Flexible and adaptable hospitals – Australian case studies

In 2009, a literature review uncovered different international approaches to achieving flexible and adaptable health facilities and concluded by recommending further research focussing on Australian hospitals to identify key site issues, design features, and major upgrades that have influenced longer term responses to changing modes of service delivery and other demands in local settings. Responding to these recommendations, this second stage research was conducted by reviewing further relevant literature and project documentation for five case studies, visiting and documenting key adaptability features of each case study facility and consulting with health facility personnel where available. Findings include that longer-term flexibility is assisted by: generous site area, lower rise hospital buildings along a horizontal circulation spine (‗hospital street‘), surplus building services capacity facilitating easy expansion/alteration, and a consistent workable planning grid supporting a range of standardised room sizes. Future investigation should consider the impact of high land values on site utilisation especially in terms of future proofing multi-storey buildings, and how to assist health clients decide when ‗enough‘ flexibility has been provided

The adaptive capacity of hospital facilities to cope with the risk of disasters caused by extreme weather events: a case study approach.

A three-year study is currently being conducted to determine the adaptive capacity of hospitals in Australia and New Zealand to cope with climate change-related extreme weather events. The primary objective of this research is to develop strategies that can be employed to improve the resilience of hospital facilities to these events. A case study approach was adopted to collect data through focus groups comprising participants who had experienced extreme weather events. Using risk and opportunity management methods, focus group workshop sessions were used as a structured approach to identify, assess and control the risks and opportunities associated with an extreme weather event scenario. The research findings indicate that there is considerable scope for clinical and non-clinical staff to work cooperatively in developing preventative as well as response and recovery strategies. The findings reinforce the view that the relationship between building users and building facilities needs to operate in an integrated fashion if any adaptive strategy is to be effective. This raises interesting governance issues which will be explored in future research

Modelling the impact of extreme weather events on healthcare infrastructure using rich picture diagrams

Healthcare infrastructure for a community comprises not only its hospital but also many other related facilities such as primary care clinics, community health centres, rural nursing posts, aged care centres, etc. These facilities form a complex set of relationships which need to work collectively for an effective response to climatechange related extreme weather events such as floods and storms. The aim of this research is to develop a conceptual understanding of the dynamic relationships of hospital facilities before, during and after an extreme weather event. This is an essential step in framing a systems model that will assist facility managers to maintain critical healthcare infrastructure during an emergency. Rich Picture Diagrams (RPDs) were used to map relationships between critical healthcare infrastructure components such as the base hospital; access roads; aged care facilities and remotely located supplies. The rich information on the inter-organisational, system and governance complexities associated with responding to extreme weather events was obtained from three hospital case studies (two in Australia and one in New Zealand). The main finding of this research is that RPDs have considerable potential in the development of soft systems models which will assist decision takers involved in the design and management of healthcare infrastructure particularly in the context of extreme weather events. The soft systems methodology which underpins this research challenges the conventional view of what constitutes a ‘facility’ and consequently has important implications for those constructing and managing facilities

Open Science principles for accelerating trait-based science across the Tree of Life.

Synthesizing trait observations and knowledge across the Tree of Life remains a grand challenge for biodiversity science. Species traits are widely used in ecological and evolutionary science, and new data and methods have proliferated rapidly. Yet accessing and integrating disparate data sources remains a considerable challenge, slowing progress toward a global synthesis to integrate trait data across organisms. Trait science needs a vision for achieving global integration across all organisms. Here, we outline how the adoption of key Open Science principles-open data, open source and open methods-is transforming trait science, increasing transparency, democratizing access and accelerating global synthesis. To enhance widespread adoption of these principles, we introduce the Open Traits Network (OTN), a global, decentralized community welcoming all researchers and institutions pursuing the collaborative goal of standardizing and integrating trait data across organisms. We demonstrate how adherence to Open Science principles is key to the OTN community and outline five activities that can accelerate the synthesis of trait data across the Tree of Life, thereby facilitating rapid advances to address scientific inquiries and environmental issues. Lessons learned along the path to a global synthesis of trait data will provide a framework for addressing similarly complex data science and informatics challenges

