UNASSIGNED: To investigate the implementation of teleconsultation and assess the level of readiness for its adoption among various types of healthcare facilities.
UNASSIGNED: This cross-sectional study involved medical doctors working in a public hospital, a private hospital, and community health centers in Yogyakarta, Indonesia. We recruited 29 medical specialists from various departments in two hospitals and 27 heads of community health centers. The readiness items were categorized into sections that encompassed various readiness areas such as core, technological, motivational, learning, work culture, and policy readiness. Data were analyzed using a one-way analysis of variance and the Kruskal-Wallis test to evaluate differences in levels of readiness across healthcare facilities. A logistic regression analysis was conducted to further assess factors predicting the implementation of teleconsultation.
UNASSIGNED: Variations in technological readiness were observed between the community health centers and the public hospital (p = 0.006) and the private hospital (p = 0.007). Differences in learning readiness were found between the public hospitals and private hospitals (p = 0.01). There were also disparities in cultural readiness between the public hospital and the private hospital (p = 0.04) and between public hospital and community health centers (p = 0.01). Logistic regression revealed an association between technological readiness and the use of video teleconsultation (OR = 1.13; p = 0.017). The private hospital was more likely to implement video-based teleconsultation than was the public hospital (OR = 2.68; p = 0.003) or community health centers (OR = 3.13; p ≤ 0.001).
UNASSIGNED: Significant differences in technology readiness were identified among community health centers, public hospitals, and private hospitals. Future policy implementation should focus on customizing technology use and providing cultural training to help healthcare institutions with different technological readiness levels.

Improving healthcare requires appropriate community involvement supported by appropriate partner engagement methods. This research aims to develop a complex tool for evaluating the social responsibility of health facilities regarding community involvement and development. We developed areas of a new reference framework for the sustainability of healthcare organizations, which includes the area of community involvement and expansion. It is made up of nine indicators. These were designed using the most representative activities reported by hospitals around the world. Their testing was conducted in an orthopedic emergency hospital. The designed indicators are community engagement actions; the interventions\' content adapted to the community; partnership and networking; the involvement of volunteers and training networks; the involvement and participation of professional associations; community-involved local opinion leaders; satisfaction with partnerships; initiatives together with the community; and educational visits. The testing and validation of health practices of the indicators highlighted their adequacy with the proposed purpose of the research and the promotion of sustainable development. We have also verified their compatibility with the requirements of national hospital accreditation legislation and the European framework for quality assurance in hospitals.

OBJECTIVE: A sustainability-oriented hospital governance has the potential to increase the efficiency of healthcare services and reduce the volume of expenses. The objective of this research is to develop a new complex tool for evaluating healthcare facility governance as a component of social responsibility, integrated into sustainability.
METHODS: We designed the research to develop the domains of a new reference framework for evaluating healthcare facility governance. The methodology for designing the indicators that make up the new reference framework consists of collecting and processing the most recent and relevant practices regarding the governance of healthcare facilities that have been reported by representative hospitals around the world.
RESULTS: We designed eight indicators that are brought together in the healthcare facility governance indicators matrix. They have descriptions and qualitative and quantitative rating scales with values from 0 to 5 that allow the degree of fulfillment to be quantified. The importance of the indicators is evaluated on a specific scale described qualitatively and quantitatively by values from 0 to 5. The values of the degree of achievement-importance couples of the indicators allow the development of improvement measures with priority according to the results revealed by the Eisenhower-type assessment diagram.
CONCLUSIONS: Validation in practice of the system of indicators at an emergency hospital in an orthopedic profile highlighted the fact that they can be integrated into other national and international reference frameworks implemented in the hospital. The added value of the implementation consists of the facilitation of sustainable development and the orientation of health personnel, patients, and interested parties toward sustainability.

This study aimed to review the literature on healthcare facilities and medical tourism from a range of nations that have established medical tourism sectors and assess the effect of healthcare facilities on medical tourism. A bibliometric study of the Scopus database was carried out by using the search terms \'(Facility AND of AND healthcare) AND TITLE-ABS-KEY (health AND tourism) AND medical tourism\' for the years 2012-2022. A qualitative evaluation of the literature was then performed to find and locate 92 articles. VOSviewer and NVivo 12 Plus were employed for data analysis. The findings indicated that the following trending subject keywords were used during the period in question: health (rate 1.97), medicine (rate 1.91), tourism (rate 1.70), care (rate 0.83), facilities (rate 0.64) and healthcare (rate 0.61). Furthermore, this research identified four distinct clusters: i) medical tourism, ii) healthcare quality, iii) healthcare system and iv) health services. The study found that healthcare facilities, as actors that have a role in the development of medical tourism, have not been sufficiently explored, even though there is evidence that they play a role in the growth of the sector. This result is in line with Heung\'s argument, which makes the same point.

