Healthcare equity in focus: bridging gaps through a spatial analysis of healthcare facilities in Irbid, Jordan.

In the Irbid Governorate, Jordan, equitable healthcare facility distribution is vital to ensuring healthcare accessibility and improving public health outcomes. This study investigated the spatial distribution, accessibility, and conformity of healthcare facilities to the Ministry of Health standards to identify areas requiring improvement. Using geographic information systems (GIS), three spatial analyses were conducted: nearest neighbor analysis, buffer analysis, and service area analysis. These analyses comprehensively assessed the healthcare landscape, revealing a random spatial distribution pattern of healthcare facilities; and indicating an absence of structured organization. The buffer analysis revealed concentrations in specific regions, while others were underserved. The Service Area Analysis revealed significant healthcare access challenges, especially in remote areas. The healthcare resource distribution of the Irbid governorate fell short of national and international standards, emphasizing the need for improvements. To address these disparities, policymakers and healthcare authorities should focus on equitably redistributing resources, tailoring allocation to local needs, improving remote area infrastructure, and refining government policies. Continuous monitoring and evaluation are imperative to ensure alignment with international standards and achieve healthcare equity. The insights from this case study provide valuable guidance for regions facing similar healthcare distribution challenges.

Evaluating airflow dynamics in common vertical circulation spaces of a multi-floor apartment building for mitigating airborne infection risks: A CFD modeling study.

As more people increasingly inhabit indoor spaces, the importance of interior environment design has grown significantly. The focus of this research is to assess the air flow and air change per hour (ACH) within common service vertical circulation spaces in apartment buildings, emphasizing the potential role of these spaces in mitigating airborne infections. The intricate relationships between the design parameters of these spaces and variables related to air circulation are examined. To achieve this goal, the investigation employed a simulation-based approach, utilizing computational fluid dynamics (CFD) analysis to scrutinize the prevalent design of common vertical circulation spaces. The simulation outcomes unequivocally reveal that the design of these spaces has a direct impact on air circulation patterns, often influencing suboptimal conditions. Armed with these insights, this research advocates for a reevaluation of design considerations of common service vertical circulation in forthcoming housing projects. Furthermore, this research proposes innovative design solutions and strategies aimed at enhancing natural ventilation and overall air flow within common service vertical circulation spaces while evaluating their performance.

Investigations into the impact of nursing unit layout on critical care nurses.

BACKGROUND: Nurses' work environment has apparent implications for maximizing their productivity, satisfaction, and improving patient care. OBJECTIVES: This study aimed to explore the influence of three nursing unit spatial layouts on critical care nurses' satisfaction and walking behavior at a university hospital. METHODS: The research used a comparative design by administering a standardized questionnaire, recording walking steps and distances using pedometers, and tracking nurses' walking behavior. Thirty-six critical care nurses working on the morning shift consented to participate in the research. RESULTS: The study results showed a relationship between the spatial layout of intensive care units (ICUs) and nurses' satisfaction and walking behavior. Questionnaire results indicated statistically significant variations in nurses' satisfaction with the location of the nursing station, the arrangement of patients' rooms, the availability of family space, and the unit's auditory privacy. Nurses in ICU1 were more satisfied with the nursing station's placement and the availability of family space inside patient rooms, while nurses in ICU2 were more satisfied with the patient bed arrangement and the unit's aural privacy than nurses in other units. The pedometer readings and movement maps revealed significant differences in nurses' walking patterns across the three ICUs. The steps, distances, and movement diagrams demonstrated that ICU1 with private rooms outperformed the other units owing to the nurse station's placement and accessibility to patients and support rooms. CONCLUSION: This study concludes that the ICU design impacts nurses' satisfaction and behavior. The optimum placement of nursing stations, patients' beds, and supporting room reduces walking distance and thus increases nurses' satisfaction and performance.

A Study of Workspace Design Characteristics Exemplified by Nurses' Satisfaction Within Three Intensive Care Units in a University Hospital.

