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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]

Healthcare facilities (HCFs) such as hospitals, clinics, and health centres are recognized as the first and last line of defence against unfavourable impacts of climate change. This study examined the climate resilience and environmental sustainability (CRES) of HCFs in seven pilot provinces of Iran. In this regard, the action levels of HCFs were explored in four major areas, including health workforce; water, sanitation and healthcare waste; energy; and infrastructure, technologies and products. Analysis of conditions at HCFs in the studied areas demonstrated that energy; infrastructure, technologies, products; and water, sanitation and healthcare waste are at a low level, while the health workforce area is considered as a medium level. Among the various types of HCFs the highest CRES is related to hospitals, and the lowest is allocated to rural–urban health centres. Therefore, raising the level of awareness, training and empowering health workforces, optimizing the use of resources particularly water and energy, waste minimization, replacing fossil fuels with renewable energy, and promoting new systems and technologies can improve HCFs resilience in these centres. The results of this research led to the establishment of an effective tool for the evaluation of the CRES of HCFs. In addition, identifying HCFs conditions can help policymakers and health system officials in planning and managing appropriately to increase the level of CRES of these systems. [ABSTRACT FROM AUTHOR]

Background: On March 11, 2020, the World Health Organization (WHO) declared COVID-19 a pandemic, highlighting the virus's widespread impact across numerous countries. This study evaluated the economic challenges and their impact on the availability of Personal Protective Equipment (PPE) during the COVID-19 pandemic in Tanzania. It aimed to explore the challenges faced by healthcare facilities, the effects on PPE distribution, and the adaptive measures implemented in response to shortages. Methods: A qualitative cross-sectional survey was conducted between August 24 and October 3, 2022, in Dar es Salaam, Arusha, Dodoma, and Mwanza regions. A total of 96 participants from 24 healthcare facilities were recruited, ensuring equal representation across all four regions. Thematic analysis was applied for data analysis, and interviews were recorded using the Kobo Toolbox. Results: The majority of healthcare professionals indicated that the economic conditions within healthcare facilities were deemed unsatisfactory, whereas only a limited number expressed a differing opinion. When asked about the availability of PPE in their facilities, nearly all expressed dissatisfaction. Most of the respondents indicated a shortage of masks, which were identified as the most commonly utilized PPE for self-protection during the COVID-19 pandemic. Conclusions: This study underscores the insufficient availability of PPE and the widespread dissatisfaction with the economic conditions within healthcare facilities during the COVID-19 response, as reported by most of the participants. There is a critical need for enhanced financial support from the government to enable healthcare facilities to acquire necessary PPE. [ABSTRACT FROM AUTHOR]

ObjectiveTo understand the spatial distribution and influencing factors of secondhand smoke (SHS) exposure in healthcare facilities in China, and to provide a reference for the development of regional tobacco control strategies and measures in these facilities. MethodsData were collected from the 2022 China Adult Tobacco Survey, including relevant data from non-collectively residing Chinese residents aged ≥ 15 years old and above in 31 provinces (autonomous regions, municipalities) across the country. Geoda 1.22 statistical software was used to conduct spatial autocorrelation analysis and ordinary least squares (OLS) spatial regression model analysis to explore the main influencing factors of SHS exposure in healthcare facilities and their spatial heterogeneity. ResultsIn 2022, the SHS exposure rate in Chinese healthcare facilities was 13.6%. The regions with the lowest exposure rates were Shanghai city and Beijing city (exposure rates between 0% and 5%), and the region with the highest exposure rate was Jiangxi province (exposure rate between 25% and 30%). Global spatial autocorrelation analysis showed that the spatial distribution of SHS exposure rates in Chinese healthcare facilities in 2022 was positively correlated and spatially clustered (Moran′s I = 0.359, Z = 3.430, P = 0.002), indicating that regions with higher exposure rates were surrounded by regions with similarly high exposure rates. Local spatial autocorrelation analysis showed that Qinghai province, Sichuan province, Chongqing city, Guizhou province, Hunan province, and Hubei province were all in high-high cluster areas, Hebei province was in a low-low cluster area, and Xinjiang Uyghur Autonomous Region, Yunnan province, and Guangdong province were all in low-high cluster areas. OLS spatial regression model analysis showed that regions with a higher proportion of males (β = 23.878, t = 3.207, P = 0.003), a higher proportion of individuals aged 0 – 14 years (β = 0.751, t = 3.665, P < 0.001), a higher proportion of individuals aged 15 – 64 years (β = 0.929, t = 3.279, P = 0.003), a higher illiteracy rate (β = 0.675, t = 2.703, P = 0.011), a higher tobacco consumer price index (β = 2.563, t = 2.384, P = 0.024), and a lower proportion of cities with smoke-free legislation (β = 0.069, t = 2.119, P = 0.034) had higher SHS exposure rates in healthcare facilities.ConclusionsSHS exposure in Chinese healthcare facilities is mainly concentrated in central-south, southwest, and northwest China. Sex ratio, the proportions of individuals aged 0 – 14 years and 15 – 64 years, illiteracy rate, tobacco consumer price index, and the proportion of cities with smoke-free legislation are the main influencing factors of SHS exposure in healthcare facilities in China.

