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This study examined the capacity of decentralised health institutions at the Sunyani Municipality for responsive healthcare delivery, through the case study design. A sample size of 102 individuals comprising 60 household respondents and 42 healthcare staff were involved. Interviews and observations were used to collect data from the respondents. The human resource capacity of the health facilities was found to be adequate for responsive healthcare delivery; however, these successes were diminished by limited financial and material resource availability. The study concludes that disproportionate resource capacity is counterproductive; thus, the government should increase its health sector financial and material resource allocations. [ABSTRACT FROM AUTHOR]

It is empirical that nurses must receive education and training to strengthen their research skills to apply evidence-based practice. This study aimed to ascertain how nurses' views toward undertaking research in private healthcare facilities correlated with their capacity for research. A predictive-correlational design was used in the study. 120 nurses were conveniently selected and included in the research. An adapted survey questionnaire from the study of Bostrom et al. (1989) and Perez et al. (2022) was used for data gathering. Results showed that majority of the respondents were female in their middle-age who had worked in the healthcare facility's ward for two years or less. Their attitude toward research undertaking and ability were both quite excellent. Nurses' attitudes regarding performing research and their research competence were significantly correlated. However, there was no discernible correlation between attitudes and the demographic profile. Furthermore, the nurses' research abilities greatly influence their attitudes toward performing research. These results show that nurses can undertake research and have a positive attitude toward it. The study emphasizes the need to strengthen these skills through education and training by highlighting the strong association between nurses' research capacities and their positive attitude toward undertaking research. Developing nurses' research abilities fosters an environment where practice is increasingly grounded on evidence. [ABSTRACT FROM AUTHOR]

Due to the capacity deficits of the healthcare sector, governments faced many difficulties when responding to the burden caused by the COVID-19 pandemic. Private sector involvement in healthcare facilities delivery enabled through public–private partnerships (PPPs) can play a crucial role in overcoming these capacity deficits. Although PPP projects can help to overcome infrastructure deficiencies, some are criticized due to the low value created for stakeholders. These include not only society in general, which uses the healthcare facilities, but also the project participants. Value generation for the latter is also an essential objective of PPP healthcare projects in a generic view, which is often neglected. This study aims to understand value creation in healthcare PPPs by developing a framework based on concepts related to the project value and eventually proposing a business model to maximize the generated value at the organizational level for all stakeholders. In order to achieve the study objective, insights are obtained from a literature survey, semistructured interviews, and focus group discussions. A value-creation model consisting of components and subcomponents of value generation and the relationship between these is proposed. The model demonstrates that the process component plays a central role in value creation, requiring sufficient assets of the parties engaged in and the appropriate governance of PPP projects. The value-creation model proposed here further highlights the driving role of a well-balanced legal framework and organizational learning. All the identified subcomponents are found to be interrelated, highlighting the importance of the proposed business model design in value creation. Overall, given the lack of healthcare facility capacity in many countries and the need to create value in healthcare PPP attempts, the proposed value-creation model is expected to help project participants develop a more value-centric way of managing, controlling, and operating these projects. [ABSTRACT FROM AUTHOR]

Background: Costa Rica, as many developing countries around the world, lacks a specific regulatory framework for hospital disinfectant efficacy testing. The aim of this study is to evaluate the efficacy of disinfectant samples used in healthcare facilities of Costa Rica to provide experimental evidence to encourage the definition of public health polices in this matter. Methods: The determination of efficacy for disinfectant samples were based on Association of Official Agricultural Chemists (AOAC) usedilution methods 955.15 (Staphylococcus aureus ATCC 6538) and 964.02 (Pseudomonas aeruginosa ATCC 15442) with minor modifications. Results: Ineffective disinfectant samples intended for their use in healthcare centers were identified. Experimental data indicates that disinfectants tested have lower activity against Gram-negative bacteria than Gram-positive bacteria. Conclusions: Despite most analyzed disinfectant samples are effective, there are products that did not satisfy performance criteria. The study gives experimental data that are useful to encourage the definition of a regulatory frame for hospital disinfectant efficacy testing in Costa Rica. [ABSTRACT FROM AUTHOR]

