INTEGRATION OF EVIDENCE-BASED AND EXPERIENCE-BASED DESIGN: CONTRIBUTIONS FROM A STUDY IN A HEALTH CARE SERVICE (original) (raw)
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The purpose this paper is to present an integrated study of Service Design and the Mechanism of the Production Function (MPF) for redesigning the health care services to improve the perceived value of the patient and increase the productivity of hospital operations by eliminating wastes. The method used was action research and applied in an ICU of a private hospital in southern Brazil. The techniques of participant observation, interviews, archival research and meetings co-creation with a team of the hospital were used to collect data. Data were analyzed through content analysis of the interviews and the Design Service and Production Engineering tools. Evidence based approaches tends to contribute to the replication of the project outcomes in future cases. The MPF can support project development in the field of Design, as well the integrated approach developed in the healthcare sector, helped to devote more time to the phases of diagnosis and implementation. The findings are useful to demonstrate that can use simultaneously approaches the Service Design and MPF for the development of more robust solutions in health care environment. Further research could be done in other private or public hospitals as well as in other hospital units besides the ICUs. Limitations include the work done in a single hospital and service unit, data collected from a small group of people in the hospital. Integrating Evidence-Based Design, Experience-Based Design and the MPF can produce a more robust way to justify and define the focus of improvements in health care services.
Revista da Escola de Enfermagem da USP, 2012
Um indicador de qualidade introduzido pela Organização Mundial da Saúde no campo da avaliação em saúde é a responsividade. Assim, o objetivo do trabalho foi elaborar um instrumento para avaliar a opinião do cliente sobre a responsividade do serviço de enfermagem de um hospital universitário público. A pesquisa desenvolveu-se nas seguintes etapas: construção do instrumento com base em levantamento bibliográfico, validação aparente, teste de aplicabilidade e teste piloto. O instrumento permite identificar as Expectativas e as Percepções do cliente, subdivididas em aspectos relacionados à Estrutura, Processo e Resultados, mensurados por meio da escala Likert com valores de 0 a 7. Com base nos resultados do teste piloto foi possível estabelecer uma indicação numérica da Taxa de Satisfação Relativa e do seu intervalo. O trabalho proporcionou a construção de uma escala de percentual de aceitabilidade para o intervalo, que pode indicar quanto o serviço de enfermagem responde às expectativa...
Construção De Programa De Segurança Do Paciente Em Hospital Público De Ensino: Pesquisa Documental
Cogitare Enfermagem, 2016
Pesquisa documental sobre a trajetória de um hospital público de ensino na construção de Programa de Segurança do Paciente. Foram consultados 200 documentos do período de 2004 a 2012, em um hospital público federal do sul do Brasil, com dados coletados entre maio de 2012 a abril de 2013. A análise documental evidencia estratégias essenciais à implantação de um programa. Entre elas, diagnóstico situacional com utilização de ferramentas da qualidade; auditorias internas com instrumentos customizados; profissionais com dedicação exclusiva e expertise na área da qualidade; capacitações direcionadas à equipe multiprofissional; incentivo à construção coletiva, o apoio da direção e o envolvimento de lideranças. O programa foi vanguardista entre os hospitais públicos federais. Desenvolvido previamente à legislação brasileira que normatiza a matéria, cumpriu em grande parte com as demandas da Resolução de Diretoria Colegiada n° 36 de 25 de julho de 2013 do Ministério da Saúde.
The 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.
Prática segura para partos em hospital universitário
Revista de Enfermagem da UFSM, 2020
Objetivo: identificar a aplicação das práticas essenciais da Lista de Verificação para Partos Seguros (LVPS) da Organização Mundial da Saúde realizadas em Hospital Universitário. Método: estudo transversal descritivo, realizado no período de janeiro a outubro de 2018, com 51 profissionais que assistem o trabalho de parto, parto e puerpério. Para identificar as práticas aplicadas, utilizou-se um questionário semiestruturado e análise estatística. Resultados: práticas relacionadas ao uso de fármacos, disponibilidade de recursos materiais, identificação de sangramento anormal, contato pele à pele, amamentação e planejamento reprodutivo estão conforme o preconizado. Contudo, não houve padronização quanto às avaliações no partograma e às orientações às mulheres e acompanhantes sobre os sinais de agravamento. Conclusões: a LVPS apresenta-se como uma ferramenta inovadora na assistência obstétrica. Oferece oportunidade de melhorias e qualificação dos cuidados, padronizando condutas essencia...