Abstract Digital technologies have been contributing to providing quality health care to patients. One aspect of this is providing accurate wait times for patients waiting to be serviced at healthcare facilities. This is naturally a complex problem as there is a multitude of factors that can impact the wait time. However, the problem becomes even more complex if the patient's journey requires visiting multiple stations in the hospital; such as having vital signs taken, doing an ultrasound, and seeing a specialist. The authors aim to provide an accurate method for estimating the wait time by utilising a real dataset of transactions collected from a major hospital over a year. The work employs feature engineering and compares several machine learning‐based algorithms to predict patients' waiting times for single‐stage and multi‐stage services. The Random Forest algorithm achieved the lowest root mean squared error (RMSE) value of 6.69 min among all machine learning algorithms. The results were also compared against a formula‐based system used in the industry, and the proposed model outperformed the existing model, showing improvements of 25.1% in RMSE and 18.9% in MAE metrics. These findings indicate a significant improvement in the accuracy of predicting waiting times compared to existing techniques.

Abstract Background Contaminated environmental surfaces play an important role in the transmission of pathogens that cause healthcare acquired infection (HAI). The present study aimed to assess the effect of enhanced cleaning techniques on bacterial contamination in high-touch areas compared to routine cleaning at the intensive care units (ICU) of the neurosurgery department of Alexandria Main University Hospital, Egypt. Methods The assessment of the knowledge and practices of healthcare cleaning workers and nurses was conducted through a questionnaire and an observational checklist. An educational program about enhanced cleaning was carried out for healthcare cleaning workers and nurses in one room of the ICU unit. Environmental surface swabs were taken from the two rooms of the ICU before and after cleaning (room A and room B). Room A was selected to apply the enhanced cleaning, and room B was selected for routine cleaning. Results A significant decrease in bacterial counts in the high-touch areas around the patients after the application of enhanced cleaning compared to routine cleaning (p

Real-Time Locating Systems (RTLS) have emerged as powerful tools for revolutionizing healthcare by improving patient safety, optimizing workflow efficiency, and enhancing resource management. From patient tracking to infection control and emergency response, RTLS offer a plethora of applications. Although challenges such as privacy and integration need to be addressed, the benefits of RTLS in healthcare remain undeniable. As technology continues to evolve, the future holds exciting possibilities for RTLS, paving the way for smarter, more efficient, and patient-centered care. [ABSTRACT FROM AUTHOR]

Introduction: In low- and-middle-income-countries (LMICs) like Ghana, universal access to quality healthcare remains a mirage and this undermines achievement of sustainable development goal (SDG) 3. The SafeCare Quality Improvement (QI) programme is an initiative of PharmAccess Foundation, a Netherlands-based non-governmental organisation (NGO). In 2009 SafeCare QI programme was launched in Ghana to help address gaps in healthcare quality standards, leveraging existing local resources. Over 600 private and public healthcare facilities are currently enrolled in the programme and is being adopted for nation-wide rollout by government of Ghana and implementing partners. Objective: This paper explored views and experiences of frontline health staff and policy makers on the SafeCare quality improvement programme in Ghana and how local resources were leveraged in its implementation. Methodology: Design/setting: The evaluation was conducted in 53 private and public healthcare facilities from seven administrative regions of Ghana across the coastal, middle, and northern geopolitical belts. The regions are Ashanti (n = 12), Bono East (n = 8), Bono (n = 3), Greater Accra (n = 12), Oti (n = 4), Savannah (n = 8) and Western (n = 9). Sampling: Quota and purposive sampling techniques were used to sample the healthcare facilities in accordance with the study eligibility criteria. Total of 45 focus group discussions (FGDs) and 47 individual in-depth interviews (IDIs) were conducted among frontline staff and policy makers from government and private local partner institutions. Analysis: Group and individual interviews were audio recorded, transcribed verbatim and thematic content analysis done using Nvivo (version 12.0) software. Findings: Overall, participants perceived the relevance and benefits of the SafeCare programme to be "very satisfactory" while the programme impact, rollout process and success were perceived to be "satisfactory". Quality healthcare standards were perceived to have improved in beneficiary health facilities due to participation in the SafeCare programme. Patient satisfaction, service utilisation and revenue generation in healthcare facilities were also attributed to the SafeCare programme. Proposals were made for harmonisation of existing QI assessment tools to mitigate duplications. Agreed data sharing protocols and interoperability with existing national database were also recommended to promote sustainability. Finally, low staff motivation, high workload, lack of financial and material resources were cited as potential impediments to full compliance with the SafeCare QI standards by healthcare facilities enrolled in the programme. Conclusions: SafeCare QI programme has contributed to QI and adherence to patient safety standards in Ghana. Sustainability is however dependent on continuous government commitment as the programme gets adopted as a national QI programme. Overlaps in content of QI assessment tools ought to be addressed to promote efficiency without compromising quality standards. The SafeCare programme demonstrates that health systems in LMICs have the potential to attain acceptable quality healthcare standards when they take advantage of existing local resources, including private-public partnership (PPP) and peer-learning opportunities. [ABSTRACT FROM AUTHOR]

