Assessment of Wayfinding Performance in Complex Healthcare Facilities: A Conceptual Framework

Wayfinding is considered to be one of the most demanding challenges to be performed by hospitals’ users. Wayfinding has been an interest among researchers from different fields, such as architecture, interior design, cognitive psychology, and facilities management, to name a few. Previous scholars have highlighted the need for a holistic framework taking into consideration both user and environmental factors. A narrative review of the literature was carried out to understand the full extent of the issue and address the ever-increasing demand for a holistic assessment framework. This article attempts to address the underlying gap by proposing a comprehensive framework that takes into account both facets of the issue through a narrative review of the literature to some of the most prominent research attempts to address the problem of wayfinding in complex healthcare settings. Furthermore, the proposed framework can assist both researchers and practicing professionals by providing a comprehensive understanding of the issue of complex wayfinding as well as of the variables to be investigated in the assessment process

A User-Centered Evaluation of Wayfinding in Outpatient Units of Public Hospitals in Malaysia: UMMC as a Case Study

The difficulty of finding one’s way in a complex structure has been a long-standing issue of many buildings with highly institutionalized functions. This has been especially observed in hospital buildings as an issue that can cause various adverse outcomes for both the institution and the user. Therefore, regular evaluation of the existing wayfinding system and its efficacy is needed. This study aimed to evaluate the wayfinding system efficacy in an outpatient unit of a Malaysian public hospital in order to provide information that could help guide future upgrade initiatives for existing healthcare facilities’ wayfinding systems. This study employed a user survey questionnaire to evaluate the wayfinding system currently in use and investigate users’ needs for a better wayfinding system. The statistical analysis of the gathered data indicated a higher than average level of dissatisfaction regarding the existing wayfinding system. The findings of the study suggest the need for an upgrade in the physical environment. Furthermore, the results of this study suggest the need to devise a set of guidelines to be employed when designing wayfinding systems in Malaysia’s public hospitals

A case study to examine undergraduate students’ intention to use internet of things (IoT) services in the smart classroom

Recently, the education sector has received increased interest in terms of the adoption of Internet of things (IoT) services for learning activities. However, despite this interest, empirical studies on the adoption of IoT services in the smart classroom are limited. Thus, the present study examines students’ intention to use IoT services in the smart classroom. Towards this end, an integrated model based on the technology acceptance model (TAM), technology readiness index (TRI), and external factors (enjoyment, compatibility, and self-efcacy) is proposed. A quantitative research design was therefore used to determine the factors that afect students’ intention to use IoT services in the smart classroom, using a sample of 230 participants. The fndings showed that compatibility, discomfort, enjoyment, and self-efcacy had a signifcant infuence on both perceived ease of use (PEoU) and perceived usefulness (PU). Furthermore, innovativeness had a signifcant efect on PEoU, and insecurity had a signifcant impact on PU. The results also revealed that PU had a signifcant infuence on the students’ behavioural intention to use. These fndings extend the understanding of students’ intention to use IoT services in the smart classroom. This study could be benefcial to researchers, educators, and IoT developers. However, it also presents a number of limitations, such as a lack of qualitative methods and the small number of theories applied

The Effects of Colour Content and Cumulative Area of Outdoor Advertisement Billboards on the Visual Quality of Urban Streets

Visual comfort has a critical effect that significantly influences public appreciation of urban environments. Although colour is an integral part of billboard design, little empirical evidence exists to support some of the popularly held ideas about the effects of colour on task performance and human psychological wellbeing. Thus, attempting to set a threshold level of allowed undesirable visual stimuli in each urban setting is considered to be essential in achieving a satisfactory level of visual quality. Therefore, this research investigates the effects of colour content of outdoor advertisement billboards on the appreciation of urban scenes by the public. This research utilises pictorial survey, R.G.B bivariate histogram technique, and an areal cumulative analysis of a group of collected pictures within one of Kuala Lumpur’s high streets. Results of the pictorial survey are cross analysed against the results of the pictorial RGB content analysis and pictorial outdoor advertisement (OA) cumulative areal analysis to indicated a strong correlation between environmental colour content, OAs’ cumulative area, and visual comfort. The study suggests that the lack of guidelines and regulations of the color content of outdoor billboard advertisement design could potentially be detrimental for the public’s appreciation of urban environments. Future research initiatives are encouraged to develop a visual quality assessment framework that contributes to the image and identity of the city of Kuala Lumpur

