Sample records for health facility management
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Health and Safety Management for Small-scale Methane Fermentation Facilities
Yamaoka, Masaru; Yuyama, Yoshito; Nakamura, Masato; Oritate, Fumiko
In this study, we considered health and safety management for small-scale methane fermentation facilities that treat 2-5 ton of biomass daily based on several years operation experience with an approximate capacity of 5 t·d-1. We also took account of existing knowledge, related laws and regulations. There are no qualifications or licenses required for management and operation of small-scale methane fermentation facilities, even though rural sewerage facilities with a relative similar function are required to obtain a legitimate license. Therefore, there are wide variations in health and safety consciousness of the operators of small-scale methane fermentation facilities. The industrial safety and health laws are not applied to the operation of small-scale methane fermentation facilities. However, in order to safely operate a small-scale methane fermentation facility, the occupational safety and health management system that the law recommends should be applied. The aims of this paper are to clarify the risk factors in small-scale methane fermentation facilities and encourage planning, design and operation of facilities based on health and safety management.
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An Application of Business Process Management to Health Care Facilities.
Hassan, Mohsen M D
The purpose of this article is to help health care facility managers and personnel identify significant elements of their facilities to address, and steps and actions to follow, when applying business process management to them. The ABPMP (Association of Business Process Management Professionals) life-cycle model of business process management is adopted, and steps from Lean, business process reengineering, and Six Sigma, and actions from operations management are presented to implement it. Managers of health care facilities can find in business process management a more comprehensive approach to improving their facilities than Lean, Six Sigma, business process reengineering, and ad hoc approaches that does not conflict with them because many of their elements can be included under its umbrella. Furthermore, the suggested application of business process management can guide and relieve them from selecting among these approaches, as well as provide them with specific steps and actions that they can follow. This article fills a gap in the literature by presenting a much needed comprehensive application of business process management to health care facilities that has specific steps and actions for implementation.
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Guidelines for Management Information Systems in Canadian Health Care Facilities
Thompson, Larry E.
1987-01-01
The MIS Guidelines are a comprehensive set of standards for health care facilities for the recording of staffing, financial, workload, patient care and other management information. The Guidelines enable health care facilities to develop management information systems which identify resources, costs and products to more effectively forecast and control costs and utilize resources to their maximum potential as well as provide improved comparability of operations. The MIS Guidelines were produced by the Management Information Systems (MIS) Project, a cooperative effort of the federal and provincial governments, provincial hospital/health associations, under the authority of the Canadian Federal/Provincial Advisory Committee on Institutional and Medical Services. The Guidelines are currently being implemented on a “test” basis in ten health care facilities across Canada and portions integrated in government reporting as finalized.
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Directory of Open Access Journals (Sweden)
Kabare Margaret
2011-09-01
Full Text Available Abstract Background Community participation has been emphasized internationally as a way of enhancing accountability, as well as a means to enhance health goals in terms of coverage, access and effective utilization. In rural health facilities in Kenya, initiatives to increase community accountability have focused on Health Facility Committees (HFCs. In Coast Province the role of HFCs has been expanded with the introduction of direct funding of rural facilities. We explored the nature and depth of managerial engagement of HFCs at the facility level in two rural districts in this Coastal setting, and how this has contributed to community accountability Methods We conducted structured interviews with the health worker in-charge and with patients in 30 health centres and dispensaries. These data were supplemented with in-depth interviews with district managers, and with health workers and HFC members in 12 health centres and dispensaries. In-depth interviews with health workers and HFC members included a participatory exercise to stimulate discussion of the nature and depth of their roles in facility management. Results HFCs were generally functioning well and played an important role in facility operations. The breadth and depth of engagement had reportedly increased after the introduction of direct funding of health facilities which allowed HFCs to manage their own budgets. Although relations with facility staff were generally good, some mistrust was expressed between HFC members and health workers, and between HFC members and the broader community, partially reflecting a lack of clarity in HFC roles. Moreover, over half of exit interviewees were not aware of the HFC's existence. Women and less well-educated respondents were particularly unlikely to know about the HFC. Conclusions There is potential for HFCs to play an active and important role in health facility management, particularly where they have control over some facility level resources
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Goodman, Catherine; Opwora, Antony; Kabare, Margaret; Molyneux, Sassy
2011-09-22
Community participation has been emphasized internationally as a way of enhancing accountability, as well as a means to enhance health goals in terms of coverage, access and effective utilization. In rural health facilities in Kenya, initiatives to increase community accountability have focused on Health Facility Committees (HFCs). In Coast Province the role of HFCs has been expanded with the introduction of direct funding of rural facilities. We explored the nature and depth of managerial engagement of HFCs at the facility level in two rural districts in this Coastal setting, and how this has contributed to community accountability We conducted structured interviews with the health worker in-charge and with patients in 30 health centres and dispensaries. These data were supplemented with in-depth interviews with district managers, and with health workers and HFC members in 12 health centres and dispensaries. In-depth interviews with health workers and HFC members included a participatory exercise to stimulate discussion of the nature and depth of their roles in facility management. HFCs were generally functioning well and played an important role in facility operations. The breadth and depth of engagement had reportedly increased after the introduction of direct funding of health facilities which allowed HFCs to manage their own budgets. Although relations with facility staff were generally good, some mistrust was expressed between HFC members and health workers, and between HFC members and the broader community, partially reflecting a lack of clarity in HFC roles. Moreover, over half of exit interviewees were not aware of the HFC's existence. Women and less well-educated respondents were particularly unlikely to know about the HFC. There is potential for HFCs to play an active and important role in health facility management, particularly where they have control over some facility level resources. However, to optimise their contribution, efforts are needed to
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Steinhardt, Laura C; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek
2014-02-20
Prompt and effective case management is needed to reduce malaria morbidity and mortality. However, malaria diagnosis and treatment is a multistep process that remains problematic in many settings, resulting in missed opportunities for effective treatment as well as overtreatment of patients without malaria. Prior to the widespread roll-out of malaria rapid diagnostic tests (RDTs) in late 2011, a national, cross-sectional, complex-sample, health facility survey was conducted in Malawi to assess patient-, health worker-, and health facility-level factors associated with malaria case management quality using multivariate Poisson regression models. Among the 2,019 patients surveyed, 34% had confirmed malaria defined as presence of fever and parasitaemia on a reference blood smear. Sixty-seven per cent of patients with confirmed malaria were correctly prescribed the first-line anti-malarial, with most cases of incorrect treatment due to missed diagnosis; 31% of patients without confirmed malaria were overtreated with an anti-malarial. More than one-quarter of patients were not assessed for fever or history of fever by health workers. The most important determinants of correct malaria case management were patient-level clinical symptoms, such as spontaneous complaint of fever to health workers, which increased both correct treatment and overtreatment by 72 and 210%, respectively (pfacility-level factors were significantly associated with case management quality. Introduction of RDTs holds potential to improve malaria case management in Malawi, but health workers must systematically assess all patients for fever, and then test and treat accordingly, otherwise, malaria control programmes might miss an opportunity to dramatically improve malaria case management, despite better diagnostic tools.
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Evaluating malaria case management at public health facilities in two provinces in Angola.
Plucinski, Mateusz M; Ferreira, Manzambi; Ferreira, Carolina Miguel; Burns, Jordan; Gaparayi, Patrick; João, Lubaki; da Costa, Olinda; Gill, Parambir; Samutondo, Claudete; Quivinja, Joltim; Mbounga, Eliane; de León, Gabriel Ponce; Halsey, Eric S; Dimbu, Pedro Rafael; Fortes, Filomeno
2017-05-03
Malaria accounts for the largest portion of healthcare demand in Angola. A pillar of malaria control in Angola is the appropriate management of malaria illness, including testing of suspect cases with rapid diagnostic tests (RDTs) and treatment of confirmed cases with artemisinin-based combination therapy (ACT). Periodic systematic evaluations of malaria case management are recommended to measure health facility readiness and adherence to national case management guidelines. Cross-sectional health facility surveys were performed in low-transmission Huambo and high-transmission Uíge Provinces in early 2016. In each province, 45 health facilities were randomly selected from among all public health facilities stratified by level of care. Survey teams performed inventories of malaria commodities and conducted exit interviews and re-examinations, including RDT testing, of a random selection of all patients completing outpatient consultations. Key health facility readiness and case management indicators were calculated adjusting for the cluster sampling design and utilization. Availability of RDTs or microscopy on the day of the survey was 71% (54-83) in Huambo and 85% (67-94) in Uíge. At least one unit dose pack of one formulation of an ACT (usually artemether-lumefantrine) was available in 83% (66-92) of health facilities in Huambo and 79% (61-90) of health facilities in Uíge. Testing rates of suspect malaria cases in Huambo were 30% (23-38) versus 69% (53-81) in Uíge. Overall, 28% (13-49) of patients with uncomplicated malaria, as determined during the re-examination, were appropriately treated with an ACT with the correct dose in Huambo, compared to 60% (42-75) in Uíge. Incorrect case management of suspect malaria cases was associated with lack of healthcare worker training in Huambo and ACT stock-outs in Uíge. The results reveal important differences between provinces. Despite similar availability of testing and ACT, testing and treatment rates were lower in
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Facility Design and Health Management Program at the Sinnhuber Aquatic Research Laboratory.
Barton, Carrie L; Johnson, Eric W; Tanguay, Robert L
2016-07-01
The number of researchers and institutions moving to the utilization of zebrafish for biomedical research continues to increase because of the recognized advantages of this model. Numerous factors should be considered before building a new or retooling an existing facility. Design decisions will directly impact the management and maintenance costs. We and others have advocated for more rigorous approaches to zebrafish health management to support and protect an increasingly diverse portfolio of important research. The Sinnhuber Aquatic Research Laboratory (SARL) is located ∼3 miles from the main Oregon State University campus in Corvallis, Oregon. This facility supports several research programs that depend heavily on the use of adult, larval, and embryonic zebrafish. The new zebrafish facility of the SARL began operation in 2007 with a commitment to build and manage an efficient facility that diligently protects human and fish health. An important goal was to ensure that the facility was free of Pseudoloma neurophilia (Microsporidia), which is very common in zebrafish research facilities. We recognize that there are certain limitations in space, resources, and financial support that are institution dependent, but in this article, we describe the steps taken to build and manage an efficient specific pathogen-free facility.
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Waweru, Evelyn; Opwora, Antony; Toda, Mitsuru; Fegan, Greg; Edwards, Tansy; Goodman, Catherine; Molyneux, Sassy
2013-10-10
Community participation in peripheral public health facilities has in many countries focused on including community representatives in Health Facility Management Committees (HFMCs). In Kenya, HFMC roles are being expanded with the phased implementation of the Health Sector Services Fund (HSSF). Under HSSF, HFMCs manage facility funds which are dispersed directly from central level into facility bank accounts. We assessed how prepared HFMCs were to undertake this new role in advance of HSSF roll out, and considered the implications for Kenya and other similar settings. Data were collected through a nationally representative sample of 248 public health centres and dispensaries in 24 districts in 2010. Data collection included surveys with in-charges (n = 248), HFMC members (n = 464) and facility users (n = 698), and record reviews. These data were supplemented by semi-structured interviews with district health managers in each district. Some findings supported preparedness of HFMCs to take on their new roles. Most facilities had bank accounts and HFMCs which met regularly. HFMC members and in-charges generally reported positive relationships, and HFMC members expressed high levels of motivation and job satisfaction. Challenges included users' low awareness of HFMCs, lack of training and clarity in roles among HFMCs, and some indications of strained relations with in-charges. Such challenges are likely to be common to many similar settings, and are therefore important considerations for any health facility based initiatives involving HFMCs. Most HFMCs have the basic requirements to operate. However to manage their own budgets effectively and meet their allocated roles in HSSF implementation, greater emphasis is needed on financial management training, targeted supportive supervision, and greater community awareness and participation. Once new budget management roles are fully established, qualitative and quantitative research on how HFMCs are adapting to
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Steinhardt, Laura C; Chinkhumba, Jobiba; Wolkon, Adam; Luka, Madalitso; Luhanga, Misheck; Sande, John; Oyugi, Jessica; Ali, Doreen; Mathanga, Don; Skarbinski, Jacek
2014-01-01
Malaria is endemic throughout Malawi, but little is known about quality of malaria case management at publicly-funded health facilities, which are the major source of care for febrile patients. In April-May 2011, we conducted a nationwide, geographically-stratified health facility survey to assess the quality of outpatient malaria diagnosis and treatment. We enrolled patients presenting for care and conducted exit interviews and re-examinations, including reference blood smears. Moreover, we assessed health worker readiness (e.g., training, supervision) and health facility capacity (e.g. availability of diagnostics and antimalarials) to provide malaria case management. All analyses accounted for clustering and unequal selection probabilities. We also used survey weights to produce estimates of national caseloads. At the 107 facilities surveyed, most of the 136 health workers interviewed (83%) had received training on malaria case management. However, only 24% of facilities had functional microscopy, 15% lacked a thermometer, and 19% did not have the first-line artemisinin-based combination therapy (ACT), artemether-lumefantrine, in stock. Of 2,019 participating patients, 34% had clinical malaria (measured fever or self-reported history of fever plus a positive reference blood smear). Only 67% (95% confidence interval (CI): 59%, 76%) of patients with malaria were correctly prescribed an ACT, primarily due to missed malaria diagnosis. Among patients without clinical malaria, 31% (95% CI: 24%, 39%) were prescribed an ACT. By our estimates, 1.5 million of the 4.4 million malaria patients seen in public facilities annually did not receive correct treatment, and 2.7 million patients without clinical malaria were inappropriately given an ACT. Malawi has a high burden of uncomplicated malaria but nearly one-third of all patients receive incorrect malaria treatment, including under- and over-treatment. To improve malaria case management, facilities must at minimum have
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Musinguzi, Geofrey; Bastiaens, Hilde; Wanyenze, Rhoda K; Mukose, Aggrey; Van Geertruyden, Jean-Pierre; Nuwaha, Fred
2015-01-01
The burden of chronic diseases is increasing in both low- and middle-income countries. However, healthcare systems in low-income countries are inadequately equipped to deal with the growing disease burden, which requires chronic care for patients. The aim of this study was to assess the capacity of health facilities to manage hypertension in two districts in Uganda. In a cross-sectional study conducted between June and October 2012, we surveyed 126 health facilities (6 hospitals, 4 Health Center IV (HCIV), 23 Health Center III (HCIII), 41 Health Center II (HCII) and 52 private clinics/dispensaries) in Mukono and Buikwe districts in Uganda. We assessed records, conducted structured interviews with heads of facilities, and administered questionnaires to 271 health workers. The study assessed service provision for hypertension, availability of supplies such as medicines, guidelines and equipment, in-service training for hypertension, knowledge of hypertension management, challenges and recommendations. Of the 126 health facilities, 92.9% reported managing (diagnosing/treating) patients with hypertension, and most (80.2%) were run by non-medical doctors or non-physician health workers (NPHW). Less than half (46%) of the facilities had guidelines for managing hypertension. A 10th of the facilities lacked functioning blood pressure devices and 28% did not have stethoscopes. No facilities ever calibrated their BP devices except one. About a half of the facilities had anti-hypertensive medicines in stock; mainly thiazide diuretics (46%), beta blockers (56%) and calcium channel blockers (48.4%). Alpha blockers, mixed alpha & beta blockers and angiotensin II receptor antagonists were only stocked by private clinics/dispensaries. Most HCIIs lacked anti-hypertensive medicines, including the first line thiazide diuretics. Significant knowledge gaps in classification of patients as hypertensive were noted among respondents. All health workers (except 5, 1.9%) indicated that they
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Scholz, Stefan; Ngoli, Baltazar; Flessa, Steffen
2015-05-01
Health care infrastructure constitutes a major component of the structural quality of a health system. Infrastructural deficiencies of health services are reported in literature and research. A number of instruments exist for the assessment of infrastructure. However, no easy-to-use instruments to assess health facility infrastructure in developing countries are available. Present tools are not applicable for a rapid assessment by health facility staff. Therefore, health information systems lack data on facility infrastructure. A rapid assessment tool for the infrastructure of primary health care facilities was developed by the authors and pilot-tested in Tanzania. The tool measures the quality of all infrastructural components comprehensively and with high standardization. Ratings use a 2-1-0 scheme which is frequently used in Tanzanian health care services. Infrastructural indicators and indices are obtained from the assessment and serve for reporting and tracing of interventions. The tool was pilot-tested in Tanga Region (Tanzania). The pilot test covered seven primary care facilities in the range between dispensary and district hospital. The assessment encompassed the facilities as entities as well as 42 facility buildings and 80 pieces of technical medical equipment. A full assessment of facility infrastructure was undertaken by health care professionals while the rapid assessment was performed by facility staff. Serious infrastructural deficiencies were revealed. The rapid assessment tool proved a reliable instrument of routine data collection by health facility staff. The authors recommend integrating the rapid assessment tool in the health information systems of developing countries. Health authorities in a decentralized health system are thus enabled to detect infrastructural deficiencies and trace the effects of interventions. The tool can lay the data foundation for district facility infrastructure management.
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Gage, Anastasia J; Ilombu, Onyebuchi; Akinyemi, Akanni Ibukun
2016-10-06
Existing studies of delivery care in Nigeria have identified socioeconomic and cultural factors as the primary determinants of health facility delivery. However, no study has investigated the association between supply-side factors and health facility delivery. Our study analyzed the role of supply-side factors, particularly health facility readiness and management practices for provision of quality maternal health services. Using linked data from the 2005 and 2009 health facility and household surveys in the five states in which the Community Participation for Action in the Social Sector (COMPASS) project was implemented, indices of health service readiness and management were developed based on World Health Organization guidelines. Multilevel logistic regression models were run to determine the association between these indices and health facility delivery among 2710 women aged 15-49 years whose last child was born within the five years preceding the surveys and who lived in 51 COMPASS LGAs. The health facility delivery rate increased from 25.4 % in 2005 to 44.1 % in 2009. Basic amenities for antenatal care provision, readiness to deliver basic emergency obstetric and newborn care, and management practices supportive of quality maternal health services were suboptimal in health facilities surveyed and did not change significantly between 2005 and 2009. The LGA mean index of basic amenities for antenatal care provision was more positively associated with the odds of health facility delivery in 2009 than in 2005, and in rural than in urban areas. The LGA mean index of management practices was associated with significantly lower odds of health facility delivery in rural than in urban areas. The LGA mean index of facility readiness to deliver basic emergency obstetric and neonatal care declined slightly from 5.16 in 2005 to 3.98 in 2009 and was unrelated to the odds of health facility delivery. Supply-side factors appeared to play a role in health facility delivery
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1994-04-01
Healthcare facility mergers and acquisitions are becoming more common as the industry consolidates. Many critical issues must be considered in mergers and acquisitions, including the management of patient health information. In addition to operational issues, licensure, regulatory, and accreditation requirements must be addressed. To ensure availability of health information to all legitimate users, patient records should be consolidated or linked in the master patient index. A record retention policy should be developed and implemented to meet user needs and assure compliance with legal, regulatory, and accreditation requirements. If health information from closed facilities will be stored for a period of time, its integrity and confidentiality must be preserved, and it must be readily accessible for patient care. The compatibility and functionality of existing information systems should be assessed, and a plan should be formulated for integration of the systems to the extent possible. Such integration may be essential for the organization to successfully meet the demands of integrated delivery systems. Existing databases should be maintained in an accessible form to meet anticipated future needs.
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Health Care Facilities Resilient to Climate Change Impacts
Directory of Open Access Journals (Sweden)
Jaclyn Paterson
2014-12-01
Full Text Available Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change.
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Health physics and quality control management of a cyclotron-based PET facility
International Nuclear Information System (INIS)
Jerabek, P.A.
1995-01-01
This paper provides an overview of the operation and management of a Positron Emission Tomography (PET) facility at the University of Texas. The facility components are discussed from an operations perspective with an emphasis on devices, and on practices and procedures which are implemented to ensure that personnel exposures are as low as reasonably achievable. The cyclotron-based PET facility uses in-house production of PET radioisotopes for preparation of radiopharmaceuticals. A combination of specially designed cyclotron equipped devices, radiopharmaceutical preparation devices, and shielded devices along with health physics practices have helped to make PET operations become routine
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Landfill gas management facilities design guidelines
Energy Technology Data Exchange (ETDEWEB)
NONE
2010-03-15
In British Columbia, municipal solid waste landfills generate over 1000 tonnes of methane per year; landfill gas management facilities are required to improve the environmental performance of solid waste landfills. The aim of this document, developed by the British Columbia Ministry of the Environment, is to provide guidance for the design, installation, and operation of landfill gas management facilities to address odor and pollutant emissions issues and also address health and safety issues. A review of technical experience and best practices in landfill gas management facilities was carried out, as was as a review of existing regulations related to landfill gas management all over the world. This paper provides useful information to landfill owners, operators, and other professionals for the design of landfill gas management facilities which meet the requirements of landfill gas management regulations.
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Kanyangarara, Mufaro; Munos, Melinda K; Walker, Neff
2017-12-01
Utilization of antenatal care (ANC) services has increased over the past two decades. Continued gains in maternal and newborn health will require an understanding of both access and quality of ANC services. We linked health facility and household survey data to examine the quality of service provision for five ANC interventions across health facilities in sub-Saharan Africa. Using data from 20 nationally representative health facility assessments - the Service Provision Assessment (SPA) and the Service Availability and Readiness Assessment (SARA), we estimated facility level readiness to deliver five ANC interventions: tetanus toxoid vaccine for pregnant women, intermittent preventive treatment for malaria in pregnancy (IPTp), syphilis detection and treatment in pregnancy, iron supplementation and hypertensive disease case management. Facility level indicators were stratified by health facility type, managing authority and location, then linked to estimates of ANC utilization in that stratum from the corresponding Demographic and Health Surveys (DHS) to generate population level estimates of the 'likelihood of appropriate care'. Finally, the association between estimates of the 'likelihood of appropriate care' from the linking approach and estimates of coverage levels from the DHS were assessed. A total of 10 534 health facilities were surveyed in the 20 health facility assessments, of which 8742 reported offering ANC services and were included in the analysis. Health facility readiness to deliver IPTp, iron supplementation, and tetanus toxoid vaccination was higher (median: 84.1%, 84.9% and 82.8% respectively) than readiness to deliver hypertensive disease case management and syphilis detection and treatment (median: 23.0% and 19.9% respectively). Coverage of at least 4 ANC visits ranged from 24.8% to 75.8%. Estimates of the likelihood of appropriate care derived from linking health facility and household survey data showed marked gaps for all interventions
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National ignition facility environment, safety, and health management plan
International Nuclear Information System (INIS)
1995-11-01
The ES ampersand H Management Plan describes all of the environmental, safety, and health evaluations and reviews that must be carried out in support of the implementation of the National Ignition Facility (NIF) Project. It describes the policy, organizational responsibilities and interfaces, activities, and ES ampersand H documents that will be prepared by the Laboratory Project Office for the DOE. The only activity not described is the preparation of the NIF Project Specific Assessment (PSA), which is to be incorporated into the Programmatic Environmental Impact Statement for Stockpile Stewardship and Management (PEIS). This PSA is being prepared by Argonne National Laboratory (ANL) with input from the Laboratory participants. As the independent NEPA document preparers ANL is directly contracted by the DOE, and its deliverables and schedule are agreed to separately with DOE/OAK
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Approaches to the management of waste from health care facilities in Czech Republic and Kazakhstan
Kaireshev, Ruslan
2015-01-01
Waste from healthcare facilities or similar facilities includes components of various physical, chemical and biological character that require special approaches during the handling, specifically with regard to possible risks to human health and the environment. Nowadays a challenge for waste management system becomes waste produced in healthcare facilities and contributes too many reasons, such as population growth and rising life expectancy. The rate of waste production from healthcare faci...
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[Organization of workplace first aid in health care facilities].
Ciavarella, M; Sacco, A; Bosco, Maria Giuseppina; Chinni, V; De Santis, A; Pagnanelli, A
2007-01-01
Laws D.Lgs. 626/94 and D.I. 388/03 attach particular importance to the organization of first aid in the workplace. Like every other enterprise, also hospitals and health care facilities have the obligation, as foreseen by the relevant legislation, to organize and manage first aid in the workplace. To discuss the topic in the light of the guidelines contained in the literature. We used the references contained in the relevant literature and in the regulations concerning organization of first aid in health care facilities. The regulations require the general manager of health care facilities to organize the primary intervention in case of emergencies in all health care facilities (health care or administrative, territorial and hospitals). In health care facilities the particular occupational risks, the general access of the public and the presence of patients who are already assumed to have altered states of health, should be the reason for particular care in guaranteeing the best possible management of a health emergency in the shortest time possible.
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Screening criteria for siting waste management facilities: Regional Management Plan
International Nuclear Information System (INIS)
1986-01-01
The Midwest Interstate Low-Level Radioactive Waste Commission (Midwest Compact) seeks to define and place into operation a system for low-level waste management that will protect the public health and safety and the environment from the time the waste leaves its point of origin. Once the system is defined it will be necessary to find suitable sites for the components of that waste management system. The procedure for siting waste management facilities that have been chosen by the compact is one in which a host state is chosen for each facility. The host state is then given the freedom to select the site. Sites will be needed of low-level waste disposal facilities. Depending on the nature of the waste management system chosen by the host state, sites may also be needed for regional waste treatment facilities, such as compactors or incinerators. This report provides example criteria for use in selecting sites for low-level radioactive waste treatment and disposal facilities. 14 refs
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Safe waste management practices in beryllium facilities
International Nuclear Information System (INIS)
Bhat, P.N.; Soundararajan, S.; Sharma, D.N.
2012-01-01
Beryllium, an element with the atomic symbol Be, atomic number 4, has very high stiffness to weight ratio and low density. It has good electrical conductive properties with low coefficient of thermal expansion. These properties make the metal beryllium very useful in varied technological endeavours, However, beryllium is recognised as one of the most toxic metals. Revelation of toxic effects of beryllium resulted in institution of stringent health and safety practices in beryllium handling facilities. The waste generated in such facilities may contain traces of beryllium. Any such waste should be treated as toxic waste and suitable safe waste management practices should be adopted. By instituting appropriate waste management practice and through a meticulously incorporated safety measures and continuous surveillance exercised in such facilities, total safety can be ensured. This paper broadly discusses health hazards posed by beryllium and safe methods of management of beryllium bearing wastes. (author)
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Healthcare waste management: current practices in selected healthcare facilities, Botswana.
Mbongwe, Bontle; Mmereki, Baagi T; Magashula, Andrew
2008-01-01
Healthcare waste management continues to present an array of challenges for developing countries, and Botswana is no exception. The possible impact of healthcare waste on public health and the environment has received a lot of attention such that Waste Management dedicated a special issue to the management of healthcare waste (Healthcare Wastes Management, 2005. Waste Management 25(6) 567-665). As the demand for more healthcare facilities increases, there is also an increase on waste generation from these facilities. This situation requires an organised system of healthcare waste management to curb public health risks as well as occupational hazards among healthcare workers as a result of poor waste management. This paper reviews current waste management practices at the healthcare facility level and proposes possible options for improvement in Botswana.
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Building capacity in health facility management: guiding principles for skills transfer in Liberia.
Rowe, Laura A; Brillant, Sister Barbara; Cleveland, Emily; Dahn, Bernice T; Ramanadhan, Shoba; Podesta, Mae; Bradley, Elizabeth H
2010-03-18
Management training is fundamental to developing human resources for health. Particularly as Liberia revives its health delivery system, facility and county health team managers are central to progress. Nevertheless, such management skills are rarely prioritized in health training, and sustained capacity building in this area is limited. We describe a health management delivery program in which a north and south institution collaborated to integrate classroom and field-based training in health management and to transfer the capacity for sustained management development in Liberia. We developed and implemented a 6-month training program in health management skills (i.e. strategic problem solving, financial management, human resource management and leadership) delivered by Yale University and Mother Patern College from Liberia, with support from the Clinton HIV/AIDS Initiative. Over three 6-month cycles, responsibility for course instruction was transferred from the north institution to the south institution. A self-administered survey was conducted of all participants completing the course to measure changes in self-rated management skills, the degree to which the course was helpful and met its stated objectives, and faculty members' responsiveness to participant needs as the transfer process occurred. Respondents (n=93, response rate 95.9%) reported substantial improvement in self-reported management skills, and rated the helpfulness of the course and the degree to which the course met its objectives highly. Levels of improvement and course ratings were similar over the three cohorts as the course was transferred to the south institution. We suggest a framework of five elements for implementing successful management training programs that can be transferred and sustained in resource-limited settings, including: 1) use a short-course format focusing on four key skill areas with practical tools; 2) include didactic training, on-site projects, and on-site mentoring; 3
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Building capacity in health facility management: guiding principles for skills transfer in Liberia
Directory of Open Access Journals (Sweden)
Dahn Bernice T
2010-03-01
Full Text Available Abstract Background Management training is fundamental to developing human resources for health. Particularly as Liberia revives its health delivery system, facility and county health team managers are central to progress. Nevertheless, such management skills are rarely prioritized in health training, and sustained capacity building in this area is limited. We describe a health management delivery program in which a north and south institution collaborated to integrate classroom and field-based training in health management and to transfer the capacity for sustained management development in Liberia. Methods We developed and implemented a 6-month training program in health management skills (i.e. strategic problem solving, financial management, human resource management and leadership delivered by Yale University and Mother Patern College from Liberia, with support from the Clinton HIV/AIDS Initiative. Over three 6-month cycles, responsibility for course instruction was transferred from the north institution to the south institution. A self-administered survey was conducted of all participants completing the course to measure changes in self-rated management skills, the degree to which the course was helpful and met its stated objectives, and faculty members' responsiveness to participant needs as the transfer process occurred. Results Respondents (n = 93, response rate 95.9% reported substantial improvement in self-reported management skills, and rated the helpfulness of the course and the degree to which the course met its objectives highly. Levels of improvement and course ratings were similar over the three cohorts as the course was transferred to the south institution. We suggest a framework of five elements for implementing successful management training programs that can be transferred and sustained in resource-limited settings, including: 1 use a short-course format focusing on four key skill areas with practical tools; 2 include
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Directory of Open Access Journals (Sweden)
Mary Nyikuri
Full Text Available Public primary health care (PHC facilities are for many individuals the first point of contact with the formal health care system. These facilities are managed by professional nurses or clinical officers who are recognised to play a key role in implementing health sector reforms and facilitating initiatives aimed at strengthening community involvement. Little in-depth research exists about the dimensions and challenges of these managers' jobs, or on the impact of decentralisation on their roles and responsibilities. In this paper, we describe the roles and responsibilities of PHC managers-or 'in-charges' in Kenya, and their challenges and coping strategies, under accelerated devolution.The data presented in this paper is part of a wider set of activities aimed at understanding governance changes under devolution in Kenya, under the umbrella of a 'learning site'. A learning site is a long term process of collaboration between health managers and researchers deciding together on key health system questions and interventions. Data were collected through seven formal in depth interviews and observations at four PHC facilities as well as eight in depth interviews and informal interactions with sub-county managers from June 2013 to July 2014. Drawing on the Aragon framework of organisation capacity we discuss the multiple accountabilities, daily routines, challenges and coping strategies among PHC facility managers.PHC in-charges perform complex and diverse roles in a difficult environment with relatively little formal preparation. Their key concerns are lack of job clarity and preparedness, the difficulty of balancing multidirectional accountability responsibilities amidst significant resource shortages, and remuneration anxieties. We show that day-to-day management in an environment of resource constraints and uncertainty requires PHC in-charges who are resilient, reflective, and continuously able to learn and adapt. We highlight the importance of
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DEFF Research Database (Denmark)
Buregyeya, Esther; Rutebemberwa, Elizeus; LaRussa, Phillip
2017-01-01
on drug stocks, availability of treatment guidelines, diagnostic equipment, and knowledge in management of malaria, pneumonia and diarrhoea, using a structured questionnaire. Results: A total of 53 public and 241 private health facilities participated in the study. While similar proportions of private...... and public health facilities stocked Coartem, the first-line anti-malarial drug, (98 vs 95%, p = 0.22), significantly more private than public health facilities stocked quinine (85 vs 53%, p chloroquine, were reported in few public and private...
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Using Tools of Strategic Management in Medical Facilities of Lublin Region
Directory of Open Access Journals (Sweden)
Jaworzynska Magdalena
2017-06-01
Full Text Available The purpose of this article is to evaluate the use of tools of strategic management in hospitals in Lublin region. The study was conducted among 14 medical entities from the area of Lublin Voivodeship. The survey was addressed to economic directors or chief accountants of health care facilities and sent by post. The questionnaire was also helpful in conducting an in-depth interview as it provided a required structure. As part of the interviews with managers of health care facilities, information beyond the questionnaire was acquired, e.g. about the mission. According to studies, most health care facilities develop strategic plans (71.4%. For 21.4% of the studied facilities, the strategic plan is known mainly to management. In contrast, 28.6% of entities do not have a strategic plan. The presented results of the research can increase the effectiveness of activities in each area of the health care facility, continuous process improvement and rapid response to changes in the environment.
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Pugliese, F; Albini, E; Serio, O; Apostoli, P
2011-01-01
The 81/2008 Act has defined a model of a health and safety management system that can contribute to prevent the occupational health and safety risks. We have developed the structure of a health and safety management system model and the necessary tools for its implementation in health care facilities. The realization of a model is structured in various phases: initial review, safety policy, planning, implementation, monitoring, management review and continuous improvement. Such a model, in continuous evolution, is based on the responsibilities of the different corporate characters and on an accurate analysis of risks and involved norms.
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Quality management in nuclear facilities decommissioning
International Nuclear Information System (INIS)
Garonis, Omar H.
2002-01-01
Internationally, the decommissioning organizations of nuclear facilities carry out the decommissioning according to the safety requirements established for the regulatory bodies. Some of them perform their activities in compliance with a quality assurance system. This work establishes standardization through a Specifications Requirement Document, for the management system of the nuclear facilities decommissioning organizations. It integrates with aspects of the quality, environmental, occupational safety and health management systems, and also makes these aspects compatible with all the requirements of the nuclear industry recommended for the International Atomic Energy Agency (IAEA). (author)
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Energy Technology Data Exchange (ETDEWEB)
Flynn, N.C. Bechtel Jacobs
2008-04-21
The Bechtel Jacobs Company LLC (BJC) policy is to provide a safe and healthy workplace for all employees and subcontractors. The implementation of this policy requires that operations of the Environmental Management Waste Management Facility (EMWMF), located one-half mile west of the U.S. Department of Energy (DOE) Y-12 National Security Complex, be guided by an overall plan and consistent proactive approach to environment, safety and health (ES&H) issues. The BJC governing document for worker safety and health, BJC/OR-1745, 'Worker Safety and Health Program', describes the key elements of the BJC Safety and Industrial Hygiene (IH) programs, which includes the requirement for development and implementation of a site-specific Health and Safety Plan (HASP) where required by regulation (refer also to BJC-EH-1012, 'Development and Approval of Safety and Health Plans'). BJC/OR-1745, 'Worker Safety and Health Program', implements the requirements for worker protection contained in Title 10 Code of Federal Regulations (CFR) Part 851. The EMWMF site-specific HASP requirements identifies safe operating procedures, work controls, personal protective equipment, roles and responsibilities, potential site hazards and control measures, site access requirements, frequency and types of monitoring, site work areas, decontamination procedures, and outlines emergency response actions. This HASP will be available on site for use by all workers, management and supervisors, oversight personnel and visitors. All EMWMF assigned personnel will be briefed on the contents of this HASP and will be required to follow the procedures and protocols as specified. The policies and procedures referenced in this HASP apply to all EMWMF operations activities. In addition the HASP establishes ES&H criteria for the day-to-day activities to prevent or minimize any adverse effect on the environment and personnel safety and health and to meet standards that define acceptable
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Health facilities are places that provide health care. They include hospitals, clinics, outpatient care centers, and specialized care centers, ... psychiatric care centers. When you choose a health facility, you might want to consider How close it ...
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The quality management journey: the progress of health facilities in Australia.
Carr, B J
1994-12-01
Many facilities in Australia have taken the Total Quality Management (TQM) step. The objective of this study was to examine progress of adopted formal quality systems in health. Sixty per cent of organizations surveyed have adopted formal systems. Of these, Deming adherents are the most common, followed by eclectic choices. Only 35% considered the quality transition as reasonably easy. There was no relationship between accreditation and formal quality systems identified. The most common improvement techniques were: flow charts, histograms, and cause and effect diagrams. Quality practitioners are happy to use several tools exceptionally well rather than have many tools at their disposal. The greatest impediment to the adoption of quality was the lack of top management support. This study did not support the view that clinicians are not readily actively supporting quality initiatives. Total Quality Management is not a mature concept; however, Chief Executive Officers are assured that rewards will be realized over time.
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The Oral Health Care Manager in a Patient-Centered Health Facility.
Theile, Cheryl Westphal; Strauss, Shiela M; Northridge, Mary Evelyn; Birenz, Shirley
2016-06-01
The dental hygienist team member has an opportunity to coordinate care within an interprofessional practice as an oral health care manager. Although dental hygienists are currently practicing within interprofessional teams in settings such as pediatric offices, hospitals, nursing homes, schools, and federally qualified health centers, they often still assume traditional responsibilities rather than practicing to the full extent of their training and licenses. This article explains the opportunity for the dental hygiene professional to embrace patient-centered care as an oral health care manager who can facilitate integration of oral and primary care in a variety of health care settings. Based on an innovative model of collaboration between a college of dentistry and a college of nursing, an idea emerged among several faculty members for a new management method for realizing continuity and coordination of comprehensive patient care. Involved faculty members began working on the development of an approach to interprofessional practice with the dental hygienist serving as an oral health care manager who would address both oral health care and a patient's related primary care issues through appropriate referrals and follow-up. This approach is explained in this article, along with the results of several pilot studies that begin to evaluate the feasibility of a dental hygienist as an oral health care manager. A health care provider with management skills and leadership qualities is required to coordinate the interprofessional provision of comprehensive health care. The dental hygienist has the opportunity to lead closer integration of oral and primary care as an oral health care manager, by coordinating the team of providers needed to implement comprehensive, patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.
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Desale, Adino; Taye, Bineyam; Belay, Getachew; Nigatu, Alemayehu
2013-01-01
Introduction Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. Methods A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a t...
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Sustainable Facilities Management
DEFF Research Database (Denmark)
Nielsen, Susanne Balslev; Elle, Morten; Hoffmann, Birgitte
2004-01-01
The Danish public housing sector has more than 20 years of experience with sustainable facilities management based on user involvement. The paper outlines this development in a historical perspective and gives an analysis of different approaches to sustainable facilities management. The focus...... is on the housing departments and strateies for the management of the use of resources. The research methods used are case studies based on interviews in addition to literature studies. The paper explores lessons to be learned about sustainable facilities management in general, and points to a need for new...
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Kanamori, Shogo; Shibanuma, Akira; Jimba, Masamine
2016-01-01
The 5S management method (where 5S stands for sort, set in order, shine, standardize, and sustain) was originally implemented by manufacturing enterprises in Japan. It was then introduced to the manufacturing sector in the West and eventually applied to the health sector for organizing and standardizing the workplace. 5S has recently received attention as a potential solution for improving government health-care services in low- and middle-income countries. We conducted a narrative literature review to explore its applicability to health-care facilities globally, with a focus on three aspects: (a) the context of its application, (b) its impacts, and (c) its adoption as part of government initiatives. To identify relevant research articles, we researched public health databases in English, including CINAHL, PubMed, ScienceDirect, and Web of Science. We found 15 of the 114 articles obtained from the search results to be relevant for full-text analysis of the context and impacts of the 5S application. To identify additional information particularly on its adoption as part of government initiatives, we also examined other types of resources including reference books, reports, didactic materials, government documents, and websites. The 15 empirical studies highlighted its application in primary health-care facilities and a wide range of hospital areas in Brazil, India, Jordan, Senegal, Sri Lanka, Tanzania, the UK, and the USA. The review also found that 5S was considered to be the starting point for health-care quality improvement. Ten studies presented its impacts on quality improvements; the changes resulting from the 5S application were classified into the three dimensions of safety, efficiency, and patient-centeredness. Furthermore, 5S was adopted as part of government quality improvement strategies in India, Senegal, Sri Lanka, and Tanzania. 5S could be applied to health-care facilities regardless of locations. It could be not only a tool for health workers and
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Management challenges faced by managers of New Zealand long-term care facilities.
Madas, E; North, N
2000-01-01
This article reports on a postal survey of 78 long-term care managers in one region of New Zealand, of whom 45 (58%) responded. Most long-term care managers (73.2%) were middle-aged females holding nursing but not management qualifications. Most long-term care facilities (69%) tended to be stand-alone facilities providing a single type of care (rest home or continuing care hospital). The most prominent issues facing managers were considered to be inadequate funding to match the growing costs of providing long-term care and occupancy levels. Managers believed that political/regulatory, economic and social factors influenced these issues. Despite a turbulent health care environment and the challenges facing managers, long-term care managers reported they were coping well and valued networking.
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Quality management standards for facility services in the Italian health care sector.
Cesarotti, Vittorio; Di Silvio, Bruna
2006-01-01
Health care, one of the most dynamic sectors in Italy, is studied with a particular focus on outsourcing non-core activities such as facility management (FM) services. The project's goals are to define national standards to balance and control facility service evolution, and to drive FM services towards organisational excellence. The authors, in cooperation with a pool of facility service providers and hospitals managers, studied cleaning services--one of the most critical areas. This article describes the research steps and findings following definition and publication of the Italian standard and its application to an international benchmarking process. The method chosen for developing the Italian standard was to merge technical, strategic and organisational aspects with the goal of standardising the contracting system, giving service providers the chance to improve efficiency and quality, while helping healthcare organisations gain from a better, more reliable and less expensive service. The Italian standard not only improved services but also provided adequate control systems for outsourcing organisations. In this win-win context, it is hoped to continually drive FM services towards organisational excellence. This study is specific to the Italian national healthcare system. However, the strategic dynamics described are common to many other contexts. A systematic method for improving hospital FM services is presented. The authors believe that lessons learned from their Italian case study can be used to better understand and drive similar services in other countries or in other FM service outsourcing sectors.
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Allen, Elizabeth Palchik; Muhwezi, Wilson Winstons; Henriksson, Dorcus Kiwanuka; Mbonye, Anthony Kabanza
2017-09-01
While several studies have documented the various barriers that caretakers of children under five routinely confront when seeking healthcare in Uganda, few have sought to capture the ways in which caretakers themselves prioritize their own barriers to seeking services. To that end, we asked focus groups of caretakers to list their five greatest challenges to seeking care on behalf of children under five. Using qualitative content analysis, we grouped responses according to four categories: (1) geographical access barriers; (2) facility supplies, staffing, and infrastructural barriers; (3) facility management and administration barriers (e.g. health worker professionalism, absenteeism and customer care); and (4) household barriers related to financial circumstances, domestic conflicts with male partners and a stated lack of knowledge about health-related issues. Among all focus groups, caretakers mentioned supplies, staffing and infrastructure barriers most often and facility management and administration barriers the least. Caretakers living furthest from public facilities (8-10 km) more commonly mentioned geographical barriers to care and barriers related to financial and other personal circumstances. Caretakers who lived closest to health facilities mentioned facility management and administration barriers twice as often as those who lived further away. While targeting managerial barriers is vitally important-and increasingly popular among national planners and donors-it should be done while recognizing that alleviating such barriers may have a more muted effect on caretakers who are geographically harder to reach - and by extension, those whose children have an increased risk of mortality. In light of calls for greater equity in child survival programming - and given the limited resource envelopes that policymakers often have at their disposal - attention to the barriers considered most vital among caretakers in different settings should be weighed. © The
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Gimbel, Sarah; Voss, Joachim; Mercer, Mary Anne; Zierler, Brenda; Gloyd, Stephen; Coutinho, Maria de Joana; Floriano, Florencia; Cuembelo, Maria de Fatima; Einberg, Jennifer; Sherr, Kenneth
2014-10-21
The objective of the prevention of Mother-to-Child Transmission (pMTCT) cascade analysis tool is to provide frontline health managers at the facility level with the means to rapidly, independently and quantitatively track patient flows through the pMTCT cascade, and readily identify priority areas for clinic-level improvement interventions. Over a period of six months, five experienced maternal-child health managers and researchers iteratively adapted and tested this systems analysis tool for pMTCT services. They prioritized components of the pMTCT cascade for inclusion, disseminated multiple versions to 27 health managers and piloted it in five facilities. Process mapping techniques were used to chart PMTCT cascade steps in these five facilities, to document antenatal care attendance, HIV testing and counseling, provision of prophylactic anti-retrovirals, safe delivery, safe infant feeding, infant follow-up including HIV testing, and family planning, in order to obtain site-specific knowledge of service delivery. Seven pMTCT cascade steps were included in the Excel-based final tool. Prevalence calculations were incorporated as sub-headings under relevant steps. Cells not requiring data inputs were locked, wording was simplified and stepwise drop-offs and maximization functions were included at key steps along the cascade. While the drop off function allows health workers to rapidly assess how many patients were lost at each step, the maximization function details the additional people served if only one step improves to 100% capacity while others stay constant. Our experience suggests that adaptation of a cascade analysis tool for facility-level pMTCT services is feasible and appropriate as a starting point for discussions of where to implement improvement strategies. The resulting tool facilitates the engagement of frontline health workers and managers who fill out, interpret, apply the tool, and then follow up with quality improvement activities. Research on
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Energy Technology Data Exchange (ETDEWEB)
Lehnen, Dieter; Demmer, Martin; Pfister, Tobias [ZERNA Planen und Pruefen GmbH, Bochum (Germany)
2013-09-01
In contrast to other fields of engineering, structural health monitoring and lifecycle management for civil engineering constructions in power plants and industrial facilities have to be developed yet. The necessity of this development immediately arises from the building regulations law with its extensive set of regulations as well as from economic constraints. Approaches and methods of structural health monitoring and lifecycle management for civil engineering constructions in power plants and industrial facilities could be improved intensively during recent years. The paper focuses on practical examples that show the necessity of comprehensive and strategic structural health monitoring in conjunction with lifecycle management for civil engineering constructions in power plants and industrial facilities unambiguously und clear. (orig.)
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Daire, Judith; Gilson, Lucy
2014-01-01
In South Africa, as elsewhere, Primary Health Care (PHC) facilities are managed by professional nurses. Little is known about the dimensions and challenges of their job, or what influences their managerial practice. Drawing on leadership and organizational theory, this study explored what the job of being a PHC manager entails, and what factors influence their managerial practice. We specifically considered whether the appointment of professional nurses as facility managers leads to an identity transition, from nurse to manager. The overall intention was to generate ideas about how to support leadership development among PHC facility managers. Adopting case study methodology, the primary researcher facilitated in-depth discussions (about their personal history and managerial experiences) with eight participating facility managers from one geographical area. Other data were collected through in-depth interviews with key informants, document review and researcher field notes/journaling. Analysis involved data triangulation, respondent and peer review and cross-case analysis. The experiences show that the PHC facility manager’s job is dominated by a range of tasks and procedures focused on clinical service management, but is expected to encompass action to address the population and public health needs of the surrounding community. Managing with and through others, and in a complex system, requiring self-management, are critical aspects of the job. A range of personal, professional and contextual factors influence managerial practice, including professional identity. The current largely facility-focused management practice reflects the strong nursing identity of managers and broader organizational influences. However, three of the eight managers appear to self-identify an emerging leadership identity and demonstrate related managerial practices. Nonetheless, there is currently limited support for an identity transition towards leadership in this context. Better
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Environmental Management Guide for Educational Facilities
APPA: Association of Higher Education Facilities Officers, 2017
2017-01-01
Since 1996, APPA and CSHEMA, the Campus Safety Health and Environmental Management Association, have collaborated to produce guidance documents to help educational facilities get ahead of the moving target that is environmental compliance. This new 2017 edition will help you identify which regulations pertain to your institution, and assist in…
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Desale, Adino; Taye, Bineyam; Belay, Getachew; Nigatu, Alemayehu
2013-01-01
Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a total of 43 facilities which, were investigated through quantitative methods using structured questionnaires interviews. Focus group discussion with the designated supply chain managers and key informant interviews were conducted for the qualitative method. There exists a well-designed logistics system for laboratory commodities with trained pharmacy personnel, distributed standard LMIS formats and established inventory control procedures. However, majority of laboratory professionals were not trained in LMIS. Majority of the facilities (60.5%) were stocked out for at least one ART monitoring and TB laboratory reagents and the highest stock out rate was for chemistry reagents. Expired ART monitoring laboratory commodities were found in 25 (73.5%) of facilities. Fifty percent (50%) of the assessed hospitals and 54% of health centers were currently using stock/bin cards for all HIV/AIDS and TB laboratory commodities in main pharmacy store, among these only 25% and 20.8% of them were updated with accurate information matching with the physical count done at the time of visit for hospitals and health centers respectively. Even though there exists a well designed laboratory LMIS, keeping quality stock/bin cards and LMIS reports were very low. Key ART monitoring laboratory commodities were stock out at many facilities at the day of visit and during the past six months. Based on findings, training of laboratory personnel's managing laboratory commodities and keeping accurate inventory control procedures
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Desale, Adino; Taye, Bineyam; Belay, Getachew; Nigatu, Alemayehu
2013-01-01
Introduction Logistics management information system for health commodities remained poorly implemented in most of developing countries. To assess the status of laboratory logistics management information system for HIV/AIDS and tuberculosis laboratory commodities in public health facilities in Addis Ababa. Methods A cross-sectional descriptive study was conducted from September 2010-January 2011 at selected public health facilities. A stratified random sampling method was used to include a total of 43 facilities which, were investigated through quantitative methods using structured questionnaires interviews. Focus group discussion with the designated supply chain managers and key informant interviews were conducted for the qualitative method. Results There exists a well-designed logistics system for laboratory commodities with trained pharmacy personnel, distributed standard LMIS formats and established inventory control procedures. However, majority of laboratory professionals were not trained in LMIS. Majority of the facilities (60.5%) were stocked out for at least one ART monitoring and TB laboratory reagents and the highest stock out rate was for chemistry reagents. Expired ART monitoring laboratory commodities were found in 25 (73.5%) of facilities. Fifty percent (50%) of the assessed hospitals and 54% of health centers were currently using stock/bin cards for all HIV/AIDS and TB laboratory commodities in main pharmacy store, among these only 25% and 20.8% of them were updated with accurate information matching with the physical count done at the time of visit for hospitals and health centers respectively. Conclusion Even though there exists a well designed laboratory LMIS, keeping quality stock/bin cards and LMIS reports were very low. Key ART monitoring laboratory commodities were stock out at many facilities at the day of visit and during the past six months. Based on findings, training of laboratory personnel's managing laboratory commodities and keeping
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Graham, Stephen M; English, Mike; Hazir, Tabish; Enarson, Penny; Duke, Trevor
2008-05-01
Effective case management is an important strategy to reduce pneumonia-related morbidity and mortality in children. Guidelines based on sound evidence are available but are used variably. This review outlines current guidelines for childhood pneumonia management in the setting where most child pneumonia deaths occur and identifies challenges for improved management in a variety of settings and different "at-risk" groups. These include appropriate choice of antibiotic, clinical overlap with other conditions, prompt and appropriate referral for inpatient care, and management of treatment failure. Management of neonates, and of HIV-infected or severely malnourished children is more complicated. The influence of co-morbidities on pneumonia outcome means that pneumonia case management must be integrated within strategies to improve overall paediatric care. The greatest potential for reducing pneumonia-related deaths in health facilities is wider implementation of the current guidelines built around a few core activities: training, antibiotics and oxygen. This requires investment in human resources and in equipment for the optimal management of hypoxaemia. It is important to provide data from a variety of epidemiological settings for formal cost-effectiveness analyses. Improvements in the quality of case management of pneumonia can be a vehicle for overall improvements in child health-care practices.
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Regulatory measures for occupational health monitoring in BARC facilities
International Nuclear Information System (INIS)
Rajdeep; Chattopadhyay, S.
2017-01-01
Bhabha Atomic Research Centre (BARC) is the premier organization actively engaged in the research and developmental activities related to nuclear science and technology for the benefit of society and the nation. BARC has various facilities like nuclear fuel fabrication facilities, research reactors, spent fuel storage facilities, nuclear fuel re-cycling facilities, radioactive waste management facilities, machining workshops and various Physics, Chemistry and Biological laboratories. In BARC, aspects related to Occupational Safety and Health (OSH) are given paramount importance. The issues related OSH are subjected to multi-tier review process. BARC Safety Council (BSC) is the apex committee in the three-tier safety and security review framework of BARC. BSC functions as regulatory body for BARC facilities. BSC is responsible for occupational safety and health of employees in BARC facilities
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WASH and gender in health care facilities: The uncharted territory.
Kohler, Petra; Renggli, Samuel; Lüthi, Christoph
2017-11-08
Health care facilities in low- and middle-income countries are high-risk settings, and face special challenges to achieving sustainable water, sanitation, and hygiene (WASH) services. Our applied interdisciplinary research conducted in India and Uganda analyzed six dimensions of WASH services in selected health care facilities, including menstrual hygiene management. To be effective, WASH monitoring strategies in health care facilities must include gender sensitive measures. We present a novel strategy, showing that applied gender sensitive multitool assessments are highly productive in assessments of WASH services and facilities from user and provider perspectives. We discuss its potential for applications at scale and as an area of future research.
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Organization and management for decommissioning of large nuclear facilities
International Nuclear Information System (INIS)
2000-01-01
For nuclear facilities, decommissioning is the final phase in the life-cycle after siting, design, construction, commissioning and operation. It is a complex process involving operations such as detailed surveys, decontamination and dismantling of plant equipment and facilities, demolition of buildings and structures, and management of resulting waste and other materials, whilst taking into account aspects of health and safety of the operating personnel and the general public, and protection of the environment. Careful planning and management is essential to ensure that decommissioning is accomplished in a safe and cost effective manner. Guidance on organizational aspects may lead to better decision making, reductions in time and resources, lower doses to the workers and reduced impact on public health and the environment. The objective of this report is to provide information and guidance on the organization and management aspects for the decommissioning of large nuclear facilities which will be useful for licensees responsible for discharging these responsibilities. The information contained in the report may also be useful to policy makers, regulatory bodies and other organizations interested in the planning and management of decommissioning. In this report, the term 'decommissioning' refers to those actions that are taken at the end of the useful life of a nuclear facility in withdrawing it from service with adequate regard for the health and safety of workers and members of the public and for the protection of the environment. The term 'large nuclear facilities' involves nuclear power plants, large nuclear research reactors and other fuel cycle facilities such as reprocessing plants, fuel conversion, fabrication and enrichment plants, as well as spent fuel storage and waste management plants. Information on the planning and management for decommissioning of smaller research reactors or other small nuclear facilities can be found elsewhere. The report covers
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Riaz, Atif; Zaidi, Shehla; Khowaja, Asif Raza
2015-03-06
A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs) in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users' perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH) services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted). A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs) conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong community-based behavior change strategies. © 2015 by Kerman University of Medical Sciences.
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Directory of Open Access Journals (Sweden)
Atif Riaz
2015-05-01
Full Text Available Background A number of developing countries have contracted out public health facilities to the Non-Government Organizations (NGOs in order to improve service utilization. However, there is a paucity of in-depth qualitative information on barriers to access services as a result of contracting from service users’ perspective. The objective of this study was to explore perceived barriers to utilizing Maternal and Neonatal Health (MNH services, in health facilities contracted out by government to NGO for service provision versus in those which are managed by government (non-contracted. Methods A community-based qualitative exploratory study was conducted between April to September 2012 at two contracted-out and four matched non-contracted primary healthcare facilities in Thatta and Chitral, rural districts of Pakistan. Using semi-structured guide, the data were collected through thirty-six Focus Group Discussions (FGDs conducted with mothers and their spouses in the catchment areas of selected facilities. Thematic analysis was performed using NVivo version 10.0 in which themes and sub-themes emerged. Results Key barriers reported in contracted sites included physical distance, user charges and familial influences. Whereas, poor functionality of health centres was the main barrier for non-contracted sites with other issues being comparatively less salient. Decision-making patterns for participants of both catchments were largely similar. Spouses and mother-in-laws particularly influenced the decision to utilize health facilities. Conclusion Contracting out of health facility reduces supply side barriers to MNH services for the community served but distance, user charges and low awareness remain significant barriers. Contracting needs to be accompanied by measures for transportation in remote settings, oversight on user fee charges by contractor, and strong communitybased behavior change strategies.
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48 CFR 970.3770 - Facilities management.
2010-10-01
... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Facilities management. 970... REGULATIONS DOE MANAGEMENT AND OPERATING CONTRACTS Facilities Management Contracting 970.3770 Facilities management. ...
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Daire, Judith; Gilson, Lucy
2014-09-01
In South Africa, as elsewhere, Primary Health Care (PHC) facilities are managed by professional nurses. Little is known about the dimensions and challenges of their job, or what influences their managerial practice. Drawing on leadership and organizational theory, this study explored what the job of being a PHC manager entails, and what factors influence their managerial practice. We specifically considered whether the appointment of professional nurses as facility managers leads to an identity transition, from nurse to manager. The overall intention was to generate ideas about how to support leadership development among PHC facility managers. Adopting case study methodology, the primary researcher facilitated in-depth discussions (about their personal history and managerial experiences) with eight participating facility managers from one geographical area. Other data were collected through in-depth interviews with key informants, document review and researcher field notes/journaling. Analysis involved data triangulation, respondent and peer review and cross-case analysis. The experiences show that the PHC facility manager's job is dominated by a range of tasks and procedures focused on clinical service management, but is expected to encompass action to address the population and public health needs of the surrounding community. Managing with and through others, and in a complex system, requiring self-management, are critical aspects of the job. A range of personal, professional and contextual factors influence managerial practice, including professional identity. The current largely facility-focused management practice reflects the strong nursing identity of managers and broader organizational influences. However, three of the eight managers appear to self-identify an emerging leadership identity and demonstrate related managerial practices. Nonetheless, there is currently limited support for an identity transition towards leadership in this context. Better
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Energy Technology Data Exchange (ETDEWEB)
Staub, P.; Weibel, K.; Zaugg, T. [Pom and Consulting Ltd., Zuerich (Switzerland); Lang, R. [Gruenberg and Partner Ltd., Zuerich (Switzerland); Frei, Ch. [Herzog Kull Group, Aarau (Switzerland)
2001-07-01
This final report presents the results of a study made on how facility management (FM) is positioned in enterprises and on how energy management can be integrated into the facility management process. Also, recommendations are made on the actions that are considered necessary to improve the understanding of facility management and energy management. The findings of an analysis made of the results of a survey among 200 enterprises, 20 interviews and 5 case studies are presented. The authors state that, in spite of the relatively small sample taken - mostly larger enterprises - trends in facility management and energy management could be shown. The findings of the survey, such as the relative importance of the integration of energy topics in facility management and the need for standardised indicators and benchmarking, are discussed in detail. Also, it is noted that the success of FM is in part due to delegation of responsibility to smaller business units or even to individual employees. The market potential for FM services is examined, with yearly growth rates of up to 20%. The importance of anchoring FM strategies at the top level of management is stressed, as is the need for promotion of the idea of facility management and training concepts for those responsible for its implementation.
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Samarbejdsformer og Facilities Management
DEFF Research Database (Denmark)
Storgaard, Kresten
Resultater fra en surveyundersøgelse om fordele og ulemper ved forskellige samarbejdsformer indenfor Facilities Management fremlægges.......Resultater fra en surveyundersøgelse om fordele og ulemper ved forskellige samarbejdsformer indenfor Facilities Management fremlægges....
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High-risk facilities. Emergency management in nuclear, chemical and hazardous waste facilities
International Nuclear Information System (INIS)
Kloepfer, Michael
2012-01-01
The book on emergency management in high-risk facilities covers the following topics: Change in the nuclear policy, risk management of high-risk facilities as a constitutional problem - emergency management in nuclear facilities, operational mechanisms of risk control in nuclear facilities, regulatory surveillance responsibilities for nuclear facilities, operational mechanism of the risk control in chemical plants, regulatory surveillance responsibilities for chemical facilities, operational mechanisms of the risk control in hazardous waste facilities, regulatory surveillance responsibilities for hazardous waste facilities, civil law consequences in case of accidents in high-risk facilities, criminal prosecution in case of accidents in high-risk facilities, safety margins as site risk for emission protection facilities, national emergency management - strategic emergency management structures, warning and self-protection of the public in case of CBRN hazards including aspects of the psych-social emergency management.
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Scott, Vera; Gilson, Lucy
2017-09-15
Governance, which includes decision-making at all levels of the health system, and information have been identified as key, interacting levers of health system strengthening. However there is an extensive literature detailing the challenges of supporting health managers to use formal information from health information systems (HISs) in their decision-making. While health information needs differ across levels of the health system there has been surprisingly little empirical work considering what information is actually used by primary healthcare facility managers in managing, and making decisions about, service delivery. This paper, therefore, specifically examines experience from Cape Town, South Africa, asking the question: How is primary healthcare facility managers' use of information for decision-making influenced by governance across levels of the health system? The research is novel in that it both explores what information these facility managers actually use in decision-making, and considers how wider governance processes influence this information use. An academic researcher and four facility managers worked as co-researchers in a multi-case study in which three areas of management were served as the cases. There were iterative cycles of data collection and collaborative analysis with individual and peer reflective learning over a period of three years. Central governance shaped what information and knowledge was valued - and, therefore, generated and used at lower system levels. The central level valued formal health information generated in the district-based HIS which therefore attracted management attention across the levels of the health system in terms of design, funding and implementation. This information was useful in the top-down practices of planning and management of the public health system. However, in facilities at the frontline of service delivery, there was a strong requirement for local, disaggregated information and experiential
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Piloting laboratory quality system management in six health facilities in Nigeria.
Directory of Open Access Journals (Sweden)
Henry Mbah
Full Text Available Achieving accreditation in laboratories is a challenge in Nigeria like in most African countries. Nigeria adopted the World Health Organization Regional Office for Africa Stepwise Laboratory (Quality Improvement Process Towards Accreditation (WHO/AFRO- SLIPTA in 2010. We report on FHI360 effort and progress in piloting WHO-AFRO recognition and accreditation preparedness in six health facility laboratories in five different states of Nigeria.Laboratory assessments were conducted at baseline, follow up and exit using the WHO/AFRO- SLIPTA checklist. From the total percentage score obtained, the quality status of laboratories were classified using a zero to five star rating, based on the WHO/AFRO quality improvement stepwise approach. Major interventions include advocacy, capacity building, mentorship and quality improvement projects.At baseline audit, two of the laboratories attained 1- star while the remaining four were at 0- star. At follow up audit one lab was at 1- star, two at 3-star and three at 4-star. At exit audit, four labs were at 4- star, one at 3-star and one at 2-star rating. One laboratory dropped a 'star' at exit audit, while others consistently improved. The two weakest elements at baseline; internal audit (4% and occurrence/incidence management (15% improved significantly, with an exit score of 76% and 81% respectively. The elements facility and safety was the major strength across board throughout the audit exercise.This effort resulted in measurable and positive impact on the laboratories. We recommend further improvement towards a formal international accreditation status and scale up of WHO/AFRO- SLIPTA implementation in Nigeria.
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The influence of facility design and human resource management on health care professionals.
Sadatsafavi, Hessam; Walewski, John; Shepley, Mardelle M
2015-01-01
Cost control of health care services is a strategic concern for organizations. To lower costs, some organizations reduce staffing levels. However, this may not be worth the trade-off, as the quality of services will likely be reduced, morale among health care providers tends to suffer, and patient satisfaction is likely to decline. The potential synergy between human resource management and facility design and operation was investigated to achieve the goal of providing cost containment strategies without sacrificing the quality of services and the commitment of employees. About 700 health care professionals from 10 acute-care hospitals participated in this cross-sectional study. The authors used structural equation modeling to test whether employees' evaluations of their physical work environment and human resource practices were significantly associated with lower job-related anxiety, higher job satisfaction, and higher organizational commitment. The analysis found that employees' evaluations of their physical work environment and human resource practices influenced their job-related feelings and attitudes. Perceived organizational support mediated this relationship. The study also found a small but positive interaction effect between the physical work environment and human resource practices. The influence of physical work environment was small, mainly because of the high predictive value of human resource practices and strong confounding variables included in the analysis. This study specifically showed the role of facility design in reducing job-related anxiety among caregivers. Preliminary evidence is provided that facility design can be used as a managerial tool for improving job-related attitudes and feelings of employees and earning their commitment. Providing a healthy and safe work environment can be perceived by employees as an indication that the organization respects them and cares about their well-being, which might be reciprocated with higher levels
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Facility Management's Role in Organizational Sustainability
Adams, Gregory K.
2013-01-01
Facility managers have questions about sustainability. How do an organization's physical facilities--its built environment--and the management of them, influence the sustainability of the organization or institution as a whole? How important is Facility Management (FM) to the overall sustainability profile of an organization? Facility managers…
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Lesotho - Health Facility Survey
Millennium Challenge Corporation — The main objective of the 2011 Health Facility Survey (HFS) was to establish a baseline for informing the Health Project performance indicators on health facilities,...
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Surplus Facilities Management Program
International Nuclear Information System (INIS)
Coobs, J.H.
1983-01-01
This is the second of two programs that are concerned with the management of surplus facilities. The facilities in this program are those related to commercial activities, which include the three surplus experimental and test reactors [(MSRE, HRE-2, and the Low Intensity Test Reactor (LITR)] and seven experimental loops at the ORR. The program is an integral part of the Surplus Facilities Management Program, which is a national program administered for DOE by the Richland Operations Office. Very briefly reported here are routine surveillance and maintenance of surplus radioactively contaminated DOE facilities awaiting decommissioning
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Capital Ideas for Facilities Management.
Golding, Stephen T.; Gordon, Janet; Gravina, Arthur
2001-01-01
Asserting that just like chief financial officers, higher education facilities specialists must maximize the long-term performance of assets under their care, describes strategies for strategic facilities management. Discusses three main approaches to facilities management (insourcing, cosourcing, and outsourcing) and where boards of trustees fit…
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Facility management in kinderschoenen : Facility management in de kinderopvang
Ronald Beckers
2008-01-01
Begin dit jaar heft Academie Diedenoort FM aan de Hogeschool van Arnhem en Nijmegen, tijdens een studiemiddag een toelichting gegeven op het vakgebied facility management aan een aantal financiële managers van organisaties die zich bezighouden met kinderopvang. In die branche staat het fm-vakgebid
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Potential of Computerized Maintenance Management System in Facilities Management
Directory of Open Access Journals (Sweden)
Noor Farisya Azahar
2014-07-01
Full Text Available For some time it has been clear that managing buildings or estates has been carried out in the context of what has become known as facilities management. British Institute of Facilities Management defined facilities management is the integration of multi-disciplinary activities within the built environment and the management of their impact upon people and the workplace. Effective facilities management is vital to the success of an organisation by contributing to the delivery of its strategic and operational objectives. Maintenance of buildings should be given serious attention before (stage design, during and after a building is completed. But total involvement in building maintenance is after the building is completed and during its operations. Residents of and property owners require their building to look attractive, durable and have a peaceful indoor environment and efficient. The objective of the maintenance management system is to stream line the vast maintenance information system to improve the productivity of an industrial plant. a good maintenance management system makes equipment and facilities available. This paper will discuss the fundamental steps of maintenance management program and Computerized Maintenance Management System (CMMS
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CLAIMS OF SUSTAINABLE FACILITIES MANAGEMENT
DEFF Research Database (Denmark)
Nielsen, Susanne Balslev
Purpose: The purpose of the paper is to provide an overview of current practices within the emergent management discipline: Sustainable Facilities Management (SFM). Background: To develop a sustainable society, facilities managers must become change agents for sustainability in the built...... environment. Facilities Management (FM) is contributing to the environmental, social and economical problems, but can at the same time also be a part of the solution. However, to integrate sustainability in FM is still an emergent niche within FM, and the examples of SFM so far seems to come out of very......-creating of new socio-technical services and technologies These SFM understandings are concluded to be coexisting claims of SFM definitions. Practical Implications: Facilities managers will be able to identify the mindset behind different services and technologies that are promoted as SFM. But maybe just...
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Computer-Aided Facilities Management Systems (CAFM).
Cyros, Kreon L.
Computer-aided facilities management (CAFM) refers to a collection of software used with increasing frequency by facilities managers. The six major CAFM components are discussed with respect to their usefulness and popularity in facilities management applications: (1) computer-aided design; (2) computer-aided engineering; (3) decision support…
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Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria
Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Kelechi, Ohiri
2016-01-01
Background: Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. Objective: To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. Method: A total of 6 states were selected across the 6 geopolitical zones of the country. However, assessments were carried out in 40 facilities in only 5 states. Selection was based on location, coverage, and minimum services offered. The facilities were divided randomly into 2 groups. The treatment group received quality-of-care assessment, continuous feedback, and improvement support, whereas the control group received quality assessment and no other support. Data were collected using the SafeCare Healthcare Standards and managed on the SafeCare Data Management System—AfriDB. Eight core areas were assessed at baseline and end line, and compliance to quality health-care standards was compared. Result: Outcomes from 40 facilities were accepted and analyzed. Overall scores increased in the treatment facilities compared to the control facilities, with strong evidence of improvement (t = 5.28, P = .0004) and 11% average improvement, but no clear pattern of improvement emerged in the control group. Conclusion: The study demonstrated governance support and active community involvement offered potential for quality improvement in primary health-care facilities. PMID:28462280
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Sport Facility Planning and Management. Sport Management Library.
Farmer, Peter J.; Mulrooney, Aaron L.; Ammon, Rob, Jr.
Students of sports facilities management will need to acquire a wide variety of managerial skills and knowledge in order to be adequately prepared to plan and manage these facilities. This textbook offers students a mix of practical examples and recognized theory to help them in the planning, constructing, promoting, and managing of sports…
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7 CFR 210.13 - Facilities management.
2010-01-01
... 7 Agriculture 4 2010-01-01 2010-01-01 false Facilities management. 210.13 Section 210.13... Participation § 210.13 Facilities management. Link to an amendment published at 74 FR 66216, Dec. 15, 2009. (a..., the added text is set forth as follows: § 210.13 Facilities management. (c) Food safety program. The...
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New Ideas on Facilities Management.
Grimm, James C.
1986-01-01
Examines trends in facilities management relating to products and people. Reviews new trends in products, including processes, techniques, and programs that are being expounded by business and industry. Discusses the "people factors" involved in facilities management. (ABB)
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International Nuclear Information System (INIS)
Domingo, José L.; Rovira, Joaquim; Vilavert, Lolita; Nadal, Martí; Figueras, María J.; Schuhmacher, Marta
2015-01-01
We performed a screening investigation to assess the human health risks of the Integrated Waste Management Facility (IWMF: mechanical–biological treatment (MBT) plant plus municipal solid waste incinerator (MSWI); Ecoparc-3) of Barcelona (Spain). Air concentrations of pollutants potentially released by the MBT plant (VOCs and bioaerosols) and the MSWI (trace elements, PCDD/Fs and PCBs) were determined. Trace elements, PCDD/Fs and PCBs were also analyzed in soil samples. The concentrations of trace elements and bioaerosols were similar to those previously reported in other areas of similar characteristics, while formaldehyde was the predominant VOC. Interestingly, PCDD/F concentrations in soil and air were the highest ever reported near a MSWI in Catalonia, being maximum concentrations 10.8 ng WHO-TEQ/kg and 41.3 fg WHO-TEQ/m 3 , respectively. In addition, there has not been any reduction in soils, even after the closure of a power plant located adjacently. Human health risks of PCDD/F exposure in the closest urban nucleus located downwind the MSWI are up to 10-times higher than those nearby other MSWIs in Catalonia. Although results must be considered as very preliminary, they are a serious warning for local authorities. We strongly recommend to conduct additional studies to confirm these findings and, if necessary, to implement measures to urgently mitigate the impact of the MSWI on the surrounding environment. We must also state the tremendous importance of an individual evaluation of MSWIs, rather than generalizing their environmental and health risks. - Highlights: • Health risks of an Integrated Waste Management Facility in Catalonia are assessed. • PCDD/F exposure near this facility is up to 10-times higher than that near others. • Environmental monitoring of incineration plants should be performed case-by-case. • Since results are very preliminary, confirmatory studies should be conducted
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Energy Technology Data Exchange (ETDEWEB)
Domingo, José L., E-mail: joseluis.domingo@urv.cat [Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Rovira, Joaquim [Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Departament d' Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Catalonia (Spain); Vilavert, Lolita; Nadal, Martí [Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Figueras, María J. [Microbiology Unit, School of Medicine, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Schuhmacher, Marta [Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Catalonia (Spain); Departament d' Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Catalonia (Spain)
2015-06-15
We performed a screening investigation to assess the human health risks of the Integrated Waste Management Facility (IWMF: mechanical–biological treatment (MBT) plant plus municipal solid waste incinerator (MSWI); Ecoparc-3) of Barcelona (Spain). Air concentrations of pollutants potentially released by the MBT plant (VOCs and bioaerosols) and the MSWI (trace elements, PCDD/Fs and PCBs) were determined. Trace elements, PCDD/Fs and PCBs were also analyzed in soil samples. The concentrations of trace elements and bioaerosols were similar to those previously reported in other areas of similar characteristics, while formaldehyde was the predominant VOC. Interestingly, PCDD/F concentrations in soil and air were the highest ever reported near a MSWI in Catalonia, being maximum concentrations 10.8 ng WHO-TEQ/kg and 41.3 fg WHO-TEQ/m{sup 3}, respectively. In addition, there has not been any reduction in soils, even after the closure of a power plant located adjacently. Human health risks of PCDD/F exposure in the closest urban nucleus located downwind the MSWI are up to 10-times higher than those nearby other MSWIs in Catalonia. Although results must be considered as very preliminary, they are a serious warning for local authorities. We strongly recommend to conduct additional studies to confirm these findings and, if necessary, to implement measures to urgently mitigate the impact of the MSWI on the surrounding environment. We must also state the tremendous importance of an individual evaluation of MSWIs, rather than generalizing their environmental and health risks. - Highlights: • Health risks of an Integrated Waste Management Facility in Catalonia are assessed. • PCDD/F exposure near this facility is up to 10-times higher than that near others. • Environmental monitoring of incineration plants should be performed case-by-case. • Since results are very preliminary, confirmatory studies should be conducted.
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Strategies for healthcare facilities, construction, and real estate management.
Lee, James G
2012-05-01
Adventist HealthCare offers the following lessons learned in improving the value of healthcare facilities, construction, and real estate management: Use an integrated approach. Ensure that the objectives of the approach align the hospital or health system's mission and values. Embrace innovation. Develop a plan that applies to the whole organization, rather than specific business units. Ensure commitment of senior leaders.
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Technical merits and leadership in facility management
Shoemaker, Jerry J
1997-01-01
After almost ten years of experience and formal education in design, construction, and facility operations and maintenance, the challenges and complexity of facility management still seem overwhelming and intangible. This document explores those complexities and challenges, and presents several philosophies and strategies practiced in facility management. The document is divided into six chapters; the introduction, facility management and leadership, building systems, facility operations, fac...
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Landman, Keren Z; Jean, Samuel E; Existe, Alexandre; Akom, Eniko E; Chang, Michelle A; Lemoine, Jean Frantz; Mace, Kimberly E
2015-10-09
Malaria is a public health concern in Haiti, although there are limited data on its burden and case management. National malaria guidelines updated in 2012 recommend treatment with chloroquine and primaquine. In December 2012, a nationally-representative cross-sectional survey of health facilities (HFs) was conducted to determine malaria prevalence among febrile outpatients and malaria case management quality at baseline before scale-up of diagnostics and case management training. Among all 833 HFs nationwide, 30 were selected randomly, in proportion to total HFs per region, for 2-day evaluations. Survey teams inventoried HF material and human resources. Outpatients of all ages were screened for temperature >37.5 °C or history of fever; those without severe symptoms were consented and enrolled. Providers evaluated and treated enrolled patients according to HF standards; the survey teams documented provider-ordered diagnostic tests and treatment decisions. Facility-based test results [microscopy and malaria rapid diagnostic tests (RDTs)] were collected from HF laboratories. Blood smears for gold-standard microscopy, and dried blood spots for polymerase chain reaction (PCR) were obtained. Malaria diagnostic capacity, defined as completing a test for an enrolled patient or having adequate resources for RDTs or microscopy, was present in 11 (37 %) HFs. Among 459 outpatients screened, 257 (56 %) were febrile, of which 193 (75 %) were eligible, and 153 (80 %) were enrolled. Among 39 patients with facility-level malaria test results available on the survey day, 11 (28 %) were positive, of whom 6 (55 %) were treated with an anti-malarial. Twenty-seven (95 %) of the 28 patients testing negative were not treated with an anti-malarial. Of 114 patients without test results available, 35 (31 %) were presumptively treated for malaria. Altogether, 42 patients were treated with an anti-malarial, one (2 %) according to Haiti's 2012 guidelines. Of 140 gold-standard smears, none
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2002-01-01
Recently we have been confronted with difficulties concerning services which are part of a new contract for facilities management. Please see below for some information about this contract. Following competitive tendering and the Finance Committee decision, the contract was awarded to the Swiss firm 'Facilities Management Network (FMN)'. The owners of FMN are two companies 'M+W Zander' and 'Avireal', both very experienced in this field of facilities management. The contract entered into force on 1st July 2002. CERN has grouped together around 20 different activities into this one contract, which was previously covered by separate contracts. The new contract includes the management and execution of many activities, in particular: Guards and access control; cleaning; operation and maintenance of heating plants, cooling and ventilation equipment for buildings not related to the tunnel or the LHC; plumbing; sanitation; lifts; green areas and roads; waste disposal; and includes a centralised helpdesk for these act...
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A Program Management Framework for Facilities Managers
King, Dan
2012-01-01
The challenge faced by senior facility leaders is not how to execute a single project, but rather, how to successfully execute a large program consisting of hundreds of projects. Senior facilities officers at universities, school districts, hospitals, airports, and other organizations with extensive facility inventories, typically manage project…
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Tushi, Aonungdok; Kaur, Prabhdeep
2017-01-01
Public sector health facilities were poorly managed due to a history of conflict in Nagaland, India. Government of Nagaland introduced "Nagaland Communitisation of Public Institutions and Services Act" in 2002. Main objectives of the evaluation were to review the functioning of Health Center Managing Committees (HCMCs), deliver health services in the institutions managed by HCMC, identify strengths as well as challenges perceived by HCMC members in the rural areas of Mokokchung district, Nagaland. The evaluation was made using input, process and output indicators. A doctor, the HCMC Chairman and one member from each of the three community health centers (CHC) and four primary health centers (PHC) were surveyed using a semi-structured questionnaire and an in-depth interview guide. Proportions for quantitative data were computed and key themes from the same were identified. Overall; the infrastructure, equipment and outpatient/inpatient service availability was satisfactory. There was a lack of funds and shortage of doctors, drugs as well as laboratory facilities. HCMCs were in place and carried out administrative activities. HCMCs felt ownership, mobilized community contributions and managed human resources. HCMC members had inadequate funds for their transport and training. They faced challenges in service delivery due to political interference and lack of adequate human, material, financial resources. Communitisation program was operational in the district. HCMC members felt the ownership of health facilities. Administrative, political support and adequate funds from the government are needed for effective functioning of HCMCs and optimal service delivery in public sector facilities.
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The future of facility management in Finland
Boateng, Ernest
2011-01-01
The objective of this study was to investigate the feasible future of facility management in Finland in order to provide an overview of the future of facility management. This is intended to serve as a guideline for the educational sector, facility management service companies, and the Facility management association in Finland (FIFMA) for future development. Qualitative method, precisely semi-structured/unstructured interview was adopted to address the problems in this study. The study c...
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New Trends in Facility Asset Management.
Adams, Matt
2000-01-01
Explains new, positive trends in facility asset management that encompasses greater acceptance and involvement of facility managers in the financial planning process, greater awareness of the need for maintenance, and facility administrators taking a greater role with business officers. The new climate for alternative renewal financing proposals…
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Berhanemeskel, Eyerusalem; Beedemariam, Gebremedhin; Fenta, Teferi Gedif
2016-01-01
A wide range of pharmaceutical products are needed for diagnosis, treatment, and prevention of HIV/AIDS. However, interrupted supplies and stock-outs are the major challenges in the supply chain of ARV medicines and related commodities. The aim of this study was to assess the supply chain management of HIV/AIDS related commodities in public health facilities of Addis Ababa, Ethiopia. A descriptive cross-sectional survey complemented by qualitative method was conducted in 24 public health facilities (4 hospitals and 20 health centers). A semi-structured questionnaire and observation check list were used to collect data on HIV/AIDS related service, reporting and ordering; receiving, transportation and storage condition of ARV medicines and test kits; and supportive supervision and logistics management information system. In addition, in-depth interview with flexible probing techniques was used to complement the quantitative data with emphasis to the storage condition of ARV medicines and test kits. Quantitative data was analyzed using SPSS version-20. Analysis of qualitative data involved rigorous reading of transcripts in order to identify key themes and data was analyzed using thematic approach. The study revealed that 16 health centers and one hospital had recorded and reported patient medication record. Six months prior to the study, 14 health centers and 2 hospitals had stopped VCT services for one time or more. Three hospitals and 18 health centers claimed to have been able to submit the requisition and report concerning ARV medicines to Pharmaceutical Fund and Supply Agency according to the specific reporting period. More than three-fourth of the health centers had one or more emergency order of ARV medicines on the day of visit, while all of hospitals had emergency order more than 3 times within 6 months prior to the study. All of the hospitals and nearly half of the health centers had an emergency order of test kits more than 3 times in the past 6
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40 CFR 792.31 - Testing facility management.
2010-07-01
... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Testing facility management. 792.31... facility management. For each study, testing facility management shall: (a) Designate a study director as... appropriately tested for identity, strength, purity, stability, and uniformity, as applicable. (e) Assure that...
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The Management System for Facilities and Activities. Safety Requirements
International Nuclear Information System (INIS)
2011-01-01
This publication establishes requirements for management systems that integrate safety, health, security, quality assurance and environmental objectives. A successful management system ensures that nuclear safety matters are not dealt with in isolation but are considered within the context of all these objectives. The aim of this publication is to assist Member States in establishing and implementing effective management systems that integrate all aspects of managing nuclear facilities and activities in a coherent manner. It details the planned and systematic actions necessary to provide adequate confidence that all these requirements are satisfied. Contents: 1. Introduction; 2. Management system; 3. Management responsibility; 4. Resource management; 5. Process implementation; 6. Measurement, assessment and improvement.
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40 CFR 160.31 - Testing facility management.
2010-07-01
... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Testing facility management. 160.31... GOOD LABORATORY PRACTICE STANDARDS Organization and Personnel § 160.31 Testing facility management. For each study, testing facility management shall: (a) Designate a study director as described in § 160.33...
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Harding, Richard; Simms, Victoria; Penfold, Suzanne; Downing, Julia; Powell, Richard A; Mwangi-Powell, Faith; Namisango, Eve; Moreland, Scott; Gikaara, Nancy; Atieno, Mackuline; Kataike, Jennifer; Nsubuga, Clare; Munene, Grace; Banga, Geoffrey; Higginson, Irene J
2014-04-01
World Health Organization's essential drugs list can control the highly prevalent HIV-related pain and symptoms. Availability of essential medicines directly influences clinicians' ability to effectively manage distressing manifestations of HIV. To determine the availability of pain and symptom controlling drugs in East Africa within President's Emergency Plan for AIDS Relief-funded HIV health care facilities. Directly observed quantitative health facilities' pharmacy stock review. We measured availability, expiration and stock-outs of specified drugs required for routine HIV management, including the World Health Organization pain ladder. A stratified random sample in 120 President's Emergency Plan for AIDS Relief-funded HIV care facilities (referral and district hospitals, health posts/centres and home-based care providers) in Kenya and Uganda. Non-opioid analgesics (73%) and co-trimoxazole (64%) were the most commonly available drugs and morphine (7%) the least. Drug availability was higher in hospitals and lower in health centres, health posts and home-based care facilities. Facilities generally did not use minimum stock levels, and stock-outs were frequently reported. The most common drugs had each been out of stock in the past 6 months in 47% of facilities stocking them. When a minimum stock level was defined, probability of a stock-out in the previous 6 months was 32.6%, compared to 45.5% when there was no defined minimum stock level (χ (2) = 5.07, p = 0.024). The data demonstrate poor essential drug availability, particularly analgesia, limited by facility type. The lack of strong opioids, isoniazid and paediatric formulations is concerning. Inadequate drug availability prevents implementation of simple clinical pain and symptom control protocols, causing unnecessary distress. Research is needed to identify supply chain mechanisms that lead to these problems.
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Directory of Open Access Journals (Sweden)
Aonungdok Tushi
2017-01-01
Full Text Available Background: Public sector health facilities were poorly managed due to a history of conflict in Nagaland, India. Government of Nagaland introduced “Nagaland Communitisation of Public Institutions and Services Act” in 2002. Main objectives of the evaluation were to review the functioning of Health Center Managing Committees (HCMCs, deliver health services in the institutions managed by HCMC, identify strengths as well as challenges perceived by HCMC members in the rural areas of Mokokchung district, Nagaland. Materials and Methods: The evaluation was made using input, process and output indicators. A doctor, the HCMC Chairman and one member from each of the three community health centers (CHC and four primary health centers (PHC were surveyed using a semi-structured questionnaire and an in-depth interview guide. Proportions for quantitative data were computed and key themes from the same were identified. Results: Overall; the infrastructure, equipment and outpatient/inpatient service availability was satisfactory. There was a lack of funds and shortage of doctors, drugs as well as laboratory facilities. HCMCs were in place and carried out administrative activities. HCMCs felt ownership, mobilized community contributions and managed human resources. HCMC members had inadequate funds for their transport and training. They faced challenges in service delivery due to political interference and lack of adequate human, material, financial resources. Conclusions: Communitisation program was operational in the district. HCMC members felt the ownership of health facilities. Administrative, political support and adequate funds from the government are needed for effective functioning of HCMCs and optimal service delivery in public sector facilities.
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Mitigating risks related to facilities management.
O'Neill, Daniel P; Scarborough, Sydney
2013-07-01
By looking at metrics focusing on the functionality, age, capital investment, transparency, and sustainability (FACTS) of their organizations' facilities, facilities management teams can build potential business cases to justify upgrading the facilities. A FACTS analysis can ensure that capital spent on facilities will produce a higher or more certain ROI than alternatives. A consistent process for managing spending helps to avoid unexpected spikes that cost the enterprise more in the long run.
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Video Surveillance in Mental Health Facilities: Is it Ethical?
Stolovy, Tali; Melamed, Yuval; Afek, Arnon
2015-05-01
Video surveillance is a tool for managing safety and security within public spaces. In mental health facilities, the major benefit of video surveillance is that it enables 24 hour monitoring of patients, which has the potential to reduce violent and aggressive behavior. The major disadvantage is that such observation is by nature intrusive. It diminishes privacy, a factor of huge importance for psychiatric inpatients. Thus, an ongoing debate has developed following the increasing use of cameras in this setting. This article presents the experience of a medium-large academic state hospital that uses video surveillance, and explores the various ethical and administrative aspects of video surveillance in mental health facilities.
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ECOLOGICAL AND ECONOMICALLY OPTIMAL MANAGEMENT OF WASTE FROM HEALTHCARE FACILITIES
Halina Marczak
2013-01-01
Modern healthcare facilities generate more and more waste, and their management is a significant constitutes a significant cost of their functioning. The undertakings aimed at lowering the costs of expenses in waste management may have a positive influence on budgetary accounts in the institutions rendering health care services. On the example of a hospital in Lublin the costs of waste management and the possibilities to lower these costs by intensifying segregation procedures were presented....
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Nanyonjo, Agnes; Bagorogoza, Benson; Kasteng, Frida; Ayebale, Godfrey; Makumbi, Fredrick; Tomson, Göran; Källander, Karin
2015-08-28
Integrated community case management (iCCM) relies on community health workers (CHWs) managing children with malaria, pneumonia, diarrhoea, and referring children when management is not possible. This study sought to establish the cost per sick child referred to seek care from a higher-level health facility by a CHW and to estimate caregivers' willingness to pay (WTP) for referral. Caregivers of 203 randomly selected children referred to higher-level health facilities by CHWs were interviewed in four Midwestern Uganda districts. Questionnaires and document reviews were used to capture direct, indirect and opportunity costs incurred by caregivers, CHWs and health facilities managing referred children. WTP for referral was assessed through the 'bidding game' approach followed by an open-ended question on maximum WTP. Descriptive analysis was conducted for factors associated with referral completion and WTP using logistic and linear regression methods, respectively. The cost per case referred to higher-level health facilities was computed from a societal perspective. Reasons for referral included having fever with a negative malaria test (46.8%), danger signs (29.6%) and drug shortage (37.4%). Among the referred, less than half completed referral (45.8%). Referral completion was 2.8 times higher among children with danger signs (p = 0.004) relative to those without danger signs, and 0.27 times lower among children who received pre-referral treatment (p average cost per case referred was US$ 4.89 and US$7.35 per case completing referral. For each unit cost per case referred, caregiver out of pocket expenditure contributed 33.7%, caregivers' and CHWs' opportunity costs contributed 29.2% and 5.1% respectively and health facility costs contributed 39.6%. The mean (SD) out of pocket expenditure was US$1.65 (3.25). The mean WTP for referral was US$8.25 (14.70) and was positively associated with having received pre-referral treatment, completing referral and increasing
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Håndbog i Facilities Management
DEFF Research Database (Denmark)
Jensen, Per Anker
Facilities Management (FM) er et nyt nøgleord som mange nu anvender i forskellige forbindelser og sammenhænge. Dette hænger i høj grad sammen med manglen på en fælles dansk referenceramme for FM, der har givet frit spillerum for de mange forskellige definitioner af det engelske ord. Dansk...... Facilities Management netværk (DFM netværk) har i mange år arbejdet for en fælles definition af begrebet sammen med arbejdet for udbredelsen af kendskabet til FM, herunder uddannelse, erfaringsudveksling m.v. DFM netværk har udgivet en Håndbog i Facilities Management i samarbejde med bogens forfatter Per...
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Cryogenic Fluid Management Facility
Eberhardt, R. N.; Bailey, W. J.
1985-01-01
The Cryogenic Fluid Management Facility is a reusable test bed which is designed to be carried within the Shuttle cargo bay to investigate the systems and technologies associated with the efficient management of cryogens in space. Cryogenic fluid management consists of the systems and technologies for: (1) liquid storage and supply, including capillary acquisition/expulsion systems which provide single-phase liquid to the user system, (2) both passive and active thermal control systems, and (3) fluid transfer/resupply systems, including transfer lines and receiver tanks. The facility contains a storage and supply tank, a transfer line and a receiver tank, configured to provide low-g verification of fluid and thermal models of cryogenic storage and transfer processes. The facility will provide design data and criteria for future subcritical cryogenic storage and transfer system applications, such as Space Station life support, attitude control, power and fuel depot supply, resupply tankers, external tank (ET) propellant scavenging, and ground-based and space-based orbit transfer vehicles (OTV).
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Legal regime of water management facilities
Directory of Open Access Journals (Sweden)
Salma Jožef
2013-01-01
Full Text Available The paper analyzes the legal regime of water management facilities in the light of Serbian, foreign and European law. Different divisions of water management facilities are carried out (to public and private ones, natural and artificial ones, etc., with determination of their legal relevance. Account is taken of the issue of protection from harmful effects of waters to such facilities, as well. The paper points also to rules on the water management facilities, from acts of planning, to individual administrative acts and measures for maintenance of required qualitative and quantitative condition of waters, depending on their purpose (general use or special, commercial use o waters. Albeit special rules on water management facilities exist, due to the natural interlocking between all the components of the environment (water, air and soil, a comprehensive approach is required. A reference is made to other basic principles of protection of water management facilities as well, such as the principle of prevention, principle of sustainable development and the principle "polluter pays". The last one represents the achievement of contemporary law, which deviates from the idea accepted in the second half of 20th century that supported the socialization of risk from harmful effects of waters.
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Systems management of facilities agreements
International Nuclear Information System (INIS)
Blundell, A.
1998-01-01
The various types of facilities agreements, the historical obstacles to implementation of agreement management systems and the new opportunities emerging as industry is beginning to make an effort to overcome these obstacles, are reviewed. Barriers to computerized agreement management systems (lack of consistency, lack of standards, scarcity of appropriate computer software) are discussed. Characteristic features of a model facilities agreement management system and the forces driving the changing attitudes towards such systems (e.g. mergers) are also described
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Shumba, Constance Sibongile; Kielmann, Karina; Witter, Sophie
2017-12-06
An in-depth understanding of how organizational culture is experienced by health workers (HWs), and influences their decisions to leave their jobs is a fundamental, yet under-examined, basis for forming effective retention strategies. This research examined HWs' working experiences and perceptions of organisational culture within private-not-for-profit, largely mission-based hospitals, and how this influenced retention. Thirty-two HWs, including managers, in 19 health facilities in Uganda were interviewed using a semi-structured topic guide. Interview transcripts were analysed using thematic content analysis. Interviews showed that the organizational culture was predominantly hierarchical, with non-participative management styles which emphasized control and efficiency. HWs and managers held different perceptions of the organizational culture. While the managers valued results and performance, HWs valued team work, recognition and participative management. The findings of this study indicate that organizational culture influences retention of HWs in health facilities and provide a useful context to inform health care managers in the PNFP sub-sector in Uganda and similar contexts. To improve retention of HWs, a gradual shift in organizational culture will be necessary, focussing on the values, beliefs and perceptions which have the greatest influence on observable behaviour.
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Simon, G E; Hoar, B R; Tucker, C B
2016-08-01
Assessment programs are one way beef producers communicate information about animal welfare to retailers and the public. Programs that monitor cattle through the production cycle (e.g., the Global Animal Partnership) or at individual stages (e.g., slaughter; the North American Meat Institute) exist, but to date, there is no assessment program addressing welfare specifically in the cow-calf sector. The objectives of this study were to measure cow-calf health and handling welfare outcomes and gather management, facility, and producer perspective information to 1) describe current practices and 2) inform assessment design. A welfare assessment, designed using features of similar beef and dairy programs, was conducted on 30 California ranches that varied in size (mean 1,051 cows [SD 1,849], range 28 to 10,000 cows) and location within the state. Cattle health and behavior and stockperson handling were measured during a routine procedure (e.g., pregnancy checks) on breeding females ( = 3,065). Management and producer perspectives were evaluated through an interview, and facility features were recorded at the chute and water access points. Cattle health problems were rare and seen only on specific ranches (e.g., prevalence of lame cattle: mean 1.3% [SD 1.5], range 0 to 7.1%). Cattle behavior and stockperson handling varied between ranches (e.g., cattle balking: mean 22.0% [SD 21.9], range 1.6 to 78.3%; electric prod use: mean 23.5 [SD 21.5], range 0 to 73.0%). Although some management and facility characteristics were shared by most (e.g., all ranches castrated bull calves; 86% used alleyways with an anti-back gate), other aspects varied (e.g., weaning age: mean 8.2 mo [SD 1.4], range 6 to 11 mo; 43% used shade cover over chute). Most producers shared similar perspectives toward their herd health management plan, but their responses varied when asked to evaluate an animal's pain experience. In terms of assessment design, there were challenges with feasibility (e
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Impact of Electronic Health Records on Long-Term Care Facilities: Systematic Review.
Kruse, Clemens Scott; Mileski, Michael; Vijaykumar, Alekhya Ganta; Viswanathan, Sneha Vishnampet; Suskandla, Ujwala; Chidambaram, Yazhini
2017-09-29
Long-term care (LTC) facilities are an important part of the health care industry, providing care to the fastest-growing group of the population. However, the adoption of electronic health records (EHRs) in LTC facilities lags behind other areas of the health care industry. One of the reasons for the lack of widespread adoption in the United States is that LTC facilities are not eligible for incentives under the Meaningful Use program. Implementation of an EHR system in an LTC facility can potentially enhance the quality of care, provided it is appropriately implemented, used, and maintained. Unfortunately, the lag in adoption of the EHR in LTC creates a paucity of literature on the benefits of EHR implementation in LTC facilities. The objective of this systematic review was to identify the potential benefits of implementing an EHR system in LTC facilities. The study also aims to identify the common conditions and EHR features that received favorable remarks from providers and the discrepancies that needed improvement to build up momentum across LTC settings in adopting this technology. The authors conducted a systematic search of PubMed, Cumulative Index of Nursing and Allied Health (CINAHL), and MEDLINE databases. Papers were analyzed by multiple referees to filter out studies not germane to our research objective. A final sample of 28 papers was selected to be included in the systematic review. Results of this systematic review conclude that EHRs show significant improvement in the management of documentation in LTC facilities and enhanced quality outcomes. Approximately 43% (12/28) of the papers reported a mixed impact of EHRs on the management of documentation, and 33% (9/28) of papers reported positive quality outcomes using EHRs. Surprisingly, very few papers demonstrated an impact on patient satisfaction, physician satisfaction, the length of stay, and productivity using EHRs. Overall, implementation of EHRs has been found to be effective in the few LTC
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Value Adding Management: A New Facilities Management Concept
DEFF Research Database (Denmark)
Jensen, Per Anker; Katchamart, Akarapong
2011-01-01
Purpose: To investigate how Facilities Management (FM) can add value and develop a management concept that can assist facilities managers in implementing value adding strategies and practices. Theory: The study is based on the management model for FM included in the European FM standards, recent...... is investigated, tested and discussed based on a case study of an international corporation. Findings: The study shows that the management model for FM creates a relevant starting point but also that stakeholder and relationship management is an essential aspect of Value Adding Management. The case study confirms...... the relevance of the basic concept and provides an important example of how Value Adding Management can be implemented and added value measured. Originality/value: The study develops a concept of Value Adding Management, which is new in FM literature. It is expected to increase the awareness of the impacts...
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International Nuclear Information System (INIS)
Kovalenko, G.; Durasova, N.
2015-01-01
The study has involved the assessment of the tailings management facilities operated at the Prydniprovsky Chemical Plant. The authors have estimated individual and collective exposure doses that may be caused by the emissions of radon, radon decay products and radioactive dust, for each human settlement located within the area of impact of the tailings management facilities. These tailings management facilities have been ranked to describe their relative hazard based on their estimated contribution to the collective exposure dose levels and associated risks
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Knowledge management and information tools for building maintenance and facility management
Talamo, Cinzia
2015-01-01
This book describes the latest methods and tools for the management of information within facility management services and explains how it is possible to collect, organize, and use information over the life cycle of a building in order to optimize the integration of these services and improve the efficiency of processes. The coverage includes presentation and analysis of basic concepts, procedures, and international standards in the development and management of real estate inventories, building registries, and information systems for facility management. Models of strategic management are discussed and the functions and roles of the strategic management center, explained. Detailed attention is also devoted to building information modeling (BIM) for facility management and potential interactions between information systems and BIM applications. Criteria for evaluating information system performance are identified, and guidelines of value in developing technical specifications for facility management service...
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Health seeking behaviour and challenges in utilising health facilities ...
African Journals Online (AJOL)
... and long distance to health facilities. Conclusions: There is potential to increase access to health care in rural areas by increasing the frequency of mobile clinic services and strengthening the community health worker strategy. Key words: Health seeking behaviour, Rural community, Health facilities, Challenges, Uganda ...
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Management of Decommissioning on a Multi-Facility Site
International Nuclear Information System (INIS)
Laraia, Michele; McIntyre, Peter; Visagie, Abrie
2008-01-01
The management of the decommissioning of multi-facility sites may be inadequate or inappropriate if based on approaches and strategies developed for sites consisting of only a single facility. The varied nature of activities undertaken, their interfaces and their interdependencies are likely to complicate the management of decommissioning. These issues can be exacerbated where some facilities are entering the decommissioning phase while others are still operational or even new facilities are being built. Multi-facility sites are not uncommon worldwide but perhaps insufficient attention has been paid to optimizing the overall site decommissioning in the context of the entire life cycle of facilities. Decommissioning management arrangements need to be established taking a view across the whole site. A site-wide decommissioning management system is required. This should include a project evaluation and approval process and specific arrangements to manage identified interfaces and interdependencies. A group should be created to manage decommissioning across the site, ensuring adequate and consistent practices in accordance with the management system. Decommissioning management should be aimed at the entire life cycle of facilities. In the case of multi facility sites, the process becomes more complex and decommissioning management arrangements need to be established with a view to the whole site. A site decommissioning management system, a group that is responsible for decommissioning on site, a site project evaluation and approval process and specific arrangements to manage the identified interfaces are key areas of a site decommissioning management structure that need to be addressed to ensure adequate and consistent decommissioning practices. A decommissioning strategy based on single facilities in a sequential manner is deemed inadequate
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Facility management research in the Netherlands
Thijssen, Thomas; van der Voordt, Theo; Mobach, Mark P.
This article provides a brief overview of the history and development of facility management research in the Netherlands and indicates future directions. Facility management as a profession has developed from single service to multi-services and integral services over the past 15 years.
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ECOLOGICAL AND ECONOMICALLY OPTIMAL MANAGEMENT OF WASTE FROM HEALTHCARE FACILITIES
Directory of Open Access Journals (Sweden)
Halina Marczak
2013-04-01
Full Text Available Modern healthcare facilities generate more and more waste, and their management is a significant constitutes a significant cost of their functioning. The undertakings aimed at lowering the costs of expenses in waste management may have a positive influence on budgetary accounts in the institutions rendering health care services. On the example of a hospital in Lublin the costs of waste management and the possibilities to lower these costs by intensifying segregation procedures were presented. Moreover, the article presents the influence of specific waste neutralisation on the costs of waste management.
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Health care provider knowledge and routine management of pre-eclampsia in Pakistan.
Sheikh, Sana; Qureshi, Rahat Najam; Khowaja, Asif Raza; Salam, Rehana; Vidler, Marianne; Sawchuck, Diane; von Dadelszen, Peter; Zaidi, Shujat; Bhutta, Zulfiqar
2016-09-30
Maternal mortality ratio is 276 per 100,000 live births in Pakistan. Eclampsia is responsible for one in every ten maternal deaths despite the fact that management of this disease is inexpensive and has been available for decades. Many studies have shown that health care providers in low and middle-income countries have limited training to manage patients with eclampsia. Hence, we aimed to explore the knowledge of different cadres of health care providers regarding aetiology, diagnosis and treatment of pre-eclampsia and eclampsia and current management practices. We conducted a mixed method study in the districts of Hyderabad and Matiari in Sindh province, Pakistan. Focus group discussions and interviews were conducted with community health care providers, which included Lady Health Workers and their supervisors; traditional birth attendants and facility care providers. In total seven focus groups and 26 interviews were conducted. NVivo 10 was used for analysis and emerging themes and sub-themes were drawn. All participants were providing care for pregnant women for more than a decade except one traditional birth attendant and two doctors. The most common cause of pre-eclampsia mentioned by community health care providers was stress of daily life: the burden of care giving, physical workload, short birth spacing and financial constraints. All health care provider groups except traditional birth attendants correctly identified the signs, symptoms, and complications of pre-eclampsia and eclampsia and were referring such women to tertiary health facilities. Only doctors were aware that magnesium sulphate is recommended for eclampsia management and prevention; however, they expressed fears regarding its use at first and secondary level health facilities. This study found several gaps in knowledge regarding aetiology, diagnosis and treatment of pre-eclampsia among health care providers in Sindh. Findings suggest that lesser knowledge regarding management of pre
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20 CFR 638.303 - Site selection and facilities management.
2010-04-01
... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Site selection and facilities management. 638... Facilities Management § 638.303 Site selection and facilities management. (a) The Job Corps Director shall... center, facilities engineering and real estate management will be conducted by the Job Corps Director or...
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Simulation modeling for the health care manager.
Kennedy, Michael H
2009-01-01
This article addresses the use of simulation software to solve administrative problems faced by health care managers. Spreadsheet add-ins, process simulation software, and discrete event simulation software are available at a range of costs and complexity. All use the Monte Carlo method to realistically integrate probability distributions into models of the health care environment. Problems typically addressed by health care simulation modeling are facility planning, resource allocation, staffing, patient flow and wait time, routing and transportation, supply chain management, and process improvement.
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Health facilities safety in natural disasters: experiences and challenges from South East Europe.
Radovic, Vesela; Vitale, Ksenija; Tchounwou, Paul B
2012-05-01
The United Nations named 2010 as a year of natural disasters, and launched a worldwide campaign to improve the safety of schools and hospitals from natural disasters. In the region of South East Europe, Croatia and Serbia have suffered the greatest impacts of natural disasters on their communities and health facilities. In this paper the disaster management approaches of the two countries are compared, with a special emphasis on the existing technological and legislative systems for safety and protection of health facilities and people. Strategic measures that should be taken in future to provide better safety for health facilities and populations, based on the best practices and positive experiences in other countries are recommended. Due to the expected consequences of global climate change in the region and the increased different environmental risks both countries need to refine their disaster preparedness strategies. Also, in the South East Europe, the effects of a natural disaster are amplified in the health sector due to its critical medical infrastructure. Therefore, the principles of environmental security should be implemented in public health policies in the described region, along with principles of disaster management through regional collaborations.
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Health Facilities Safety in Natural Disasters: Experiences and Challenges from South East Europe
Directory of Open Access Journals (Sweden)
Vesela Radovic
2012-05-01
Full Text Available The United Nations named 2010 as a year of natural disasters, and launched a worldwide campaign to improve the safety of schools and hospitals from natural disasters. In the region of South East Europe, Croatia and Serbia have suffered the greatest impacts of natural disasters on their communities and health facilities. In this paper the disaster management approaches of the two countries are compared, with a special emphasis on the existing technological and legislative systems for safety and protection of health facilities and people. Strategic measures that should be taken in future to provide better safety for health facilities and populations, based on the best practices and positive experiences in other countries are recommended. Due to the expected consequences of global climate change in the region and the increased different environmental risks both countries need to refine their disaster preparedness strategies. Also, in the South East Europe, the effects of a natural disaster are amplified in the health sector due to its critical medical infrastructure. Therefore, the principles of environmental security should be implemented in public health policies in the described region, along with principles of disaster management through regional collaborations.
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Ugo, Okoli; Ezinne, Eze-Ajoku; Modupe, Oludipe; Nicole, Spieker; Winifred, Ekezie; Kelechi, Ohiri
2016-01-01
Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. A total of 6 states were selected across the 6 geopolitical zones of the country. However, assessments were carried out in 40 facilities in only 5 states. Selection was based on location, coverage, and minimum services offered. The facilities were divided randomly into 2 groups. The treatment group received quality-of-care assessment, continuous feedback, and improvement support, whereas the control group received quality assessment and no other support. Data were collected using the SafeCare Healthcare Standards and managed on the SafeCare Data Management System-AfriDB. Eight core areas were assessed at baseline and end line, and compliance to quality health-care standards was compared. Outcomes from 40 facilities were accepted and analyzed. Overall scores increased in the treatment facilities compared to the control facilities, with strong evidence of improvement ( t = 5.28, P = .0004) and 11% average improvement, but no clear pattern of improvement emerged in the control group. The study demonstrated governance support and active community involvement offered potential for quality improvement in primary health-care facilities.
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Factors affecting medical waste management in lowlevel health ...
African Journals Online (AJOL)
African Journal of Environmental Science and Technology ... evaluation of medical waste management systems was conducted in the low-level health ... In Ilala, 70% of the health facilities burn wastes in poorly designed incinerators, open pit ...
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Fast Flux Test Facility, Sodium Storage Facility project-specific project management plan
International Nuclear Information System (INIS)
Shank, D.R.
1994-01-01
This Project-Specific Project Management Plan describes the project management methods and controls used by the WHC Projects Department to manage Project 03-F-031. The Sodium Storage Facility provides for storage of the 260,000 gallons of sodium presently in the FFTF Plant. The facility will accept the molten sodium transferred from the FFTF sodium systems, and store the sodium in a solid state under an inert cover gas until such time as a Sodium Reaction Facility is available for final disposal of the sodium
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Fast Flux Test Facility, Sodium Storage Facility project-specific project management plan
Energy Technology Data Exchange (ETDEWEB)
Shank, D.R.
1994-12-29
This Project-Specific Project Management Plan describes the project management methods and controls used by the WHC Projects Department to manage Project 03-F-031. The Sodium Storage Facility provides for storage of the 260,000 gallons of sodium presently in the FFTF Plant. The facility will accept the molten sodium transferred from the FFTF sodium systems, and store the sodium in a solid state under an inert cover gas until such time as a Sodium Reaction Facility is available for final disposal of the sodium.
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Buregyeya, Esther; Nuwaha, Fred; Verver, Suzanne; Criel, Bart; Colebunders, Robert; Wanyenze, Rhoda; Kalyango, Joan N; Katamba, Achilles; Mitchell, Ellen Mh
2013-08-01
Tuberculosis infection control (TBIC) is rarely implemented in the health facilities in resource limited settings. Understanding the reasons for low level of implementation is critical. The study aim was to assess TBIC practices and barriers to implementation in two districts in Uganda. We conducted a cross-sectional study in 51 health facilities in districts of Mukono and Wakiso. The study included: a facility survey, observations of practices and eight focus group discussions with health workers. Quantitative: Only 16 facilities (31%) had a TBIC plan. Five facilities (10%) were screening patients for cough. Two facilities (4%) reported providing masks to patients with cough. Ventilation in the waiting areas was inadequate for TBIC in 43% (22/51) of the facilities. No facility possessed N95 particulate respirators. Qualitative: Barriers that hamper implementation of TBIC elicited included: under-staffing, lack of space for patient separation, lack of funds to purchase masks, and health workers not appreciating the importance of TBIC. TBIC measures were not implemented in health facilities in the two Ugandan districts where the survey was done. Health system factors like lack of staff, space and funds are barriers to implement TBIC. Effective implementation of TBIC measures occurs when the fundamental health system building blocks--governance and stewardship, financing, infrastructure, procurement and supply chain management are in place and functioning appropriately.
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Facility accident considerations in the US Department of Energy Waste Management Program
International Nuclear Information System (INIS)
Mueller, C.
1994-01-01
A principal consideration in developing waste management strategies is the relative importance of Potential radiological and hazardous releases to the environment during postulated facility accidents with respect to protection of human health and the environment. The Office of Environmental Management (EM) within the US Department of Energy (DOE) is currently formulating an integrated national program to manage the treatment, storage, and disposal of existing and future wastes at DOE sites. As part of this process, a Programmatic Environmental impact Statement (PEIS) is being prepared to evaluate different waste management alternatives. This paper reviews analyses that have been Performed to characterize, screen, and develop source terms for accidents that may occur in facilities used to store and treat the waste streams considered in these alternatives. Preliminary results of these analyses are discussed with respect to the comparative potential for significant releases due to accidents affecting various treatment processes and facility configurations. Key assumptions and sensitivities are described
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Decommissioning of nuclear facilities: Decontamination, disassembly and waste management
International Nuclear Information System (INIS)
1983-01-01
The term 'decommissioning', as used within the nuclear industry, means the actions taken at the end of a facility's useful life to retire the facility from service in a manner that provides adequate protection for the health and safety of the decommissioning workers, the general public, and for the environment. These actions can range from merely closing down the facility and a minimal removal of radioactive material coupled with continuing maintenance and surveillance, to a complete removal of residual radioactivity in excess of levels acceptable for unrestricted use of the facility and its site. This latter condition, unrestricted use, is the ultimate goal of all decommissioning actions at retired nuclear facilities. The purpose of this report is to provide an information base on the considerations important to decommissioning, the methods available for decontamination and disassembly of a nuclear facility, the management of the resulting radioactive wastes, and the areas of decommissioning methodology where improvements might be made. Specific sections are devoted to each of these topics, and conclusions are presented concerning the present status of each topic. A summary of past decommissioning experience in Member States is presented in the Appendix. The report, with its discussions of necessary considerations, available operational methods, and waste management practices, together with supporting references, provides an appreciation of the activities that comprise decommissioning of nuclear facilities. It is anticipated that the information presented in the report should prove useful to persons concerned with the development of plans for the decommissioning of retired nuclear facilities
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ICT Adoption in Facilities Management Supply Chain
DEFF Research Database (Denmark)
Scupola, Ada
2012-01-01
This article involves a qualitative study of factors impacting the adoption of ICT solutions in the Danish facility management supply chain. The results show that there are a number of drivers and barriers that influence the adoption of ICT solutions in this service sector. These have been grouped...... concerned with ICT adoption, operations and service management (especially facilities management) as well as operation managers and ICT managers....
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Ectopic pregnancy experience in a tertiary health facility in South ...
African Journals Online (AJOL)
Background: Ectopic pregnancy is a life-threatening gynecological emergency, and a significant cause of maternal morbidity and mortality in Nigeria. Objective: To determine the incidence, clinical presentation, risk factors and management outcomes of ectopic pregnancies in a tertiary health facility. Methods: A retrospective ...
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Does PDC Belong in Facilities Management?
Dessoff, Alan
2012-01-01
Whether planning, design, and construction (PDC) of buildings should be part of facilities management, with its traditional operations and maintenance functions, or separated from it, has been a divisive question on many campuses for a long time. Now, although it is not happening everywhere, facilities managers at a number of institutions, public…
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21 CFR 58.31 - Testing facility management.
2010-04-01
... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Testing facility management. 58.31 Section 58.31... management. For each nonclinical laboratory study, testing facility management shall: (a) Designate a study... appropriately tested for identity, strength, purity, stability, and uniformity, as applicable. (e) Assure that...
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Application of probabilistic methods to accident analysis at waste management facilities
International Nuclear Information System (INIS)
Banz, I.
1986-01-01
Probabilistic risk assessment is a technique used to systematically analyze complex technical systems, such as nuclear waste management facilities, in order to identify and measure their public health, environmental, and economic risks. Probabilistic techniques have been utilized at the Waste Isolation Pilot Plant (WIPP) near Carlsbad, New Mexico, to evaluate the probability of a catastrophic waste hoist accident. A probability model was developed to represent the hoisting system, and fault trees were constructed to identify potential sequences of events that could result in a hoist accident. Quantification of the fault trees using statistics compiled by the Mine Safety and Health Administration (MSHA) indicated that the annual probability of a catastrophic hoist accident at WIPP is less than one in 60 million. This result allowed classification of a catastrophic hoist accident as ''not credible'' at WIPP per DOE definition. Potential uses of probabilistic techniques at other waste management facilities are discussed
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Facilities Management Practices in Malaysia: A Literature Review
Directory of Open Access Journals (Sweden)
Isa Nordiana Mohd
2016-01-01
Full Text Available Facilities management in Malaysia has been practiced for decades. The development of its formal practice parallels the improvement of the built environment in the nation. Involvement of the public and private sectors teaming up in arranging the National Asset and Facilities Management (NAFAM in demonstrates the vital collaboration in the facilities management area in Malaysia. Facilities management is seen distinctively as indicated by diverse geographical locations, interests and schools of thought. Facilities management is delegated a service-based industry which gives proficient counsel and administration of clients’ building facilities including residential, commercial, industrial, airports terminals and offices. The aim of this paper is to review the gaps that exist, especially on how FM is being practice in comparison with the published FM body of knowledge. Very relying upon literature, this paper discovered a gap that is an unclear description of current FM applications. This research aims to give new bits of knowledge to upgrade comprehension of FM execution in Malaysia.
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A guide to the management of tailings facilities
International Nuclear Information System (INIS)
Bedard, C.; Ferguson, K.; Gladwin, D.; Lang, D.; Maltby, J.; McCann, M.; Poirier, P.; Schwenger, R.; Vezina, S.; West, S.; Duval, J.; Gardiner, E.; Jansons, K.; Lewis, B.; Matthews, J.; Mchaina, D.; Puro, M.; Siwik, R.; Welch, D.
1998-01-01
The 'Guide to the Management of Tailings Facilities' has been developed by the Mining Association of Canada in an effort to provide guidance to its member companies on sound practices for the safe and environmentally responsible management of tailings facilities. The guide is a reference tool to help companies ensure that they are managing their tailings facilities responsibly, integrating environmental and safety considerations in a consistent manner, with continuous improvement in the operation of tailings facilities. The key to managing tailings responsibly is consistent application of engineering capabilities through the full life cycle. The guide provides a basis for the development of customized tailings management systems to address specific needs at individual operations, and deals with environmental impacts, mill tailing characteristics, tailings facility studies and plans, dam and related structure design, and control and monitoring. Aspects relating to tailings facility siting, design, construction, operation, decommissioning and closure are also fully treated. 1 tab., 3 figs
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Directory of Open Access Journals (Sweden)
Naoko Kozuki
Full Text Available This analysis seeks to identify strengths and gaps in the existing facility capacity for intrapartum and immediate postpartum fetal and neonatal care, using data collected as a part of Malawi's Helping Babies Breath program evaluation. From August to September 2012, the Maternal and Child Health Integrated Program (MCHIP conducted a cross-sectional survey in 84 Malawian health facilities to capture current health facility service availability and readiness and health worker capacity and practice pertaining to labor, delivery, and immediate postpartum care. The survey collected data on availability of equipment, supplies, and medications, and health worker knowledge and performance scores on intrapartum care simulation and actual management of real clients at a subset of facilities. We ran linear regression models to identify predictors of high simulation performance of routine delivery care and management of asphyxiated newborns across all facilities surveyed. Key supplies for infection prevention and thermal care of the newborn were found to be missing in many of the surveyed facilities. At the health center level, 75% had no clinician trained in basic emergency obstetric care or newborn care and 39% had no midwife trained in the same. We observed that there were no proportional increases in available transport and staff at a facility as catchment population increased. In simulations of management of newborns with breathing problems, health workers were able to complete a median of 10 out of 16 tasks for a full-term birth case scenario and 20 out of 30 tasks for a preterm birth case scenario. Health workers who had more years of experience appeared to perform worse. Our study provides a benchmark and highlights gaps for future evaluations and studies as Malawi continues to make strides in improving facility-based care. Further progress in reducing the burden of neonatal and fetal death in Malawi will be partly predicated on guaranteeing
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Kozuki, Naoko; Oseni, Lolade; Mtimuni, Angella; Sethi, Reena; Rashidi, Tambudzai; Kachale, Fannie; Rawlins, Barbara; Gupta, Shivam
2017-01-01
This analysis seeks to identify strengths and gaps in the existing facility capacity for intrapartum and immediate postpartum fetal and neonatal care, using data collected as a part of Malawi's Helping Babies Breath program evaluation. From August to September 2012, the Maternal and Child Health Integrated Program (MCHIP) conducted a cross-sectional survey in 84 Malawian health facilities to capture current health facility service availability and readiness and health worker capacity and practice pertaining to labor, delivery, and immediate postpartum care. The survey collected data on availability of equipment, supplies, and medications, and health worker knowledge and performance scores on intrapartum care simulation and actual management of real clients at a subset of facilities. We ran linear regression models to identify predictors of high simulation performance of routine delivery care and management of asphyxiated newborns across all facilities surveyed. Key supplies for infection prevention and thermal care of the newborn were found to be missing in many of the surveyed facilities. At the health center level, 75% had no clinician trained in basic emergency obstetric care or newborn care and 39% had no midwife trained in the same. We observed that there were no proportional increases in available transport and staff at a facility as catchment population increased. In simulations of management of newborns with breathing problems, health workers were able to complete a median of 10 out of 16 tasks for a full-term birth case scenario and 20 out of 30 tasks for a preterm birth case scenario. Health workers who had more years of experience appeared to perform worse. Our study provides a benchmark and highlights gaps for future evaluations and studies as Malawi continues to make strides in improving facility-based care. Further progress in reducing the burden of neonatal and fetal death in Malawi will be partly predicated on guaranteeing properly equipped and
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Data management facility for JT-60
International Nuclear Information System (INIS)
Ohasa, K.; Kurimoto, K.; Mochizuki, O.
1983-01-01
This study considers the Data Management Facility which is provided for unified management of various diagnostics data with JT-60 experiments. This facility is designed for the purpose of data access. There are about 30 kinds of diagnostic devices that are classified by diagnostic objects equipped for JT-60 facility. It gathers the diagnostic date about 10 Mega Byte per each discharge. Those diagnostic data are varied qualitatively and quantitatively by experimental purpose. Other fundamental information like discharge condition, adjustive value for diagnostic devices is required to process those gathered data
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Facility Environmental Management System
Federal Laboratory Consortium — This is the Web site of the Federal Highway Administration's (FHWA's) Turner-Fairbank Highway Research Center (TFHRC) facility Environmental Management System (EMS)....
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Technical Merits and Leadership in Facility Management
National Research Council Canada - National Science Library
Shoemaker, Jerry
1997-01-01
.... The document is divided into six chapters; the introduction, facility management and leadership, building systems, facility operations, facility maintenance strategies, and the conclusion and final analysis...
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Waste management considerations in nuclear facility decommissioning
International Nuclear Information System (INIS)
Elder, H.K.; Murphy, E.S.
1981-01-01
Decommissioning of nuclear facilities involves the management of significant quantities of radioactive waste. This paper summarizes information on volumes of waste requiring disposal and waste management costs developed in a series of decommissioning studies performed for the U.S. Nuclear Regulatory Commission by the Pacific Northwest Laboratory. These studies indicate that waste management is an important cost factor in the decommissioning of nuclear facilities. Alternatives for managing decommissioning wastes are defined and recommendations are made for improvements in waste management practices
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Semasaka Sengoma, Jean Paul; Krantz, Gunilla; Nzayirambaho, Manasse; Munyanshongore, Cyprien; Edvardsson, Kristina; Mogren, Ingrid
2017-07-09
This study estimated health facility-based prevalence for pre-eclampsia/eclampsia, postpartum haemorrhage and caesarean section (CS) due to prolonged labour/dystocia. The background characteristics of Rwandan pregnant women, the course of labour and the level of healthcare were investigated in relation to pregnancy and delivery outcomes. This is health facility-based study and data were collected in 2014-2015 through structured interviews and medical records (n=817) in Kigali and Northern Province, Rwanda. Frequencies and prevalence were used to describe participants' background factors, labour and delivery-related characteristics. Bivariable and multivariable logistic regression models were performed for different background factors and pregnancy/delivery outcomes. Pre-eclampsia/eclampsia, postpartum haemorrhage and CS due to prolonged labour/dystocia represented 1%, 2.7% and 5.4% of all participants, respectively. In total, 56.4% of the participants were transferred from facilities with low levels to those with higher levels of healthcare, and the majority were transferred from health centres to district hospitals, with CS as the main reason for transfer. Participants who arrived at the health facility with cervical dilation grade of ≤3 cm spent more hours in maternity ward than those who arrived with cervical dilatation grade of ≥4 cm. Risk factors for CS due to prolonged labour or dystocia were poor households, nulliparity and residence far from health facility. The estimated health facility-based prevalence of pregnancy-related complications was relatively low in this sample from Rwanda. CS was the main reason for the transfer of pregnant women from health centres to district hospitals. Upgrading the capacity of health centres in the management of pregnant women in Rwanda may improve maternal and fetal health. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is
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Ajao, K O; Ogundun, O A; Afolabi, O T; Ojo, T O; Atiba, B P; Oguntunase, D O
2014-12-01
Tuberculosis (TB) is a major public health problem in the world and Africa has approximately one quarter of the world's cases. One of the greatest challenges facing most TB programmes is the non-compliance to TB treatment among TB patients. This study aimed at determining the challenges of management of tuberculosis (TB) across selected Osun State health facilities. The study employed a descriptive cross-sectional design. A semi-structured questionnaire was used to collect data from 102 TB patients in the health facilities. The instrument measured socio-demographic variables, patient related factors, socio-economic variables, health care system related factors to TB disease and treatment. Data were analysed and summarized using descriptive and inferential statistics. Statistical significance was placed at p facilities (χ2 = 21.761, p facility and patient-related factors were largely responsible.
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Novignon, Jacob; Nonvignon, Justice
2017-06-12
and public facilities. There is need for primary health facility managers to improve productivity via effective and efficient resource use. Efforts to improve efficiency should focus on training health workers and improving facility environment alongside effective monitoring and evaluation exercises.
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DKIST facility management system integration
White, Charles R.; Phelps, LeEllen
2016-07-01
The Daniel K. Inouye Solar Telescope (DKIST) Observatory is under construction at Haleakalā, Maui, Hawai'i. When complete, the DKIST will be the largest solar telescope in the world. The Facility Management System (FMS) is a subsystem of the high-level Facility Control System (FCS) and directly controls the Facility Thermal System (FTS). The FMS receives operational mode information from the FCS while making process data available to the FCS and includes hardware and software to integrate and control all aspects of the FTS including the Carousel Cooling System, the Telescope Chamber Environmental Control Systems, and the Temperature Monitoring System. In addition it will integrate the Power Energy Management System and several service systems such as heating, ventilation, and air conditioning (HVAC), the Domestic Water Distribution System, and the Vacuum System. All of these subsystems must operate in coordination to provide the best possible observing conditions and overall building management. Further, the FMS must actively react to varying weather conditions and observational requirements. The physical impact of the facility must not interfere with neighboring installations while operating in a very environmentally and culturally sensitive area. The FMS system will be comprised of five Programmable Automation Controllers (PACs). We present a pre-build overview of the functional plan to integrate all of the FMS subsystems.
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Facility management i fremtidens bankdrift
Vollan, Silje Steen
2015-01-01
Facility Management (FM) er et relativt ungt fagområde som er i sterk utvikling. Bank og finansbransjen har hatt en tradisjon med å eie og forvalte egne bygninger, noe som har gitt et underbevisst fokus på FM. Økt digitalisering fører til at bankene står overfor nye utfordringer og muligheter. Nye produkter og tjenester dukker opp og dette fører til at FM enheten utfordres med høyere krav til profesjonalitet og effektivitet. Internasjonale trender i markedet viser at flere facility management...
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Johansson, Emily White; Nsona, Humphreys; Carvajal-Aguirre, Liliana; Amouzou, Agbessi; Hildenwall, Helena
2017-12-01
Research shows inadequate Integrated Management of Childhood Illness (IMCI)-pneumonia care in various low-income settings but evidence is largely from small-scale studies with limited evidence of patient-, provider- and facility-levels determinants of IMCI non-severe pneumonia classification and its management. The Malawi Service Provision Assessment 2013-2014 included 3149 outpatients aged 2-59 months with completed observations, interviews and re-examinations. Mixed-effects logistic regression models quantified the influence of patient-, provider and facility-level determinants on having IMCI non-severe pneumonia and its management in observed consultations. Among 3149 eligible outpatients, 590 (18.7%) had IMCI non-severe pneumonia classification in re-examination. 228 (38.7%) classified cases received first-line antibiotics and 159 (26.9%) received no antibiotics. 18.6% with cough or difficult breathing had 60-second respiratory rates counted during consultations, and conducting this assessment was significantly associated with IMCI training ever received (odds ratio (OR) = 2.37, 95% confidence interval (CI): 1.29-4.31) and negative rapid diagnostic test results (OR = 3.21, 95% CI: 1.45-7.13). Older children had lower odds of assessments than infants (OR = 48-59 months: 0.35, 95% CI: 0.16-0.75). Children presenting with any of the following complaints also had reduced odds of assessment: fever, diarrhea, skin problem or any danger sign. First-line antibiotic treatment for classified cases was significantly associated with high temperatures (OR = 3.26, 95% CI: 1.24-8.55) while older children had reduced odds of first-line treatment compared to infants (OR = 48-59 months: 0.29, 95% CI: 0.10-0.83). RDT-confirmed malaria was a significant predictor of no antibiotic receipt for IMCI non-severe pneumonia (OR = 10.65, 95% CI: 2.39-47.36). IMCI non-severe pneumonia care was sub-optimal in Malawi health facilities in 2013-2014 with inadequate
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2010-01-01
... and Related Waste Management Facilities F Appendix F to Part 50 Energy NUCLEAR REGULATORY COMMISSION... Relating to the Siting of Fuel Reprocessing Plants and Related Waste Management Facilities 1. Public health... facilities for the temporary storage of highlevel radioactive wastes, may be located on privately owned...
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Measuring the quality of child health care at first-level facilities.
Gouws, Eleanor; Bryce, Jennifer; Pariyo, George; Armstrong Schellenberg, Joanna; Amaral, João; Habicht, Jean-Pierre
2005-08-01
Sound policy and program decisions require timely information based on valid and relevant measures. Recent findings suggest that despite the availability of effective and affordable guidelines for the management of sick children in first-level health facilities in developing countries, the quality and coverage of these services remains low. We report on the development and evaluation of a set of summary indices reflecting the quality of care received by sick children in first-level facilities. The indices were first developed through a consultative process to achieve face validity by involving technical experts and policymakers. The definition of evaluation measures for many public health programs stops at this point. We added a second phase in which standard statistical techniques were used to evaluate the content and construct validity of the indices and their reliability, drawing on data sets from the multi-country evaluation of integrated management of childhood illness (MCE) in Brazil, Tanzania and Uganda. The statistical evaluation identified important conceptual errors in the indices arising from the theory-driven expert review. The experts had combined items into inappropriate indicators resulting in summary indices that were difficult to interpret and had limited validity for program decision making. We propose a revised set of summary indices for the measurement of child health care in developing countries that is supported by both expert and statistical reviews and that led to similar programmatic insights across the three countries. We advocate increased cross-disciplinary research within public health to improve measurement approaches. Child survival policymakers, program planners and implementers can use these tools to improve their monitoring and so increase the health impact of investments in health facility care.
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Application of the Management System for Facilities and Activities. Safety Guide (Spanish Edition)
International Nuclear Information System (INIS)
2016-01-01
This publication provides guidance for following the requirements for management systems that integrate safety, health, security, quality assurance and environmental objectives. A successful management system ensures that nuclear safety matters are not dealt with in isolation but are considered within the context of all these objectives. The aim of this publication is to assist Member States to establish and implement effective management systems that coherently integrate all aspects of managing nuclear facilities and activities.
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XML Based Scientific Data Management Facility
Mehrotra, P.; Zubair, M.; Bushnell, Dennis M. (Technical Monitor)
2002-01-01
The World Wide Web consortium has developed an Extensible Markup Language (XML) to support the building of better information management infrastructures. The scientific computing community realizing the benefits of XML has designed markup languages for scientific data. In this paper, we propose a XML based scientific data management ,facility, XDMF. The project is motivated by the fact that even though a lot of scientific data is being generated, it is not being shared because of lack of standards and infrastructure support for discovering and transforming the data. The proposed data management facility can be used to discover the scientific data itself, the transformation functions, and also for applying the required transformations. We have built a prototype system of the proposed data management facility that can work on different platforms. We have implemented the system using Java, and Apache XSLT engine Xalan. To support remote data and transformation functions, we had to extend the XSLT specification and the Xalan package.
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Mathieu, Els; Dorkenoo, Ameyo M; Datagni, Michael; Cantey, Paul T; Morgah, Kodjo; Harvey, Kira; Ziperstein, Joshua; Drexler, Naomi; Chapleau, Gina; Sodahlon, Yao
2013-07-01
Lymphatic filariasis (LF) is a vector-borne parasitic disease that can clinically manifest as disabling lymphedema. Although the LF elimination program aims to reduce disability and to interrupt transmission, there has been a scarcity of disease morbidity management programs, particularly on a national scale. This report describes the implementation of the first nationwide LF lymphedema management program. The program, which was initiated in Togo in 2007, focuses on patient behavioral change. Its goal is two-fold: to achieve a sustainable program on a national-scale, and to serve as a model for other countries. The program has five major components: 1) train at least one health staff in lymphedema care in each health facility in Togo; 2) inform people with a swollen leg that care is available at their dispensary; 3) train patients on self-care; 4) provide a support system to motivate patients to continue self-care by training community health workers or family members and providing in home follow-up; and 5) integrate lymphedema management into the curriculum for medical staff. The program achieved the inclusion of lymphedema management in the routine healthcare package. The evaluation after three years estimated that 79% of persons with a swollen leg in Togo were enrolled in the program. The adherence rate to the proposed World Health Organization treatment of washing, exercise, and leg elevation was more than 70% after three years of the program, resulting in a stabilization of the lymphedema stage and a slight decrease in reported acute attacks among program participants. Health staff and patients consider the program successful in reaching and educating the patients. After the external funding ended, the morbidity management program is maintained through routine Ministry of Health activities.
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Gupta, Shaili; Altice, Frederick L
2009-03-01
Among the blood-borne chronic viral infections, hepatitis B virus (HBV) infection is one that is not only treatable but also preventable by provision of vaccination. Despite the availability of HBV vaccine for the last 15 years, more than 1.25 million individuals in the USA have chronic HBV infection, and about 5,000 die each year from HBV-related complications. From a societal perspective, access to treatment of chronic viral infections, like HIV and viral hepatitis, is highly cost-effective and has lasting benefits by reducing risk behaviors, morbidity, mortality, as well as disease transmission in the community. Individuals in correctional facilities are specially predisposed to such chronic viral infections because of their high-risk behaviors. The explosion of incarceration in the USA over the last few decades and the disproportionate burden of morbidity and mortality from chronic infections among the incarcerated have put incredible strains on an overcrowded system that was not originally designed to provide comprehensive medical care for chronic illnesses. Recently, there has been a call to address medical care for individuals with chronic medical conditions in correctional settings, including those with infectious diseases. The economic and public health burden of chronic hepatitis B and its sequelae, including cirrhosis and hepatocellular carcinoma, is felt most prominently in managed care settings with limited budgets, like correctional facilities. Prevalence of HBV infection among the incarcerated in the USA is fivefold that of the general population. We present a review of diagnosis, prevention, and the recently streamlined treatment guidelines for management of HBV infection in correctional settings, and discuss the implications and public health impact of these measures.
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The Behavioral Health Role in Nursing Facility Social Work.
Myers, Dennis R; Rogers, Robin K; LeCrone, Harold H; Kelley, Katherine
2017-09-01
Types of compromised resident behaviors licensed nursing facility social workers encounter, the behavioral health role they enact, and effective practices they apply have not been the subject of systematic investigation. Analyses of 20 in-depth interviews with Bachelor of Social Work (BSW)/Master of Social Work (MSW) social workers averaging 8.8 years of experience identified frequently occurring resident behaviors: physical and verbal aggression/disruption, passive disruption, socially and sexually inappropriateness. Six functions of the behavioral health role were care management, educating, investigating, preventing, mediating, and advocating. Skills most frequently applied were attention/affirmation/active listening, assessment, behavior management, building relationship, teamwork, and redirection. Narratives revealed role rewards as well as knowledge deficits, organizational barriers, personal maltreatment, and frustrations. Respondents offered perspectives and prescriptions for behavioral health practice in this setting. The findings expand understanding of the behavioral health role and provide an empirical basis for more research in this area. Recommendations, including educational competencies, are offered.
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Service quality for facilities management in hospitals
Sui Pheng, Low
2016-01-01
This book examines the Facilities Management (FM) of hospitals and healthcare facilities, which are among the most complex, costly and challenging kind of buildings to manage. It presents and evaluates the FM service quality standards in Singapore’s hospitals from the patient’s perspective, and provides recommendations on how to successfully improve FM service quality and achieve higher patient satisfaction. The book also features valuable supplementary materials, including a checklist of 32 key factors for successful facilities management and another checklist of 24 service attributes for hospitals to achieve desirable service quality in connection with facilities management. The book adopts a unique approach of combining service quality and quality theory to provide a more holistic view of how FM service quality can be achieved in hospitals. It also integrates three instruments, namely the SERVQUAL model, the Kano model and the QFD model to yield empirical results from surveys for implementation in hosp...
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7 CFR 205.271 - Facility pest management practice standard.
2010-01-01
... 7 Agriculture 3 2010-01-01 2010-01-01 false Facility pest management practice standard. 205.271... Requirements § 205.271 Facility pest management practice standard. (a) The producer or handler of an organic facility must use management practices to prevent pests, including but not limited to: (1) Removal of pest...
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41 CFR 102-72.40 - What are facility management delegations?
2010-07-01
... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What are facility management delegations? 102-72.40 Section 102-72.40 Public Contracts and Property Management Federal Property... AUTHORITY Delegation of Authority § 102-72.40 What are facility management delegations? Facility management...
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Health service providers in Somalia: their readiness to provide malaria case-management.
Noor, Abdisalan M; Rage, Ismail A; Moonen, Bruno; Snow, Robert W
2009-05-13
Studies have highlighted the inadequacies of the public health sector in sub-Saharan African countries in providing appropriate malaria case management. The readiness of the public health sector to provide malaria case-management in Somalia, a country where there has been no functioning central government for almost two decades, was investigated. Three districts were purposively sampled in each of the two self-declared states of Puntland and Somaliland and the south-central region of Somalia, in April-November 2007. A survey and mapping of all public and private health service providers was undertaken. Information was recorded on services provided, types of anti-malarial drugs used and stock, numbers and qualifications of staff, sources of financial support and presence of malaria diagnostic services, new treatment guidelines and job aides for malaria case-management. All settlements were mapped and a semi-quantitative approach was used to estimate their population size. Distances from settlements to public health services were computed. There were 45 public health facilities, 227 public health professionals, and 194 private pharmacies for approximately 0.6 million people in the three districts. The median distance to public health facilities was 6 km. 62.3% of public health facilities prescribed the nationally recommended anti-malarial drug and 37.7% prescribed chloroquine as first-line therapy. 66.7% of public facilities did not have in stock the recommended first-line malaria therapy. Diagnosis of malaria using rapid diagnostic tests (RDT) or microscopy was performed routinely in over 90% of the recommended public facilities but only 50% of these had RDT in stock at the time of survey. National treatment guidelines were available in 31.3% of public health facilities recommended by the national strategy. Only 8.8% of the private pharmacies prescribed artesunate plus sulphadoxine/pyrimethamine, while 53.1% prescribed chloroquine as first-line therapy. 31.4% of
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Health service providers in Somalia: their readiness to provide malaria case-management
Directory of Open Access Journals (Sweden)
Moonen Bruno
2009-05-01
Full Text Available Abstract Background Studies have highlighted the inadequacies of the public health sector in sub-Saharan African countries in providing appropriate malaria case management. The readiness of the public health sector to provide malaria case-management in Somalia, a country where there has been no functioning central government for almost two decades, was investigated. Methods Three districts were purposively sampled in each of the two self-declared states of Puntland and Somaliland and the south-central region of Somalia, in April-November 2007. A survey and mapping of all public and private health service providers was undertaken. Information was recorded on services provided, types of anti-malarial drugs used and stock, numbers and qualifications of staff, sources of financial support and presence of malaria diagnostic services, new treatment guidelines and job aides for malaria case-management. All settlements were mapped and a semi-quantitative approach was used to estimate their population size. Distances from settlements to public health services were computed. Results There were 45 public health facilities, 227 public health professionals, and 194 private pharmacies for approximately 0.6 million people in the three districts. The median distance to public health facilities was 6 km. 62.3% of public health facilities prescribed the nationally recommended anti-malarial drug and 37.7% prescribed chloroquine as first-line therapy. 66.7% of public facilities did not have in stock the recommended first-line malaria therapy. Diagnosis of malaria using rapid diagnostic tests (RDT or microscopy was performed routinely in over 90% of the recommended public facilities but only 50% of these had RDT in stock at the time of survey. National treatment guidelines were available in 31.3% of public health facilities recommended by the national strategy. Only 8.8% of the private pharmacies prescribed artesunate plus sulphadoxine/pyrimethamine, while 53
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Metering management at the plutonium research and development facilities
International Nuclear Information System (INIS)
Hirata, Masaru; Miyamoto, Fujio; Kurosawa, Makoto; Abe, Jiro; Sakai, Haruyuki; Suzuki, Tsuneo.
1996-01-01
Nuclear fuel research laboratory of the Oarai Research Laboratory of the Japan Atomic Energy Research Institute is an R and D facility to treat with plutonium and processes various and versatile type samples in chemical and physical form for use of various experimental researches even though on much small amount. Furthermore, wasted and plutonium samples are often transported to other KMP and MBA such as radioactive waste management facility, nuclear reactor facility and so forth. As this facility is a place to treat plutonium important on the safeguards, it is a facility necessary for detection and allowance actions and for detail managements on the metering management data to report to government and IAEA in each small amount sample and different configuration. In this paper, metering management of internationally regulated matters and metering management system using a work station newly produced in such small scale facility were introduced. (G.K.)
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Directory of Open Access Journals (Sweden)
Mfinanga Godfrey S
2009-04-01
Full Text Available Abstract Background Hemorrhage is the leading cause of obstetric mortality. Studies show that Active Management of Third Stage of Labor (AMTSL reduces Post Partum Hemorrhage (PPH. This study describes the practice of AMTSL and barriers to its effective use in Tanzania. Methods A nationally-representative sample of 251 facility-based vaginal deliveries was observed for the AMTSL practice. Standard Treatment Guidelines (STG, the Essential Drug List and medical and midwifery school curricula were reviewed. Drug availability and storage conditions were reviewed at the central pharmaceutical storage site and pharmacies in the selected facilities. Interviews were conducted with hospital directors, pharmacists and 106 health care providers in 29 hospitals visited. Data were collected between November 10 and December 15, 2005. Results Correct practice of AMTSL according to the ICM/FIGO definition was observed in 7% of 251 deliveries. When the definition of AMTSL was relaxed to allow administration of the uterotonic drug within three minutes of fetus delivery, the proportion of AMTSL use increased to 17%. The most significant factor contributing to the low rate of AMTSL use was provision of the uterotonic drug after delivery of the placenta. The study also observed potentially-harmful practices in approximately 1/3 of deliveries. Only 9% out of 106 health care providers made correct statements regarding the all three components of AMTSL. The national formulary recommends ergometrine (0.5 mg/IM or oxytocin (5 IU/IM on delivery of the anterior shoulder or immediately after the baby is delivered. Most of facilities had satisfactory stores of drugs and supplies. Uterotonic drugs were stored at room temperature in 28% of the facilities. Conclusion The knowledge and practice of AMTSL is very low and STGs are not updated on correct AMTSL practice. The drugs for AMTSL are available and stored at the right conditions in nearly all facilities. All providers used
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World Class Facilities Management
DEFF Research Database (Denmark)
Malmstrøm, Ole Emil; Jensen, Per Anker
2013-01-01
Alle der med entusiasme arbejder med Facilities Management drømmer om at levere World Class. DFM drømmer om at skabe rammer og baggrund for, at vi i Danmark kan bryste os at være blandt de førende på verdensplan. Her samles op på, hvor tæt vi er på at nå drømmemålet.......Alle der med entusiasme arbejder med Facilities Management drømmer om at levere World Class. DFM drømmer om at skabe rammer og baggrund for, at vi i Danmark kan bryste os at være blandt de førende på verdensplan. Her samles op på, hvor tæt vi er på at nå drømmemålet....
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Community health facility preparedness for a cholera surge in Haiti.
Mobula, Linda Meta; Jacquet, Gabrielle A; Weinhauer, Kristin; Alcidas, Gladys; Thomas, Hans-Muller; Burnham, Gilbert
2013-01-01
With increasing population displacement and worsening water insecurity after the 2010 earthquake, Haiti experienced a large cholera outbreak. Our goal was to evaluate the strengths and weaknesses of seven community health facilities' ability to respond to a surge in cholera cases. Since 2010, Catholic Relief Services (CRS) with a number of public and private donors has been working with seven health facilities in an effort to reduce morbidity and mortality from cholera infection. In November 2012, CRS through the Centers for Disease Control and Prevention (CDC)'s support, asked the Johns Hopkins Center for Refugee and Disaster Response to conduct a cholera surge simulation tabletop exercise at these health facilities to improve each facility's response in the event of a cholera surge. Using simulation development guidelines from the Pan American Health Organization and others, a simulation scenario script was produced that included situations of differing severity, supply chain, as well as a surge of patients. A total of 119 hospital staff from seven sites participated in the simulation exercise including community health workers, clinicians, managers, pharmacists, cleaners, and security guards. Clinics that had challenges during the simulated clinical care of patients were those that did not appropriately treat all cholera patients according to protocol, particularly those that were vulnerable, those that would need additional staff to properly treat patients during a surge of cholera, and those that required a better inventory of supplies. Simulation-based activities have the potential to identify healthcare delivery system vulnerabilities that are amenable to intervention prior to a cholera surge.
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Sustainability and the facilities management in Malaysia
Directory of Open Access Journals (Sweden)
Asbollah Asra Zaliza
2016-01-01
Full Text Available Facilities Management (FM in the industry of environment involves numerous expertise, especially from the management side. Other than that, technology and finance are the other factors involved as well. One essential aspect of FM, other than the emphasis on technical operation, is its performance. In parallel, the performance does impact occupant behaviour and, at the same time, this performance does affect the environment. In short, this indicates that FM is in a key position to participate in delivering a sustainable environment for the industry of built environment. Sustainable facilities Management (SFM is crucial because buildings consume more resources which will, in consequence, negatively impact the environment and generate large amounts of waste. This justifies the importance of sustainability under the umbrella of facilities management. However, FM is quite new in Malaysia’s environment. Government agencies, such as JKR, have adopted and are practicing FM at the moment. Fortunately, there has been an increasing trend and awareness of SFM adoption. Therefore, this paper aims to understand and identify the contribution and practices of Sustainable Facilities Management (SFM in Malaysia; focusing on the development taken in regards to SFM.
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Directory of Open Access Journals (Sweden)
Tarcan Ertugrul
2015-01-01
Full Text Available This study based on literature review aims to evaluate and emphasize the affect of the strategic facility management (SFM on choice of medical tourism destination. Medical Tourism, which ranges from the health care services involving a cure to the wellness services involving no specific health trouble to pleasure and amusement services, is one of the most growing sectors in the world. Cost and quality of medical services are among the main reasons for the choice of destination. Strategic facility management has a positive correlation on the levels of quality, cost and customer satisfaction. Thus medical tourism and destination managers should take into account of the potential advantages of value creation offered through SFM in order to be chosen by customers (stakeholders.
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Los Alamos Plutonium Facility Waste Management System
International Nuclear Information System (INIS)
Smith, K.; Montoya, A.; Wieneke, R.; Wulff, D.; Smith, C.; Gruetzmacher, K.
1997-01-01
This paper describes the new computer-based transuranic (TRU) Waste Management System (WMS) being implemented at the Plutonium Facility at Los Alamos National Laboratory (LANL). The Waste Management System is a distributed computer processing system stored in a Sybase database and accessed by a graphical user interface (GUI) written in Omnis7. It resides on the local area network at the Plutonium Facility and is accessible by authorized TRU waste originators, count room personnel, radiation protection technicians (RPTs), quality assurance personnel, and waste management personnel for data input and verification. Future goals include bringing outside groups like the LANL Waste Management Facility on-line to participate in this streamlined system. The WMS is changing the TRU paper trail into a computer trail, saving time and eliminating errors and inconsistencies in the process
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Facilities management and industrial safety
International Nuclear Information System (INIS)
2003-06-01
This book lists occupation safety and health acts with purpose, definition and management system of safety and health, enforcement ordinance of occupation safety and health acts and enforcement regulations such as general rules, safety and health cover, system of management on safety and health, regulation of management on safety and health, regulations of harmfulness and protection of danger, heath management for workers, supervisor and command and inspection of machine and equipment.
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Construction Management for Conventional Facilities of Proton Accelerator
International Nuclear Information System (INIS)
Kim, Jun Yeon; Cho, Jin Sam; Lee, Jae Sang
2008-05-01
Proton Engineering Frontier Project, puts its aim to building 100MeV 20mA linear proton accelerator which is national facility for NT, BT, IT, and future technologies, expected to boost up the national industry competitiveness. This R and D, Construction Management is in charge of the supportive works as site selection, architecture and engineering of conventional facilities, and overall construction management. The major goals of this work are as follows: At first, architecture and engineering of conventional facilities. Second, construction management, audit and inspection on construction of conventional facilities. Lastly, cooperation with the project host organization for adjusting technical issues of overall construction. In this research, We reviewed the basic design and made a detail design of conventional facilities. Preparation for construction license, site improvement and access road construction is fulfilled. Also, we made the technical support for project host as follows : selection of project host organization and host site selection, construction technical work for project host organization and procedure management
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Prevalence and predictors of giving birth in health facilities in Bugesera District, Rwanda
Directory of Open Access Journals (Sweden)
Joharifard Shahrzad
2012-12-01
Full Text Available Abstract Background The proportion of births attended by skilled health personnel is one of two indicators used to measure progress towards Millennium Development Goal 5, which aims for a 75% reduction in global maternal mortality ratios by 2015. Rwanda has one of the highest maternal mortality ratios in the world, estimated between 249–584 maternal deaths per 100,000 live births. The objectives of this study were to quantify secular trends in health facility delivery and to identify factors that affect the uptake of intrapartum healthcare services among women living in rural villages in Bugesera District, Eastern Province, Rwanda. Methods Using census data and probability proportional to size cluster sampling methodology, 30 villages were selected for community-based, cross-sectional surveys of women aged 18–50 who had given birth in the previous three years. Complete obstetric histories and detailed demographic data were elicited from respondents using iPad technology. Geospatial coordinates were used to calculate the path distances between each village and its designated health center and district hospital. Bivariate and multivariate logistic regressions were used to identify factors associated with delivery in health facilities. Results Analysis of 3106 lifetime deliveries from 859 respondents shows a sharp increase in the percentage of health facility deliveries in recent years. Delivering a penultimate baby at a health facility (OR = 4.681 [3.204 - 6.839], possessing health insurance (OR = 3.812 [1.795 - 8.097], managing household finances (OR = 1.897 [1.046 - 3.439], attending more antenatal care visits (OR = 1.567 [1.163 - 2.112], delivering more recently (OR = 1.438 [1.120 - 1.847] annually, and living closer to a health center (OR = 0.909 [0.846 - 0.976] per km were independently associated with facility delivery. Conclusions The strongest correlates of facility-based delivery in Bugesera District include previous delivery at a
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Rose-Wood, Alyson; Heard, Nathan; Thermidor, Roody; Chan, Jessica; Joseph, Fanor; Lerebours, Gerald; Zugaldia, Antonio; Konkel, Kimberly; Edwards, Michael; Lang, Bill; Torres, Carmen-Rosa
2014-08-01
Master health facility lists (MHFLs) are gaining attention as a standards-based means to uniquely identify health facilities and to link facility-level data. The ability to reliably communicate information about specific health facilities can support an array of health system functions, such as routine reporting and emergency response operations. MHFLs support the alignment of donor-supported health information systems with county-owned systems. Recent World Health Organization draft guidance promotes the utility of MHFLs and outlines a process for list development and governance. Although the potential benefits of MHFLs are numerous and may seem obvious, there are few documented cases of MHFL construction and use. The international response to the 2010 Haiti earthquake provides an example of how governments, nongovernmental organizations, and others can collaborate within a framework of standards to build a more complete and accurate list of health facilities. Prior to the earthquake, the Haitian Ministry of Health (Ministère de la Santé Publique et de la Population [MSPP]) maintained a list of public-sector health facilities but lacked information on privately managed facilities. Following the earthquake, the MSPP worked with a multinational group to expand the completeness and accuracy of the list of health facilities, including information on post-quake operational status. This list later proved useful in the response to the cholera epidemic and is now incorporated into the MSPP's routine health information system. Haiti's experience demonstrates the utility of MHFL formation and use in crisis as well as in the routine function of the health information system.
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Zaidi, Shehla; Riaz, Atif; Rabbani, Fauziah; Azam, Syed Iqbal; Imran, Syeda Nida; Pradhan, Nouhseen Akber; Khan, Gul Nawaz
2015-11-25
The case of contracting out government health services to non-governmental organizations (NGOs) has been weak for maternal, newborn, and child health (MNCH) services, with documented gains being mainly in curative services. We present an in-depth assessment of the comparative advantages of contracting out on MNCH access, quality, and equity, using a case study from Pakistan. An end-line, cross-sectional assessment was conducted of government facilities contracted out to a large national NGO and government-managed centres serving as controls, in two remote rural districts of Pakistan. Contracting out was specific for augmenting MNCH services but without contractual performance incentives. A household survey, a health facility survey, and focus group discussions with client and spouses were used for assessment. Contracted out facilities had a significantly higher utilization as compared to control facilities for antenatal care, delivery, postnatal care, emergency obstetric care, and neonatal illness. Contracted facilities had comparatively better quality of MNCH services but not in all aspects. Better household practices were also seen in the district where contracting involved administrative control over outreach programs. Contracting was also faced with certain drawbacks. Facility utilization was inequitably higher amongst more educated and affluent clients. Contracted out catchments had higher out-of-pocket expenses on MNCH services, driven by steeper transport costs and user charges for additional diagnostics. Contracting out did not influence higher MNCH service coverage rates across the catchment. Physical distances, inadequate transport, and low demand for facility-based care in non-emergency settings were key client-reported barriers. Contracting out MNCH services at government health facilities can improve facility utilization and bring some improvement in quality of services. However, contracting out of health facilities is insufficient to increase
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Directory of Open Access Journals (Sweden)
Kizito Kuchibanda
2015-01-01
Full Text Available The increase of healthcare facilities in Shinyanga municipality has resulted in an increase of healthcare wastes, which poses serious threats to the environment, health workers, and the general public. This research was conducted to investigate management practices of healthcare wastes in Shinyanga municipality with a view of assessing health risks to health workers and the general public. The study, which was carried out in three hospitals, involved the use of questionnaires, in-depth interview, and observation checklist. The results revealed that healthcare wastes are not quantified or segregated in all the three hospitals. Healthcare wastes at the Shinyanga Regional Referral Hospital are disposed of by on-site incineration and burning and some wastes are disposed off-site. At Kolandoto DDH only on-site burning and land disposal are practiced, while at Kambarage UHC healthcare solid wastes are incinerated, disposed of on land disposal, and burned. Waste management workers do not have formal training in waste management techniques and the hospital administrations pay very little attention to appropriate management of healthcare wastes. In light of this, it is evident that management of healthcare solid wastes is not practiced in accordance with the national and WHO’s recommended standards.
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Knowledge Map of Facilities Management
DEFF Research Database (Denmark)
Nenonen, Suvi; Jensen, Per Anker; Lindahl, Göran
2014-01-01
both the research community and FM-practitioners can develop new models for identifying knowledge needs and gaps and to improve knowledge sharing and knowledge flow and thus the fulfilment of their mission and goals. Knowledge maps can also help in organizing research activities and analysing......Purpose This paper aims to draft a knowledge map of the fragmented and multidisciplinary research of and relevant to FM. Facilities management knowledge map is a tool for presenting what relevant data and knowledge, a.k.a. knowledge, resides in different disciplines. Knowledge mapping is a step...... in creating an inventory of knowledge (i.e. the knowledge base) and developing/improving the processes of knowledge sharing in research, education and practice. Theory Knowledge mapping is discussed in terms of knowledge management. The research is connected to knowledge mapping in the facilities management...
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Legionnaires' Disease: a Problem for Health Care Facilities
... Clips Legionnaires’ Disease A problem for health care facilities Language: English (US) Español (Spanish) Recommend on Facebook ... drinking. Many people being treated at health care facilities, including long-term care facilities and hospitals, have ...
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Risk management study for the retired Hanford Site facilities
International Nuclear Information System (INIS)
Coles, G.A.; Shultz, M.V.; Taylor, W.E.
1993-04-01
Risk from retired surplus facilities has always been assumed to be low at the Hanford Site as the facilities are inactive and have few potentials for causing an offsite hazardous material release. However,the fatal accident that occurred in the spring of 1992 in which an employee fell through a deteriorated roof at the 105-F Reactor Building has raised the possibility that retired facilities represent a greater risk than was originally assumed. Therefore, Westinghouse Hanford Company and the US Department of Energy management have determined that facility risk management strategies and programmatic plans should be reevaluated to assure risks are identified and appropriate corrective action plans are developed. To evaluate risk management strategies, accurate risk information about the current and projected condition of the facilities must be developed. This work procedure has been created to address the development of accurate and timely risk information. By using the evaluation results in this procedure, it will be possible to create a prioritized baseline for managing facility risk until all retired surplus facilities are demolished
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Waste Management Facilities Cost Information Report
Energy Technology Data Exchange (ETDEWEB)
Feizollahi, F.; Shropshire, D.
1992-10-01
The Waste Management Facility Cost Information (WMFCI) Report, commissioned by the US Department of Energy (DOE), develops planning life-cycle cost (PLCC) estimates for treatment, storage, and disposal facilities. This report contains PLCC estimates versus capacity for 26 different facility cost modules. A procedure to guide DOE and its contractor personnel in the use of estimating data is also provided. Estimates in the report apply to five distinctive waste streams: low-level waste, low-level mixed waste, alpha contaminated low-level waste, alpha contaminated low-level mixed waste, and transuranic waste. The report addresses five different treatment types: incineration, metal/melting and recovery, shredder/compaction, solidification, and vitrification. Data in this report allows the user to develop PLCC estimates for various waste management options.
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Waste Management Facilities Cost Information Report
International Nuclear Information System (INIS)
Feizollahi, F.; Shropshire, D.
1992-10-01
The Waste Management Facility Cost Information (WMFCI) Report, commissioned by the US Department of Energy (DOE), develops planning life-cycle cost (PLCC) estimates for treatment, storage, and disposal facilities. This report contains PLCC estimates versus capacity for 26 different facility cost modules. A procedure to guide DOE and its contractor personnel in the use of estimating data is also provided. Estimates in the report apply to five distinctive waste streams: low-level waste, low-level mixed waste, alpha contaminated low-level waste, alpha contaminated low-level mixed waste, and transuranic waste. The report addresses five different treatment types: incineration, metal/melting and recovery, shredder/compaction, solidification, and vitrification. Data in this report allows the user to develop PLCC estimates for various waste management options
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International Nuclear Information System (INIS)
Bach, J.F.H.
2015-01-01
Gestational trophoblastic disease (GTD) is a rare kind of proliferative disorder of trophoblastic cells which develops from the placenta in early pregnancy. It can be benign, premalignant or malignant. Molar pregnancy, also known as Hydatidiform Mole, is a form of benign GTD. The complete hydatidiform mole (CHM) sub-type which limited to endometrium is most common. It has excellent prognosis if early appropriate diagnosis and management are done. A well performed ultrasound(US) play a primordial role in the diagnosis of maternal health disorders during routine prenatal care. This helps in avoiding complications and consequently aids in achieving the objectives of the Millennium Development Goals (MDGs) in Rwanda. To understand the definition of Gestational trophoblastic disease(GTD) and to recognize key diagnostic findings of complete molar pregnancy on ultrasound and appropriate management in maternal follow up. Review the differential diagnosis for ultrasound findings seen with GTD and other modalities Ultrasound is the first modality to be used in all rural health facilities for diagnosis of suspected Gestational trophoblastic disease (GTD) for better results. It is available and free of radiation
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Technical Merits and Leadership in Facility Management
National Research Council Canada - National Science Library
Shoemaker, Jerry
1997-01-01
After almost ten years of experience and formal education in design, construction, and facility operations and maintenance, the challenges and complexity of facility management still seem overwhelming and intangible...
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Public Facilities Management and Action Research for Sustainability
DEFF Research Database (Denmark)
Galamba, Kirsten Ramskov
Current work is the main product of a PhD study with the initial working title ‘Sustainable Facilities Management’ at Centre for Facilities Management – Realdania Research, DTU Management 1. December 2008 – 30. November 2011. Here the notion of Public Sustainable Facilities Management (FM......) is analysed in the light of a change process in a Danish Municipal Department of Public Property. Three years of Action Research has given a unique insight in the reality in a Municipal Department of Public Property, and as to how a facilitated change process can lead to a more holistic and sustainable...
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FFTF [Fast Flux Test Facility] management
International Nuclear Information System (INIS)
Bennett, C.L.
1986-11-01
Fuel Management at the Fast Flux Test Facility (FFTF) involves more than just the usual ex-core and in-core management of standard fuel and non-fuel components between storage locations and within the core since it is primarily an irradiation test facility. This mission involves testing an ever increasing variety of fueled and non-fueled experiments, each having unique requirements on the reactor core as well as having its own individual impact on the reload design. This paper describes the fuel management process used by the Westinghouse Hanford Company Core Engineering group that has led to the successful reload design of nine operating cycles and the irradiation of over 120 tests
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A review of sustainable facilities management knowledge and practice
Directory of Open Access Journals (Sweden)
Baaki Timothy Kurannen
2016-01-01
Full Text Available Sustainability is seen as a far-reaching issue now, and one which the facilities management [FM] profession cannot overlook. This paper explores current sustainable facilities management [SFM] knowledge and practice with specific focus on performance as part of a research focus toward proposing a sustainable FM performance management framework for sustainable healthcare waste management in Malaysia. This paper utilized a review of extant literature on the subject of SFM, FM performance and FM development in Malaysia as source of information. Findings reflect the increasing recognition of the need for the strategic FM function, and how facilities managers are best positioned to drive organizations’ sustainability agendas. In Malaysian context, this recognition is barely evident as findings show FM practice is still immature and predominantly operational. Unlike developed FM markets, FM relevance in Malaysia is being driven by the public sector. Also findings show a disharmony between organizations’ sustainability priority areas and the responsibilities for facilities managers to execute them where the sustainability policy of organizations prioritize one FM service and the facilities managers’ responsibilities prioritize another. As most of SFM implementation is driven by legislation this seems to strengthen the position that, organizations continue to view support services as non-value-adding, as unavoidable liabilities. The implication of this is the pressure on the FM function to continually express its strategic relevance to organizations by tangible value-adding performance output. This creates a new perspective to measuring and managing facilities performance. This paper therefore elevates the importance of FM performance management in SFM context taking into account the peculiar position of the facilities manager. This is seen as a way forward for FM to better express its value to the organization
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Energy Technology Data Exchange (ETDEWEB)
Moser, R
2005-06-15
This brochure issued by IFMA (International Facility Management Association) Switzerland and the Swiss Federal Office of Energy (SFOE) presents interactive guidelines for energy management in the area of facility management. These guidelines are based on the results of a project carried out by the International Energy Agency's Annex 40 'Operator competence'. The guidelines provide a step-by-step guide from initial analysis through to successful project completion and answer many questions that may crop up during the process. The focus is placed on energy aspects. Tools and 14 sample process descriptions are provided along with practical examples. Theoretical aspects are also presented and discussed, including models for operator roles and the processes involved. Also, change, risk and knowledge management are examined. Notes and information on possibilities for further education are presented.
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Energy Technology Data Exchange (ETDEWEB)
Moser, R.
2005-06-15
This brochure issued by IFMA (International Facility Management Association) Switzerland and the Swiss Federal Office of Energy (SFOE) presents interactive guidelines for energy management in the area of facility management. These guidelines are based on the results of a project carried out by the International Energy Agency's Annex 40 'Operator competence'. The guidelines provide a step-by-step guide from initial analysis through to successful project completion and answer many questions that may crop up during the process. The focus is placed on energy aspects. Tools and 14 sample process descriptions are provided along with practical examples. Theoretical aspects are also presented and discussed, including models for operator roles and the processes involved. Also, change, risk and knowledge management are examined. Notes and information on possibilities for further education are presented.
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Risk management activities at the DOE Class A reactor facilities
International Nuclear Information System (INIS)
Sharp, D.A.; Hill, D.J.; Linn, M.A.; Atkinson, S.A.; Hu, J.P.
1993-01-01
The probabilistic risk assessment (PRA) and risk management group of the Association for Excellence in Reactor Operation (AERO) develops risk management initiatives and standards to improve operation and increase safety of the DOE Class A reactor facilities. Principal risk management applications that have been implemented at each facility are reviewed. The status of a program to develop guidelines for risk management programs at reactor facilities is presented
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Application of the Management System for Facilities and Activities. Safety Guide
International Nuclear Information System (INIS)
2009-01-01
This publication provides guidance for following the requirements for management systems that integrate safety, health, security, quality assurance and environmental objectives. A successful management system ensures that nuclear safety matters are not dealt with in isolation but are considered within the context of all these objectives. The aim of this publication is to assist Member States to establish and implement effective management systems that coherently integrate all aspects of managing nuclear facilities and activities. Contents: 1. Introduction; 2. Management system; 3. Management responsibility; 4. Resource management; 5. Process implementation; 6. Measurement, assessment and improvement; Appendix I: Transition to an integrated management system; Appendix II: Activities in the document control process; Appendix III: Activities in the procurement process; Appendix IV: Performance of independent assessments; Annex I: Electronic document management system; Annex II: Media for record storage; Annex III: Record retention and storage; Glossary.
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Uduma, Ogenna; Galligan, Marie; Mollel, Henry; Masanja, Honorati; Bradley, Susan; McAuliffe, Eilish
2017-08-30
A systematic and structured approach to the support and supervision of health workers can strengthen the human resource management function at the district and health facility levels and may help address the current crisis in human resources for health in sub-Saharan Africa by improving health workers' motivation and retention. A supportive supervision programme including (a) a workshop, (b) intensive training and (c) action learning sets was designed to improve human resource management in districts and health facilities in Tanzania. We conducted a randomised experimental design to evaluate the impact of the intervention. Data on the same measures were collected pre and post the intervention in order to identify any changes that occurred (between baseline and end of project) in the capacity of supervisors in intervention a + b and intervention a + b + c to support and supervise their staff. These were compared to supervisors in a control group in each of Tanga, Iringa and Tabora regions (n = 9). A quantitative survey of 95 and 108 supervisors and 196 and 187 health workers sampled at baseline and end-line, respectively, also contained open-ended responses which were analysed separately. Supervisors assessed their own competency levels pre- and post-intervention. End-line samples generally scored higher compared to the corresponding baseline in both intervention groups for competence activities. Significant differences between baseline and end-line were observed in the total scores on 'maintaining high levels of performance', 'dealing with performance problems', 'counselling a troubled employee' and 'time management' in intervention a + b. In contrast, for intervention a + b + c, a significant difference in distribution of scores was only found on 'counselling a troubled employee', although the end-line mean scores were higher than their corresponding baseline mean scores in all cases. Similar trends to those in the supervisors' reports are seen in
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The prevention and management of constipation in older adults in a residential aged care facility.
Grieve, Jennifer
2006-03-01
The need to implement programs for developing leadership and practice improvement skills using an evidence-based practice approach to practice change is becoming more apparent in the health and aged care services. This is no more apparent than in high care residential health and aged care services, where health professionals are increasingly required to provide care for older people with multifocal and complex healthcare needs. This paper describes one of the projects undertaken as part of the Joanna Briggs Institute Commonwealth Department of Health and Ageing Clinical Aged Care Fellowship program from February 2005 to June 2005. This purpose of this particular project was twofold. First it sought to improve the local practice in the prevention and management of constipation and that this practice was performed according to the best available evidence. Second to use the Joanna Briggs Institute Practical Application of Clinical Guidance (PACES) program to implement a process of audit and feedback as a strategy to improve practice. The project was designed to link in with the facility's existing quality improvement program and better practice continence management project. The project was conducted over 6 months and was divided into six stages involving the identification of evidence-based standards of care, an initial audit to determine appropriate sample size, a clinical audit across the facility, planning of the implementation process, implementation of the action plan and re-audit to assess practice change. Overall, the results were extremely positive and demonstrated a real improvement in practice relating to constipation in the project facility. This success, however, needs to be seen in the context of the benefits of having the support of senior management, an existing quality improvement and continence management better practice project, and a culture of clinical review. Although there will always be more work to be done, the success of this project can be
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Deuboué Tchialeu, Rodrigue Innocent; Yaya, Sanni; Labonté, Ronald
2016-02-29
(IDRC). The study is currently in the data analysis phase and results are expected during the first half of 2016. This investigation will highlight the detailed processes in place for the care of hypertensive patients in primary health care facilities, and thus also identify the challenges. It will also describe the drug supply chain management systems in place and identify their strengths and weaknesses. The findings, along with the estimates from modeling and simulation, will inform the health system minimum requirements to scale-up interventions to manage and control the hypertension epidemic in the Western Cape province of South Africa.
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Study on archive management for nuclear facility decommissioning projects
International Nuclear Information System (INIS)
Huang Ling; Gong Jing; Luo Ning; Liao Bing; Zhou Hao
2011-01-01
This paper introduces the main features and status of the archive management for nuclear facility decommissioning projects, and explores and discusses the countermeasures in its archive management. Taking the practice of the archive management system of a reactor decommissioning project as an example, the paper illustrates the establishment of archive management system for the nuclear facility decommissioning projects. The results show that the development of a systematic archive management principle and system for nuclear decommissioning projects and the construction of project archives for the whole process from the design to the decommissioning by digitalized archive management system are one effective route to improve the complete, accurate and systematic archiving of project documents, to promote the standardization and effectiveness of the archive management and to ensure the traceability of the nuclear facility decommissioning projects. (authors)
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Aryeetey, Genevieve Cecilia; Nonvignon, Justice; Amissah, Caroline; Buckle, Gilbert; Aikins, Moses
2016-06-07
In 2004, Ghana began implementation of a National Health Insurance Scheme (NHIS) to minimize out-of-pocket expenditure at the point of use of service. The implementation of the scheme was accompanied by increased access and use of health care services. Evidence suggests most health facilities are faced with management challenges in the delivery of services. The study aimed to assess the effect of the introduction of the NHIS on health service delivery in mission health facilities in Ghana. We conceptualised the effect of NHIS on facilities using service delivery indicators such as outpatient and inpatient turn out, estimation of general service readiness, revenue and expenditure, claims processing and availability of essential medicines. We collected data from 38 mission facilities, grouped into the three ecological zones; southern, middle and northern. Structured questionnaires and exit interviews were used to collect data for the periods 2003 and 2010. The data was analysed in SPSS and MS Excel. The facilities displayed high readiness to deliver services. There were significant increases in outpatient and inpatient attendance, revenue, expenditure and improved access to medicines. Generally, facilities reported increased readiness to deliver services. However, challenging issues around high rates of non-reimbursement of NHIS claims due to errors in claims processing, lack of feedback regarding errors, and lack of clarity on claims reporting procedures were reported. The implementation of the NHIS saw improvement and expansion of services resulting in benefits to the facilities as well as constraints. The constraints could be minimized if claims processing is improved at the facility level and delays in reimbursements also reduced.
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41 CFR 102-74.10 - What is the basic facility management policy?
2010-07-01
... facility management policy? 102-74.10 Section 102-74.10 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT General Provisions § 102-74.10 What is the basic facility management policy? Executive agencies...
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ESCO as Innovative Facilities Management in Danish Municipalities
DEFF Research Database (Denmark)
Jensen, Jesper Ole; Oesten, Pimmie; Nielsen, Susanne Balslev
2010-01-01
Purpose: Increasing energy efficiency of existing buildings is high on the Facility Management (FM) agenda, therefore building owners and FM Managers need insight into a variety of organizational possibilities for energy renovation projects. This paper explores how ESCO can foster innovative....... It is the first publication from the project "Energy Service Concepts" carried out at the Danish Centre for Facilities Management (www.cfm.dtu.dk). Results have not been published before....
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Health seeking behaviour and challenges in utilising health facilities in Wakiso district, Uganda.
Musoke, David; Boynton, Petra; Butler, Ceri; Musoke, Miph Boses
2014-12-01
The health seeking behaviour of a community determines how they use health services. Utilisation of health facilities can be influenced by the cost of services, distance to health facilities, cultural beliefs, level of education and health facility inadequacies such as stock-out of drugs. To assess the health seeking practices and challenges in utilising health facilities in a rural community in Wakiso district, Uganda. The study was a cross sectional survey that used a structured questionnaire to collect quantitative data among 234 participants. The sample size was obtained using the formula by Leslie Kish. While 89% of the participants were aware that mobile clinics existed in their community, only 28% had received such services in the past month. The majority of participants (84%) did not know whether community health workers existed in their community. The participants' health seeking behaviour the last time they were sick was associated with age (p = 0.028) and occupation (p = 0.009). The most significant challenges in utilising health services were regular stock-out of drugs, high cost of services and long distance to health facilities. There is potential to increase access to health care in rural areas by increasing the frequency of mobile clinic services and strengthening the community health worker strategy.
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International Nuclear Information System (INIS)
1983-09-01
This publication discusses three commercial facilities that receive and dispose of low-level radioactive waste. The facilities are located in Barnwell, South Carolina; Beatty, Nevada; and Richland, Washington. All three facilities initiated operations in the 1960s. The three facilities have operated without such major problems as those which led to the closure of three other commercial disposal facilities located in the United States. The Beatty site could be closed in 1983 as a result of a Nevada Board of Health ruling that renewal of the site license would be inimical to public health and safety. The site remains open pending federal and state court hearings, which began in January 1983, to resolve the Board of Health ruling. The three sites may also be affected by NRC's 10 CFR Part 61 regulations, but the impact of those regulations, issued in December 1982, has not yet been assessed. This document provides detailed information on the history and current status of each facility. This information is intended, primarily, to assist state officials - executive, legislative, and agency - in planning for, establishing, and managing low-level waste disposal facilities. 12 references
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International Nuclear Information System (INIS)
1995-04-01
The purpose of the Isotopes Facilities Deactivation Project (IFDP) is to place former isotopes production facilities at the Oak Ridge National Laboratory in a safe, stable, and environmentally sound condition suitable for an extended period of minimum surveillance and maintenance (S ampersand M) and as quickly and economically as possible. Implementation and completion of the deactivation project will further reduce the already small risks to the environment and to public safety and health. Furthermore, the project should result in significant S ampersand M cost savings in the future. The IFDP management plan has been prepared to document the project objectives, define organizational relationships and responsibilities, and outline the management control systems to be employed in the management of the project. The project has adopted a strategy to deactivate the simple facilities first, to reduce the scope of the project, and to gain experience before addressing more difficult facilities. A decision support system is being developed to identify those activities, that best promote the project mission and result in largest cost savings. The Work Plan for the Isotopes Facilities Deactivation Project at Oak Ridge National Laboratory (Energy Systems 1994) defines the project schedule, the cost estimate, and the technical approach for the project
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Abeje, Tadiye; Negera, Edessa; Kebede, Eshetu; Hailu, Tsegaye; Hassen, Ismaile; Lema, Tsehainesh; Yamuah, Lawrence; Shiguti, Birru; Fenta, Melkamu; Negasa, Megersa; Beyene, Demissew; Bobosha, Kidist; Aseffa, Abraham
2016-04-07
Leprosy is a chronic infectious disease of public health importance and one of the leading causes of permanent physical disability. Nevertheless, the drop in prevalence following multidrug therapy has resulted in the neglect of leprosy. The annual incidence of leprosy has remained the same in Ethiopia since decades with more than 76% of the reported new cases coming from Oromia and Amhara Regional States. This study was aimed to assess the knowledge, attitude and skill of general health workers in leprosy control activities at public health facilities in Oromia and Amhara Regional States. A cross-sectional study was conducted from September 2011 to February 2012 at different public health facilities in selected eight zones in Oromia and Amhara Regional States. A multistage sampling method was used to obtain representative samples. High and low endemic zones for leprosy were included in the study in both regional states. Data were collected from general health workers through a structured self-administered questionnaire and at on-site assessment of their performance. Baseline socio-demographic data, health workers' attitude towards leprosy and their knowledge and skill in the management of leprosy were assessed. Bloom's cut off point was used to describe the knowledge and practical skills of the respondents while Likert's scale was used for attitude assessment. A total of 601 general health workers responsible for leprosy control activities at public health facilities were included in knowledge and attitude assessment and 83 of them were subjected to practical evaluation, with on-site observation of how they handle leprosy patients. These included medical doctors (4%), health officers and nurses with Bachelor degree in Science (27%), clinical nurses with diploma (66%) and health assistants (2.8%). The median age of the respondents was 26.0 years and females made up of 45%. Generally the knowledge and skills of the respondents were found to be poor while attitude
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COGEMA's UMF [Uranium Management Facility
International Nuclear Information System (INIS)
Lamorlette, G.; Bertrand, J.P.
1988-01-01
The French government-owned corporation, COGEMA, is responsible for the nuclear fuel cycle. This paper describes the activities at COGEMA's Pierrelatte facility, especially its Uranium Management Facility. UF6 handling and storage is described for natural, enriched, depleted, and reprocessed uranium. UF6 quality control specifications, sampling, and analysis (halocarbon and volatile fluorides, isotopic analysis, uranium assay, and impurities) are described. In addition, the paper discusses the filling and cleaning of containers and security at UMF
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Facility Management Innovation (FMI)
Mobach, Mark P.; Nardelli, Giulia; Kok, Herman; Konkol, Jennifer; Alexander, Keith; Alexander, Keith
2014-01-01
This current green paper deals with innovation in facility management (FM), a subject which is at the heart of Working Group 3, in benefit of the EuroFM Research Network. It aims to stimulate discussion and further collaborative work, and to generate new knowledge for the European FM community. We
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Construction Management for Conventional Facilities of Proton Accelerator
International Nuclear Information System (INIS)
Kim, Jun Yeon; Cho, Jang Hyung; Cho, Sung Won
2013-01-01
Proton Engineering Frontier Project, puts its aim to building 100MeV 20mA linear proton accelerator which is national facility for NT, BT, IT, and future technologies, expected to boost up the national industry competitiveness. This R and D, Construction Management is in charge of the supportive works such as site selection, architecture and engineering of conventional facilities, and overall construction management. The major goals of this work are as follows: At first, architecture and engineering of conventional facilities. Second, construction management, supervision and inspection on construction of conventional facilities. Lastly, cooperation with the project host organization, Gyeongju city, for adjusting technically interrelated work during construction. In this research, We completed the basic, detail, and field changed design of conventional facilities. Acquisition of necessary construction and atomic license, radiation safety analysis, site improvement, access road construction were successfully done as well. Also, we participated in the project host related work as follows: Project host organization and site selection, construction technical work for project host organization and procedure management, etc. Consequently, we so fulfilled all of the own goals which were set up in the beginning of this construction project that we could made contribution for installing and running PEFP's developed 100MeV 20mA linear accelerator
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Pradhan, Nousheen Akber; Rizvi, Narjis; Sami, Neelofar; Gul, Xaher
2013-07-05
Integrated management of childhood illnesses (IMCI) strategy has been proven to improve health outcomes in children under 5 years of age. Pakistan, despite being in the late implementation phase of the strategy, continues to report high under-five mortality due to pneumonia, diarrhea, measles, and malnutrition - the main targets of the strategy. The study determines the factors influencing IMCI implementation at public-sector primary health care (PHC) facilities in Matiari district, Sindh, Pakistan. An exploratory qualitative study with an embedded quantitative strand was conducted. The qualitative part included 16 in-depth interviews (IDIs) with stakeholders which included planners and policy makers at a provincial level (n=5), implementers and managers at a district level (n=3), and IMCI-trained physicians posted at PHC facilities (n=8). Quantitative part included PHC facility survey (n=16) utilizing WHO health facility assessment tool to assess availability of IMCI essential drugs, supplies, and equipments. Qualitative content analysis was used to interpret the textual information, whereas descriptive frequencies were calculated for health facility survey data. The major factors reported to enhance IMCI implementation were knowledge and perception about the strategy and need for separate clinic for children aged under 5 years as potential support factors. The latter can facilitate in strategy implementation through allocated workforce and required equipments and supplies. Constraint factors mainly included lack of clear understanding of the strategy, poor planning for IMCI implementation, ambiguity in defined roles and responsibilities among stakeholders, and insufficient essential supplies and drugs at PHC centers. The latter was further substantiated through health facilities' survey findings, which indicated that none of the facilities had 100% stock of essential supplies and drugs. Only one out of all 16 surveyed facilities had 75% of the total supplies
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Harries, Anthony D; Zachariah, Rony; Tayler-Smith, Katie; Schouten, Erik J; Chimbwandira, Frank; Van Damme, Wim; El-Sadr, Wafaa M
2010-12-01
The debate on the interaction between disease-specific programmes and health system strengthening in the last few years has intensified as experts seek to tease out common ground and find solutions and synergies to bridge the divide. Unfortunately, the debate continues to be largely academic and devoid of specificity, resulting in the issues being irrelevant to health care workers on the ground. Taking the theme 'What would entice HIV- and tuberculosis (TB)-programme managers to sit around the table on a Monday morning with health system experts', this viewpoint focuses on infection control and health facility safety as an important and highly relevant practical topic for both disease-specific programmes and health system strengthening. Our attentions, and the examples and lessons we draw on, are largely aimed at sub-Saharan Africa where the great burden of TB and HIV ⁄ AIDS resides, although the principles we outline would apply to other parts of the world as well. Health care infections, caused for example by poor hand hygiene, inadequate testing of donated blood, unsafe disposal of needles and syringes, poorly sterilized medical and surgical equipment and lack of adequate airborne infection control procedures, are responsible for a considerable burden of illness amongst patients and health care personnel, especially in resource-poor countries. Effective infection control in a district hospital requires that all the components of a health system function well: governance and stewardship, financing,infrastructure, procurement and supply chain management, human resources, health information systems, service delivery and finally supervision. We argue in this article that proper attention to infection control and an emphasis on safe health facilities is a concrete first step towards strengthening the interaction between disease-specific programmes and health systems where it really matters – for patients who are sick and for the health care workforce who provide
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Waweru, Evelyn; Goodman, Catherine; Kedenge, Sarah; Tsofa, Benjamin; Molyneux, Sassy
2016-03-01
In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility's bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user fee reduction and improve equity in access. We conducted a process evaluation of HSSF implementation based on a theory of change underpinning the intervention. Methods included interviews at national, district and facility levels, facility record reviews, a structured exit survey and a document review. We found impressive achievements: HSSF funds were reaching facilities; funds were being overseen and used in a way that strengthened transparency and community involvement; and health workers' motivation and patient satisfaction improved. Challenges or unintended outcomes included: complex and centralized accounting requirements undermining efficiency; interactions between HSSF and user fees leading to difficulties in accessing crucial user fee funds; and some relationship problems between key players. Although user fees charged had not increased, national reduction policies were still not being adhered to. Finance mechanisms can have a strong positive impact on peripheral facilities, and HFMCs can play a valuable role in managing facilities. Although fiduciary oversight is essential, mechanisms should allow for local decision-making and ensure that unmanageable paperwork is avoided. There are also limits to what can be achieved with relatively small funds in
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Managing facilities in a Scandinavian manner:
DEFF Research Database (Denmark)
Elle, Morten; Engelmark, Jesper; Jørgensen, Bo
2004-01-01
Presents the aims and needs of research in facilities management (FM) at the section of Planning and Management of Building Processes at BYG*DTU. As the building stock in Denmark is rapidly increasing, socio-demographic developments implies profound changes in both the needs of inhabitants and th...
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Daily storage management of hydroelectric facilities
Chappin, E.J.L.; Ferrero, M.; Lazzeroni, P.; Lukszo, Z.; Olivero, M.; Repetto, M.
2012-01-01
This work presents a management procedure for hydroelectric facilities with daily storage. The water storage gives an additional degree of freedom allowing to shift in time power production when it is more convenient and to work at the maximum efficiency of hydraulic turbine. The management is
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National Ignition Facility Cryogenic Target Systems Interim Management Plan
International Nuclear Information System (INIS)
Warner, B
2002-01-01
Restricted availability of funding has had an adverse impact, unforeseen at the time of the original decision to projectize the National Ignition Facility (NIF) Cryogenic Target Handling Systems (NCTS) Program, on the planning and initiation of these efforts. The purpose of this document is to provide an interim project management plan describing the organizational structure and management processes currently in place for NCTS. Preparation of a Program Execution Plan (PEP) for NCTS has been initiated, and a current draft is provided as Attachment 1 to this document. The National Ignition Facility is a multi-megajoule laser facility being constructed at Lawrence Livermore National Laboratory (LLNL) by the National Nuclear Security Administration (NNSA) in the Department of Energy (DOE). Its primary mission is to support the Stockpile Stewardship Program (SSP) by performing experiments studying weapons physics, including fusion ignition. NIF also supports the missions of weapons effects, inertial fusion energy, and basic science in high-energy-density physics. NIF will be operated by LLNL under contract to the University of California (UC) as a national user facility. NIF is a low-hazard, radiological facility, and its operation will meet all applicable federal, state, and local Environmental Safety and Health (ES and H) requirements. The NCTS Interim Management Plan provides a summary of primary design criteria and functional requirements, current organizational structure, tracking and reporting procedures, and current planning estimates of project scope, cost, and schedule. The NIF Director controls the NIF Cryogenic Target Systems Interim Management Plan. Overall scope content and execution schedules for the High Energy Density Physics Campaign (SSP Campaign 10) are currently undergoing rebaselining and will be brought into alignment with resources expected to be available throughout the NNSA Future Years National Security Plan (FYNSP). The revised schedule for
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MAPPING OF HEALTH FACILITIES IN JIMETA METROPOLIS: A ...
African Journals Online (AJOL)
PROF EKWUEME
one of the major problems hindering the proper planning and monitoring of the various health facilities ... A digital map, showing the spatial distribution of health facilities in Jimeta metropolis .... mapping process to quicken map production.
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Directory of Open Access Journals (Sweden)
Nousheen Akber Pradhan
2013-07-01
Full Text Available Background: Integrated management of childhood illnesses (IMCI strategy has been proven to improve health outcomes in children under 5 years of age. Pakistan, despite being in the late implementation phase of the strategy, continues to report high under-five mortality due to pneumonia, diarrhea, measles, and malnutrition – the main targets of the strategy. Objective: The study determines the factors influencing IMCI implementation at public-sector primary health care (PHC facilities in Matiari district, Sindh, Pakistan. Design: An exploratory qualitative study with an embedded quantitative strand was conducted. The qualitative part included 16 in-depth interviews (IDIs with stakeholders which included planners and policy makers at a provincial level (n=5, implementers and managers at a district level (n=3, and IMCI-trained physicians posted at PHC facilities (n=8. Quantitative part included PHC facility survey (n=16 utilizing WHO health facility assessment tool to assess availability of IMCI essential drugs, supplies, and equipments. Qualitative content analysis was used to interpret the textual information, whereas descriptive frequencies were calculated for health facility survey data. Results: The major factors reported to enhance IMCI implementation were knowledge and perception about the strategy and need for separate clinic for children aged under 5 years as potential support factors. The latter can facilitate in strategy implementation through allocated workforce and required equipments and supplies. Constraint factors mainly included lack of clear understanding of the strategy, poor planning for IMCI implementation, ambiguity in defined roles and responsibilities among stakeholders, and insufficient essential supplies and drugs at PHC centers. The latter was further substantiated through health facilities’ survey findings, which indicated that none of the facilities had 100% stock of essential supplies and drugs. Only one out of all
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Construction of BIM-based SMART-ITL Facility Management System
International Nuclear Information System (INIS)
Jeon, Woo-Jin; Yi, Sung-Jae; Park, Hyun-Sik; Ryu, Sung-Uk; Bae, Hwang; Hwang, Sang-Chul; Min, Byung-Eui
2015-01-01
The flow area and volume are scaled down to 1/49. The ratio of the hydraulic diameter is 1/7. Therefore, SMART-ITL is a large-scale thermalhydraulic test facility with about 45 m height, which is consisted of 10 m underground and 35 m from the ground level. Until now, the management of design data and maintenance of large scale test facilities have been managed based on hard-copy information. Recently, Thermal Hydraulics Safety Research Division (THSRD) at Korea Atomic Energy Research Institute (KAERI) has developed Facility Management System (FMS) based Building Information Modeling (BIM) to manage its design data more effectively for these large scale test facilities of SMART-ITL and ATLAS, and this BIM technology has been applied to SMART-ITL at the first. This study proposed a method of effective management and maintenance of design data applied to the SMART-ITL. That is, a FMS was developed based on the BIM technology for SMART-ITL. Figure 2 shows an overview of FMS development process based on BIM technology. SMART-ITL FMS facilitates its management and maintenance more effectively and accurately by 3- dimensional visualization. It enables the shape information of large scale test facilities to be visualized intuitively in a virtual space, and the efficient maintenance of data and instruments is possible by linking 3D shape information
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Construction of BIM-based SMART-ITL Facility Management System
Energy Technology Data Exchange (ETDEWEB)
Jeon, Woo-Jin; Yi, Sung-Jae; Park, Hyun-Sik; Ryu, Sung-Uk; Bae, Hwang [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Hwang, Sang-Chul; Min, Byung-Eui [DDRsoft Co., Daejeon (Korea, Republic of)
2015-10-15
The flow area and volume are scaled down to 1/49. The ratio of the hydraulic diameter is 1/7. Therefore, SMART-ITL is a large-scale thermalhydraulic test facility with about 45 m height, which is consisted of 10 m underground and 35 m from the ground level. Until now, the management of design data and maintenance of large scale test facilities have been managed based on hard-copy information. Recently, Thermal Hydraulics Safety Research Division (THSRD) at Korea Atomic Energy Research Institute (KAERI) has developed Facility Management System (FMS) based Building Information Modeling (BIM) to manage its design data more effectively for these large scale test facilities of SMART-ITL and ATLAS, and this BIM technology has been applied to SMART-ITL at the first. This study proposed a method of effective management and maintenance of design data applied to the SMART-ITL. That is, a FMS was developed based on the BIM technology for SMART-ITL. Figure 2 shows an overview of FMS development process based on BIM technology. SMART-ITL FMS facilitates its management and maintenance more effectively and accurately by 3- dimensional visualization. It enables the shape information of large scale test facilities to be visualized intuitively in a virtual space, and the efficient maintenance of data and instruments is possible by linking 3D shape information.
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Cost of delivering health care services at primary health facilities in Ghana
Directory of Open Access Journals (Sweden)
Maxwell Ayindenaba Dalaba
2017-11-01
Full Text Available Abstract Background There is limited knowledge on the cost of delivering health services at primary health care facilities in Ghana which is posing a challenge in resource allocations. This study therefore estimated the cost of providing health care in primary health care facilities such as Health Centres (HCs and Community-based Health Planning and Services (CHPS in Ghana. Methods The study was cross-sectional and quantitative data was collected from the health provider perspective. Data was collected between July and August, 2016 at nine primary health facilities (six CHPS and three HCs from the Upper West region of Ghana. All health related costs for the year 2015 and revenue generated for the period were collected. Data were captured and analysed using Microsoft excel. Costs of delivery health services were estimated. In addition, unit costs such as cost per Outpatient Department (OPD attendance were estimated. Results The average annual cost of delivering health services through CHPS and HCs was US$10,923 and US$44,638 respectively. Personnel cost accounted for the largest proportion of cost (61% for CHPS and 59% for HC. The cost per OPD attendance was higher at CHPS (US$8.79 than at HCs (US$5.16. The average Internally Generated Funds (IGF recorded for the period at CHPS and HCs were US$2327 and US$ 15,795 respectively. At all the facilities, IGFs were greatly lower than costs of running the health facilities. Also, at both the CHPS and HCs, the National Health Insurance Scheme (NHIS reimbursement was the main source of revenue accounting for over 90% total IGF. Conclusions The average annual cost of delivering primary health services through CHPS and HCs is US$10,923 and US$44,638 respectively and personnel cost accounts for the major cost. The government should be guided by these findings in their financial planning, decision making and resource allocation in order to improve primary health care in the country. However, more similar
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Facility information management system; Shisetsu joho kanri system
Energy Technology Data Exchange (ETDEWEB)
NONE
2000-01-10
A facility management system (FMS) was developed as a tool for efficiently operating and managing building facilities and related equipment. The maintenance management data is designed to be collected through automatic formation of data base by using a work flow function and releasing the daily business from paper work. The data base thus formed can be retrieved and displayed by utilizing a network system. The plan view for construction facilities is made a minute plan comparable to the ground plan by taking in DXF type drawing data such as a completion drawing, making it a colored display for example to create an intuitive expression understandable at first sight. The plan is controlled by the level including equipment classification and is capable of superimposed display. Detailed management data is displayed by mouse clicking of registered icons, allowing required information to be readily taken out. (translated by NEDO)
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Integrated Facilities Management and Fixed Asset Accounting.
Golz, W. C., Jr.
1984-01-01
A record of a school district's assets--land, buildings, machinery, and equipment--can be a useful management tool that meets accounting requirements and provides appropriate information for budgeting, forecasting, and facilities management. (MLF)
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Risk management plan for the National Ignition Facility
International Nuclear Information System (INIS)
Brereton, S.; Lane, M.; Smith, C.; Yatabe, J.
1998-01-01
The National Ignition Facility (NIF) is a U.S. Department of Energy inertial confinement laser fusion facility, currently under construction at the Lawrence Livermore National Laboratory (LLNL). NIF is a critical tool for the Department of Energy (DOE) science- based Stockpile Stewardship and Management Program. In addition, it represents a major step towards realizing inertial confinement fusion as a source of energy. The NIF will focus 192 laser beams onto spherical targets containing a mixture of deuterium and tritium, causing them to implode. This will create the high temperatures and pressures necessary for these targets to undergo fusion. The plan is for NIF to achieve ignition (i.e., self-heating of the fuel) and energy gain (i.e., more fusion energy produced than laser energy deposited) in the laboratory for the first time. A Risk Management Plan was prepared for the NIF design and construction Project. The plan was prepared in accordance with the DOE Life Cycle Asset Management Good Practice Guide. The objectives of the plan were to: (1) identify the risks to the completion of the Project in terms of meeting technical and regulatory requirements, cost, and schedule, (2) assess the risks in terms of likelihood of occurrence and their impact potential relative to technical performance, ES ampersand H (environment, safety and health), costs, and schedule, and (3) address each risk in terms of suitable risk management measures. Major risk elements were identified for the NIF Project. A risk assessment methodology was developed, which was utilized to rank the Project risks with respect to one another. Those elements presenting greater risk were readily identified by this process. This paper describes that methodology and the results
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Dual-Use Aspects of System Health Management
Owens, P. R.; Jambor, B. J.; Eger, G. W.; Clark, W. A.
1994-01-01
System Health Management functionality is an essential part of any space launch system. Health management functionality is an integral part of mission reliability, since it is needed to verify the reliability before the mission starts. Health Management is also a key factor in life cycle cost reduction and in increasing system availability. The degree of coverage needed by the system and the degree of coverage made available at a reasonable cost are critical parameters of a successful design. These problems are not unique to the launch vehicle world. In particular, the Intelligent Vehicle Highway System, commercial aircraft systems, train systems, and many types of industrial production facilities require various degrees of system health management. In all of these applications, too, the designers must balance the benefits and costs of health management in order to optimize costs. The importance of an integrated system is emphasized. That is, we present the case for considering health management as an integral part of system design, rather than functionality to be added on at the end of the design process. The importance of maintaining the system viewpoint is discussed in making hardware and software tradeoffs and in arriving at design decisions. We describe an approach to determine the parameters to be monitored in any system health management application. This approach is based on Design of Experiments (DOE), prototyping, failure modes and effects analyses, cost modeling and discrete event simulation. The various computer-based tools that facilitate the approach are discussed. The approach described originally was used to develop a fault tolerant avionics architecture for launch vehicles that incorporated health management as an integral part of the system. Finally, we discuss generalizing the technique to apply it to other domains. Several illustrations are presented.
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How can facility managers add value?
DEFF Research Database (Denmark)
Jensen, Per Anker; van der Voordt, Theo
2015-01-01
Recent years have seen a growing interest in the concept of added value of facilities management (FM) and corporate real estate management (CREM), and how to attain and measure it. There is a wide variety of definitions in use, and recognition of different types of added value, such as user value...
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Aliabadi, Amir A.; Rogak, Steven N.; Bartlett, Karen H.; Green, Sheldon I.
2011-01-01
Health care facility ventilation design greatly affects disease transmission by aerosols. The desire to control infection in hospitals and at the same time to reduce their carbon footprint motivates the use of unconventional solutions for building design and associated control measures. This paper considers indoor sources and types of infectious aerosols, and pathogen viability and infectivity behaviors in response to environmental conditions. Aerosol dispersion, heat and mass transfer, deposition in the respiratory tract, and infection mechanisms are discussed, with an emphasis on experimental and modeling approaches. Key building design parameters are described that include types of ventilation systems (mixing, displacement, natural and hybrid), air exchange rate, temperature and relative humidity, air flow distribution structure, occupancy, engineered disinfection of air (filtration and UV radiation), and architectural programming (source and activity management) for health care facilities. The paper describes major findings and suggests future research needs in methods for ventilation design of health care facilities to prevent airborne infection risk. PMID:22162813
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Dismantlement and Radioactive Waste Management of DPRK Nuclear Facilities
Energy Technology Data Exchange (ETDEWEB)
Jooho, W.; Baldwin, G. T.
2005-04-01
One critical aspect of any denuclearization of the Democratic People’s Republic of Korea (DPRK) involves dismantlement of its nuclear facilities and management of their associated radioactive wastes. The decommissioning problem for its two principal operational plutonium facilities at Yongbyun, the 5MWe nuclear reactor and the Radiochemical Laboratory reprocessing facility, alone present a formidable challenge. Dismantling those facilities will create radioactive waste in addition to existing inventories of spent fuel and reprocessing wastes. Negotiations with the DPRK, such as the Six Party Talks, need to appreciate the enormous scale of the radioactive waste management problem resulting from dismantlement. The two operating plutonium facilities, along with their legacy wastes, will result in anywhere from 50 to 100 metric tons of uranium spent fuel, as much as 500,000 liters of liquid high-level waste, as well as miscellaneous high-level waste sources from the Radiochemical Laboratory. A substantial quantity of intermediate-level waste will result from disposing 600 metric tons of graphite from the reactor, an undetermined quantity of chemical decladding liquid waste from reprocessing, and hundreds of tons of contaminated concrete and metal from facility dismantlement. Various facilities for dismantlement, decontamination, waste treatment and packaging, and storage will be needed. The shipment of spent fuel and liquid high level waste out of the DPRK is also likely to be required. Nuclear facility dismantlement and radioactive waste management in the DPRK are all the more difficult because of nuclear nonproliferation constraints, including the call by the United States for “complete, verifiable and irreversible dismantlement,” or “CVID.” It is desirable to accomplish dismantlement quickly, but many aspects of the radioactive waste management cannot be achieved without careful assessment, planning and preparation, sustained commitment, and long
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Dismantlement and Radioactive Waste Management of DPRK Nuclear Facilities
International Nuclear Information System (INIS)
Jooho, W.; Baldwin, G.T.
2005-01-01
One critical aspect of any denuclearization of the Democratic People's Republic of Korea (DPRK) involves dismantlement of its nuclear facilities and management of their associated radioactive wastes. The decommissioning problem for its two principal operational plutonium facilities at Yongbyun, the 5MWe nuclear reactor and the Radiochemical Laboratory reprocessing facility, alone present a formidable challenge. Dismantling those facilities will create radioactive waste in addition to existing inventories of spent fuel and reprocessing wastes. Negotiations with the DPRK, such as the Six Party Talks, need to appreciate the enormous scale of the radioactive waste management problem resulting from dismantlement. The two operating plutonium facilities, along with their legacy wastes, will result in anywhere from 50 to 100 metric tons of uranium spent fuel, as much as 500,000 liters of liquid high-level waste, as well as miscellaneous high-level waste sources from the Radiochemical Laboratory. A substantial quantity of intermediate-level waste will result from disposing 600 metric tons of graphite from the reactor, an undetermined quantity of chemical decladding liquid waste from reprocessing, and hundreds of tons of contaminated concrete and metal from facility dismantlement. Various facilities for dismantlement, decontamination, waste treatment and packaging, and storage will be needed. The shipment of spent fuel and liquid high level waste out of the DPRK is also likely to be required. Nuclear facility dismantlement and radioactive waste management in the DPRK are all the more difficult because of nuclear nonproliferation constraints, including the call by the United States for 'complete, verifiable and irreversible dismantlement,' or 'CVID.' It is desirable to accomplish dismantlement quickly, but many aspects of the radioactive waste management cannot be achieved without careful assessment, planning and preparation, sustained commitment, and long completion times
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Facility management progettare, misurare, gestire e remunerare i servizi
Tronconi, Oliviero
2014-01-01
Il valore aggiunto del Facility Management consiste in una nuova dimensione e importanza dell'organizzazione: quella del fornitore che si affianca all'azienda/cliente per supportarla e risolvere qualsiasi problema inerente ai suoi diversi servizi/bisogni. Questo valore deriva da una maggior capacità di coordinamento e gestione del fornitore/partner e da una più elevata motivazione e qualità professionale delle risorse impiegate. Ma il contributo più significativo risiede della capacità di incrementare la qualità delle informazioni e, quindi, la conoscenza sui processi attuati e sui risultati raggiunti. Il Facility Management è, nella sua accezione più evoluta, il passaggio dal "fare artigianale" alla "gestione delle informazioni che sono causa ed effetto del fare". Una gestione sistematica che deve originare un più alto livello di conoscenza dei processi e che costituisce l'essenza, il nucleo fondamentale del Facility Management. Nella chiave di lettura proposta dal volume, il Facility Management è ...
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RCRA facility stabilization initiative
International Nuclear Information System (INIS)
1995-02-01
The RCRA Facility Stabilization Initiative was developed as a means of implementing the Corrective Action Program's management goals recommended by the RIS for stabilizing actual or imminent releases from solid waste management units that threaten human health and the environment. The overall goal of stabilization is to, as situations warrant, control or abate threats to human health and/or the environment from releases at RCRA facilities, and/or to prevent or minimize the further spread of contamination while long-term remedies are pursued. The Stabilization initiative is a management philosophy and should not be confused with stabilization technologies
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Criticality management of Tokai reprocessing facility
Energy Technology Data Exchange (ETDEWEB)
Nojiri, Ichiro [Japan Nuclear Cycle Development Inst., Tokai, Ibaraki (Japan)
2001-01-01
In fuel cycle centers a number of equipment and vessels of various types and of complex design are used in several processes, i.e. dissolution of spent fuels, separation and storage of uranium and plutonium from fission products and transuranium elements. For each processes, Monte Carlo codes are frequently applied to manage the fuel criticality. Safety design depends largely on specific features of each facilities. The present report describes status of criticality management for main processes in Tokai Reprocessing Facility, JNC, and the criticality conditions specifically existing there. The guiding principle throughout consists of mass control, volume control, design (form) control, concentration control, and control due to employment of neutron poisons. (S. Ohno)
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Best practices for managing large CryoEM facilities.
Alewijnse, Bart; Ashton, Alun W; Chambers, Melissa G; Chen, Songye; