Benchmarking Relevance for Hospital Design and Planning: An International Web-Based Survey

OBJECTIVE

The study aims to investigate what design practitioners and healthcare facility managers deem as important benchmarking metrics worldwide, investigating country differences in benchmarking usage and which metrics are prioritized.

BACKGROUND

Benchmarking is a regular practice in the healthcare sector, both for clinical and managerial aspects to compare, measure, and improve standardized processes. However, limited knowledge is available about benchmarking procedures in hospital planning, design, and construction.

METHODS

A web-based survey was designed, revised, and pilot-tested in five countries; it was adjusted according to local experts' suggestions and submitted globally via SoSci multilingual platform to persons involved in hospital design, research, construction, and facility management. It was composed of closed questions on 5-point Likert-type scale ranking frequency or importance and open-ended questions divided into six sections. Two hundred and eighty full responses have been collected. Statistical analysis was performed via PowerBI and R-Studio, while qualitative analysis was performed via MAXQDA.

RESULTS

The findings reported allow for both specific insights per each country or category as well as enabling general considerations of a practice that is becoming always more international with 30%-50% of respondents working in the international context. The evaluation of the survey highlights the most important benchmarks, among others. For example, for respondents from the top five countries (Sweden, Spain, Germany, Italy, and the United States), the most important metric for benchmark comparability is whether the project was new construction, new construction attached to an existing hospital, or interior renovation. Construction date, client type (public vs. private), and country of location were also generally rated as the most important metrics by respondents. Other metrics that were consistently rated as important globally included inpatient unit layout, walking distances, number of floors, and whether all patient rooms are private. Space-related metrics are considered very important elements in the design and planning of healthcare facilities worldwide. Regarding cost-related metrics, all countries consider the ratio construction cost per building gross area as the most important.

CONCLUSIONS

Benchmarking emerges as a relevant tool for hospital design and planning as it can support efficiency, standardization, and confidence; currently, benchmarking is still underutilized due to the challenge of international comparison, access to data outside each specific company, and variation design metrics nationally. Benchmarking strategies should be further investigated to support knowledge exchange and to ensure reliable and comparable information globally.

Perinatal social work during the Covid-19 pandemic: Reflecting on concepts of time and liminality

This article reflects upon the experiences of two perinatal, hospital social workers during the unprecedented time of the Covid-19 in Ireland, as discussed with their academic colleague. This encounter revealed the complexity of service delivery that emerged, when managing the needs of vulnerable clients whilst being mindful of personal safety. One of the social workers was pregnant so was conscious of possible risks to her unborn child, as well as her young family at home. The second social worker, her line manager, discusses the dilemmas associated with the management of risk when allocating staff to contexts where they would be in direct contact with Covid-19. At the core of the analysis of these situations is the notion of liminal space and the realisation that time appears to have a new meaning; what we once knew as normal no longer exists, but we have yet to reach the 'new normal'.

New ways of seeing: Health social work leadership and research capacity building

Building research capacity amongst social work practitioners is critically important for leaders in the social work profession. To reverse an apparent reluctance to use evidence and engage in research, strong social work leadership in practice organisations is needed. The literature on leadership in health social work is relatively silent regarding research capacity building as a leadership attribute but it is argued in this paper that leadership is crucial. A programme of research capacity building and its outcomes in a health social work department is described, identifying key principles guiding its establishment and tasks undertaken. A transformational leadership style characterised this approach to research capacity building which delivered benefits to the staff and the service.

Practice Evaluation Strategies Among Social Workers: Why an Evidence-Informed Dual-Process Theory Still Matters

Practice evaluation strategies range in style from the formal-analytic tools of single-subject designs, rapid assessment instruments, algorithmic steps in evidence-informed practice, and computer software applications, to the informal-interactive tools of clinical supervision, consultation with colleagues, use of client feedback, and clinical experience. The purpose of this article is to provide practice researchers in social work with an evidence-informed theory that is capable of explaining both how and why social workers use practice evaluation strategies to self-monitor the effectiveness of their interventions in terms of client change. The author delineates the theoretical contours and consequences of what is called dual-process theory. Drawing on evidence-informed advances in the cognitive and social neurosciences, the author identifies among everyday social workers a theoretically stable, informal-interactive tool preference that is a cognitively necessary, sufficient, and stand-alone preference that requires neither the supplementation nor balance of formal-analytic tools. The author's delineation of dual-process theory represents a theoretical contribution in the century-old attempt to understand how and why social workers evaluate their practice the way they do.