This topic focuses on the problems that arise in providing medical care to the population during armed conflict or martial law. Under such conditions, hospitals, clinics, and other healthcare facilities have to work in challenging circumstances with limited resources and reduced security for medical personnel. This topic explores such issues as how martial law affects the work of medical institutions, what problems arise in providing medical care to the population in war, how war affects the health of the people, and what consequences it may have in the long term. Research in this area will help to understand how to organize better and prepare medical facilities to work in war conditions and ensure high-quality medical care to the population in emergencies. The methods used to write this article were analysis, synthesis, generalization, explanation, and data qualification. The primary and fundamental sources for writing an article may vary depending on the topic, but generally, the following sources can be recommended. Academic studies: these can be scholarly articles, monographs, dissertations, conference papers, and other materials related to the topic of your article. These sources can help you find information about the latest research in the field and allow you to see the approaches and methodologies used in the studies. Official sources: These can be legal documents, reports, regulations, guidelines, and other materials issued by government agencies, ministries, and other departments. These sources can help you understand the rules and regulations governing your article's topic. Expert reviews: these can be interviews with experts in the field, articles, and other materials written by well-known specialists. These sources can help you understand the views and opinions of well-known experts on the issues related to your paper. [ABSTRACT FROM AUTHOR]

Healthcare systems in low-resource settings need effective methods for managing their scant resources, especially people and equipment. Digital technologies may provide means for circumventing the constraints hindering low-income economies from improving their healthcare services. Although analytical and simulation techniques, such as queuing theory and discrete event simulation, have already been successfully applied in addressing various optimisation problems across different operational contexts, the literature reveals that their application in optimisation of healthcare maintenance systems remains relatively unexplored. This study considers the problem of maintenance workflow optimisation with respect to labour, equipment availability and cost. The study aims to provide objective means for forecasting resource demand, given a set of task requests with varying priorities and queue characteristics that flow from multiple queues, and in parallel, into the same maintenance process for resolution. The paper presents how discrete event simulation is adopted in combination with simulated annealing to develop a decision-support tool that helps healthcare asset managers leverage operational performance data to project future asset-performance trends objectively, and thereby determine appropriate interventions for optimal performance. The study demonstrates that healthcare facilities can achieve efficiency in a cost-effective manner through tool-generated maintenance strategies, and that any future changes can be expeditiously re-evaluated and addressed. [ABSTRACT FROM AUTHOR]

Copyright of Les Cahiers du CREAD is the property of Centre de Rrecherche en Economie Appliquee pour Developpement and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: We evaluated the use of evidence-based practices (EBPs) for smoking cessation in centers providing behavioral healthcare for patient populations that included some proportion of sexual and gender minorities (SGMs). Methods: Healthcare providers from 75 healthcare centers across Texas serving SGMs with behavioral health needs participated in a survey assessing their center's tobacco control policies and practices. Results: Nearly half (N = 36) of participating centers had a comprehensive tobacco-free workplace policy, 30.67% employed ≥ 1 tobacco treatment specialist, 73.91% employed = 1 prescriber, 80.82% mandated screening for patient tobacco use at intake, and 57.53% provided a template for tobacco use assessments. Overall, 70.67% of providers asked patients about smoking status, 69.33% advised patients to quit, 64.00% assessed patients' interest in quitting, 58.67% assisted patients with quit attempts, and 36.00% arranged follow-up. Providers' ability to tailor interventions for special populations like SGMs ranged from very low/0 to very high/10 (M = 4.63 + 2.59). Conclusions: There are opportunities to improve policy implementation, standardization and usage of evidence-based interventions, and intervention tailoring within settings providing care to SGM patients in Texas to address their tobacco use inequities. [ABSTRACT FROM AUTHOR]