Background: Contaminated environmental surfaces play an important role in the transmission of pathogens that cause healthcare acquired infection (HAI). The present study aimed to assess the effect of enhanced cleaning techniques on bacterial contamination in high-touch areas compared to routine cleaning at the intensive care units (ICU) of the neurosurgery department of Alexandria Main University Hospital, Egypt. Methods: The assessment of the knowledge and practices of healthcare cleaning workers and nurses was conducted through a questionnaire and an observational checklist. An educational program about enhanced cleaning was carried out for healthcare cleaning workers and nurses in one room of the ICU unit. Environmental surface swabs were taken from the two rooms of the ICU before and after cleaning (room A and room B). Room A was selected to apply the enhanced cleaning, and room B was selected for routine cleaning. Results: A significant decrease in bacterial counts in the high-touch areas around the patients after the application of enhanced cleaning compared to routine cleaning (p < 0.001) was observed. Gram-negative bacteria isolated from high-touch areas accounted for 45.6% of the samples collected before enhanced cleaning, and they became 16.3% after enhanced cleaning (p < 0.001), while they accounted for 40% after routine cleaning. The enhanced cleaning intervention in Room A resulted in a significant reduction in total infections, decreasing from 18 cases in the six months prior to the intervention to 11 cases in the six months following its implementation. (p < 0.05). Conclusion: The effect of enhanced cleaning was evident in decreasing bacterial counts in the high-touch areas around the patient and consequently in the records of the HAI rate inside the ICU. Clinical trial registration number: PACTR202402531001186, date: 15 February 2024, 'retrospectively registered'. [ABSTRACT FROM AUTHOR]

Purpose: Human resources in service organizations constitute the fifth crucial element of the marketing mix. This is also true in healthcare facilities, where medical services fundamentally rely on people. It is primarily these people that the client/patient seeks. Therefore, managing human capital in these facilities is a noteworthy element. The aim of this article is to examine the human resource management process and the related problems in selected healthcare facilities in the Silesian Voivodeship. This study is a pilot study, highlighting gaps and research issues in this thematic area. Design/methodology/approach: The study was based on targeted research. Custom-designed survey questionnaires were sent to healthcare facilities with a request for voluntary participation. The thematic scope was presented. The research tool was a custom-designed survey questionnaire. Contact with the facility was made through direct contacts with persons responsible for human resources in the facility. The study lasted from June 2 to July 4, 2024, and included employees from three healthcare facilities. Responses were obtained from several participants. Findings: The study can serve as a small contribution to creating the foundation for developing guidelines for healthcare facilities concerning human capital management. The study identified problematic areas and aspects of human capital management that require special attention. Additionally, it highlighted organizational elements of the facilities that are highly valued by employees. Research limitations/implications: This study should be expanded to include a significantly larger number of healthcare facilities, potentially covering all of Poland. This is due to the specific nature of healthcare systems and recruitment processes. However, the results concerning Poland could be compared with solutions from other European countries. Such an approach could help managers and employees understand the human capital management process not only at the recruitment stage but also at other stages of management. The main problem of the study was the relatively short data collection period and the weak response from entities and employees who could be included in the study. Practical implications: Help for managers. Social implications: Better management of healthcare facilities and their personnel leads to improved healthcare accessibility and thus to the overall health improvement of the population. A well-managed healthcare facility with well-conducted internal marketing can enhance job satisfaction, increase employee engagement, and improve the quality of customer/patient service. Originality/value: This study can help managers understand the necessity of properly implementing internal marketing and managing personnel effectively. There is relatively little literature specifically addressing this issue in Poland in recent years, especially in connection with internal facility marketing. [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]

