A comparative evaluation of internal medicine wards in spain

Objective – This analysis investigates the functional and environmental quality of several internal medicine wards in Spain. Background – Despite the economic recession, the Spanish healthcare system has proven to be resilient. In the near future, Spain will be faced with the demographic challenge of an ever-ageing population. Further efforts should be made to ensure a sustainable and affordable healthcare system. The elderly population is the group that requires the highest rates of healthcare resources, especially in acute-care hospitals, with the maximum hospital attendances and the longest average length of stay. Since there is scientific evidence that links healthcare outcomes with design (evidence-based-design), one way of improving the efficiency of healthcare delivery is by enhancing the quality of existing internal medicine wards as it is usually the place where the elderly inpatients are cared for. Post-Occupancy- Evaluation (POE) tools have been used globally to assess the performance of existing buildings but little has been applied in the Spanish context. Research question – How well do existing internal medicine wards perform in relation to guidelines and research on functional and environmental quality? Methods – Both quantitative and qualitative methods have been used in this case study for the triangulation of data. Four internal medicine wards have been evaluated with the following methods: architectural layout analysis, photo analysis and a POE tool designed for the Spanish context (CURARQ-H). Results – Not surprisingly, the oldest ward scores lower than the most recent buildings. The analysis reveals that the patients’ area is the one that gets better grades while the access area scores the lowest marks. Further details on improvement measures are given for each ward area. Conclusion – Compared to Scandinavia, USA or Canada, healthcare architecture in Spain is being slow to embark on EBD. This evaluation method together with CURARQ-H tool could be an enabler for generating synergies between healthcare staff and architects in Spain and work as an accelerator in the use of EBD at a national level.publishedVersio

LEVERAGING BLOCKCHAIN TECHNOLOGY FOR SLA ENFORCEMENT IN HEALTH CARE CLOUD PARTNERSHIPS

The healthcare industry is rapidly adopting cloud-based solutions to improve operational efficiency and patient outcomes. However, healthcare cloud partnerships often face challenges related to the lack of scalability, trust, and Service Level Agreement (SLA) enforcement, and has a notable impact on consumer care quality. To address this issue, the study proposed leveraging blockchain technology to enhance SLA enforcement by using smart contracts in health care cloud partnerships for small and medium-sized facilities. The research questions were: Q.1 What are the current challenges facing small to medium sized healthcare facilities in enforcing SLAs in cloud partnerships? Q.2 How can BC-based smart contracts helps enhance scalability in cloud computing systems in healthcare SMEs by enforcing Service Level Agreements (SLAs) in a safe and efficient manner? Q.3 What are the factors that affect the implementation of blockchain-based smart contracts for SLA enforcement in healthcare SMEs cloud partnerships? The project utilized case studies to demonstrate the effectiveness of using BC technology based smart contracts to enhance SLA enforcement and improve patient outcomes. The findings and conclusions were as follows: 1. Current challenges facing healthcare SMEs in enforcing SLAs in cloud partnerships: SMEs may lack bargaining power, resources, and technical expertise to effectively negotiate, monitor, and enforce SLAs in cloud partnerships, leading to service disruptions, compliance issues, and financial losses. 2. BC-based smart contracts can enhance the scalability of cloud computing systems in healthcare SMEs by automating SLA execution, ensuring real-time data integrity, transparency, and accountability, reducing fraud, error, and transaction costs, and enabling decentralized trust among stakeholders. 3. Factors affecting the implementation of BC-based smart contracts to better SLA enforcement in healthcare SMEs cloud partnerships: regulatory uncertainty, interoperability, standardization, privacy, security, cost, complexity, governance, and user adoption, and 4. Unique Trends and challenges in the healthcare industry for its data analysis: increasing demand for real-time, patient-centered, personalized, and evidence-based care, generating and integrating large volumes of diverse and complex data from multiple sources, ensuring data quality, privacy, and security, complying with regulations and standards, and fostering collaboration and innovation across stakeholders. MedRec, SimplyVital Health, and Medical Chain demonstrate how BC provides secure data sharing, encryption and access control mechanisms, and promotes interoperability through standard data formats and protocols. Results showed improved scalability, trust, and SLA enforcement with the use of BC technology. Further research in the other domains of this area is recommended. It is required to address broader aspects related to the topic. The areas for further study that emerged from the findings and conclusions of this project include: 1. interoperability,2. trusted monitoring solutions, 3.user experience, 4. privacy and security,5. med tokens, cost and 6. integration with existing BSS and OSS. Keywords: Cloud computing, Blockchain technology, SLA enforcement, Smart Contracts, Healthcare cloud, Blockchain-based SLA enforcement, Smart Healthcare, e-healthcare, Scalability

Challenges and Insights in Inter-Organizational Collaborative Healthcare Networks: An Empirical Case Study of a Place-Based Network

