| 1. |
- Pauli Bock, Emelie, et al.
(author)
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Literature Review : Evidence-Based Health Outcomes and Perceptions of the Built Environment in Pediatric Hospital Facilities.
- 2021
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In: Journal of Pediatric Nursing. - : Elsevier. - 0882-5963 .- 1532-8449. ; 61, s. e42-e50
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Journal article (peer-reviewed)abstract
- PROBLEM: The current knowledge of evidence-based design for adults is not always implemented when hospital buildings are designed. Scientific data are sparse on the effects of hospital design in pediatric settings on health outcomes in children, parents, and staff. The objective of this review is to determine the evidence-based impact of the built environment in pediatric hospital facilities on health outcomes in children, parents, and staff.ELIGIBILITY CRITERIA: A systematic literature review was carried out on the electronic databases Cochrane Library, Embase, Medline and CINAHL from the period of 2008 to 2019. The review considered studies using either quantitative, qualitative, or mixed methodologies.SAMPLE: Out of 1414 reviewed articles the result is based on eight included articles.RESULTS: Two of these eight articles included health outcomes. The other six articles presented results on measures of perceptions and/or satisfaction for children, parents or staff with the built environment when transitioning to a new or renovated facility. These were generally higher for the new compared to the old facility.CONCLUSIONS: Given the small number of studies addressing the question posed in this review, no firm conclusions can be drawn.IMPLICATIONS: The review illustrates the need for more research in the pediatric setting assessing the evidence-based health outcomes of aspects of physical environmental design in pediatric hospitals or units in children, parents and staff.
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| 2. |
- Adam, Abderisak, 1988, et al.
(author)
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The dynamic capabilities of public construction clients in the healthcare sector
- 2020
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In: International Journal of Managing Projects in Business. - 1753-8378 .- 1753-8386. ; 13:1, s. 153-171
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Journal article (peer-reviewed)abstract
- Purpose: Previous research within the dynamic capabilities literature has primarily targeted the strategic innovation of technology firms and significantly less interest has been given to project-based organizations that operate in the construction sector. A recent study by Davies and Brady (2016) places the dynamic capabilities concept in a project-based context, drawing upon research on dynamic capabilities and organizational ambidexterity. The purpose of this paper is to apply the aforementioned framework in a case involving public construction clients with the aim of examining their approaches for maintaining or developing project capabilities depending on the volatility of the environment. Design/methodology/approach: The study is based on a case study of a decentralized association of 16 healthcare client organizations in Swedish counties, which was compared to a centralized unit for healthcare planning and construction in Norway. In total, 19 interviews were conducted, alongside two workshops and a feedback questionnaire. Findings: The interviewees emphasized the lack of adequate support to handle the increasingly more complex projects. Results indicate the need for a more segmented approach for understanding how dynamic capabilities are managed in client organizations based not merely on the level of stability in the environment, but also taking into account the resources that are utilized. It is further argued that there is a need for a more granular research approach to studying the development of capabilities in a case-based setting, an approach that more specifically links the development of dynamic capabilities with their relevant antecedent activities. Originality/value: The study sheds light on how the various approaches for maintaining/developing project capabilities available to the public sector construction client depend on the volatility of the environment and the resources they require.
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| 3. |
- Bellini, Elena, et al.
(author)
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Sensory Design in the Birth Environment: Learning from Existing Case Studies
- 2023
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In: Buildings. - : MDPI AG. - 2075-5309. ; 13:3
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Journal article (peer-reviewed)abstract
- Studies have shown how built environments for hospitals can influence psychological and physiological conditions and status for childbearing women. Sensory attributes of birth spaces can enhance comfort, feelings of wellbeing, and, to some extent, clinical outcomes. Recently, some case studies of multisensory rooms for the birth environment have been developed based on, e.g., Snoezelen room examples. The aim of this research is to develop an overview of how sensory aspects for birth environments are designed, used, and tested in current and recent studies. Case studies were selected according to sensory aspect significance, observing space factors, and relationship with the experience and comfort of users (women, partners, midwives). All case studies were analysed to collect information about the design and validation process. The collected data were organised in categories and compared for the selected case studies. Main findings were summarised in tables with the aim of underlining how sensory design processes and projects can positively influence comfort for birthing. Conclusions about how to bring forward the issue of sensory design so that it can be used and applied to support childbearing women is discussed.
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| 4. |
- Björnson Skogström, Lisa, 1980, et al.