BackgroundAntimicrobial resistance (AMR) is a growing concern globally and is notably prevalent in Kenya. The World Health Organization (WHO) Global Action Plan (GAP) and the Kenya National Action Plan (NAP) on AMR emphasize the need for effective antimicrobial stewardship (AMS) programs to combat AMR. The USAID-funded Medicines, Technologies, and Pharmaceutical Services (MTaPS) program has supported AMS implementation in 20 healthcare facilities (HCFs) in Nyeri, Kisumu, Murang’a, and Kilifi counties since 2019, focusing on developing and operationalizing AMS programs based on national, WHO, and Centres for Disease Control and Prevention (CDC) guidelines. However, there is paucity of information on how the AMS programs have been implemented in Nyeri and Kisumu Counties. This study evaluates the progress in AMS program implementation in these two counties between 2019 and 2023.MethodsBaseline and follow up assessments were conducted using a 33-item AMS questionnaire adapted from the CDC’s Core Elements of Hospital Antibiotic Stewardship Programs (CEHASP) and WHO guidelines. The assessment evaluated 13 thematic areas.ResultsAMS implementation showed significant improvements, with Nyeri county increasing from 12% to 76% and Kisumu from 17% to 78%. Several elements achieved 100% implementation in both counties, including core governance structures, accountability, and medical expertise. Education programs reached 88% implementation in Kisumu and 100% in Nyeri. Leadership support improved from 0% to 54% in Nyeri and from 0% to 60% in Kisumu. However, tracking antimicrobial use (AMU) and AMR through process measures remained the lowest implemented element (33% in Kisumu, 19% in Nyeri). Other challenges included limited microbiology services affecting antibiogram production, inadequate monitoring of adherence to treatment guidelines (0-7% implementation), and suboptimal implementation of policies and guidelines (48-58%).ConclusionsThese findings suggest that the implementation of antimicrobial stewardship programs (ASP) in resource-limited settings can be successful, as evidenced by the improvements in core governance, accountability, and medical expertise observed in the selected healthcare facilities. However, critical gaps remain in tracking antimicrobial use and resistance and monitoring treatment guideline adherence. To strengthen ASPs, we recommend establishing standardized national protocols for tracking and monitoring, developing regional laboratory networks to improve microbiology services access, and implementing electronic health records systems.

Abstract Environmental cleaning is essential to patient and health worker safety, yet it is a substantially neglected area in terms of knowledge, practice, and capacity-building, especially in resource-limited settings. Public health advocacy, research and investment are urgently needed to develop and implement cost-effective interventions to improve environmental cleanliness and, thus, overall healthcare quality and safety. We outline here the CLEAN Group Consensus exercise yielding twelve urgent research questions, grouped into four thematic areas: standards, system strengthening, behaviour change, and innovation.

Aim. To evaluate the influence of biological and socio-political emergencies on the safety of healthcare staff members. Materials and methods. The study used bibliosemantic, statistical, and mathematical methods, analyzing official statistical data on the healthcare system state in Ukraine. Results. While performing their functions in healthcare facilities, medical workers are exposed to the risk of negative effects from biological, psychophysiological, chemical, physical, and social harmful and hazardous factors. Adverse occupational factors in hospital environments exert a complex, combined, or concurrent effect, and its impact intensity can be enormously increased in various types of emergency situations. During the COVID-19 pandemic, a steep increase in occupational injuries in the national healthcare (in fact, by 30 times) has been documented, including due to the registration of acute infectious diseases among medical personnel at the workplace. Similar trends are also evidenced in indicators of lethal injuries, professional and occupationally induced morbidity. Furthermore, Ukraine has faced overlapping emergency situations of socio-political terms, caused by the full-scale aggression of the Russian Federation, and medical-biological problems caused by the COVID-19 pandemic, significantly complicating the state of affairs. According to official data, only in the first year of the full-scale invasion of Ukraine, about 1500 healthcare facilities were damaged, 106 medical workers died, including 33 at their workplace. Conclusions. The resilience of healthcare facilities to various types of emergency situations is an extremely important component of ensuring the hospital environment safety and, as practice shows, requires improvement. There is an urgent need to develop clear response algorithms for healthcare facilities to cope with emergency situations that could influence them. Reinforcing a safety culture in the national medical sector could become the goal and foundation for future strategies to create a safe hospital environment by improving and enhancing the safety culture.

Architectures for health have a crucial role in collectivity: according to international ranking scores (for example, CEOWorld Magazine’s Health Care Index), in Italy, there are very advanced and well-functioning healthcare services, even though many facilities are old and obsolete, unorganized, dilapidated, and sometimes unsafe. It has been estimated that 60% of facilities have been built more than 40 years ago. Recent studies suggest that the service life of hospitals should be set around 60 years; after reaching this age, the structure must be redesigned. The present contribution analyses this “rule of thumb” in relation to its impact on user perception. It adopts a Multi-Criteria Decision Analysis (MCDA) method to assess the importance users attribute to the quality of the structure and the personnel working there. Specifically, 9 criteria have been selected, including extrinsic and intrinsic features not directly associated with the abovementioned issues. With this approach in mind, we analyzed the 10 best Italian hospitals’ structures and the quality of treatments. The contribution highlights a significant methodological gap in identifying the relationship between building characteristics and their effects on the service, which are often treated as separate. Thus, the research proposes an innovative method by placing users at the center of the evaluation of priorities. This is particularly crucial in healthcare facilities where all the individuals (patients and staff) and the systems’ processes affect each other. This research line has several possible results; here, it preliminarily involves questioning the 60-year-old threshold for providing highquality services in hospitals.