The objective of the study was to assess the factors that motivate or demotivate households to choose among the three healthcare facilities, public healthcare, private health care and traditional healthcare facilities in South Africa as revealed by Statistics South Africa. The utilisation of healthcare facilities in South Africa is such that more households prefer public healthcare facilities more than other healthcare facilities. The multinomial logit model was used, with traditional/self-medication category as the reference or baseline category. The results indicated that gender, income, and access to grants were significant in influencing the probability of a household choosing a public healthcare facility, while age, income, grants, salaries/wages/commission, and pensions were significant in influencing the choice of private healthcare institutions. Therefore, the study recommends that due to a large portion of households that are using public health facilities compared to private and traditional facilities, the government must invest more in public healthcare facilities in South Africa. [ABSTRACT FROM AUTHOR]

The Health Promoting Hospitals (HPH) networks, founded by the World Health Organisation, support the introduction of health promotion in healthcare. This development involves the creation of a health promoting built environment. However, few studies have explored the HPH in relation to the built environments, and it is unclear how HPH-networks incorporate the built environment in their work. The study therefore examined the Swedish HPH-Network in relation to the built environment. The mixed-method study included data from (i) key online material from the Swedish network, (ii) a survey with open-ended questions of representatives of the networks' workgroups and (iii) semi-structured interviews with the built environment workgroup. The study showed that the built environment is unevenly and incoherently incorporated in the network. Moreover, there is more attention for healing and healthy rather than health-promotive strategies, indicating a knowledge gap. Descriptions of the health promoting built environment are diverse, and address design features, design strategies or indicate places for health promotion interventions. The descriptions of the built environment are combined with various HPH goals and population groups. To utilize the built environment as a resource for HPHs, the networks should consider incorporating the built environment in documents and action plans at all organizational levels. [ABSTRACT FROM AUTHOR]

Ageing has always directly impacted the healthcare systems and, more specifically, the eldercare costs, as initiatives related to eldercare need to be addressed beyond the regular healthcare costs. This study aims to examine the general issues of eldercare in the Singapore context, as the population of the country is ageing rapidly. The main objective of the study is to examine the eldercare initiatives of the government and their likely impact on the ageing population. The methodology adopted in this study is Cross-Industry Standard Process for Data Mining (CRISP-DM). Reviews related to the impact of an ageing population on healthcare systems in the context of eldercare initiatives were studied. Analysis methods include correlation and machine learning algorithms, such as Decision Tree, Logistic Regression and Receiver Operating Characteristics curve analysis. Suggestions have been provided for various healthcare and eldercare systems’ initiatives and needs that are required to transform to cope with the ageing population. [ABSTRACT FROM AUTHOR]

Copyright of Annali di Igiene, Medicina Preventiva e di Comunità is the property of Societa Editrice Universo s.r.l. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article is devoted to changes in the model of medical staff's motivation and pay, the expediency of which has arisen in connection with the transformation of healthcare facilities into communal nonprofit enterprises. The changes between public healthcare facilities and communal non-profit enterprises were studied according to the following criteria: organizational and legal form, status, financing, activity planning, form of accounts, reporting, audit. The main stages of the process of reorganization of healthcare facilities and their transformation into communal non-profit enterprises are considered. The distribution of types of medical care depending on the type of services and the qualifications of specialists who provide care, is provided. New models of medical staff's motivation and pay that can be used after the transformation of public healthcare facilities are considered. [ABSTRACT FROM AUTHOR]

India is an uphill industry as a destination for medical tourism. In this present global healthcare, service patients are seeking the best medical facility at a low cost. Certain patients who go for low - cost treatment will move to the country where facilities are at a high standard, technologically advanced at low cost. So, patients travelling from one home country to another country for seeking treatment are named as Medical tourism. In this global scenario, most Asian countries are becoming competitors for the growth of medical tourism namely India, Singapore, Malaysia, Thailand. Indian medical tourism is rapidly growing with a CAGR of 22.87%. In this stage, the researcher felt the choice of international patients is very important and identified the variables like quality of service and Diagnostic facilities after doing extensive literature which influences the choice of a healthcare facility. A structured questionnaire is conducted by taking International patients as samples and SPSS is used for analyzing the data. [ABSTRACT FROM AUTHOR]

