 05/25/2015] [Indexed: 01/22/2023]
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Jørgensen P, Jacobsen P, Poulsen JH. Identifying the potential of changes to blood sample logistics using simulation. Scandinavian Journal of Clinical and Laboratory Investigation 2013; 73:279-85. [DOI: 10.3109/00365513.2013.773063] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Traversari R, Goedhart R, Schraagen JM. Process Simulation during the Design Process Makes the Difference: Process Simulations Applied to a Traditional Design. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2013; 6:58-76. [DOI: 10.1177/193758671300600206] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective: The objective is evaluation of a traditionally designed operating room using simulation of various surgical workflows. Background: A literature search showed that there is no evidence for an optimal operating room layout regarding the position and size of an ultraclean ventilation (UCV) canopy with a separate preparation room for laying out instruments and in which patients are induced in the operating room itself. Neither was literature found reporting on process simulation being used for this application. Many technical guidelines and designs have mainly evolved over time, and there is no evidence on whether the proposed measures are also effective for the optimization of the layout for workflows. Methods: The study was conducted by applying observational techniques to simulated typical surgical procedures. Process simulations which included complete surgical teams and equipment required for the intervention were carried out for four typical interventions. Four observers used a form to record conflicts with the clean area boundaries and the height of the supply bridge. Preferences for particular layouts were discussed with the surgical team after each simulated procedure. Results: We established that a clean area measuring 3 × 3 m and a supply bridge height of 2.05 m was satisfactory for most situations, provided a movable operation table is used. The only cases in which conflicts with the supply bridge were observed were during the use of a surgical robot (Da Vinci) and a surgical microscope. During multiple trauma interventions, bottlenecks regarding the dimensions of the clean area will probably arise. Conclusions: The process simulation of four typical interventions has led to significantly different operating room layouts than were arrived at through the traditional design process.
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Social network analysis in healthcare settings: a systematic scoping review. PLoS One 2012; 7:e41911. [PMID: 22870261 PMCID: PMC3411695 DOI: 10.1371/journal.pone.0041911] [Citation(s) in RCA: 123] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 06/29/2012] [Indexed: 12/02/2022] Open
Abstract
Background Social network analysis (SNA) has been widely used across a range of disciplines but is most commonly applied to help improve the effectiveness and efficiency of decision making processes in commercial organisations. We are utilising SNA to inform the development and implementation of tailored behaviour-change interventions to improve the uptake of evidence into practice in the English National Health Service. To inform this work, we conducted a systematic scoping review to identify and evaluate the use of SNA as part of an intervention to support the implementation of change in healthcare settings. Methods and Findings We searched ten bibliographic databases to October 2011. We also searched reference lists, hand searched selected journals and websites, and contacted experts in the field. To be eligible for the review, studies had to describe and report the results of an SNA performed with healthcare professionals (e.g. doctors, nurses, pharmacists, radiographers etc.) and others involved in their professional social networks. We included 52 completed studies, reported in 62 publications. Almost all of the studies were limited to cross sectional descriptions of networks; only one involved using the results of the SNA as part of an intervention to change practice. Conclusions We found very little evidence for the potential of SNA being realised in healthcare settings. However, it seems unlikely that networks are less important in healthcare than other settings. Future research should seek to go beyond the merely descriptive to implement and evaluate SNA-based interventions.
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Masursky D, Dexter F, Kwakye MO, Smallman B. Measure to Quantify the Influence of Time from End of Surgery to Tracheal Extubation on Operating Room Workflow. Anesth Analg 2012; 115:402-6. [DOI: 10.1213/ane.0b013e318257a0f2] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Talsma A, Chard R, Kleiner C, Anderson C, Geun H. AORN and University of Michigan School of nursing research alliance. AORN J 2011; 93:761-6. [PMID: 21624528 DOI: 10.1016/j.aorn.2010.11.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2010] [Revised: 10/28/2010] [Accepted: 11/22/2010] [Indexed: 11/25/2022]
Abstract
Research related to perioperative care requires advanced training and is well suited to take place at a research-intensive university. A recent research alliance established between AORN and the University of Michigan School of Nursing, Ann Arbor, uses the strengths of both a robust perioperative professional organization and a research-intensive university to make progress toward improving patient safety and transforming the perioperative work environment. Research activities undertaken by this alliance include investigating nurse staffing characteristics and patient outcomes, as well as evaluating the congruence and definitions of data elements contained in AORN's SYNTEGRITY™ Standardized Perioperative Framework. Disseminating the findings of the alliance is expected to facilitate the communication and application of new knowledge to nursing practice and help advance the perioperative nursing profession.
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Abstract
Recent healthcare legislation, financial pressures, and regulatory oversight have increased the need to create improved mechanisms for performance measurement, quality management tracking, and outcomes-based research. The Anesthesia Quality Institute (AQI) has established the National Anesthesia Clinical Outcomes Registry (NACOR) to support these requirements for a wide-range of customers including individual anesthesiologists, anesthesia practices, hospitals, and credentialing agencies. Concurrently, the availability of increased digital sources of healthcare data make it possible to capture massive quantities of data in a more efficient and cost-effective manner than ever before. With NACOR, AQI has established a user-friendly, automated process to effectively and efficiently collect a wide-range of anesthesia-related data directly from anesthesia practices. This review will examine the issues guiding the evolution of NACOR as well as some potential pitfalls in its growth and usage.
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Current world literature. Curr Opin Anaesthesiol 2010; 23:283-93. [PMID: 20404787 DOI: 10.1097/aco.0b013e328337578e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abstract
PURPOSE OF REVIEW Ongoing healthcare reforms in Germany have required strenuous efforts to adapt hospital and operating room organizations to the needs of patients, new technological developments, and social and economic demands. This review addresses the major developments in German operating room management research and current practice. RECENT FINDINGS The introduction of the diagnosis-related group system in 2003 has changed the incentive structure of German hospitals to redesign their operating room units. The role of operating room managers has been gradually changing in hospitals in response to the change in the reimbursement system. Operating room managers are today specifically qualified and increasingly externally hired staff. They are more and more empowered with authority to plan and control operating rooms as profit centers. For measuring performance, common perioperative performance indicators are still scarcely implemented in German hospitals. In 2008, a concerted time glossary was established to enable consistent monitoring of operating room performance with generally accepted process indicators. These key performance indicators are a consistent way to make a procedure or case - and also the effectiveness of the operating room management - more transparent. SUMMARY In the presence of increasing financial pressure, a hospital's executives need to empower an independent operating room management function to achieve the hospital's economic goals. Operating room managers need to adopt evidence-based methods also from other scientific fields, for example management science and information technology, to further sustain operating room performance.
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