Purpose Public sectors have responded to grand societal challenges by establishing Collaboratives – new inter-organisational partnerships to secure better quality health services. In the UK, a proliferation of collaboration-based healthcare networks exists that could help to both enhance the value of investments in quality improvement programmes. The nature and organisational form of such improvements is still a subject of debate within the public-sector literature. Placed-based collaboration has been proposed as a possible solution. In response, this research paper presents the results and findings of a placed-based collaborative network, highlighting challenges and insights. Design/methodology/approach This study adopted a social constructionist epistemological approach, using a qualitative methodology. A single case study was used, and data collected in three different stages over a two-year period. Findings The study finds that leadership, data-enabled learning through system-wide training and development, and the provision of an enabling environment that is facilitated by an academic partner, can go a long way in the managing of healthcare networks for improving quality. Research limitations/implications Regardless of the tensions and challenges with placed-based networks, they could still be a solution in maximising the public value required by government investments in the healthcare sector since they offer a more innovative structure that can help to address complex issues beyond the remit of hierarchical structures. This research is limited by the use of a single case study. Practical implications Across countries health systems are moving away from markets to collaborative models for health care delivery and from individual services to population based approaches. This paper provides insights to inform leaders of collaborative health models in the design and delivery of these new collaborations. Social implications As demand rises (as a result of increasing complexity and demographics) in the western world, health systems are seeking to redefine the boundaries between health service provision and community self-reliance and resilience. This paper provides insights into the new partnership between health institutions and communities, providing opportunities for more social-based and solidarity-based healthcare models which place patients and the public at the heart of change

Web-Based Application for Toddler Nutrition Classification Using C4.5 Algorithm

Health is something that is important for everyone, from year to year various efforts have been developed to get better and quality health. Good nutritional status for toddlers will contribute to their health and also the growth and development of toddlers. Fulfillment of nutrition in children under five years old (toddlers) is a factor that needs to be considered in maintaining health, because toddlerhood is a period of development that is vulnerable to nutritional problems. There are more than 100 toddler data registered at the Integrated Healthcare Center in Peresak Village, Narmada District, West Lombok Regency. The book contains data on toddlers along with the results of weighing which is carried out every month. However, to classify the nutritional status of toddlers, they are still going through the process of recording in a notebook by recording the measurement results and then looking at the reference table to determine their nutritional status. This method is still conventional or manual so it takes a long time to determine the nutritional status. Therefore, the solution in this study is to develop a web-based application for the classification of the nutritional status of children under five using the C4.5 method. The stages of this research consisted of problem analysis, collection of 197 instances of nutritional status datasets obtained from Integrated Healthcare Center Presak, analysis of system requirements, use case design, implementation using the C4.5 method, and performance testing based on accuracy, sensitivity, and specificity. The results of this study are a website-based application for the classification of the nutritional status of children under five using the C4.5 method. The performance of the C4.5 method in the classification of the nutritional status of toddlers using testing data as much as 20% gets an accuracy of 95%, sensitivity of 100%, and specificity of 66.6%. Thus, the C4.5 method can be used to classify the nutritional status of children under five, because it has a very good performance

Restorative servicescapes in health care: examining the influence of hotel-like attributes on patient well-being

This study examines how 527 patients across different health states assessed the influence of hotel-like attributes on their well-being. Using theoretical mechanisms of attention restoration underlying restorative servicescapes, we postulated that hotel-like products and services will enhance patients’ perceived well-being, which, in turn, will favorably affect their behavioral intentions. We also tested an alternative model that included additional direct relationships between hotel-like products and services and behavioral intentions, based on the tenets of cue utilization theory. After conducting a series of nested model comparison procedures, we confirmed that the alternative model provided a theoretically and empirically stronger explanation for the dynamics of hotel-like restorative servicescapes. Although the differences between less healthy and more healthy patients were not statistically significant, the less healthy group demonstrated the same pattern of relationships as in the overall model, indicating that such patients may be more likely to derive greater restorative benefits from hotel-like hospital rooms, which may also make them more likely to pay higher out-of-pocket expenses for such rooms. The study furthers the empirical research agenda on evidence-based design (EBD) and the role of hospitality in health care.Accepted manuscrip

Evaluation of the personal health budget pilot programme

1. The personal health budget initiative is a key aspect of personalisation across health care services in England. Its aim is to improve patient outcomes, by placing patients at the centre of decisions about their care. Giving people greater choice and control, with patients working alongside health service professionals to develop and execute a care plan, given a known budget, is intended to encourage more responsiveness of the health and care system. 2. The personal health budget programme was launched by the Department of Health in 2009 after the publication of the 2008 Next Stage Review. An independent evaluation was commissioned alongside the pilot programme with the aim of identifying whether personal health budgets ensured better health and care outcomes when compared to conventional service delivery and, if so, the best way for personal health budgets to be implemented

Colorado Children's Healthcare Access Program: Helping Pediatric Practices Become Medical Homes for Low-Income Children

Describes a nonprofit improving access to care for children enrolled in Medicaid by helping pediatric practices become medical homes, offering administrative support, and assisting with referrals to community groups and agencies. Includes lessons learned