Abstract: Due to the emergence of “Humanized Healthcare"
introduced by Professor Dr. Prawase Wasi in 2003[1], the
development of this paradigm tends to be widely implemented. The
organizations included Healthcare Accreditation Institute (public
organization), National Health Foundation, Mahidol University in
cooperation with Thai Health Promotion Foundation, and National
Health Security Office (Thailand) have selected the hospitals or
infirmaries that are qualified for humanized healthcare since 2008-
2010 and 35 of them are chosen to be the outstandingly navigating
organizations for the development of humanized healthcare,
humanized healthcare award [2].
The research aims to study the current issue, characteristics and
patterns of hospital administration contributing to humanized
healthcare system in Thailand. The selected case studies are from
four hospitals including Dansai Crown Prince Hospital, Leoi;
Ubolrattana Hospital, Khon Kaen; Kapho Hospital, Pattani; and
Prathai Hospital, Nakhonrachasima. The methodology is in-depth
interviewing with 10 staffs working as hospital executive directors,
and representatives from leader groups including directors,
multidisciplinary hospital committees, personnel development
committees, physicians and nurses in each hospital. (Total=40) In
addition, focus group discussions between hospital staffs and general
people (including patients and their relatives, the community leader,
and other people) are held by means of setting 4 groups including 8
people within each group. (Total=128) The observation on the
working in each hospital is also implemented. The findings of the
study reveal that there are five important aspects found in each
hospital including (1) the quality improvement under the mental and
spiritual development policy from the chief executives and lead
teams, leaders as Role model and they have visionary leadership; (2)
the participation hospital administration system focusing on learning
process and stakeholder- needs, spiritual human resource
management and development; (3) the relationship among people
especially staffs, team work skills, mutual understanding, effective
communication and personal inner-development; (4) organization
culture relevant to the awareness of patients- rights as well as the
participation policy including spiritual growth achieving to the same
goals, sharing vision, developing public mind, and caring; and (5)
healing structures or environment providing warmth and convenience
for hospital staffs, patients and their relatives and visitors.
Abstract: The cost of damage to the non-structural systems in
critical facilities like nuclear power plants and hospitals can exceed
80% of the total cost of damage during an earthquake. The failure of
nonstructural components, especially, piping systems led to leakage of
water and subsequent shut-down of hospitals immediately after the
event. Consequently, the evaluation of performance of these types of
structural configurations has become necessary to mitigate the risk and
to achieve reliable designs.
This paper focuses on a methodology to evaluate the static and
dynamic characteristics of complex actual piping system based on
NFPA-13 and SMACNA guidelines. The result of this study revealed
that current piping system subjected to design lateral force and design
spectrum based on UBC-97 was failed in both cases and mode shapes
between piping system and building structure were very different
Abstract: The Beshar River is one aquatic ecosystem,which is
affected by pollutants. This study was conducted to evaluate the
effects of human activities on the water quality of the Beshar river.
This river is approximately 190 km in length and situated at the
geographical positions of 51° 20' to 51° 48' E and 30° 18' to 30° 52'
N it is one of the most important aquatic ecosystems of Kohkiloye
and Boyerahmad province next to the city of Yasuj in southern Iran.
The Beshar river has been contaminated by industrial, agricultural
and other activities in this region such as factories, hospitals,
agricultural farms, urban surface runoff and effluent of wastewater
treatment plants. In order to evaluate the effects of these pollutants
on the quality of the Beshar river, five monitoring stations were
selected along its course. The first station is located upstream of
Yasuj near the Dehnow village; stations 2 to 4 are located east, south
and west of city; and the 5th station is located downstream of Yasuj.
Several water quality parameters were sampled. These include pH,
dissolved oxygen, biological oxygen demand (BOD), temperature,
conductivity, turbidity, total dissolved solids and discharge or flow
measurements. Water samples from the five stations were collected
and analysed to determine the following physicochemical
parameters: EC, pH, T.D.S, T.H, No2, DO, BOD5, COD during 2008
to 2009. The study shows that the BOD5 value of station 1 is at a
minimum (1.5 ppm) and increases downstream from stations 2 to 4 to
a maximum (7.2 ppm), and then decreases at station 5. The DO
values of station 1 is a maximum (9.55 ppm), decreases downstream
to stations 2 - 4 which are at a minimum (3.4 ppm), before increasing
at station 5. The amount of BOD and TDS are highest at the 4th
station and the amount of DO is lowest at this station, marking the
4th station as more highly polluted than the other stations. The
physicochemical parameters improve at the 5th station due to
pollutant degradation and dilution. Finally the point and nonpoint
pollutant sources of Beshar river were determined and compared to
the monitoring results.