Biomedical waste management (BMWM) in India poses significant challenges that demand thorough examination and strategic interventions. As the country\'s healthcare sector expands rapidly, proper management of biomedical waste becomes increasingly critical to safeguarding public health and environmental integrity. Biomedical waste, encompassing industrial waste, hospital waste, and waste from other healthcare facilities, poses a heightened risk of infection and injury compared to any other form of waste. A lack of understanding regarding safe medical waste disposal practices can be hazardous to one\'s health as well as the environment. To improve waste management practices in the country, we can suggest effective strategies and recommendations by developing a deeper understanding of the current situation. To manage medical waste effectively, healthcare professionals must be knowledgeable about and have experience with this process. This evaluation study provides a comprehensive overview of current BMWM methods in India, shedding light on the benefits, drawbacks, challenges, and areas for improvement in the healthcare waste management system. Several important facets of BMWM were highlighted by the literature research, including waste segregation, treatment techniques, and disposal options, as well as compliance and regulatory frameworks.

UNASSIGNED: Disease surveillance is very crucial especially in high vulnerability settings like Pakistan. However, surveillance and outbreak response management are still evolving in the country and research studies are needed to assess the existing system.
UNASSIGNED: To assess the impact of integrated disease surveillance and response system (IDSRS) implemented by the provincial government to strengthen infectious disease surveillance and reporting in 6 districts of Pakistan in 2016.
UNASSIGNED: A baseline cross-sectional assessment of health facilities and the healthcare workforce was conducted in 2016 to identify needs and gaps in public sector health facilities and the health system of 6 selected districts of Khyber Pakhtunkhwa Province, Pakistan. This was followed by a 2018 endline survey of the same facilities using the same variables.
UNASSIGNED: Overall, there was improvement in district management and facility level performance (χ2 (1, 314) = 21.19, P < 0.001, V = 0.26). District level management improved significantly in areas with relatively lower Gross Domestic Product (GDP)? χ2(1, 154) = 30.41, P <0.001, V = 0.44). Facilitation domain variables improved in the lower GDP districts (χ2 (1, 74) = 5.76, P = 0.016, V = 0.28) and showed counterintuitive deterioration (χ2 (1, 74) = 4.80, P = 0.028, V = 0.25) in relatively higher GDP areas.
UNASSIGNED: IDSRS is effective in improving surveillance and response systems, however, its effectiveness appears to depend on locale-specific economies and can be enhanced by modifying the implementation approach. Better empowerment of the local workforce can contribute to such improvement.
تقييم أثر النظام المتكامل لترصُّد الأمراض والاستجابة لها على إدارة الترصُّد في مرافق الرعاية الصحية في باكستان.
ضياء الحق، شيراز فازيد، بشارات حسين، محمد فؤاد خان، عاصف بتاني، بلال بهراوار، عاصف بتاني، شاهين أفريدي.
UNASSIGNED: يُعَدُّ ترصُّد الأمراض أمر بالغ الأهمية، لا سيَّما في الأماكن المعرضة بشدة للخطر، مثل باكستان.
UNASSIGNED: هدفت هذه الدراسة الى تقييم النظام المتكامل لترصُّد الأمراض والاستجابة لها الذي تنفذه حكومة الإقليم بهدف تعزيز ترصُّد الأمراض المُعْدية والإبلاغ عنها في 6 مناطق في باكستان في عام 2016.
UNASSIGNED: استُخدم الإِحْصاء لجمع البيانات على مستوى المناطق، في حين استُخدم أسلوب أخذ العينات العشوائية الطبقية لاختيار 12 مرفقًا صحيًّا لتقييمها. واستُخدمت أداة منظمة الصحة العالمية لجمع البيانات. وأُدخلت البيانات ببرنامج Microsoft Excel وحُلِّلت بالإصدار 14,2 من برنامج STATA. واستُخدم التناظر التقريبي والتجانس الهامشي (ستيوارت-ماكسويل) لتقييم عدم التوافق بين متغيرات المؤشرات ما قبل تطبيقهما وما بعده.