(author)
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Women’s Experiences of Physical Features in a Specially Designed Birthing Room: A Mixed-Methods Study in Sweden
- 2022
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In: HERD. - : SAGE Publications. - 2167-5112 .- 1937-5867. ; 15:3, s. 193-205
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Journal article (peer-reviewed)abstract
- Aim: To explore women’s experiences of physical features in a birthing room designed to be adaptable to personal wishes and needs during labor and birth. Background: Childbirth is a central life event influenced by numerous factors, including the healthcare environment; however, there is insufficient knowledge on how the physical design affects women during birth. Methods: This study was part of a randomized controlled trial in the Room4Birth research project, including women randomized to receive care in a new birthing room designed with physical features changeable according to personal wishes. Data consisted of responses to two questions analyzed with descriptive statistics (n = 202) and semi-structured interviews analyzed for content (n = 19). Results: A total of 93.6% (n = 189) assessed the physical features in the birthing room as meaningful to a very high or high extent. The overall impression of the room was positive and exceeded women’s expectations. They felt welcomed and strengthened by the room, which shifted the focus to a more positive emotional state. The room differed from traditional hospital birthing rooms, contained familiar features that maintained integrity, and had space for companions. The variety of physical features was appreciated. Of nine listed physical features, the bathtub was ranked most important, followed by the projection of nature scenery, and dimmable lighting, but the room as a whole appeared most important. Conclusions: When planning and designing hospital-based birthing rooms, it is crucial to offer possibilities to adapt the room and physical features according to personal wishes.
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| 5. |
- Brambilla, Andrea, et al.
(author)
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Complex Projects Assessment. The Impact of Built Environment on Healthcare Staff Wellbeing
- 2020
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In: Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics). - Cham : Springer International Publishing. - 1611-3349 .- 0302-9743. ; 12253 LNCS, s. 345-354
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Conference paper (peer-reviewed)abstract
- Projects, plans and programmes for complex environments such as healthcare facilities need to be designed with specific consideration of the multitude of users, technologies and policies in order to address a sustainable and resilient development. Several Evidence Based Design (EBD) studies highlight the deep interrelation between built and natural systems with human or organizations-related outcomes, but the effect on healthcare staff such as Medical Doctors (MD) is still underexplored. The paper investigates the assessment of self-reported satisfaction and wellbeing of MDs in healthcare facilities. A multidimensional assessment model composed of 53 Likert scale questions has been developed from literature review and existing tools, and submitted to a statistically significant sample of workers in 2 different office settings of an Italian hospital. Since MDs spend a considerable amount of their working time in offices, the qualities of such space are very important. The study highlights and confirms that localization, indoor environment, natural and artificial light are relevant drivers for staff satisfaction and wellbeing. Further investigations on a wider and diverse sample are encouraged.
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| 6. |
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| 7. |
- Brambilla, Andrea, et al.
(author)
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Flexibility during the covid-19 pandemic response: Healthcare facility assessment tools for resilient evaluation
- 2021
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 18:21
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Journal article (peer-reviewed)abstract
- Healthcare facilities are facing huge challenges due to the outbreak of COVID-19. Around the world, national healthcare contingency plans have struggled to cope with the population health impact of COVID-19, with healthcare facilities and critical care systems buckling under the ex-traordinary pressures. COVID-19 has starkly highlighted the lack of reliable operational tools for assessing the level sof flexibility of a hospital building to support strategic and agile decision making. The aim of this study was to modify, improve and test an existing assessment tool for evaluating hospital facilities flexibility and resilience. We followed a five-step process for collecting data by (i) doing a literature review about flexibility principles and strategies, (ii) reviewing healthcare design guidelines, (iii) examining international healthcare facilities case studies, (iv) conducting a critical review and optimization of the existing tool, and (v) assessing the usability of the evaluation tool. The new version of the OFAT framework (Optimized Flexibility Assessment Tool) is composed of nine evaluation parameters and subdivided into measurable variables with scores ranging from 0 to 10. The pilot testing of case studies enabled the assessment and verification the OFAT validity and reliability in support of decision makers in addressing flexibility of hospital design and/or operations. Healthcare buildings need to be designed and built based on principles of flexibility to accommodate current healthcare operations, adapting to time-sensitive physical transformations and responding to contemporary and future public health emergencies.
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| 8. |
- Eriksson, Erik, 1977-, et al.
