A Classification of Healthcare Facilities: Toward the Development of Energy Performance Benchmarks for Day Surgery Centers in Australia.

OBJECTIVE: In the literature, there is no consistent classification of healthcare facilities. In order to benchmark, assess, and compare the environmental performance of these buildings, it is important to clearly identify the typology within the scope of a particular research. This article identifies the different typologies within the healthcare sector, particularly in Australia, with the aim of the development of energy performance benchmarks for day surgery/procedure centers. BACKGROUND: Healthcare buildings encompass a wide range of facilities. They all share the same purpose of healing and offering a health service for patients. However, they vary significantly in terms of patient type and service provided. These buildings consume a considerable amount of energy, and as a result of the different designs and sizes, their pattern of energy consumption varies. METHODS: The research used a systematic review of the literature to determine how the term "healthcare facility" has been employed in different contexts. In order to better understand the differences in healthcare facilities, definitions and the origin of hospitals and healthcare facilities are introduced and a framework for the classification of healthcare facilities and hospitals is proposed. RESULTS: Healthcare facilities are classified into the following six categories: patient type, care provided, management and ownership, level of care, facility size, and location. Based on these classifications, a categorization for the studies of energy performance in healthcare is introduced. CONCLUSIONS: This study provides a basis for assessment and comparison for a particular healthcare building typology that will assist researchers working in the field of design and energy assessment of healthcare facilities.

[A national survey of postoperative pain management in France: influence of type of surgical centres]. / Evaluation des pratiques sur l'analgésie postopératoire en France: enquête nationale avec analyse des différences de pratique selon le type d'établissement.

BACKGROUND: The French Society of Anaesthesia and Intensive Care has supported a national survey of postoperative pain (POP) management in various type of surgical centres. METHODOLOGY: The survey was cross-checking data on information, evaluation, treatment concerning POP of adult patient within 24h after surgery in surgical centres randomly selected according to teaching status, public or private funding and size. A local anaesthetist referent provided information on management of POP. RESULTS: One thousand and nine hundred adult patients were audited. Information on POP was better understood in private centres. Rarely prescribed, written evaluation of POP was frequent on the ward (>90%) without any difference between centres. In all centres, POP evaluation tool were by decreasing frequency, numerical scale, nonspecific tool, visual analog scale and verbal scale. In all institutions, pain was rarely a criterion for recovery room discharge. Reported POP was mild at rest, moderate when moving and intense for maximal pain with no difference between centres. Incidence of side-effects was similar in all centres according to patient or chart, with mainly nausea and vomiting. Analgesics were frequently started during anaesthesia. Patient-controlled analgesia was used less frequently than subcutaneous morphine whose prescription frequently did not follow guidelines especially in small hospital. Non opioid analgesic included paracetamol, ketoprofen mainly in private structure and nefopam mainly in university hospital. Epidural or peripheral nerve blocks were underused similarly in all centres. Evaluation or treatment protocols were less frequent in university hospital. CONCLUSION: This national, prospective, patient-based, observational survey reveals similar achievements in different surgical centres but also some differences and persistent challenges for POP management.