UNASSIGNED: بشكل عام، كان هناك تحسُّن في أداء إدارة المناطق الصحية والأداء على مستوى المرافق (χ2 (314،1) = 21,19، القيمة الاحتمالية <001، التباين = 0,26). وتحسَّنت الإدارة على مستوى المناطق تحسنًا كبيرًا في المناطق ذات الناتج المحلي الإجمالي الأقل نسبيًّا (χ2 (154،1) 30,41، القيمة الاحتمالية <0,001، التباين = 0,44). وتحسَّنت متغيرات مجال التيسير في المناطق ذات الناتج المحلي الإجمالي الأدنى (χ2 (74،1) = 5,76، القيمة الاحتمالية = 0,16، التباين = 0,28) وأظهرت تراجعًا غير متوقع (χ2 (74،1) = 4,80، القيمة الاحتمالية = 0,28، التباين = 0,25) في المناطق ذات الناتج المحلي الإجمالي الأعلى نسبيًّا.
UNASSIGNED: يُعَد النظام المتكامل لترصُّد الأمراض والاستجابة لها فعَّالًًا في تحسين نُظُم الترصُّد والاستجابة، ولكن يبدو أن فعاليته تتوقف على الاقتصادات الخاصة بكل موقع، ويمكن تعزيزها بتعديل نهج التنفيذ. ويمكن أن تسهم زيادة تمكين القوى العاملة المحلية في هذا التحسين.
Évaluation de l\'impact du système de surveillance intégrée des maladies et de riposte sur la gestion de la surveillance au sein des établissements de santé au Pakistan.
UNASSIGNED: La surveillance des maladies constitue un enjeu crucial, en particulier dans les régions à forte vulnérabilité comme le Pakistan. Toutefois, la surveillance et la gestion de la riposte aux flambées épidémiques sont encore en évolution dans le pays et des études de recherche sont nécessaires pour évaluer le système existant.
UNASSIGNED: Déterminer l\'impact du système de surveillance intégrée des maladies et de riposte mis en place par le gouvernement provincial pour renforcer la surveillance et la notification des maladies infectieuses dans six districts du Pakistan au cours de l\'année 2016.
UNASSIGNED: Une évaluation transversale initiale des établissements et des personnels de santé a été réalisée en 2016 pour identifier les besoins et les lacunes des établissements sanitaires du secteur public et du système de santé de six districts sélectionnés de la province de Khyber Pakhtunkhwa (Pakistan). Cette évaluation a été suivie d\'une enquête finale en 2018 auprès des mêmes établissements en utilisant les mêmes variables.
UNASSIGNED: Dans l\'ensemble, une amélioration a été constatée en ce qui concerne la gestion des districts et la performance des établissements (χ2 (1,314) = 21,19, p < 0,001, v = 0,26). La gestion au niveau des districts s\'est nettement améliorée dans les zones où le produit intérieur brut (PIB) est relativement plus faible (χ2 (1,154) = 30,41, p < 0,001, v = 0,44). Les variables du domaine de facilitation ont affiché une amélioration dans les districts où le PIB est plus faible (χ2 (1,74) = 5,76, p = 0,016, v = 0,28), mais elles se sont paradoxalement dégradées (χ2 (1,74) = 4,80, p = 0,028, v = 0,25) dans les zones où le PIB est relativement plus élevé.
UNASSIGNED: Le système de surveillance intégrée des maladies et de riposte est efficace pour renforcer les systèmes de ce genre. Toutefois, son efficacité semble dépendre des économies spécifiques locales et peut être améliorée en modifiant la méthode de mise en œuvre. Une meilleure autonomisation du personnel local peut y contribuer.

Health care accounts for 9-10% of greenhouse gas (GHG) emissions in the United States. Strategies for monitoring these emissions at the hospital level are needed to decarbonize the sector. However, data collection to estimate emissions is challenging, especially for smaller hospitals. We explored the potential of gradient boosting machines (GBM) to impute missing data on resource consumption in the 2020 survey of a consortium of 283 hospitals participating in Practice Greenhealth. GBM imputed missing values for selected variables in order to predict electricity use and beef consumption (R2=0.82) and anesthetic gas desflurane use (R2=0.51), using administrative data readily available for most hospitals. After imputing missing consumption data, estimated GHG emissions associated with these three examples totaled over 3 million metric tons of CO2 equivalent emissions (MTCO2e). Specifically, electricity consumption had the largest total carbon footprint (2.4 MTCO2e), followed by beef (0.6 million MTCO2e) and desflurane consumption (0.03 million MTCO2e) across the 283 hospitals. The approach should be applicable to other sources of hospital GHGs in order to estimate total emissions of individual hospitals and to refine survey questions to help develop better intervention strategies.