Abstract: Oral health is particular important to the hospitalized
patients with chronic schizophrenia for an extreme high potential of the respiratory infections. Due to the degeneration of physical capability, patients of this kind typically fall dependent in the activity of daily living (ADL). A very high percentage of patients had dental
problems of which mostly could be easily avoid by easy regular tooth brushing. Purpose of the project is to develop a mechanism in helping the schizophrenia patients in rebuilding a tooth-cleaning habit. The
project observed and evaluated the tooth-cleaning behavior of 100
male patients in a psychiatric hospital, and found the majority of them
ignored such an activity in a three-month period of time. In the meantime, the primary care-givers were not aware or not convinced
the importance of such a need of dental hygiene, and thus few if any
tooth cleaning training or knowledge on dental hygiene were given to
the patients. The project then developed a program based on the numerous observations and discussions. The improvement program
included patients- group education, care-givers- training, and a
tool-kit for tooth-brush holding was erected. The project launched
with some incentive package. The outcomes were encouraging with
87% of the patients had rebuilt their tooth-brushing habits against
previous 22%, and the tooth cleaning kits were 100% kept against 22%
in the past. This project had significantly improved the oral health of
the patients. The project, included the procedure and the tool-kit
holder specific for this purpose, was a good examples for psychiatric
hospitals.
Abstract: TELMES project aims to develop a securized
multimedia system devoted to medical consultation teleservices. It
will be finalized with a pilot system for a regional telecenters
network that connects local telecenters, having as support
multimedia platforms. This network will enable the implementation
of complex medical teleservices (teleconsulations, telemonitoring,
homecare, urgency medicine, etc.) for a broader range of patients
and medical professionals, mainly for family doctors and those
people living in rural or isolated regions. Thus, a multimedia,
scalable network, based on modern IT&C paradigms, will result. It
will gather two inter-connected regional telecenters, in Iaşi and
Piteşti, Romania, each of them also permitting local connections of
hospitals, diagnostic and treatment centers, as well as local networks
of family doctors, patients, even educational entities. As
communications infrastructure, we aim to develop a combined fixmobile-
internet (broadband) links. Other possible communication
environments will be GSM/GPRS/3G and radio waves. The
electrocardiogram (ECG) acquisition, internet transmission and
local analysis, using embedded technologies, was already
successfully done for patients- telemonitoring.
Abstract: This paper proposes a novel architecture for At-
Home medical care which enables senior citizens, patients
with chronic ailments and patients requiring post- operative
care to be remotely monitored in the comfort of their homes.
This architecture is implemented using sensors and wireless
networking for transmitting patient data to the hospitals,
health- care centers for monitoring by medical professionals.
Patients are equipped with sensors to measure their
physiological parameters, like blood pressure, pulse rate etc.
and a Wearable Data Acquisition Unit is used to transmit the
patient sensor data. Medical professionals can be alerted to
any abnormal variations in these values for diagnosis and
suitable treatment. Security threats and challenges inherent to
wireless communication and sensor network have been
discussed and a security mechanism to ensure data
confidentiality and source authentication has been proposed.
Symmetric key algorithm AES has been used for encrypting
the data and a patent-free, two-pass block cipher mode CCFB
has been used for implementing semantic security.
Abstract: In recent years, rapid advances in software and hardware in the field of information technology along with a digital imaging revolution in the medical domain facilitate the generation and storage of large collections of images by hospitals and clinics. To search these large image collections effectively and efficiently poses significant technical challenges, and it raises the necessity of constructing intelligent retrieval systems. Content-based Image Retrieval (CBIR) consists of retrieving the most visually similar images to a given query image from a database of images[5]. Medical CBIR (content-based image retrieval) applications pose unique challenges but at the same time offer many new opportunities. On one hand, while one can easily understand news or sports videos, a medical image is often completely incomprehensible to untrained eyes.