An investigation examined the structured scientific evidence on healthcare facilities (the healing built environment - HBE) and its impact on patients' health outcomes under a holistic conceptual evaluative framework. The integrative review considered 127 papers (of which 59 were review papers). It found there was no adequate framework that could integrate existing research findings holistically. Such a holistic framework needs to demonstrate the cumulative and interactive effects of various HBE characteristics on patients' health outcomes and wellbeing. An environment-occupant-health (E-O-H) framework is proposed, taking a holistic perspective to identify and evaluate different HBE characteristics. The E-O-H framework should support future research by (1) identifying the HBE characteristics that affect health outcomes; (2) defining appropriate future research designs; and (3) understanding the need for holistic analysis of the integrated effects of diverse HBE characteristics on health outcomes. [ABSTRACT FROM AUTHOR]

This article provides a set of recommendations, selected from the systematic literature review carried out, regarding signage systems for healthcare institutions that can be used for designing or redesigning more competent signage systems. The signage systems in healthcare settings are usually poorly designed due to the expansion of the original facilities, a lack of awareness of existing guidelines by the developers, and a lack of agreement between the existing recommendations. There are several guidelines and recommendations available in the literature; however, each work was developed for specific cultural contexts, so there is a lack of uniformity among them. Hence, there is a need to uniformize the guidelines for signage design in healthcare, in order to provide supportive information for developers to build and implement effective and efficient signage systems. This study examined the available literature on the subject and established a set of guidelines organized in categories to help the design process. A literature review was conducted, and 34 selected publications were analyzed from which recommendations were created. A best practices manual was also studied and used as the analytical framework to establish the design categories of the developed recommendations. This review resulted in guidelines divided into nine design categories that should be considered in the design and implementation process of signage systems in healthcare facilities. [ABSTRACT FROM AUTHOR]

Background: Ghana is implementing activities towards universal health coverage (UHC) as well as the attainment of the health-related Sustainable Development Goals (SDGs) by the health sector by the year 2030. Aside lack of empirical forecast of the required healthcare facilities to achieve these mandates, health workforce deficits are also a major threat. We therefore modelled the needed healthcare facilities in Ghana and translated it into year-by-year staffing requirements based on established staffing standards. Methods: Two levels of modelling were used. First, a predictive model based on Markov processes was used to estimate the future healthcare facilities needed in Ghana. Second, the projected healthcare facilities were translated into aggregate staffing requirements using staffing standards developed by Ghana's Ministry of Health (MoH). Results: The forecast shows a need to expand the number/capacity of healthcare facilities in order to attain UHC. All things being equal, the requisite healthcare infrastructure for UHC would be attainable from 2023. The forecast also shows wide variations in staffing-need-availability rate, ranging from 15% to 94% (average being 68%) across the various staff types. Thus, there are serious shortages of staff which are worse amongst specialists. Conclusion: Ghana needs to expand and/or increase the number of healthcare facilities to facilitate the attainment of UHC. Also, only about 68% of the health workforce (HWF) requirements are employed and available for service delivery, leaving serious shortages of the essential health professionals. Immediate recruitment of unemployed but qualified health workers is therefore imperative. Also, addressing health worker productivity, equitable distribution of existing workers, and attrition may be the immediate steps to take whilst a long-term commitment to comprehensively address HWF challenges, including recruitments, expansion and streamlining of HWF training, is pursued. [ABSTRACT FROM AUTHOR]

Building health systems that are responsive to community needs particularly for the poor is essential. In view of the growing divergence both between and within the states, disaggregated studies are necessary for identification of the critical areas calling for policy intervention. In this connection, the article is an attempt to analyse the performance of healthcare system of Andhra Pradesh (AP) at district level by focusing on technical efficiency. The study is based on secondary data. Stochastic frontier model has been used for analysis. The results show that the efficiency of the public health delivery system remains low. Not all the districts with lower infant mortality rate (IMR) have efficient health systems. The disparities across districts in terms of availability of hospitals and primary health centres have an adverse impact on improving IMR in AP. Overcoming these disparities within the health system may lead to improvement of public health system at district level in AP. Further, reduction in IMR may be possible at a faster pace in the state if such efforts are coupled with steps to promote literacy particularly female literacy. This could make them empowered to demand for adequate health infrastructure and ensure better utilization of it in poorly performing districts. [ABSTRACT FROM AUTHOR]

