Considerations for development of pharmacy support models for COVID-19 alternate care sites.

PURPOSE: Guidance on alternate care site planning based on the experience of a health-system pharmacy department in preparing for an expected surge in coronavirus disease 2019 (COVID-19) cases is provided. SUMMARY: In disaster response situations such as the COVID-19 pandemic, healthcare institutions may be compelled to transition to a contingency care model in which staffing and supply levels are no longer consistent with daily practice norms and, while usual patient care practices are maintained, establishment of alternate care sites (eg, a convention center) may be necessitated by high patient volumes. Available resources to assist hospitals and health systems in alternate care site planning include online guidance posted within the COVID-19 resources section of the US Army Corps of Engineers website, which provides recommended medication and supply lists; and the Federal Healthcare Resilience Task Force's alternate care site toolkit, a comprehensive resource for all aspects of alternate care site planning, including pharmacy services. Important pharmacy planning issues include security and storage of drugs, state board of pharmacy and Drug Enforcement Administration licensing considerations, and staff credentialing, education, and training. Key medication management issues to be addressed in alternate site care planning include logistical challenges of supply chain maintenance, optimal workflow for compounded sterile preparations (eg, on-site preparation vs off-site preparation and delivery from a nearby hospital), and infusion pump availability and suitability to patient acuity levels. CONCLUSION: Planning for and operation of alternate care sites in disaster response situations should include involvement of pharmacists in key decision-making processes at the earliest planning stages.

Avances en la gestión del bloque quirúrgico. El papel del coordinador de quirófano / Advances in operating room management. The role of operating room director

No disponible

Health systems engineering as an improvement strategy: a case example using location-allocation modeling.

Finding the optimal geographic location for a medical service is a common challenge for healthcare organizations. However, there is limited use or description of methods to determine the optimal location of a medical service. We describe a case study of how location-allocation techniques used by industrial engineers assisted a regional healthcare network develop a plan for optimal location of sleep medicine services within its network.

Creating healing intensive care unit environments: physical and psychological considerations in designing critical care areas.

A number of elements contribute to a healing ICU environment. The layout of a critical care unit helps create an environment that supports caregiving, which helps alleviate a host of work-related stresses. A quieter environment, one that includes family and friends, dotted with windows and natural light, creates a space that makes people feel balanced and reassured. A healing environment responds to the needs of all the people within a critical care unit-those who receive or give care and those who support patients and staff. Critical care units should be designed to focus on healing the body, the mind, and the senses. The design and policies of that department can be created in such a way to provide a sense of calm and balance. The physical environment has an impact on patient outcomes; the psychological environment can, too. A healing ICU environment will balance both. The authors discuss the ways in which architecture, interior design, and behavior contribute to a healing ICU environment.

Impact of place on people and process: the integration of research on the built environment in the planning and design of critical care areas.

What is the role of the built environment in healing? What aspects of the built environment promote healing, staff efficiency, and patient safety? How can we know if these assertions hold true? Can scientific research help us validate these assumptions? These questions are important to explore, especially for our most vulnerable patients-those in critical care settings. This article explores the historical influences on health care design, reveals how the current health care transformation movement has accelerated the incorporation of elements of the built environment into patient safety and quality improvement effort, discusses how healing environments are constructed, and examines how the literature of health care and health care design organizations have incorporated the impact of the built environment on patient, family, and staff outcomes and satisfaction. Finally, a case study of applying "design hypotheses" and a scientific method to the design of an intensive care unit setting is offered. This article will help critical care nurses understand the role the built environment has in creating optimal healing environments.

Finishes and furnishings: considerations for critical care environments.

When selecting finishes and furnishings within a critical care unit, multiple factors can ultimately affect patient outcomes, impact costs, and contribute to operational efficiencies. First, consider the culture of the regional location, operations of the specific facility, and the recent focus on patient-centered care. The intention is to create an appropriate familiarity and comfort level with the environment for the patient and family. Second, safety and infection control are of utmost concern, particularly for the critical care patient with limited mobility. The planning and design team must be acutely aware of the regulations and guidelines of various governing agencies, local codes, and best design practices that can directly affect choices of finishes and furnishings. Flooring, wall, and window finishes, lighting, art and color, as well as furniture and fabric selection should be considered. Issues to address include maintenance, durability, sustainability, infection control, aesthetics, safety, wayfinding, and acoustics. Balancing these issues with comfort, patient and staff satisfaction, accommodations for an aging population, increasing bariatric needs, efficient operations, and avoidance of "never events" requires team collaboration and communication, knowledge of product advancements, a keen awareness of how environmental stimuli are perceived, and utilization of the best available evidence to make informed design decisions.

Understanding family requirements in the intensive care room.

This article explores how the built environment can promote family interaction in the intensive care room and how the family can be supported within the room to care for their loved one. Four families with children in the intensive care unit were interviewed about their intensive care room environment. Patient care and the diagnosis and treatment of the child were not discussed. Two families were chosen from a cardiac intensive care unit and 2 families from a medical-surgical intensive care unit. All intensive care rooms were equipped with medical gas booms. All families were preparing for transfer to the inpatient area. This article summarizes the discussion with families and identifies guiding principles for designers and health care personnel to consider when creating a new intensive care room environment.

¿Es conveniente regular las externalizaciones? ¿Es factible una regulación de las externalizaciones? / Is it convenient to organize the externalizations of patients? Is it feasible to make a regulation of the externalization of patients?