Psychometric properties of the Norwegian version of the Safety Attitudes Questionnaire (SAQ), Generic version (Short Form 2006)

<p>Abstract</p> <p>Background</p> <p>How to protect patients from harm is a question of universal interest. Measuring and improving safety culture in care giving units is an important strategy for promoting a safe environment for patients. The Safety Attitudes Questionnaire (SAQ) is the only instrument that measures safety culture in a way which correlates with patient outcome. We have translated the SAQ to Norwegian and validated the translated version. The psychometric properties of the translated questionnaire are presented in this article.</p> <p>Methods</p> <p>The questionnaire was translated with the back translation technique and tested in 47 clinical units in a Norwegian university hospital. SAQ's (the Generic version (Short Form 2006) the version with the two sets of questions on perceptions of management: on unit management and on hospital management) were distributed to 1911 frontline staff. 762 were distributed during unit meetings and 1149 through the postal system. Cronbach alphas, item-to-own correlations, and test-retest correlations were calculated, and response distribution analysis and confirmatory factor analysis were performed, as well as early validity tests.</p> <p>Results</p> <p>1306 staff members completed and returned the questionnaire: a response rate of 68%. Questionnaire acceptability was good. The reliability measures were acceptable. The factor structure of the responses was tested by confirmatory factor analysis. 36 items were ascribed to seven underlying factors: Teamwork Climate, Safety Climate, Stress Recognition, Perceptions of Hospital Management, Perceptions of Unit Management, Working conditions, and Job satisfaction. Goodness-of-Fit Indices showed reasonable, but not indisputable, model fit. External validity indicators – recognizability of results, correlations with "trigger tool"-identified adverse events, with patient satisfaction with hospitalization, patient reports of possible maltreatment, and patient evaluation of organization of hospital work – provided preliminary validation.</p> <p>Conclusion</p> <p>Based on the data from Akershus University Hospital, we conclude that the Norwegian translation of the SAQ showed satisfactory internal psychometric properties. With data from one hospital only, we cannot draw strong conclusions on its external validity. Further validation studies linking the SAQ-scores to patient outcome data should be performed.</p

When Does an Alien Become a Native Species? A Vulnerable Native Mammal Recognizes and Responds to Its Long-Term Alien Predator

The impact of alien predators on native prey populations is often attributed to prey naiveté towards a novel threat. Yet evolutionary theory predicts that alien predators cannot remain eternally novel; prey species must either become extinct or learn and adapt to the new threat. As local enemies lose their naiveté and coexistence becomes possible, an introduced species must eventually become ‘native’. But when exactly does an alien become a native species? The dingo (Canis lupus dingo) was introduced to Australia about 4000 years ago, yet its native status remains disputed. To determine whether a vulnerable native mammal (Perameles nasuta) recognizes the close relative of the dingo, the domestic dog (Canis lupus familiaris), we surveyed local residents to determine levels of bandicoot visitation to yards with and without resident dogs. Bandicoots in this area regularly emerge from bushland to forage in residential yards at night, leaving behind tell-tale deep, conical diggings in lawns and garden beds. These diggings were less likely to appear at all, and appeared less frequently and in smaller quantities in yards with dogs than in yards with either resident cats (Felis catus) or no pets. Most dogs were kept indoors at night, meaning that bandicoots were not simply chased out of the yards or killed before they could leave diggings, but rather they recognized the threat posed by dogs and avoided those yards. Native Australian mammals have had thousands of years experience with wild dingoes, which are very closely related to domestic dogs. Our study suggests that these bandicoots may no longer be naïve towards dogs. We argue that the logical criterion for determining native status of a long-term alien species must be once its native enemies are no longer naïve