Objective: To assess quality of postabortion care (PAC) offered by Kenyan healthcare facilities.Methods: A cross-sectional survey was conducted using data from the Incidence and Magnitude of Unsafe Abortions study, conducted among 326 PAC-providing healthcare facilities throughout Kenya from March 13 to June 30, 2012. Descriptive results with weighted proportions and an ordered probit model were used.Results: Overall, 408 (41.8%) first-trimester PAC cases were treated using appropriate technology versus 826 (82.6%) second-trimester cases. Private healthcare facilities lagged behind public healthcare facilities on the use of appropriate technology: 264 (47.5%) public and 144 (33.1%) private facilities used such technology for first-trimester abortion, and 664 (89.6%) public versus 162 (68.8%) private for second-trimester abortions). Most healthcare facilities (251, 70.7%) had at least one provider trained in PAC. A total of 273 (80.7%) healthcare facilities reported offering contraception to all PAC patients, mainly short-acting methods. Delivery of PAC services depended on the availability of separate evacuation room (public level 2-3: odds ratio [OR] 22.93; public level 4-6: OR 77.14), and the number of family planning methods offered within the facility (public level 2-3: OR 1.38; public level 4-6 OR 1.57; private level 2-3: OR 2.27; private level 4-5: 4.89).Conclusion: Effective monitoring of PAC services, particularly among private healthcare facilities, might improve overall quality of services. [ABSTRACT FROM AUTHOR]

Background: WHO and UNICEF have proposed an action plan to achieve universal water, sanitation and hygiene (WASH) coverage in healthcare facilities (HCFs) by 2030. The WASH targets and indicators for HCFs include: an improved water source on the premises accessible to all users, basic sanitation facilities, a hand washing facility with soap and water at all sanitation facilities and patient care areas. To establish viable targets for WASH in HCFs, investigation beyond 'access' is needed to address the state of WASH infrastructure and service provision. Patient and caregiver use of WASH services is largely unaddressed in previous studies despite being critical for infection control.Methods: The state of WASH services used by staff, patients and caregivers was assessed in 17 rural HCFs in Rwanda. Site selection was non-random and predicated upon piped water and power supply. Direct observation and semi-structured interviews assessed drinking water treatment, presence and condition of sanitation facilities, provision of soap and water, and WASH-related maintenance and record keeping. Samples were collected from water sources and treated drinking water containers and analyzed for total coliforms, E. coli, and chlorine residual.Results: Drinking water treatment was reported at 15 of 17 sites. Three of 18 drinking water samples collected met the WHO guideline for free chlorine residual of >0.2 mg/l, 6 of 16 drinking water samples analyzed for total coliforms met the WHO guideline of <1 coliform/100 mL and 15 of 16 drinking water samples analyzed for E. coli met the WHO guideline of <1 E. coli/100 mL. HCF staff reported treating up to 20 L of drinking water per day. At all sites, 60% of water access points (160 of 267) were observed to be functional, 32% of hand washing locations (46 of 142) had water and soap and 44% of sanitary facilities (48 of 109) were in hygienic condition and accessible to patients. Regular maintenance of WASH infrastructure consisted of cleaning; no HCF had on-site capacity for performing repairs. Quarterly evaluations of HCFs for Rwanda's Performance Based Financing system included WASH indicators.Conclusions: All HCFs met national policies for water access, but WHO guidelines for environmental standards including water quality were not fully satisfied. Access to WASH services at the HCFs differed between staff and patients and caregivers. [ABSTRACT FROM AUTHOR]