Environmental cleaning is essential to patient and health worker safety, yet it is a substantially neglected area in terms of knowledge, practice, and capacity-building, especially in resource-limited settings. Public health advocacy, research and investment are urgently needed to develop and implement cost-effective interventions to improve environmental cleanliness and, thus, overall healthcare quality and safety. We outline here the CLEAN Group Consensus exercise yielding twelve urgent research questions, grouped into four thematic areas: standards, system strengthening, behaviour change, and innovation. [ABSTRACT FROM AUTHOR]

Hospitals are critical infrastructures that must remain operational during disasters, yet they often become disaster targets themselves. This study offers a global retrospective analysis of hospital disasters from 1976 to 2023, drawing on data from the Emergency Events Database (EM-DAT). Our methodology combines a historical data review with an evaluation of the impact of technological advancements, community awareness, governmental policies, and psychological support mechanisms on disaster mitigation. By categorizing disasters into collapses, explosions, and fires, we specifically examine incidents leading to significant human casualties and property damage. This retrospective study employs quantitative analysis to identify trends and patterns in hospital disasters, utilizing statistical methods to assess data categorization by EM-DAT and to evaluate the frequency, severity and geographical disparities of these incidents. A notable increase in hospital fires highlights an urgent need for improved safety standards and preparedness. Our analysis also reveals significant regional differences in hospital safety protocols, advocating for tailored preparedness strategies. Enhanced safety standards and disaster preparedness within healthcare facilities are imperative. We propose the development of comprehensive, region-specific preparedness strategies, informed by our findings, to mitigate the impact of future hospital disasters. Addressing these challenges necessitates a global, collaborative approach, emphasizing the role of international cooperation in fostering safer healthcare environments. [ABSTRACT FROM AUTHOR]

Having a consistent and readily available clean water supply is essential, not only for convenience but also to safeguard public health. While disruptions to the supply of clean water can impact communities of all kinds, some infrastructures and healthcare facilities are more vulnerable than others, such as those located in remote areas or within First Nations communities. This paper presents a case study of water disruption events within Sechelt and the First Nations community of Bella Bella, describing also the associated response efforts and lessons learned. Both events shared similar response activities, requiring the curtailing of normal water usage, the establishment of emergency operations centres, the sourcing of resources via supply chain or transportation partners, implementation of infection prevention and public health considerations, and collaboration with internal and external agencies. The learnings highlight a need for greater focus on building resiliency within healthcare facilities, especially those that serve remote or First Nations communities. The study also presents recommendations for water disruption response planning at the site and community level, and the establishment of non-centralised backup water systems. [ABSTRACT FROM AUTHOR]

Infrastructure for water, sanitation, hygiene, cleaning, and waste management is essential for supporting safe environmental conditions in healthcare facilities. Routine maintenance is important for preventing infrastructure breakdowns, but few studies have examined healthcare facility maintenance practices. This study documented environmental maintenance tasks in healthcare facilities in Niger, described bottlenecks to maintenance, and assessed strategies for coping with breakdowns. At 34 rural healthcare facilities in Niger, we conducted quantitative surveys to assess frequency of maintenance tasks and held qualitative interviews with healthcare facility staff to understand bottlenecks to maintenance. On at least a monthly basis, 4% of healthcare facilities inspected their water source and pump for the purpose of detecting and replacing worn parts, 15% inspected water taps and basins, and 29% inspected incinerators. Healthcare facility staff described barriers to accessing government funds for maintenance. Instead, they paid out of their own salaries or raised funds through appeals to community members or revenue generation initiatives. Other bottlenecks included ill-defined management responsibilities and difficulty of finding skilled technicians for maintenance. Findings highlight opportunities to support healthcare facilities in budgeting, advocacy, and training skilled technicians. Initiatives to install infrastructure at healthcare facilities will be more sustainable if they are accompanied by postconstruction planning, training, and funding for maintenance. [ABSTRACT FROM AUTHOR]

Hospitals, as institutions serving a diverse population, must address the needs of individuals with disabilities. While many nations prioritize a public health approach to hospital accessibility, this research contends that specialized strategies are vital to accommodate the complex requirements of all users. The study employs a mixed-method methodology. It encompasses an in-depth literature review on accessible design theories, cross-country comparisons of regulations in five nations (Greece, UK, USA, Australia, Sweden), and a survey evaluating existing accessibility within Greek hospitals. The review and cross-country comparisons underscore the pressing demand for specialized attention to wheelchair users and reveal a glaring absence of regulations catering to the visually and hearing impaired. The survey results illuminate a concerning trend of noncompliance with existing rules, underscoring the urgency for legislative actions and the establishment of international standards to ensure comprehensive accessibility. Although strides have been taken, strict adherence to regulations remains paramount. The research places paramount importance on social well-being and equity in healthcare access for individuals with disabilities. It is evident that individuals experience emotional difficulties when confronted with accessibility obstacles, underscoring the necessity to integrate emotional support into hospital design in conjunction with accessible design principles. The study aligns closely with the principles of equity, diversity, and inclusion, advocating for equal access to healthcare and specialized care for vulnerable populations. In conclusion, the research significantly contributes to the conference's overarching theme by delving into the intricate interplay between design, social well-being, and emotional health within healthcare facilities. The primary focus on the inclusion of individuals with disabilities serves as a driving force in the pursuit of a more equitable and accessible healthcare landscape. [ABSTRACT FROM AUTHOR]

