Federica Pascale

Hospital resilience to natural hazards: classification and performance of utilities

Purpose – The purpose of this paper is to: explore major and potential challenges facing healthcare facilities operation specifically those related to utility supplies; and quantify the impact of utility supplies interruption on the operation of healthcare facilities through the development of an estimation model. Design/methodology/approach – A pluralistic qualitative and quantitative research approach benefiting from an online computer program that applies the discriminant function analysis approach. Information was collected from 66 hospitals following three major earthquakes that struck northeast Japan in 2003. Findings – Analysis demonstrated that healthcare utilities face three major challenges: vulnerability of infrastructure to natural hazards; low performance of alternative sources; and lack of consideration of healthcare utility supplies in resilience codes and legislations. The study also proposed a method to estimate the impact of utility interruption of healthcare facilities. A model has been...

Healthcare emergency planning and management to major hazards in the UK

This study aims to examine the challenges and opportunities UK healthcare emergency planners and responders have to cope with major hazards. The study followed a qualitative research methodology where data was collected from a comprehensive literature review, an international workshop and interviews. The findings established that the UK healthcare emergency planning process needs to: consider the integration of soft and hard resources in planning; involve independent experts for further support; and use IT systems innovatively to develop a comprehensive emergency model, predict vulnerabilities and optimise effectiveness and efficiency. The major recommendations are to: identify and evaluate risks more accurately; enhance opportunities and reduce risks associated with multiagency approaches; ensure that soft and hard resources are well integrated in planning; involve and integrate more with independent parties such as academia for extra support; and innovatively use IT systems to develop a comprehensive emergency model, predict vulnerabilities and optimise operability.

Integration of resilience and sustainability: from theory to application

Purpose – This study aims to explore the challenges associated with the integration of resilience and sustainability, and propose a workable solution that ensures resilient and sustainable buildings. Recent research outcomes suggest that the number of natural hazards, both environmental and geophysical, will increase due to the effect of global warming. Various approaches have been investigated to reduce environmental degradation and to improve the physical resilience to natural hazards. However, most of these approaches are fragmented and when combined with cultural barriers, they often result into less-efficient assessment tools. Design/methodology/approach – The primary source of information used to develop this paper has been research publications, policy papers, reports and tool guidelines. A set of questions were developed to guide the review which was complemented with information distilled from the HFA 2005-2015 to develop an integration process to evaluate 10 international sustainability appraisa...

Evaluation of factors and approaches affecting emergency department space planning

Purpose – This paper aims to evaluate emergency department (ED) design space planning approaches and draw lessons for developing more resilient and integrated ED guidelines. Two key objectives have been set; these include: exploring potential factors affecting the ED performance, and investigate how ED space planning is addressed internationally through the evaluation of international case studies and design guidelines. Design/methodology/approach – A robust research method has been adopted including comprehensive literature review in addition to 76 case studies from Italy and the USA. Findings – Findings show that the important factors in defining ED space requirements are attendance variability, vulnerable groups and mass casualty events. The study concludes that current design guidelines and approaches need to be updated to meet with the current and future demand by taking into account design performance: effectiveness, efficiency and resilience, to avoid underestimating ED space; and that the US EDs a...

Learning lessons from the 2011 Van Earthquake to enhance healthcare surge capacity in Turkey

ABSTRACT Historically, Turkey has adopted a reactive approach to natural hazards which resulted in significant losses. However, following the 1999 Kocaeli Earthquake, a more proactive approach has been adopted. This study aims to explore the way this new approach operates on the ground. A multinational and multidisciplinary team conducted a field investigation following the 2011 Van Earthquake to identify lessons to inform healthcare emergency planning in Turkey and elsewhere. The team interviewed selected stakeholders including, healthcare emergency responders, search and rescue services, ambulance services, and health authority representatives, in addition to conducting a focus group. Data were analysed according to an open coding process and SWOT (strength, weakness, opportunity, and threat) analysis. The findings suggest that the approach succeeded in developing a single vision by consolidating official efforts in a more structured way, mobilising many governmental and non-governmental organisations, securing significant amounts of resources including physical and human, and increasing the resilience and flexibility of infrastructure to expand its capacity. However, more attention is required to the development of stronger management procedures and acquisition of further resources.

A built environment response to the rising costs of dementia

Purpose - This paper identifies costs related to dementia care provision and explores how purposeful built environment investments can help control these costs and improve Quality of Life and clinical outcomes. Design/methodology/approach - This research adopts a multi-method approach where the findings of a literature review drove the analysis of data obtained from the 115 pilot projects funded by the Department of Health England’s National Dementia Capital Investment Programme. Findings - Under the UK government’s new productivity challenge, it is fundamental to identify actions that provide Value for Money in order to prioritise policy and practice. This paper identifies healthcare spaces (e.g. bathroom) where the impact of the built environment on healthcare costs are most evident, and building elements (e.g. lighting) to which these costs can be directly associated. The paper advocates the development of evidence and decision support tools capable of: linking built environment interventions to the healthcare costs; and helping the health and social care sectors to develop effective and efficient capital investment strategies. Research limitations/implications - Further work needs to develop more systematic ways of rationalising pro-active and timely built environment interventions capable of mitigating dementia (and elderly) care cost escalation. Originality/value - This research takes an innovative view on capital investment for care environments and suggests that appropriate built environment interventions can have a profound impact on costs associated with dementia care provision.