Objective In the literature, there is no consistent classification of healthcare facilities. In order to benchmark, assess, and compare the environmental performance of these buildings, it is important to clearly identify the typology within the scope of a particular research. This article identifies the different typologies within the healthcare sector, particularly in Australia, with the aim of the development of energy performance benchmarks for day surgery/procedure centers. Background Healthcare buildings encompass a wide range of facilities. They all share the same purpose of healing and offering a health service for patients. However, they vary significantly in terms of patient type and service provided. These buildings consume a considerable amount of energy, and as a result of the different designs and sizes, their pattern of energy consumption varies. Methods The research used a systematic review of the literature to determine how the term “healthcare facility” has been employed in different contexts. In order to better understand the differences in healthcare facilities, definitions and the origin of hospitals and healthcare facilities are introduced and a framework for the classification of healthcare facilities and hospitals is proposed. Results Healthcare facilities are classified into the following six categories: patient type, care provided, management and ownership, level of care, facility size, and location. Based on these classifications, a categorization for the studies of energy performance in healthcare is introduced. Conclusions This study provides a basis for assessment and comparison for a particular healthcare building typology that will assist researchers working in the field of design and energy assessment of healthcare facilities. [ABSTRACT FROM AUTHOR]

Objective: identifying the knowledge level of the employees regarding the research policies of mid and high complexity healthcare facilities in the Aburra Valley, Colombia. Methodology: cross-section research, with surveys for 224 employees of the healthcare providing institutions of high (52) and mid (322) complexity, both public and private, in 2011. Results: regarding the knowledge about the existence of research policies, we found that it is higher in the employees of high complexity institutions (p = 0.000). Over 70% of the employees surveyed showed their interest in working on research projects. Conclusion: public high complexity healthcare facilities showed more developments on research and we found great interest of the employees of the health sector on research, regardless of the complexity level, the type of facility, and education level. [ABSTRACT FROM AUTHOR]

The condition of the physical environment within healthcare facilities has a large impact on the quality of care, recovery time, and patient satisfaction. To maintain and ensure adequate operation of the physical environment, facility management must maintain a state of continuous compliance and constant readiness. This requires the facility management personnel to have a full understanding of the regulatory standards and guidelines that address the performance of a healthcare facility. This paper discusses an analysis of the major healthcare standards and guidelines that the American Society of Healthcare Engineers suggests facility management groups need to be familiar with. A gap analysis is performed to identify gaps between the design and construction guidelines and their ability to support healthcare facility operation and performance standards. Finally, a case example is used to discuss how the standards and regulations can be incorporated into a healthcare facility information framework to support facility operations and performance compliance. [ABSTRACT FROM AUTHOR]

Effective facility management is a critical aspect of ensuring an adequate physical environment to administer care. Maintaining the environment is complicated with numerous critical systems because of occupants with compromised immune systems, and the need to maintain the systems with minimal effect on clinical operations. The complexity and importance of tasks that facility managers deal with require them to have adequate, up-to-date, and easily accessible information. This paper presents a case study that analyzes the impact of facility management on healthcare delivery. The work was completed in the preliminary stages of a research initiative for developing a lifecycle information management system to support facility management within healthcare. A case concerning mechanical systems and critical failures in a healthcare setting is analyzed to identify the types of information needed to adequately perform maintenance tasks. The information is then analyzed for origin along the lifecycle of the facility, its format, and suitable granularity. The aim of the discussed research is to support the development of a healthcare facility information management framework and product model. The product model and framework will aid in the efficient and effective management of facility and clinical information to support facility management activities in healthcare environments. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Information and Communication Technology (ICT) solutions (e.g. e-health, telemedicine, e-education) are often viewed as vehicles to bridge the digital divide between rural and urban healthcare centres and to resolve shortcomings in the rural health sector. This study focused on factors perceived to infl uence the uptake and use of ICTs as e-health solutions in selected rural Eastern Cape healthcare centres, and on structural variables relating to these facilities and processes. Attention was also given to two psychological variables that may underlie an individual's acceptance and use of ICTs: usefulness and ease of use. Recommendations are made with regard to how ICTs can be used more effectively to improve health systems at fi ve rural healthcare centres where questionnaire and interview data were collected: St. Lucy's Hospital, Nessie Knight Hospital, the Tsilitwa Clinic, the Madzikane Ka-Zulu Memorial Hospital and the Nelson Mandela General Hospital. [ABSTRACT FROM AUTHOR]