Romania’s healthcare system faces persistent regional disparities, shaped by historical governance structures, economic inequalities, and systemic inefficiencies. This study analyzes the evolution of healthcare facilities across development regions during two key periods: before European Union (EU) integration in 2007 and after 2017. Using statistical data from Eurostat, the National Institute of Statistics (INS), and other sources, the article presents a detailed comparison of healthcare infrastructure across regions. The findings reveal persistent inequalities, despite modernization efforts driven by EU funding. The study highlights critical areas for policy intervention to address these disparities and promote equitable healthcare access. [ABSTRACT FROM AUTHOR]

Aim. To evaluate the influence of biological and socio-political emergencies on the safety of healthcare staff members. Materials and methods. The study used bibliosemantic, statistical, and mathematical methods, analyzing official statistical data on the healthcare system state in Ukraine. Results. While performing their functions in healthcare facilities, medical workers are exposed to the risk of negative effects from biological, psychophysiological, chemical, physical, and social harmful and hazardous factors. Adverse occupational factors in hospital environments exert a complex, combined, or concurrent effect, and its impact intensity can be enormously increased in various types of emergency situations. During the COVID-19 pandemic, a steep increase in occupational injuries in the national healthcare (in fact, by 30 times) has been documented, including due to the registration of acute infectious diseases among medical personnel at the workplace. Similar trends are also evidenced in indicators of lethal injuries, professional and occupationally induced morbidity. Furthermore, Ukraine has faced overlapping emergency situations of socio-political terms, caused by the full-scale aggression of the Russian Federation, and medical-biological problems caused by the COVID-19 pandemic, significantly complicating the state of affairs. According to official data, only in the first year of the full-scale invasion of Ukraine, about 1500 healthcare facilities were damaged, 106 medical workers died, including 33 at their workplace. Conclusions. The resilience of healthcare facilities to various types of emergency situations is an extremely important component of ensuring the hospital environment safety and, as practice shows, requires improvement. There is an urgent need to develop clear response algorithms for healthcare facilities to cope with emergency situations that could influence them. Reinforcing a safety culture in the national medical sector could become the goal and foundation for future strategies to create a safe hospital environment by improving and enhancing the safety culture. [ABSTRACT FROM AUTHOR]

Healthcare facilities consist of multiple large buildings with complex energy systems and high energy consumption, resulting in high carbon emissions. The increasing trend in energy consumption of these facilities and the process of selecting an energy supplier from the open market requires reliable and robust energy forecasting studies. This situation calls for the use of reliable and accurate energy consumption prediction models for the energy needs of healthcare buildings. The aim of this study is to present a prediction framework based on historical energy consumption at different time intervals using six supervised regression algorithms, three linear single, one non-linear single and two non-linear ensembles. The approach adopted for predicting hospital energy consumption involves five steps: data acquisition, data pre-processing, data prediction, hyper-parameter optimisation and feature analysis. Furthermore, all regression algorithms have undergone hyper-parameter optimisation using random search, grid search and Bayesian optimisation to achieve the minimum prediction errors represented by different metrics. The results displayed that the two ensemble models, Extreme Gradient Boosting and Random Forest, outperformed single models in hourly, daily, and monthly energy load prediction. Nevertheless, when considering the computational time for all regression models, the single models have better computational times, although the error metrics are not as good as for the ensemble models. In addition, grid search and Bayesian optimisation performed better than random search in finding optimal hyperparameter values for all datasets. Finally, thanks to feature importance analysis, the most influential features under the hourly, daily, and monthly electrical and monthly natural gas prediction were identified. [ABSTRACT FROM AUTHOR]

Geographical accessibility is important for promoting health equity, and calculating it requires the locations of all existing healthcare facilities in a region. Authoritative location data collected by governments is accurate but mostly not publicly available, while point-of-interest (POI) data from online sources, such as Baidu Maps and AutoNavi Maps are easily accessible. However, the accuracy of the latter has not been thoroughly analyzed. Taking Baotou, a medium-sized city in China, as aneample, we assessed the suitability of using POI data for measuring geographic accessibility to healthcare facilities.We computedthe difference of geographic accessibility calculated based on POI data and that on authoritative data.Logistic regression and a multiple linear regression model was applied to identify factors related to the consistency between the two data sources. Compared to authoritative data, POI data exhibited discrepancies, with completeness of 54.9% and accuracy of 63.7%. Geographic accessibility calculated based on both data showed similar patterns, with good consistency for hospitals and in urban areas. However, large differences (>30 minutes) were shown in rural areas for primary healthcare facilities. The differences were small regarding to population- weighted average accessibility (with slight underestimation of 3.07 minutes) and population coverage across various levels of accessibility (with differences less than 1% of the population) for the entire area. In conclusion, POI data can be considered foruse in both urban areas and at the level of entire city; however, awareness should be raised in rural areas.