(author)
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Public management in turbulent times : COVID-19 as an ecosystem disruptor
- 2021
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In: Australian journal of public administration. - : John Wiley and Sons Inc. - 0313-6647 .- 1467-8500. ; 80:4, s. 732-747
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Journal article (peer-reviewed)abstract
- The decentralisation of Swedish healthcare closer to citizens has been slow. Drawing from empirical material of the reform prior and amidst the COVID-19 pandemic, this paper argues that the pandemic has disrupted the healthcare ecosystem. Consequently, citizen-centred collaborations have accelerated integration of resources (such as knowledge and skills) across organisational, hierarchical and professional borders. However, collaborations have been delimited to traditional healthcare providers, neglecting the resources of citizens and other actors to be used to improve service delivery. The pandemic has revealed strengths and weaknesses with the prevailing healthcare ecosystem that post-COVID-19 public management must address, both theoretically and practically. Theoretically, the paper contributes to the development of a public service logic, addressing both strengths and difficulties with the logic in turbulent times. Practically, the empirical descriptions contribute to improved understanding of public service delivery reform and how it is impacted during the pandemic. © 2021 The Authors. Australian Journal of Public Administration published by John Wiley & Sons Australia, Ltd on behalf of Institute of Public Administration Australia.
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| 9. |
- Goldkuhl, Lisa, 1983, et al.
(author)
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Impact of Birthing Room Design on Maternal Childbirth Experience: Results From the Room4Birth Randomized Trial
- 2023
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In: HERD. - : SAGE Publications. - 2167-5112 .- 1937-5867. ; 16:1, s. 200-218
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Journal article (peer-reviewed)abstract
- Objective: To study the effect of the birthing room design on nulliparous women’s childbirth experience up to 1 year after birth. Background: Although it is known that the birth environment can support or hinder birth processes, the impact of the birthing room design on maternal childbirth experience over time is insufficiently studied. Methods: The Room4Birth randomized controlled trial was conducted at a labor ward in Sweden. Nulliparous women in active stage of spontaneous labor were randomized (n = 406) to either a regular birthing room (n = 202) or a new birthing room designed with more person-centered considerations (n = 204). Childbirth experiences were measured 2 hr, 3 months, and 12 months after birth by using a Visual Analogue Scale of Overall Childbirth Experience (VAS-OCE), the Fear of Birth Scale (FOBS), and the Childbirth Experience Questionnaire (CEQ2). Results: Women randomized to the new room had a more positive childbirth experience reported on the VAS-OCE 3 months (p =.002) and 12 months (p =.021) after birth compared to women randomized to a regular room. Women in the new room also scored higher in the total CEQ2 score (p =.039) and within the CEQ2 subdomain own capacity after 3 months (p =.028). The remaining CEQ2 domains and the FOBS scores did not differ between the groups. Conclusions: These findings show that a birthing room offering more possibilities to change features and functions in the room according to personal needs and requirements, positively affects the childbirth experience of nulliparous women 3 and 12 months after they have given birth.
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| 10. |
- Goldkuhl, Lisa, 1983, et al.
(author)
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Room4Birth – The effect of giving birth in a hospital birthing room designed with person-centred considerations: A Swedish randomised controlled trial
- 2022
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In: Sexual and Reproductive Healthcare. - : Elsevier BV. - 1877-5764 .- 1877-5756. ; 32
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Journal article (peer-reviewed)abstract
- Objective: To evaluate if a birthing room designed with person-centred considerations improves labour and birth outcomes for nulliparous women when compared to regular birthing rooms. Methods: A randomised controlled trial was conducted at a Swedish labour ward between January 2019 and October 2020. Nulliparous women in spontaneous labour were randomised either to a birthing room designed with person-centred considerations (New room) or a Regular room. The primary outcome was a composite of four variables: vaginal non-instrumental birth; no oxytocin augmentation; postpartum blood loss < 1000 ml; and a positive childbirth experience. To detect a difference of 8% between the groups, 1274 study participants were needed, but the trial was terminated early due to consequences of the Covid-19 pandemic. Results: A total of 406 women were randomised; 204 to the New room and 202 to the Regular room. There was no significant difference in the primary outcome between the groups (42.2% versus 35.1%; odds ratio: 1.35, 95% Confidence Interval 0.90–2.01; p = 0.18). Participants in the New room used epidural analgesia to a lower extent (54.4% versus 65.3%, relative risk: 0.83, 95% Confidence Interval 0.71–0.98; p = 0.03) and reported to a higher degree that the room contributed to a sense of safety, control, and integrity (p=<0.001). Conclusions: The hypothesis that the New room would improve the primary outcome could not be verified. Considering the early discontinuation of the study, results should be interpreted with caution. Nevertheless, analyses of our secondary outcomes emphasise the experiential value of the built birth environment in improving care for labouring women.
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