OBJECTIVE: Ensuring the sustainability of healthcare facilities requires the evaluation of patient matters with appropriate methods and tools. The objective of this research is to develop a new tool for assessing patient matters as a component of social responsibility requirements that contribute to the sustainability of healthcare facilities.
METHODS: We carried out an analytical observational study in which, starting from the domains of the reference framework for the sustainability of health facilities (economic, environmental, social, provision of sustainable medical care services and management processes), we designed indicators that describe patient matters. To achieve this, we extracted from the scientific literature the most recent data and aspects related to patient matters that have been reported by representative hospitals from all over the world. These were organized into the four sequences of the quality cycle. We designed the method of evaluating the indicators based on the information couple achievement degree-importance of the indicator. In the experimental part of the study, we validated the indicators for the evaluation of patient matters and the evaluation method at an emergency hospital with an orthopedic profile.
RESULTS: We developed the patient matters indicator matrix, the content of the 8 indicators that make it up, questions for the evaluation of the indicators, and the evaluation grids of the indicators. They describe five levels for each variable of the achievement degree-importance couple. The practical testing of the indicators at the emergency hospital allowed the calculation of sustainability indicators and the development of a prioritization matrix for improvement measures.
CONCLUSIONS: Indicators designed in this research cover social responsibility requirements that describe patient matters. They are compatible and can be used by health facilities along with other implemented national and international requirements. Their added value consists in promoting social responsibility and sustainable development of healthcare facilities.

UNASSIGNED: The partogram or partograph is a tool used to monitor the progress of labour and serves as a diagnostic tool for labour-related abnormalities such as prolonged labour, cephalopelvic disproportion (CPD) and obstructed labour. Appropriate utilisation of the partogram aids health caregivers with early diagnosis and facilitates clinical judgement and interventions to prevent complications of abnormal labour. The partogram is thus a mandatory tool to be utilised to monitor the progress of labour for intrapartum care in South Africa.
UNASSIGNED: This study aimed to assess and describe the utilisation of the partogram in a district of the North West Province.
UNASSIGNED: The study was conducted in the private rooms of facilities rendering maternity services in the district.
UNASSIGNED: A quantitative cross-sectional descriptive design was employed. A purposive sampling was used to select healthcare facilities, and simple random sampling was employed to select plotted partograms. Data were collected using a checklist and analysed using Statistical Package for Social Sciences software version 22.
UNASSIGNED: A total of 279 partograms were analysed. The average partogram utilisation was 20% correct and 80% substandard or not recorded. All files had partogram documents included.
UNASSIGNED: A large percentage (80%) of the partograms were not completed according to the World Health Organization (WHO) standards. There was a concern about high proportions of unrecorded parameters such as monitoring of foetal and maternal conditions, and the progress of labour.
UNASSIGNED: The findings and recommendations of the study could improve partogram utilisation in maternity care.

OBJECTIVE: To clarify the state of screening and support systems for socially high-risk pregnant women at obstetric facilities across Japan and identify the characteristics of facilities related to the implementation of screening.
METHODS: This cross-sectional study used a self-administered questionnaire. Participants were managers of hospitals, clinics, and midwifery birth centers handling deliveries in 47 prefectures across Japan. The questionnaire comprised items regarding the characteristics of participants and their facilities, service provision related to socially high-risk women available at the facility, the number of specified pregnant women (tokutei ninpu) per year, methods of screening, and support systems within the obstetric facilities. Descriptive statistics and multivariate logistic regression analysis were performed using IBM-SPSS version 24 for the association between facility characteristics and screening practices for socially high-risk pregnant women.
RESULTS: Valid responses were received from 716 of 2512 obstetric facilities. Rates of specified expectant mothers per annual number of deliveries were identified as follows: perinatal medical centers (2.7%), general hospitals (1.6%), obstetrics and gynecology hospitals (1.0%), and clinics (0.8%). A total of 426 facilities (60.6%) reported screening all expectant mothers to identify socially high-risk pregnant women. Multiple logistic regression analysis revealed that facility characteristics and service/care provision related to screening practices included availability of in-hospital midwife-led care and in-hospital midwifery clinics (adjusted odds ratio 1.61; 95% CI [1.30, 1.47]), one-on-one care by midwife (1.73; 95% CI [1.15, 2.59]), multidisciplinary meetings within the facility (1.70; 95% CI [1.14, 2.56]), follow-up support systems after discharge (1.90; 95% CI [1.17, 3.09]), and participation in the regional council for children in need of protection (2.33; 95% CI [1.13, 4.81]).
CONCLUSIONS: Approximately 60% of surveyed obstetric facilities screen for socially high-risk women. Increasing service provision at facilities may be necessary to implement screening.