Abstract: Most, if not all, public hospitals in Thailand have encountered a common problem regarding the increasing demand for medical services. The increasing number of patients causes so much strain on the hospital-s services, over-crowded, overloaded working hours, staff fatigue, medical error and long waiting time. This research studied the characteristics of operational processes of the medical care services at the medicine department in a large public university hospital. The research focuses on details regarding methods, procedures, processes, resources, and time management in overall processes. The simulation model is used as a tool to analyze the impact of various improvement strategies.
Abstract: Operating rooms are important assets for hospitals as
they generate the largest revenue and, at the same time, produce the
largest cost for hospitals. The model presented in this paper helps
make capacity planning decisions on the combination of open
operating rooms (ORs) and estimated overtime to satisfy the
allocated OR time to each specialty. The model combines both
decisions on determining the amount of OR time to open and to
allocate to different surgical specialties. The decisions made are
based on OR costs, overutilization and underutilization costs, and
contribution margins from allocating OR time. The results show the
importance of having a good estimate of specialty usage of OR time
to determine the amount of needed capacity and highlighted the
tradeoff that the OR manager faces between opening more ORs
versus extending the working time of the ORs already in use.
Abstract: The purpose of this article is to introduce an advanced
system for the support of processing of medical image information,
and the terminology related to this system, which can be an important
element to a faster transition to a fully digitalized hospital.
The core of the system is a set of DICOM compliant applications
running over a dedicated computer network. The whole integrated
system creates a collaborative platform supporting daily routines in
the radiology community, developing communication channels,
supporting the exchange of information and special consultations
among various medical institutions as well as supporting medical
training for practicing radiologists and medical students. It gives the
users outside of hospitals the tools to work in almost the same
conditions as in the radiology departments.
Abstract: Hospitals in southern Hualien teamed with the
Hypertension Joint Care Network. Working with the network, the
team provided a special designed health education to the individual
who had been identified as a hypertension patient in the outpatient
department. Some metabolism improvements achieved. This is a
retrospective study by purposively taking 106 patients from a hospital
between 2008 and 2010. Records of before and after education
intervention of the objects was collected and analyzed to see the how
the intervention affected the patients- hypertension control via clinical
parameter monitoring. The results showed that the clinical indicators,
the LDL-C, the cholesterol and the systolic blood pressure were
significantly improved. The study provides evidence for the
effectiveness of the network in controlling hypertension.
Abstract: Information regarding early onset neonatal sepsis
(EONS) pathogens may vary between regions. Global perspectives
showed Group B Streptococcal (GBS) as the most common causative
pathogens, but the widespread use of intrapartum antibiotics has
changed the pathogens pattern towards gram negative
microorganisms, especially E. coli. Objective of this study is to
describe the pathogens isolated, to assess current treatment and risk
of EONS. Records of 899 neonates born in three General Hospitals
between 2009 until 2012 were retrospectively reviewed. Proven was
found in 22 (3%) neonates. The majority was isolated with gram
positive organisms, 17 (2.3%). All grams positive and most gram
negative organisms showed sensitivity to the tested antibiotics. Only
two rare gram negative organisms showed total resistant. Male was
possible risk of proven EONS. Although proven EONS remains
uncommon in Malaysia, nonetheless, the effect of intrapartum
antibiotics still required continuous surveillance.
Abstract: Researchers of drug-drug interaction alert systems
have often suggested that there were high overridden rate for alerts and
also too false alerts. However, research about decreasing false alerts is
scant. Therefore, the aim of this article attempts to proactive
identification of false alert for drug-drug interaction and provide
solution to decrease false alerts. This research involved retrospective
analysis prescribing database and calculated false alert rate by using
MYSQL and JAVA. Results of this study showed 17% of false alerts
and the false alert rate in the hospitals (37%) was more than in the
clinics. To conclude, this study described the importance that
drug-drug interaction alert system should not only detect drug name
but also detect frequency or route, as well as in providing solution to
decrease false alerts.