Validation of a multiple criteria tool for healthcare facilities quality evaluation

Putting the pieces together: towards an integrative framework for healthcare performance

PURPOSE

In the past few decades, performance measuring systems have become important managerial tools for healthcare organizations. Healthcare performance metrics are a useful tool in understanding how healthcare organizations achieve their goals while satisfying the needs of their patients and conforming to national and international standards. Various efforts have been made to assess healthcare performance. Most of these measures are focused on a single perspective or developed by a single source to meet management and strategic objectives on time.

DESIGN/METHODOLOGY/APPROACH

We develop a review of the literature to shed light on the measures used to assess performance in the healthcare sector at various points in time, as well as to establish a thorough understanding of healthcare performance measurement.

FINDINGS

Developing real-time digital traceability of metrics and an integrative perspective that increases the actionability of information acquired is an attractive potential made possible by the introduction of new technologies and the digitization of data.

ORIGINALITY/VALUE

We conclude that a proper measurement system should be one to combine patient, physician, non-medical staff and system perspective, which will further facilitate the assessment of healthcare performance and the comparative function.

Decision support system (DSS) for facilities rehabilitation and management (part 1): development of integrated AHP-MAUT performance assessment model (PAM)

Purpose

The purpose of this paper (Part 1 of 2) is to develop a systematic performance assessment model (PAM) for measuring facilities condition in terms of physical, environmental and operational impacts on performance.

Design/methodology/approach

The methodology entailed a review of literature to identify performance impacting factors (PIFs) of a facility. PIFs were categorized as physical, environmental and operational. Subsequently, 71 experts were interviewed to prioritize the identified PIFs in terms of their impact on facility performance via analytical hierarchy process (AHP) technique. A second round of interviews with 11 experts was conducted to set a utility scoring mechanism for the PIFs via multiattribute utility theory (MAUT) technique, the utility score in correlation to a set scale would describe the level of service(LoS). Finally, AHP and MAUT outputs were mathematically integrated to determine the final condition rating index of all PIFs and the whole facility as a result.

Findings

First, PIFs of a case study mosque facility under three scenarios with different groupings of functional spaces were defined. Functional spaces’ prioritization was as follows: prayer hall (57%–65%), wet areas (25%–26%), minaret (9%–10%), and yard/site (7%–8%). Subsequently, each space’s PIFs and its subcategories were assigned weights as well, the first level of PIFs’ relative weights was as follows: physical (68%–73%), operational (19%–20%) and environmental (7%–13%). Physical PIFs weights differed per functional space but structural factor dominated with (38%–71%) relative weight except for the yard/site. Finally, a detailed condition evaluation mechanism for each PIF was defined.

Originality/value

This study contributes to facilities management industry and offers a systematic approach encompassing multiple PIFs that will regulate inspection then maintenance through desired corrective actions by facility managers to achieve desired LoS.

Analysis of Functional Layout in Emergency Departments (ED). Shedding Light on the Free Standing Emergency Department (FSED) Model

The ever-increasing number of hospital Emergency Department (ED) visits pose a challenge to the effective running of health systems in many countries globally and multiple strategies have been adopted over the years to tackle the plight. According to a systematic review of the available literature, of the numerous models of healthcare systems used to address the issue in western countries, the FSED Model has the greatest potential for reducing hospital ED overcrowding as it can reduce the additional load by diverting minor cases, freeing up space for more urgent cases. The aim of the study is to shed light on the Free Standing Emergency Department (FSED) model and compare it with the traditional Hospital Based Emergency Department (HBED) in international contexts. In this study, 23 papers have been collected in a literature review and the main features have been highlighted; 12 case studies have been analyzed from a layout point of view and data have been collected in terms of surfaces, functions, and flow patterns. The percentages of floor areas devoted to each function have been compared to define evolution strategies in the development of emergency healthcare models and analyses. The use of FSED models is an interesting way to face the overcrowding problem and a specific range for functional area layout has been identified. Further studies on its application in different contexts are encouraged.

Inclusive Design of Workspaces: Mixed Methods Approach to Understanding Users

Accessible design within the built environment has often focused on mobility conditions and has recently widened to include mental health. Additionally, as one in seven are neurodivergent (including conditions such as ADHD, autism, dyslexia, and dyspraxia), this highlights a growing need for designing for ‘non-visible’ conditions in addition to mobility. Emphasised by the growing disability pay gap and the disability perception gap, people with disabilities are still facing discrimination and physical barriers within the workplace. This research aimed to identify key ways of reducing physical barriers faced by people with a disability and thus encourage more comfortable and productive use of workspaces for all. Once the need for designing for a spectrum of users and inclusive workspace design was understood, a survey was then circulated to students and staff at a large university in the UK (working remotely from home), with the aim of understanding how people have adapted their home spaces and what barriers they continue to face. Quantitative and qualitative results were compared to the literature read with key issues emerging, such as separating work and rest from spaces in bedrooms. The survey findings and literature were evaluated, extracting key performance-based goals (e.g., productivity and focus within a study space) and prescriptive design features (e.g., lighting, furniture, and thermal comfort), whilst also considering the inclusivity of these features. The key conclusion establishes that, to achieve maximum benefit, it is important to work with the users to understand specific needs and identify creative and inclusive solutions.

Effect of Housing Quality on the Mental Health of University Students during the COVID-19 Lockdown

COVID-19 outbreak imposed rapid and severe public policies that consistently impacted the lifestyle habits and mental health of the general population. Despite vaccination, lockdown restrictions are still considered as potential measures to contrast COVID-19 variants spread in several countries. Recent studies have highlighted the impacts of lockdowns on the population's mental health; however, the role of the indoor housing environment where people spent most of their time has rarely been considered. Data from 8177 undergraduate and graduate students were collected in a large, cross-sectional, web-based survey, submitted to a university in Northern Italy during the first lockdown period from 1 April to 1 May 2020. Logistic regression analysis showed significant associations between moderate and severe depression symptomatology (PHQ-9 scores ≥ 15), and houses with both poor indoor quality and small dimensions (OR = 4.132), either medium dimensions (OR = 3.249) or big dimensions (OR = 3.522). It was also found that, regardless of housing size, poor indoor quality is significantly associated with moderate-severe depressive symptomatology. Further studies are encouraged to explore the long-term impact of built environment parameter modifications on mental health, and therefore support housing and public health policies.

Hospital Construction Cost Affecting Their Lifecycle: An Italian Overview

The need for 24/7 operation, and the increasing requests of high-quality healthcare services contribute to framing healthcare facilities as a complex topic, also due to the changing and challenging environment and huge impact on the community. Due to its complexity, it is difficult to properly estimate the construction cost in a preliminary phase where easy-to-use parameters are often necessary. Therefore, this paper aims to provide an overview of the issue with reference to the Italian context and proposes an estimation framework for analyzing hospital facilities' construction cost. First, contributions from literature reviews and 14 case studies were analyzed to identify specific cost components. Then, a questionnaire was administered to construction companies and experts in the field to obtain data coming from practical and real cases. The results obtained from all of the contributions are an overview of the construction cost components. Starting from the data collected and analyzed, a preliminary estimation tool is proposed to identify the minimum and maximum variation in the cost when programming the construction of a hospital, starting from the feasibility phase or the early design stage. The framework involves different factors, such as the number of beds, complexity, typology, localization, technology degree and the type of maintenance and management techniques. This study explores the several elements that compose the cost of a hospital facility and highlights future developments including maintenance and management costs during hospital facilities' lifecycle.