This review brings together, defines and illustrates some business and management techniques with the potential to enhance the running of the operating theatre. These include: quality improvement (including total quality management), benchmarking, project planning, business process reengineering and the use of databases and decision support systems. There are few reports in the academic healthcare literature of instances where these techniques have been applied in practice. We explore the reasons why this should be so. It is, however, possible to make some practical suggestions for those who wish to bring about change and improvement. We advocate that a theoretical framework is adopted to guide the process, and that repeated measurements are made to establish a baseline and track progress. Perhaps most importantly within healthcare, an appreciation of team dynamics and ‘hidden agendas’ within the workforce is vital, and engaging staff in the process early on, with open communication thereafter, is more likely to lead to success. [ABSTRACT FROM AUTHOR]

The salient phases in a facility’s service life that are most decisive for the effectiveness of its facilities management (FM) are the preliminary design, construction, and maintenance. The effectiveness of facilities is vastly affected by decisions pertaining to the strategy of the organization that owns or uses the facilities. The goal of this study was to develop key performance indicators (KPIs) for strategic FM that will provide a conclusive approach towards the facility’s service life conditions. Parameters were developed by means of field surveys and statistical analyses, and were validated by means of case studies. The research resulted in a series of 11 KPIs for strategic healthcare FM, which can be classified into four categories: development, organization and management, performance, and maintenance efficiency parameters. The study proposes age and occupancy coefficients as essential parameters for the assessment of large healthcare facilities needs, as an effective measure for long term facility maintenance planning, and for measuring FM effectiveness. The paper stresses that strategic healthcare facilities management must integrate quantitative performance, manpower, and maintenance indicators. [ABSTRACT FROM AUTHOR]

Background: While there has been a trend for greater number of women to deliver at health facilities across Tanzania, mothers and their family members continue to face mistreatment with respectful maternity care during childbirth being violated. The objective of this study was to describe the experience of mothers and fathers in relation to (mis) treatment during childbirth in Tanzania.Methods: Using a qualitative descriptive design, 12 semi-structured interviews and four focus group discussions were held with mothers and fathers who were attending a postnatal clinic in the Lake Zone region of Tanzania. Mothers' age ranged from 20 to 45 years whereas fathers' age ranged from 25 to 60 years. Data were analyzed using a priori coding based on Bohren's et al. typology of the mistreatment of women during childbirth.Results: Mothers reported facing mistreatment and disrespectful maternity care through verbal abuse (harsh or rude language and judgmental or accusatory comments), failure to meet professional standards of care (refused pain relief, unconsented surgical operations, neglect, abandonment or long delays, and skilled attendant absent at time of delivery), poor rapport between women and providers (poor communication, lack of supportive care, denied husbands presence at birth, denied mobility, denied safe traditional practices, no respect for their preferred birth positions), and health system conditions and constraints (poor physical condition of facilities, supply constraints, bribery and extortion, unclear fee structures). Despite some poor care, some mothers also reported positive birthing experiences and respectful maternity care by having a skilled attendant assistance at delivery, having good communication from nurses, receiving supportive care from nurses and privacy during delivery.Conclusion: Despite the increasing number of deliveries occurring in the hospital, there continue to be challenges in providing respectful maternity care. Humanizing birth care in Tanzania continues to have a long way to go, however, there is evidence that changes are occurring as mothers notice and report positive changes in delivery care practices. [ABSTRACT FROM AUTHOR]

The article discusses the concept of the focused factory model. Authors highlight that the focused factory model combines one of the key generic strategies and the ideas and concepts from manufacturing. The genesis of this model has its roots in trying to restore the competitive edge for manufacturing in the U.S. They assert that this model has much benefit for healthcare and, by applying such a model to the structuring of healthcare facilities, they can realize the benefits of this model that have been experienced in manufacturing.