The hospital setting is often perceived as slow to change. While employee-driven approaches offer a promising alternative to traditional top-down methods, guidance is limited. This study provides a description and formative evaluation of an employee-driven working group (WG) approach to tailor ward-specific measures to improve care in the dying phase. The aim is to evaluate the WG process and offer practical insights for transferability to other hospitals.

Formative mixed-methods evaluation of a WG process to tailor ward-specific evidence-informed measures on 10 wards outside specialized palliative care at 2 German medical centers. To analyze factors relevant for the WG process, the Consolidated Framework for Implementation Research 2.0 was applied. Data included baseline evaluation (medical record analysis, staff survey and focus groups, informal caregiver interviews), WG protocols, and an online survey with WG participants.

Multiprofessional WGs were established on all hospital wards, with an average of 7 meetings per ward within 1 year and 4 participants per meeting. Adapting the process to participants’ wishes and needs were crucial, particularly regarding the desired degree of external input. We identified 4 barriers (e.g. declining participation, institutional limits) and 7 facilitators (e.g. involvement of staff in leading positions, multiprofessional composition). The WGs tailored 34 measures, e.g. team meetings to improve communication within the team. Participants’ views were generally positive: 91% felt able to share their thoughts, 66% were satisfied with the outcome, and 77% would participate again.

The employee-driven approach was feasible and useful for tailoring ward-specific measures. However, integrating top-down elements proved to be beneficial. The identified barriers and facilitators provide insights for transferring an employee-driven approach to other hospitals to improve care in the dying phase outside specialized palliative care settings.

The study was registered in the German Clinical Trials Register (DRKS00025405).

This study aimed to examine health care workers’ (HCWs) perceptions of hospital disaster planning and preparedness within the context of building resilient health care systems. It also evaluated HCWs’ involvement in the planning process.

Thirteen HCWs from 2 Queensland hospitals participated in in-depth, semi-structured interviews. These interviews were audio-recorded with participant consent and transcribed verbatim. Transcripts, recordings, and participant details were coded for confidentiality. Thematic analysis was used to identify essential patterns in the data and make sense of them.

HCWs’ perspectives on disaster planning underscored the importance of comprehensive planning, business continuity, proactive approaches emphasizing anticipation and risk mitigation, and implementation of established plans through training, resource management, and operational readiness. HCWs’ participation in planning ranged from high engagement through collaboration and continuous improvement to moderate or lower levels focusing on regulatory compliance and resource allocation.

This study highlights HCWs’ views regarding disaster planning and preparedness for building resilient health care systems. HCWs emphasised comprehensive planning and proactive preparedness, aligning with global priorities for disaster risk reduction. They stress the importance of education, training, operational readiness, and continuous improvement. This study underlines the vital role of HCWs’ participation in disaster planning and the need for comprehensive training initiatives.

The project aimed to characterize the exposure to seismic hazard in the emergency area of a high-complexity hospital in Cali, Colombia.

The occupancy of the emergency area was analyzed over 6 months, determining the value of material elements exposed to the seismic hazard. Four phases were executed: search for pre-existing information, occupancy analysis, evaluation of exposed assets, and results analysis. The information was analyzed using a Geographic Information System (GIS), which allowed the visualization of demographic behavior in different locations and times.

The results confirmed that the seismic hazard is high, exacerbated by local geomechanical characteristics. It was observed that the average occupancy of most studied areas exceeded capacity. The value of the exposed assets was estimated at COP 3 221 008 640 (USD 959 844.76), the demolition value at COP 10 582 770 000 (USD 3 153 613.49), and the reconstruction value at COP 30 293 640 275 (USD 9 027 356.03). In the worst-case scenario, the losses were equivalent to 12.4% of the hospital’s annual budget.

The data allow the hospital to take preventive measures and educate the staff to identify and mitigate critical areas. It also contributes to the knowledge of the approximate value of economic losses and the impact of potential human losses.

A surge of pediatric respiratory illnesses beset the United States in late 2022 and early 2023. This study evaluated within-surge hospital acute and critical care resource availability and utilization. The study aimed to determine pediatric hospital acute and critical care resource use during a respiratory illness surge.

Between January and February 2023, an online survey was sent to the sections of hospital medicine and critical care of the American Academy of Pediatrics, community discussion forums of the Children’s Hospital Association, and PedSCCM—a pediatric critical care website. Data were summarized with median values and interquartile range.

Across 35 hospitals with pediatric intensive care units (PICU), increase in critical care resource use was significant. In the month preceding the survey, 26 (74%) hospitals diverted patients away from their emergency department (ED) to other hospitals, with 46% diverting 1-5 patients, 23% diverting 6-10 patients, and 31% diverting more than 10 patients. One in 5 hospitals reported moving patients on mechanical ventilation from the PICU to other settings, including the ED (n = 2), intermediate care unit (n = 2), cardiac ICU (n = 1), ward converted to an ICU (n = 1), and a ward (n = 1). Utilization of human critical care resources was high, with PICU faculty, nurses, and respiratory therapists working at 100% capacity.