Summary: Background: Infection prevention and control (IPC) helps prevent disease transmission in healthcare facilities. There is a dearth of information on the implementation of IPC during the COVID-19 outbreak in Cameroon using the recommended WHO COVID-19 IPC scorecard tool. The present study assessed healthcare facilities' compliance to IPC by continuous assessments, with an evaluation of the tool using the hierarchy of control theory. Methods: This cross-sectional study was conducted in the 10 administrative regions of Cameroon by evaluating healthcare facilities prioritized by the Ministry of Public Health as high-risk facilities between March 2020 and November 2023. Comparisons were made regarding the facilities' ownership, level and status. Results: 2,188 assessments from 1,358 healthcare facilities were collected. The median IPC scores at each evaluation were between the intermediate and advanced level, with a bias linked with decreasing selection of facilities. However, only 172 (13%) healthcare facilities achieved advanced IPC score (≥75%). Higher IPC scores were found in hospitals (p

Healthcare facilities often face long queues and extended waiting times, disrupting the service process and increasing the risk of spreading infectious diseases. To address these challenges, this study utilized Scrum methodology to develop a Doctor Appointment application based on the Progressive Web Application (PWA). System usability testing uses the System Usability Scale (SUS) to ensure user-friendliness. The application includes doctor schedules, appointment booking, service status checking, and a visit history review. It is integrated with the Emesys system from PT Bigs Integrasi Teknologi, which serves as the case study location. The implementation of Scrum involved various stakeholders, including end-users, leading to improved team coordination and accountability through five planned sprints. The SUS testing results showed an average score of 78.58 from 30 respondents, indicating a high level of usability approaching the excellent category. This suggests that users are satisfied with the ease of use and overall application experience. However, further evaluation revealed that users may require some time to adapt to the application.

BackgroundIn resource-limited areas, especially in conflict-affected settings, managing the risk of hospital-acquired infections is difficult due to the destruction of essential facilities in healthcare settings. The study aimed to assess adherence to Infection prevention practices and associated factors among healthcare workers in Northeastern Ethiopia following the Northern Ethiopia conflict.Methods and materialsA facility-based cross-sectional study was done with 408 healthcare workers. The survey data was collected using a structured questionnaire based on published articles. Data entry and analysis was done using Epi-Data version 4.6 and SPSS version 25.0, respectively. Binary logistic regression was used to determine the association between dependent and outcome variables, with a cut-off p value 0.05 at 95% confidence interval with a p-value less than 0.05 and a 95% confidence interval for determining factors associated with adherence to infection prevention practices among study participants.ResultsThe study included 408 healthcare workers with a response rate of 96.7%. The majority of participants were women 206 (50.5%), married 250 (61.3%), Orthodox followers 211 (51.7%), and educational status of master holder and above with a master’s degree or higher 177 (43.4%). Slightly more than half, 53.7% (219) of the respondents demonstrated safe infection prevention practices. Respondents who received training on infection prevention practices (AOR = 2.662, 95% CI: 1.361, 5.120) had an active infection prevention committee (AOR = 2.203, 95% CI: 1.359, 3.572), use infection prevention guidelines in working departments (AOR = 2.090, 95% CI: 1.013, 4.312), and access to adequate personal protective equipment (AOR = 2.773, 95% CI: 1.560, 4.929) were factors significantly associated with adherence to infection prevention practices.ConclusionOverall, only half of the respondents practiced safe infection prevention practices. Receive training on infection prevention guidelines, presence of active infection prevention committee and working guidelines, and the availability of personal protective equipment were factors of infection prevention. Hence, essential facilities like Personal protective equipment, working guidelines should be supplied by donors.

INTRODUCTION: Malawi is rapidly closing the gap in achieving the UNAIDS 95-95-95 targets, with 90% of people living with HIV in Malawi aware of their status. As we approach epidemic control, interventions to improve coverage will become more costly. There is, therefore, an urgent need to identify innovative and low-cost strategies to maintain and increase testing coverage without diverting resources from other HIV services. The objective of this study is to model different combinations of facility-based HIV testing modalities and determine the most cost-effective strategy to increase the proportion of men and youth testing for HIV. METHODS: A data-driven individual-based model was parameterized with data from a community-representative survey (socio-demographic, health service utilization and HIV testing history) of men and youth in Malawi (data collected August 2019). In total, 79 different strategies for the implementation of HIV self-testing (HIVST) and provider-initiated-testing-and-counselling at the outpatient department (OPD) were evaluated. Outcomes included percent of men/youth tested for HIV in a 12-month period, cost-effectiveness and human resource requirements. The testing yield was assumed to be constant across the scenarios. RESULTS: Facility-based HIVST offered year-round resulted in the greatest increase in the proportion of men and youth tested in the OPD (from 45% to 72%-83%), was considered cost-saving for HIVST kit priced at $1.00, and generally reduced required personnel as compared to the status quo. At higher HIVST kit prices, and more relaxed eligibility criteria, all scenarios that considered year-round HIVST in the OPD remained on the cost-effectiveness frontier. CONCLUSIONS: Facility-based HIVST is a cost-effective strategy to increase the proportion of men/youth tested for HIV in Malawi and decreases the human resource requirements for HIV testing in the OPD-providing additional healthcare worker time for other priority healthcare activities.