No disponible

[The Portfolio Activities Matrices; a strategic planning tool for guiding decision making in healthcare management]. / Le matrici di Portfolio Attività: uno strumento di pianificazione strategica per orientare le decisioni gestionali in sanità

Management of healthcare organizations relies on the availability of decision-making tools. The Portfolio Activities Matrices is a method that can be applied to healthcare management. It allows simultaneous evaluation of indicators of efficiency, case-mix, cost and demand, so that the strengths and weaknesses of the organization may be identified. The method is complex and may have some degree of subjectivity. Nevertheless, it is a useful tool for performing the evaluations necessary for strategic planning management decisions, which must consider available resources as well as the social role of the organization.

La planificación de la salud en Cataluña, 1990-2000. Algunas claves para afrontar el futuro / Health planning in Catalonia 1990-2000. Some keys to afford future

Fundamento y objetivo: Las transformaciones sociales ocurridas en las últimas décadas han tenido un gran impacto en los servicios sanitarios y por extensión en los procesos de planificación. El objetivo es describir la evolución de los procesos de planificación de salud y servicios. Métodos: Revisión documental y entrevistas con miembros de los equipos de planificación. Resultados: Se identifican dos etapas de planificación: la de la década de los ochenta, orientada a la ordenación territorial y a los recursos sanitarios, y la de la década de los noventa a objetivos de salud (plan de salud, PS). El PS de Cataluña hace propuestas dirigidas a la promoción de la salud, prevención de la enfermedad, calidad de los servicios y satisfacción de los ciudadanos. Se inicia con el análisis de la situación de salud de la población y de los servicios, identifica los problemas prioritarios y define objetivos e intervenciones, aplica las propuestas y evalúa. Se elabora de forma descentralizada (regiones sanitarias) y con la participación de los profesionales, ciudadanos y sectores implicados. Permite identificar problemas y grupos de población vulnerables, definir objetivos cuantificados y con horizonte temporal, mejorar la gestión asistencial, la participación y la descentralización, evaluar resultados, explicitar el compromiso de las instituciones públicas y trabajar intersectorialmente. Se identifican aspectos susceptibles de mejora, principalmente en la participación, la proyección del PS en los servicios y el trabajo intersectorial. Conclusiones: La planificación por objetivos de salud ha supuesto un salto cualitativo. Para reforzar la potencialidad del PS habría que mejorar la gestión de su aplicación, así como asegurar la viabilidad de las intervenciones con un mayor compromiso intersectorial e institucional (AU)

Background and objective: The deep social transformations ocurred in the latest decades have influenced dramatically in health services and, by extension, in planning processes. The objective is to describe the evolution of health planning processes and services. Methods: Documental review and interviews with planning teams members. Results: We have identified two planning stages: The 80s, that showed a health planning oriented to territorial ordenation and health resources and in the other hand the 90s with the appearance of health objectives. The Catalonian health plan makes proposals related to health promotion, disease prevention, quality of services and citizens satisfaction. It starts with the analysis of population and services health situation. Then identify the priority problems and define objectives and interventions. Finally it applies the proposals and evaluate them. It is drawn up in a descentralized way (health regions) and with the collaboration of professionals, citizens and interested parties. Moreover, it allows to identify problems and vulnerable population groups, to define cuantitative objectives with deadlines and improve the assistential management and descentralization. It can also evaluate results and clarify public institutions commitments and work intersectorially. In addition, aspects with an improvement potential are identified, mainly related to participation, health plan projection on services and intersectorial work. Conclusions: Health planning by means of health objectives has brought about a qualitative jump. In order to reinforce the potentiality of health plans, we should improve the management of its application and secure the viability of interventions with a major intersectorial and institutional commitment (AU)

On the value of architecture and facility management in health administration education.

This article discusses the role and function of architecture and facility management in health administration education vis-à-vis an interdisciplinary set of courses taught in a graduate-level health administration program. These courses provide the future health care executive with theory and applied knowledge on a variety of topics. These include the history of health care facilities, issues in facility planning and management, principles of patient and staff-focused design, campus master planning, participatory methods to involve end users in the design of their work, and care settings. Additional skills acquired include an introduction to contract negotiations, the reading of technical documents such as blueprints, the post-occupancy assessment of facilities-in-use, and familiarity with future trends. Students address the topic of managerial ethics in relation to the built environment in some detail as a vehicle to illustrate the nature of key fine-grain issues of importance to the health administration scholar and professional. The discussion concludes with the presentation of a model curriculum in this subject area.

[Authorization and accreditation: management of the conversion of hospital buildings]. / Autorizzazione ed accreditamento: la gestione delle trasformazioni del patrimonio edilizio ospedaliero.

The Emilia Romagna Region decided own accreditation and procedures pattern following decisions, by different levels and graduated stages: authorization, institutional accreditation and finally contractual agreements. For Emilia Romagna Health Administration, authorization step represented "the necessary minimum level of security to exercise health activity", carried out by self evaluation of general and specific requirements of health structures, outlined by specific check-list, to bring about the maximum time allowed five years realization of structure adjustment plans. Beginning from this context the Local Health Unit of Modena, introduced by an audit test of conformity levels caught up, the guide line of computer management of technical assistance, change to use or amplification of health permission of structure and installations take a census by the business administration. The method allows by operative guide lines standardization to certify the validity of innovations realized, in all Departements/Services, for own conformity of structures, plant design and installation, sanitary regulations and security for wards services, auxiliary rooms. The development of this method allow to link activity and professionality for different duties of supervision and inspection, to guarantee the maintenance of levels assurance of health structures.