Involvement of patients' perspectives on treatment with noninvasive ventilation in patients with chronic obstructive pulmonary disease-A qualitative study

AIMS AND OBJECTIVES

To clarify chronic obstructive pulmonary disease patients' perspectives on treatment with noninvasive ventilation and develop management strategies for the treatment based on these perspectives.

BACKGROUND

The effect of treating chronic obstructive pulmonary disease patients with noninvasive ventilation is well-documented, as is the problem of patient difficulties in tolerating the treatment. Knowledge of how patients with chronic obstructive pulmonary disease experience and evaluate treatment with noninvasive ventilation is limited; therefore, more information of patient perspectives is needed to develop treatment practices in respiratory medicine.

METHOD

This study is based on critical psychological practice research.

DESIGN

A co-researcher group comprising diverse health professionals was set up and headed by the principal researcher. The group convened seven times over 12 months to develop new management strategies based on patients' perspectives on noninvasive ventilation. Health professionals contributed with experience-based perspectives, and the researcher contributed with data from participant observation in the department and semi-structured interviews with 16 patients and four relatives.

RESULTS

Interviews revealed that patients with chronic obstructive pulmonary disease regarded noninvasive ventilation treatment positively even though they experienced discomfort and anxiety. Patients' perspectives revealed that patients with chronic obstructive pulmonary disease conduct their everyday lives with chronic obstructive pulmonary disease looking at chronic obstructive pulmonary disease as a basic life condition rather than an illness. This approach had a major impact on chronic obstructive pulmonary disease patients' attitudes to noninvasive ventilation treatment and hospitalisation.

CONCLUSION

Investigation of patient perspectives generated results that were highly productive in facilitating multidisciplinary collaboration and in developing and sustaining new management strategies. Critical psychological practice research facilitated ongoing development of clinical practice related to noninvasive ventilation treatment.

RELEVANCE TO CLINICAL PRACTICE

Focus on patients' perspectives in treatment with noninvasive ventilation resulted in the development of new management strategies regarding patient care, joint ward rounds, and in addition, one room at the ward, to which a nurse was assigned, was designated for chronic obstructive pulmonary disease patients treated with noninvasive ventilation.

Using Social Cognitive Theory to Explain the Intention of Final-year Pharmacy Students to Undertake a Higher Degree in Pharmacy Practice Research

Objective. To develop and test a conceptual model that hypothesized student intention to undertake a higher degree in pharmacy practice research (PPR) would be increased by self-efficacy, outcome expectancy, and the social influence of faculty members. Methods. Cross-sectional surveys were completed by 387 final-year pharmacy undergraduates enrolled in 2012 and 2013. Structural equation modeling was used to explore relationships between variables and intention. Results. Fit indices were good. The model explained 55% of the variation in intention. As hypothesized, faculty social influence increased self-efficacy and indirectly increased outcome expectancy and intention. Conclusion. To increase pharmacy students' orientation towards a career in PPR, faculty members could use their social influence by highlighting PPR in their teaching.

Using cultural-historical activity theory to analyze social service practices evolving from the Norwegian HUSK projects

The HUSK projects catalyzed innovation in the practices of providing social services that could yield useful insights both within and outside of Norway if analyzed in these two ways: (a) retrospective analysis of the development of individual HUSK projects in light of their cultural-historical contexts, and (b) comparative analysis of the efforts to advance multi-sector collaboration in some of the HUSK projects. Such analyses require a practice-based research approach that takes into account culture and history. In this article the author explains how cultural-historical activity theory provides such an approach, illustrated via several HUSK cases. The author suggests five questions for future analyses of the HUSK projects and argues that insights gleaned from such analyses could contribute significantly to research on-and the provision of-social services.

Making sense of HUSK: practice implications for social change initiatives

As an exemplar of bottom-up progressive social experimentation, HUSK provides opportunities to examine how innovative practice is supported and challenged in bureaucratic settings. In this analysis the author uses a sensemaking lens to identify critical issues and questions for those seeking to promote progressive change initiative in social welfare systems. Findings identify essential organizational and managerial supports needed to support service user voice and participation and reinforce the importance of reflexivity in practice and research.

Engaging social work practitioners in research: challenges and opportunities

Contemporary emphasis on measuring and evaluating observable, behavioral outcomes reflects a major change in the profession toward greater empirical basis for social work practice. This intellectual and methodological shift has created a gap between practitioners and researchers. While social work practitioners definitely should be more knowledgeable and receptive to interventions that have proven to be effective in helping people, social work academics must pay more attention to the realities of social work practitioners who struggle daily with expanding caseloads, ever-increasing time pressures to help clients whose lives are embedded in poverty, unemployment, oppression, racism, homelessness, and violence.