Enhancing Wayfinding Performance in Existing Healthcare Facilities Using Virtual Reality Environments to Revise the Distribution of Way-Showing Devices

Wayfinding is the process of navigating the environment by using the available environmental cues. The issue of wayfinding difficulty in large healthcare facilities has grabbed the attention of many researchers in terms of its potential taxing effects on both users and institutions alike. While the challenge of regulating the process of designing wayfinding systems is still an active field of investigation, there has been a paucity of research addressing the challenge of distributing way-showing items based on users’ performance within healthcare environments. This study proposes a wayfinding enhancement scheme whereby users’ wayfinding performance data forms the basis of the process of distributing way-showing items within an outpatient unit in Malaysia. Furthermore, two virtual reality experiments were carried out, the first representing the existing wayfinding system and the second representing the new distribution. A cross-comparison between the two sets of results was conducted to evaluate the effect resulting from altering the as-built wayfinding system. The results indicated an overall reduction of time consumed to reach the same destinations as well as lesser distances traveled within the environment resulting from the implementation of the new distribution. This study puts forward the concept of implementing virtual reality environments to address wayfinding systems’ design challenges in healthcare facilities rather than relying on designers’ intuition

Global Incidence and Risk Factors Associated With Postoperative Urinary Retention Following Elective Inguinal Hernia Repair

Importance Postoperative urinary retention (POUR) is a well-recognized complication of inguinal hernia repair (IHR). A variable incidence of POUR has previously been reported in this context, and contradictory evidence surrounds potential risk factors.Objective To ascertain the incidence of, explore risk factors for, and determine the health service outcomes of POUR following elective IHR.Design, Setting, and Participants The Retention of Urine After Inguinal Hernia Elective Repair (RETAINER I) study, an international, prospective cohort study, recruited participants between March 1 and October 31, 2021. This study was conducted across 209 centers in 32 countries in a consecutive sample of adult patients undergoing elective IHR.Exposure Open or minimally invasive IHR by any surgical technique, under local, neuraxial regional, or general anesthesia.Main Outcomes and Measures The primary outcome was the incidence of POUR following elective IHR. Secondary outcomes were perioperative risk factors, management, clinical consequences, and health service outcomes of POUR. A preoperative International Prostate Symptom Score was measured in male patients.Results In total, 4151 patients (3882 male and 269 female; median [IQR] age, 56 [43-68] years) were studied. Inguinal hernia repair was commenced via an open surgical approach in 82.2% of patients (n = 3414) and minimally invasive surgery in 17.8% (n = 737). The primary form of anesthesia was general in 40.9% of patients (n = 1696), neuraxial regional in 45.8% (n = 1902), and local in 10.7% (n = 446). Postoperative urinary retention occurred in 5.8% of male patients (n = 224), 2.97% of female patients (n = 8), and 9.5% (119 of 1252) of male patients aged 65 years or older. Risk factors for POUR after adjusted analyses included increasing age, anticholinergic medication, history of urinary retention, constipation, out-of-hours surgery, involvement of urinary bladder within the hernia, temporary intraoperative urethral catheterization, and increasing operative duration. Postoperative urinary retention was the primary reason for 27.8% of unplanned day-case surgery admissions (n = 74) and 51.8% of 30-day readmissions (n = 72).Conclusions The findings of this cohort study suggest that 1 in 17 male patients, 1 in 11 male patients aged 65 years or older, and 1 in 34 female patients may develop POUR following IHR. These findings could inform preoperative patient counseling. In addition, awareness of modifiable risk factors may help to identify patients at increased risk of POUR who may benefit from perioperative risk mitigation strategies

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population