The respiratory illness surge triggered significant hospital resource use and diversion of patients away from hospitals. Pediatric public health emergency-preparedness should innovate around resource capacity.

The COVID-19 pandemic created many challenges for in-patient care including patient isolation and limitations on hospital visitation. Although communication technology, such as video calling or texting, can reduce social isolation, there are challenges for implementation, particularly for older adults.

This study used a mixed methodology to understand the challenges faced by in-patients and to explore the perspectives of patients, family members, and health care providers (HCPs) regarding the use of communication technology. Surveys and focus groups were used.

Patients who had access to communication technology perceived the COVID-19 pandemic to have more adverse impact on their well-beings but less on hospitalization outcomes, compared to those without. Most HCPs perceived that technology could improve programs offered, connectedness of patients to others, and access to transitions of care supports. Focus groups highlighted challenges with technology infrastructure in hospitals.

Our study findings may assist efforts in appropriately adopting communication technology to improve the quality of in-patient and transition care.

Peru’s health infrastructures, particularly hospitals, are exposed to disaster threats of different natures. Traditionally, earthquakes have been the main disaster in terms of physical and structural vulnerability, but the coronavirus disease 2019 (COVID-19) pandemic has also shown their functional vulnerability. Public hospitals in Lima are very different in terms of year constructed, type of construction, and number of floors, making them highly vulnerable to earthquakes. In addition, they are subject to a high demand for care daily. Therefore, if a major earthquake were to occur in Lima, the hospitals would not have the capacity to respond to the high demand.

The aim of this study was to analyze the Hospital Safety Index (HSI) in hospitals in Lima (Peru).

This was a cross-sectional observational study of 18 state-run hospitals that met the inclusion criteria; open access data were collected for the indicators proposed by the Pan American Health Organization (PAHO) Version 1. Associations between variables were calculated using the chi-square test, considering a confidence level of 95%. A P value less than .05 was considered to determine statistical significance.

The average bed occupancy rate was 90%, the average age was 70 years, on average had one bed per 25,126 inhabitants, and HSI average score was 0.36 with a vulnerability of 0.63. No association was found between HSI and hospital characteristics.

Most of the hospitals were considered Category C in earthquake and disaster safety, and only one hospital was Category A. The hospital situation needs to be clarified, and the specific deficiencies of each institution need to be identified and addressed according to their own characteristics and context.

The National Pediatric Cardiology Quality Improvement Collaborative (NPC-QIC) lacks a rigorous enrollment audit process, unlike other collaborative networks. Most centers require individual families to consent to participate. It is unknown whether there is variation across centers or biases in enrollment.

We used the Pediatric Cardiac Critical Care Consortium (PC4) registry to assess enrollment rates in NPC-QIC for those centers participating in both registries using indirect identifiers (date of birth, date of admission, gender, and center) to match patient records. All infants born 1/1/2018–12/31/2020 and admitted 30 days of life were eligible. In PC4, all infants with a fundamental diagnosis of hypoplastic left heart or variant or who underwent a surgical or hybrid Norwood or variant were eligible. Standard descriptive statistics were used to describe the cohort and center match rates were plotted on a funnel chart.

Of 898 eligible NPC-QIC patients, 841 were linked to 1,114 eligible PC4 patients (match rate 75.5%) in 32 centers. Match rates were lower in patients of Hispanic/Latino ethnicity (66.1%, p = 0.005), and those with any specified chromosomal abnormality (57.4%, p = 0.002), noncardiac abnormality (67.8%, p = 0.005), or any specified syndrome (66.5%, p = 0.001). Match rates were lower for patients who transferred to another hospital or died prior to discharge. Match rates varied from 0 to 100% across centers.

It is feasible to match patients between the NPC-QIC and PC4 registries. Variation in match rates suggests opportunities for improvement in NPC-QIC patient enrollment.

The study aimed to identify the factors that influence the disaster preparedness of hospitals and validate an evaluation framework to assess hospital disaster preparedness (HDP) capability in the Eastern Province of Saudi Arabia.

A cross-sectional survey of all hospitals (n = 72) in the Eastern Region of Saudi Arabia was conducted. A factor analysis method was used to identify common factors and validate the evaluation framework to assess HDP capacity.

Sixty-three (63) hospitals responded to the survey. A 3-factor structure was identified as key predicators of HDP capacity. The first factor was the most highly weighted factor, which included education and training (0.849), monitoring and assessing HDP (0.723), disaster planning (0.721), and command and control (0.713). The second factor included surge capacity (0.708), triage system (0.844), post-disaster recovery (0.809), and communication (0.678). The third factor represented safety and security (0.638) as well as logistics, equipment, and supplies (0.766).

The identified 3-factor structure provides an innovative approach to assist the operationalization of the concept of HDP capacity building and service improvement, as well as serve as a groundwork to further develop instrument for assessing HDP in future studies.