Which Values Should Guide Health Care Organizations' Retrofit Expenditures on Patient-Centered and Evidence-Based Design?

When built environments in health care result from an evidence-based design (EBD) process, they are interventions that can improve patients' health outcomes. This commentary on a case discusses which ethical values should guide organizations' capital expenditure decisions about retrofits, which might be more costly than the original budget. This discussion urges reevaluation of the common assumption that capital improvements are "sunk costs," since such improvements can promote long-term positive health outcomes for an organization's patients, thereby advancing both financial value and ethical values.

The Impact of Design Factors on User Behavior in a Virtual Hospital Room to Explore Fall Prevention Strategies.

Objectives: Falls in hospitals pose a significant safety risk, leading to injuries, prolonged hospitalization, and lasting complications. This study explores the potential of augmented reality (AR) technology in healthcare facility design to mitigate fall risk.

Background: Few studies have investigated the impact of hospital room layouts on falls due to the high cost of building physical prototypes.

An Auditory Sonic Sleep Treatment for Individuals Living With Dementia in a Memory Care Setting: A Quality Improvement Program Evaluation.

Background: The absence of a cure for dementia, combined with the increased longevity of the baby boom generation, is resulting in a dramatic increase in the number of people living with dementia. Aging-related changes coupled with dementia-related behavioral symptoms pose unique challenges for those living with dementia as well as those who provide care. There is evidence that improved sleep can improve health and well-being.

The increase in medical admissions with anorexia nervosa during the COVID-19 pandemic in Western Australia.

Objective: A comparative study to describe the increase in medical admissions of children and adolescents with anorexia nervosa (AN) in Western Australia in 2019 (pre-pandemic) and 2020 (peri-pandemic).

Method: Patient demographics, physiological parameters, length of stay, time to assessment by the Eating Disorder Service (EDS), and commencement of specialist eating disorder (ED) outpatient treatment was collected for adolescents admitted with AN between 1st January 2019 and 31st December 2020.

Results: The number of admissions doubled from 126 in 2019 to 268 in 2020.

Evaluating Efficacy of a COVID-19 Alternative Care Site Preparedness Assessment Tool for Catastrophic Healthcare Surge Capacity during Pandemic Response.

During the COVID-19 pandemic, implementing catastrophic healthcare surge capacity required a network of facility infrastructure beyond the immediate hospital to triage the rapidly growing numbers of infected individuals and treat emerging disease cases. Providing regional continuity-of-care requires an assessment of buildings for alternative care sites (ACS) to extend healthcare operations into non-healthcare settings. The American Institute of Architects (AIA) appointed a COVID-19 ACS Task Force involving architects, engineers, public health, and healthcare professionals to conduct a charrette (i.

Context Availability and Sentence Availability Ratings for 3,000 English Words and their Association with Lexical Processing.

Words that can be easily placed in contexts are more easily processed, yet norms for context availability are limited. Here, participants rated 3,000 words for context availability and sentence availability, a new metric predicted to capture information relating to textual variation. Both variables were investigated alongside other word-level characteristics to explore lexical-semantic space.

Designing a Patient Room as a Fall Protection Strategy: The Perspectives of Healthcare Design Experts.

Despite decades of research into patient falls, there is a dearth of evidence about how the design of patient rooms influences falls. Our multi-year study aims to better understand how patient room design can increase stability during ambulation, serving as a fall protection strategy for frail and/or elderly patients. The aim of this portion of the study was to ascertain the architect's perspective on designing a room to mitigate the risk of falls, as well as to evaluate the face validity of a predictive algorithm to assess risk in room design using the input of a design advisory council (AC).

DEEP SCOPE: A Framework for Safe Healthcare Design.

Thinking in patient safety has evolved over time from more simplistic accident causation models to more robust frameworks of work system design. Throughout this evolution, less consideration has been given to the role of the built environment in supporting safety. The aim of this paper is to theoretically explore how we think about harm as a systems problem by mitigating the risk of adverse events through proactive healthcare facility design.

Paediatric headbox as aerosol and droplet barrier.

Background: High-flow nasal oxygen (HFNO) is frequently used in hospitals, producing droplets and aerosols that could transmit SARS-CoV-2.

Aim: To determine if a headbox could reduce droplet and aerosol transmission from patients requiring HFNO.

Methods: The size and dispersion of propylene glycol (model for patient-derived infectious particles) was measured using a spectrometer and an infant mannequin receiving 10-50 L/min of HFNO using (1) no headbox, (2) open headbox, (3) headbox-blanket or (4) headbox with a high-efficiency particulate (HEP) filter covering the neck opening.