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Due to the pandemic, the entire staff employed in healthcare institutions were directly exposed to longer working hours and unstable working conditions. Based on these facts, the research in this article aims to find out more about employees' satisfaction with working conditions and management's engagement in preserving their health and safety. Thus, a multiple-criteria decision analysis (MCDA) model based on the analyzed attitudes and opinions of employees was formed to reveal the interdependencies between working conditions resulting from the undertaken management activities, employee satisfaction and workplace safety. The results show that both nurses and drivers were least satisfied with working conditions during the pandemic while indicating those workplaces to be the most endangered. Additionally, the proposed model can be successfully applied to any type of organization to identify insufficiently effective management activities, address them accordingly and thereby improve the level of employee satisfaction. [ABSTRACT FROM AUTHOR]

Drug planning is essential to ensure the fulfillment of the right type, amount, and time criteria. Forecasting can be utilized during the planning stage to predict future drug needs. Perfect forecasting is impossible due to uncertainties in various factors, necessitating selecting the best method. This study aimed to identify the optimal forecasting method for healthcare facilities based on the smallest Mean Absolute Deviation (MAD), Mean Square Error (MSE), and Mean Absolute Percent Error (MAPE) values obtained from forecasting results using time series methods like Single Moving Average (SMA), Weight Moving Average (WMA), (Single Exponential Smoothing) SES, Double Exponential Smoothing (DES), and Triple Exponential Smoothing (TES). This research involved a descriptive observational study with retrospective data and adhered to PRISMA guidelines. PubMed, Google Scholar, and Garuda served as the data sources. Nine articles meeting the eligibility criteria were employed. The findings revealed that the SES, DES, and TES methods produced forecasts with MAPE values below 10%, indicating highly accurate forecasting. The MAPE values for the SMA and WMA methods were less than 50%, which is still acceptable. Therefore, the ES methods, particularly SES, are highly recommended for accurate drug planning. Forecasting accuracy factors include data stability, pattern consistency, and smoothing constants. The SES method emerged as the best forecasting method, generating the smallest MAD, MSE, and MAPE values compared to other methods, falling below 10%, reflecting highly accurate forecasting. [ABSTRACT FROM AUTHOR]

The aim of this paper is to present the evolution of Digital Health (DH) in Brazil, in relation to the adoption of DH as a basis for the development of public policies, with a focus on improving the delivery of health care to patients and expanding its coverage. Data from the ICT in Health survey from the Regional Centre for Studies on the Development of the Information Society (Cetic.br) were analysed. The main challenges identified are related to gaps in patient information, which requires interaction between different facilities and to more complex functionalities related to guidelines and guidance in patient care. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Location or distance from healthcare facilities affects the use of health facilities by households. The use of health facilities also have an impact on the socioeconomic conditions. Distance from healthcare facilities significantly affects catastrophic health expenditures. This study aimed to determine the association of physical distance to healthcare facilities with the economic deprivation of households. OBJECTIVE: This study aims to analyze the distance of healthcare facilities from households in different wealth index categories of Odisha. The study argues that the household wealth index is associated with the distance to healthcare facilities. METHODOLOGY: This study is based on six purposively selected districts in Odisha: Rayagada, Kalahandi, Angul, Keonjhar, Khordha, and Kendrapara in India. A cross-sectional household survey was conducted to collect the data. A total of 902 household data points were collected. Data analysis was carried out using SPSS version 25. RESULTS: A difference is observed among households that need to travel more than one hour to reach a private doctor or private hospital: 42.6% of poor households face this challenge, whereas only 25% of wealthy households do. Among those who cannot reach a public hospital in less than an hour, a larger proportion are from poor households (62.6%). The poor and wealthy segments of the population have nearly equal access to NGO-run healthcare facilities in terms of proximity. We observe that poor households are less likely than wealthy households to reach private pharmacists in less than an hour and are more likely to require over an hour to reach them. CONCLUSION: Ensuring healthcare facilities is the minimum requirement within one hour of reach for every household in India. Underreporting of illnesses and diseases is one of the major factors of high mortality in the population. Physical accessibil ity to healthcare facilities can reduce the mortality burden on the population. [ABSTRACT FROM AUTHOR]