BACKGROUND: The critical conditions of intensive care patients require providing them with a higher acuity of care. Thus, it is essential to focus on critical care nurses and improve their work environment in a way that maximizes productivity, collaboration, satisfaction, and leads to improved patient care. PURPOSE: This study aims to explore the role the workplace layout design play in determining nurses' satisfaction in three intensive care units (ICUs) at a university hospital. METHOD: A prospective, cross-sectional, single-center, survey-based design was employed in this study. Data were obtained, via a standardized questionnaire, from 36 morning shift nurses. The nurses' self-reported satisfaction scores in three different ICUs with differing overall layouts, nursing station locations, and workplace design were statistically compared. RESULTS: The study found that ICU 1 (private rooms, single corridor, central nursing station, close to supported services) had higher nursing satisfaction levels than ICUs 2 and 3 (open wards with separate service zones), F(2,34) = 5.054, p = .012. However, overall satisfaction was higher with the ICU 2 primary workspace design, possibly due to the perceived acoustic privacy in this configuration, F(2,34)= 4.492, p = .019. The ability of the ICU layout design to enhance teamwork and minimize traffic in patients care areas was found to be an important predictor of nurses' satisfaction. The primary workspace design capacity to minimize congestion and the presence of large numbers of providers in a confined workplace might account for variation in nurses' satisfaction. CONCLUSION: Physical environment variables in the ICU design may contribute to staff workplace satisfaction scores and may help in guiding informed choices regarding the future ICU design.

The impact of clinic design on teamwork development in primary care.

BACKGROUND: Traditional clinic design supports a high-volume, hierarchical practice model. New design models are evolving to foster a high-functioning team delivery model. PURPOSE: The goal of this study was to determine whether new design models, specifically colocation, improve care team development. METHODOLOGY/APPROACH: A quasi-experimental design was used in this study to obtain validated teamwork development scores and patient satisfaction data to compare clinic design models. We took advantage of a difference in designs of primary care clinics among several clinics within the same care system in the Upper Midwest region of the United States. The participants were staff members of the primary care delivery teams in the studied clinics. The intervention was a redesign of staff space in the clinic. Our measures included a validated measure of team development and a commonly used patient satisfaction tool that were both in use at our institution at the time of the study. RESULTS: Teamwork scores were significantly higher in clinics where the primary work space of the entire team was colocated than in clinics where providers were in spaces separate from other team members. The differences in scores held across team roles, including providers, registered nurses, and licensed practical nurses. Patient satisfaction was not different. CONCLUSION: Colocation in clinic design appears to have a significant impact on team development across primary care team member roles. PRACTICE IMPLICATIONS: Primary care practice leaders should consider colocated clinic designs if their goal is to optimize care team development in support of team-based care delivery models. A more precise understanding of colocation that includes aspects such as distance to and visibility to teammates might help improve design in the future.

Spatial Influences on Team Awareness and Communication in Two Outpatient Clinics: a Multiple Methods Study.

BACKGROUND: Healthcare organizations are moving their primary care teams out of private offices into shared workspaces for many reasons, including teamwork improvement and cost reduction. OBJECTIVE: Identify the specific aspects of layout and design that enable two fundamental processes of high-functioning teams: communication and situation awareness. DESIGN: This was a multi-method study employing qualitative interviews, floor plan analysis, observations, behavior mapping, and surveys. PARTICIPANTS: Two primary care clinics in a large, integrated healthcare system in the upper Midwest, with Clinic S in a suburban location and Clinic A in a rural setting. In the two clinics, a total of 36 staff members were interviewed, 57 (66% response rate) staff members were surveyed, and 2013 individual-points were recorded during 63 behavior mapping observations. MAIN MEASURES: Communication encounters, team members' perception of the environment and teamwork, visibility, distance, functional pathways, and self-reported mode and frequency of staff communication. KEY RESULTS: Observations, interviews, and surveys identified environmental factors that predict staff awareness and communication patterns. Visibility impacts situation awareness. Frequency of face-to-face communication increases with visibility and proximity between workstations (e.g., Clinic A nurses' intra-role communication without workstation proximity vs inter-role communication with workstation proximity: 22.6% [11.4, 33.9] vs 77.4% [66.1, 88.6], p = 0.001) and with staff members' functional paths. Visual exposure to patients predicts staff's concerns about their communication (Clinic S: 2.29 ± 0.81 vs Clinic A: 3.20 ± 0.84, p < 0.001). CONCLUSIONS: Design and layout of team spaces have important influences on the way that team members work together. The organizational goals of the healthcare system, particularly which staff members need to work together most frequently, should drive the specific design solution.