Pre- and post-intervention study examining immunisation rates, documentation, catch-up delivery and the impact of a dedicated immunisation service at a tertiary paediatric hospital.

Aim: To explore immunisation rates and catch-up delivery to children admitted to hospital before and after an immunisation service was commenced.

Methods: This pre- and post-intervention study examined 300 admissions prior to (cohort 1) and 300 following (cohort 2) the introduction of an immunisation service. Immunisation rates, documentation, catch-up delivery and accuracy of the Australian Immunisation Register (AIR) were examined.

Development of a Novel Computational Model for Evaluating Fall Risk in Patient Room Design.

Objectives: This study proposes a computational model to evaluate patient room design layout and features that contribute to patient stability and mitigate the risk of fall.

Background: While common fall risk assessment tools in nursing have an acceptable level of sensitivity and specificity, they focus on intrinsic factors and medications, making risk assessment limited in terms of how the physical environment contributes to fall risk.

Methods: We use literature to inform a computational model (algorithm) to define the relationship between these factors and the risk of fall.

We Agree, Don't We? The Delphi Method for Health Environments Research.

Objective: This overview is intended to provide the process framework for built environment researchers to use the Delphi method. The article outlines the methodological criteria originally established for the Delphi method, as well as commonly accepted modifications, to advance guidance for evidence-based built environment considerations.

Background: Increasingly used in healthcare research, the Delphi method is a process for gaining consensus through controlled feedback from a panel-a group made up of experts or individuals knowledgeable on the subject.

Sensory cue combination in children under 10 years of age.

Cue combination occurs when two independent noisy perceptual estimates are merged together as a weighted average, creating a unified estimate that is more precise than either single estimate alone. Surprisingly, this effect has not been demonstrated compellingly in children under the age of 10 years, in contrast with the array of other multisensory skills that children show even in infancy. Instead, across a wide variety of studies, precision with both cues is no better than the best single cue - and sometimes worse.

Single-Occupancy Patient Rooms: A Systematic Review of the Literature Since 2006.

Aim: Our review evaluated both the effects of single-occupancy patient rooms (SPRs) on patient outcomes for hospitalized adults and user opinion related to SPRs.

Background: In 2006, a requirement for SPRs in hospitals was instituted in the United States. This systematic literature review evaluates research published since that time to evaluate the impact of SPRs.

The SCOPE of Hospital Falls: A Systematic Mixed Studies Review.

Purpose: This systematic mixed studies review on hospital falls is aimed to facilitate proactive decision-making for patient safety during the healthcare facility design.

Background: Falls were identified by the Centers for Medicare & Medicaid Services as a nonreimbursed hospital-acquired condition (HAC) due to volume and cost, and additional financial penalties were introduced with the 2014 U.S.

A double conundrum: concurrent presentation of Hashimoto's thyroiditis and ulcerative colitis.

We describe a case of a 31-year-old man who presented with a 3-day history of crampy abdominal pain, anorexia, malaise and diarrhoea of increasing frequency, with the passage of both mucus and haematochezia. The patient's biochemical investigations revealed hyponatraemia, hypothyroidism and elevated inflammatory markers. The patient underwent an ultrasound and fine-needle aspiration of the thyroid and was diagnosed as having Hashimoto's thyroiditis.

Information theoretic evaluation of a noiseband-based cochlear implant simulator.

Noise-band vocoders are often used to simulate the signal processing algorithms used in cochlear implants (CIs), producing acoustic stimuli that may be presented to normal hearing (NH) subjects. Such evaluations may obviate the heterogeneity of CI user populations, achieving greater experimental control than when testing on CI subjects. However, it remains an open question whether advancements in algorithms developed on NH subjects using a simulator will necessarily improve performance in CI users.

Firefighting to Innovation: Using Human Factors and Ergonomics to Tackle Slip, Trip, and Fall Risks in Hospitals.

Objective: The aim of this study was to use a theoretical model (bench) for human factors and ergonomics (HFE) and a comparison with occupational slips, trips, and falls (STFs) risk management to discuss patient STF interventions (bedside).

Background: Risk factors for patient STFs have been identified and reported since the 1950s and are mostly unchanged in the 2010s. The prevailing clinical view has been that STF events indicate underlying frailty or illness, and so many of the interventions over the past 60 years have focused on assessing and treating physiological factors (dizziness, illness, vision/hearing, medicines) rather than designing interventions to reduce risk factors at the time of the STF.