Indicadores De Gestión Para Medir La Eficiencia Hospitalaria
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La presente investigación documental es carácter proyectivo. Se busca la estudiar las transformaciones del sector mediante la aplicación de nuevas tecnologías en ganancias de productividad. Esta investigación aborda el análisis de eficiencia de las<br> entidades no lucrativas del sector público sanitario en función de indicadores como herramienta útil de gestión. Se determinó que el resultado de la actividad de las entidades no lucrativas no suelen ser un output tangible, sino el cumplimiento de unos objetivos en la prestación de un conjunto de servicios a la comunidad. La contribución de las mismas al bienestar social resultaría el punto de referencia último para orientar la asignación de recursos destinada a satisfacer las necesidades de la población
Evidence Based Design in Healthcare Facilities
Bilecik Şeyh Edebali Üniversitesi Fen Bilimleri Dergisi
The design of healthcare structures is a complex and constantly evolving issue due to the need for addressing various interrelated functions. Today, user involvement in the design phase is considered to be one of the main pillars of successful design. However, in healthcare structures, efforts toward this end are often hampered by the need for identifying the various requirements of multiple user groups and for setting priorities between different requirements of these groups. Recently, the effects of physical environmental conditions on user satisfaction have become more important in health building designs. Along with the rise of user satisfaction in design, the concept called 'evidence-based design' is increasingly attracting the attention of researchers and has become the theoretical concept of the healing physical environment in design. The aim of this study is to determine the gaps and areas needed to improve the effects of the physical environment on the user in terms...
Revista de Enfermagem UFPE on line, 2015
Objective: to describe the process of the Systematization of Nursing Care implementation in the Intensive Care Unit of a public hospital. Method: a descriptive study of qualitative approach, performed with four nurses and five nursing technicians. Data were collected by semi-structured interviews, direct observation and document analysis. The interviews were submitted to categorical analysis. The observation and document analysis were used to corroborate data obtained in the interviews. The research was approved the project by the Ethics Committee in Research, Protocol 214/2009. Results: seven categories emerged from the analysis of interviews containing subcategories: Knowledge about SAE; Implementation strategies; Professional training and the satisfaction with the training; Changes in work routine; Facilities with SAE; Difficulties; Benefits of SAE. Conclusion: it was possible to analyze partially the implementation of SAE, considering the time in which they occur, identifying the methodologies adopted and the main consequences of these procedures. Descriptors: Evaluation in Nursing; Patient Care Planning; Nursing Process; Hospital Nursing Service. RESUMO Objetivo: descrever o processo de implantação e implementação da Sistematização da Assistência de Enfermagem em Unidade de Terapia Intensiva de um hospital público. Método: estudo descritivo, de abordagem qualitativa, realizado com quatro enfermeiros e cinco técnicos de enfermagem. Os dados foram coletados por meio de entrevista semiestruturada, observação direta e análise documental. As entrevistas foram submetidas à análise de conteúdo categorial. A observação e a análise documental serviram para corroborar os dados obtidos nas entrevistas. A pesquisa teve aprovado o projeto pelo Comitê de Ética em Pesquisa, Protocolo 214/2009. Resultados: da análise das entrevistas, emergiram sete categorias, contendo as seguintes subcategorias: Conhecimentos sobre a SAE; Estratégias de implantação; Treinamento dos profissionais e satisfação com o treinamento; Mudanças na rotina de trabalho; Facilidades com a SAE; Dificuldades; Benefícios da SAE. Conclusão: foi possível analisar a implantação e implementação da SAE parcialmente, considerando-se a amplitude temporal na qual ocorrem, identificando-se as metodologias adotadas e as principais consequências desses procedimentos. Descritores: Avaliação em Enfermagem;
Design thinking applied to the health sector: A case study in a Brazilian hospital
Being innovative is an important feature for companies that wish to be competitive and survive in the marketplace. However, there are different paths that could lead to innovation and different approaches that emerge with the intention to help companies innovate. Design Thinking is one of these approaches. It proposes an innovation process centered on the user that can be applied to a wide array of contexts. This study aims to describe the application of Design Thinking in the health sector, report the experience gained, and analyze the results. Initially, the literature on the subject was reviewed, including the main models of Design Thinking in Brazil and other countries. The approach was applied to the hemodialysis unit of a hospital in Belo Horizonte, Brazil. The main goal was to innovate and improve the experience of patients in their first week of hemodialysis sessions. Finally, the results were analyzed, a contrast between what was planned and what was actually done was studied, and a comparison between the literature and the practice was established. The study issue is fairly recent and there were not many cases for comparison. In this particular project, it was not possible to prove that the approach improved the experience of hospital patients.
Use of Evidence in the Design of Healthcare Environments
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Problems related to value loss in building design are well known (Huovila et al., 1997; Koskela, 2000). Common problems include clients' requirements not being captured or lost throughout the design process; little improvement and optimisation of design solutions and mistakes whilst developing design (Huovila et al., 1997). Solutions developed to date are considered to be still insufficient to resolve these issues. Many authors discuss problems associated with the design process in construction including