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Hospital Architecture in Spain and Italy: Gaps Between Education and Practice
No full textAim
The research sheds light on the challenges and limitations of Spanish and Italian hospital design by looking at the gaps between education and practice.
Background
Hospital design plays an important role in providing high-quality and cost-effective facilities for any healthcare system. Spain and Italy face contemporary challenges (i.e., elderly population, staff retention, and obsolete healthcare facilities) and have similar issues of life expectancy, health expenditure, hospital beds provision, and decentralized tax-financed healthcare systems.
Method
A cross-sectional, mixed-method study was used. This involved two different data collection strategies and analysis for each area of investigation: (i) education and (ii) practice. For the former, educational programs were reviewed via a web search; for the latter, an online survey of 53 architectural/engineering offices involved in hospital design was conducted.
Results
Hospital design education is limited to 0/58 in Spanish and 2/60 courses in Italian universities, although each country offers three postgraduate courses. The practitioners’ survey shows that even though their offices have a long history of healthcare design, only 48% in Spain and 60% in Italy have received specific university training. Office staff lack employees with medical backgrounds, which hinders any partnership between health and design fields either for design practice or the education fields. Laws, national regulations, technical guidelines, and previous experience are the most useful information sources, while international scientific publications appear underused by practitioners.
Conclusions
Italian and Spanish healthcare architecture could be improved by promoting multidisciplinary teams (in practice and education) and improving the education offer by tailoring it to national needs
Benchmarking Relevance for Hospital Design and Planning: An International Web-Based Survey
No full textObjective: The study aims to investigate what design practitioners and healthcare facility managers deem as important benchmarking metrics worldwide, investigating country differences in benchmarking usage and which metrics are prioritized.Background: Benchmarking is a regular practice in the healthcare sector, both for clinical and managerial aspects to compare, measure, and improve standardized processes. However, limited knowledge is available about benchmarking procedures in hospital planning, design, and construction.Methods: A web-based survey was designed, revised, and pilot-tested in five countries; it was adjusted according to local experts' suggestions and submitted globally via SoSci multilingual platform to persons involved in hospital design, research, construction, and facility management. It was composed of closed questions on 5-point Likert-type scale ranking frequency or importance and open-ended questions divided into six sections. Two hundred and eighty full responses have been collected. Statistical analysis was performed via PowerBI and R-Studio, while qualitative analysis was performed via MAXQDA.Results: The findings reported allow for both specific insights per each country or category as well as enabling general considerations of a practice that is becoming always more international with 30%-50% of respondents working in the international context. The evaluation of the survey highlights the most important benchmarks, among others. For example, for respondents from the top five countries (Sweden, Spain, Germany, Italy, and the United States), the most important metric for benchmark comparability is whether the project was new construction, new construction attached to an existing hospital, or interior renovation. Construction date, client type (public vs. private), and country of location were also generally rated as the most important metrics by respondents. Other metrics that were consistently rated as important globally included inpatient unit layout, walking distances, number of floors, and whether all patient rooms are private. Space-related metrics are considered very important elements in the design and planning of healthcare facilities worldwide. Regarding cost-related metrics, all countries consider the ratio construction cost per building gross area as the most important.Conclusions: Benchmarking emerges as a relevant tool for hospital design and planning as it can support efficiency, standardization, and confidence; currently, benchmarking is still underutilized due to the challenge of international comparison, access to data outside each specific company, and variation design metrics nationally. Benchmarking strategies should be further investigated to support knowledge exchange and to ensure reliable and comparable information globally
Designing a Post-Occupancy-Evaluation (POE) Tool for Hospitals. Addressing functional and emotional users’ needs in hospitals
Get PDFThis abstract is an introduction to my PhD thesis in progress at Escuela Técnica Superior de Arquitectura de Madrid (Universidad Politécnica de Madrid). My area of interest is the influence of Architecture on Healthcare and vice versa. My research field is the environmental conditions (both quantitative and qualitative) in specific areas of an acute hospital where recovery takes place. The article focuses on the methodology followed on this study which consists of a literature analysis, a three-month hospital placement in Dénia (Alicante), study trips to reference hospitals and a three-month placement at the “Centre for Healthcare Architecture” Chalmers University of Technology, Sweden. The aim of my research is to design a post-occupancy-evaluation (POE) tool which gathers the latest research on evidence-based design, best practice advice and lessons learnt on hospital facilities
Evaluation of Functional & Environmental Factors in Spanish Acute-care Hospital Design = Evaluación de los factores funcionales y ambientales en el diseño de hospitales de agudos españoles
No full textThe aim of this doctoral thesis is to explore the evaluation of functional and environmental factors in acute-care hospital design that might have an impact on healthcare outcomes. Despite the progress of the evidence-based design process in North-European and North American countries, in Spain it still has not been fully developed. The purpose of this design process is to establish a link between design variables and health-related outcomes. Acutecare hospitals are buildings in constant change to cope with the evolving demands of clinical progress and the social context. Thus, acknowledging the functional and environmental factors that impact on the care process and evaluating them in existing acute-care hospitals becomes of paramount importance. This dissertation follows a mixed-method methodology based on four perspectives: 1) the field, with an ethnographic study during a three-month placement in an acute-care hospital; 2) the theory, with literature analysis; 3) the future, with an ethnographic study of sixteen acute-care hospital visits considered as best practice, and 4) the present, with the evaluation of four acutecare hospitals in Spain. The primary result of this work is the tool CURARQ. The purpose of this tool is, on the one hand to provide a first diagnostic of the functional and environmental quality of the studied unit, and on the other hand to guide in the design decision process of a new development. This tool has been created for seven units in the acute-care hospital and has been tested in four acute-care hospitals in “Comunidad Valenciana”. Secondary results include: 1) feedback and scripts from users during the acute-care hospital placement; 2) evaluation through architectural layouts and photographs of the acute-care hospital visits; and 3) evaluation of CURARQ scores of the four evaluated acute-care hospitals. This document provides a current overview of functional and environmental factors in acutecare hospitals, which evidence: 1) the need for refurbishment to promote clinical innovation; 2) the need to update national standards, 3) the usefulness of CURARQ tool to identify priority buildings to intervene, and 4) the usefulness of CURARQ tool to generate synergies between healthcare staff, patients, researchers, and architects to promote the potential of the evidencebased design process in Spain. ----------RESUMEN---------- El objetivo de esta tesis doctoral es explorar la evaluación de los factores funcionales y ambientales en el diseño de los hospitales de agudos, que puedan afectar a los resultados sanitarios. A pesar del progreso del proceso de diseño basado en evidencias en países del norte de Europa y de Norteamérica, en España todavía está poco desarrollado. La finalidad de este proceso de diseño es establecer vínculos entre variables de diseño y resultados sanitarios. El hospital de agudos es un edificio en constante evolución para responder a las demandas del desarrollo clínico y su contexto social. Por este motivo, es vital identificar los factores funcionales y ambientales que impactan en el proceso de los cuidados y evaluarlos en hospitales de agudos existentes. La metodología de esta tesis se basa en los métodos mixtos desde cuatro perspectivas distintas: 1) la práctica, con estudio etnográfico durante una estancia de tres meses en un hospital de agudos; 2) la teoría, con el análisis de la literatura; 3) el futuro, con estudio etnográfico de dieciséis hospitales de agudos considerados como buenas prácticas; y 4) el presente, con la evaluación de cuatro hospitales de agudos en España. El principal resultado de este trabajo es la herramienta CURARQ. La finalidad de esta herramienta es por un lado obtener un primer diagnóstico de la calidad funcional y ambiental de la unidad estudiada, y por otro guiar la toma de decisiones para futuros diseños. Esta herramienta se ha creado para siete unidades del hospital de agudos y se ha aplicado en cuatro casos de la Comunidad Valenciana. Los resultados secundarios incluyen: 1) evaluación y rutinas según las personas usuarias de la estancia en el hospital de agudos; 2) evaluación mediante el estudio de las distribuciones en planta y fotografías de las visitas a hospitales de agudos; y 3) evaluación de las puntuaciones obtenidas con la herramienta CURARQ en los cuatro hospitales de agudos evaluados. Esta tesis ofrece una visión general de la situación de los factores funcionales y ambientales en los hospitales de agudos, lo que evidencia: 1) la necesidad de renovar los edificios para promover la innovación clínica, 2) la necesidad de actualizar los estándares nacionales, 3) la utilidad de la herramienta CURARQ para identificar los edificios donde es necesario intervenir con prioridad y 4) la utilidad de la herramienta CURARQ para generar sinergias entre el personal sanitario, pacientes, investigadores/as y arquitectos/as que permitan explotar el potencial del proceso de diseño basado en evidencias en España
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
The role of architecture in long-term care facilities
Get PDFLa adecuación de los centros residenciales sociales a la Estrategia de desinstitucionalización requiere de una serie de cambios y transformaciones que afectan al espacio físico donde tiene lugar el día a día de las personas que lo habitan y utilizan. El objetivo de este estudio es analizar el impacto de las limitaciones arquitectónicas para las personas con discapacidad que viven en centros de carácter institucional. Para ello, utilizamos el método de análisis temático inductivo en 24 entrevistas y 2 grupos focales realizadas a un total de 45 personas de tres centros españoles (incluyendo perfiles profesionales sanitarios, técnicos, personas usuarias y familiares). Los resultados se organizan en cuatro temas principales: 1) Relación del edificio hacia el exterior; 2) Instalaciones obsoletas y problemas de mantenimiento; 3) Inseguridades derivadas; y 4) Criterios organizativos y estructurales. En definitiva, los centros analizados presentan carencias graves que limitan la autonomía de las personas con o sin discapacidad que residen o que hacen uso de ellos. Más estudios son necesarios para promover tipologías, programas funcionales y criterios de diseño basados en evidencias, alineados con políticas públicas, que fomenten la autonomía e independencia de las personas con diversidad funcional. Asimismo, es necesaria también la promoción de una mayor relación con la comunidad y el entorno circundante, y un diseño más ergonómico y saludable para todas las personas, incluido el personal trabajador de este tipo de dotaciones y equipamientos
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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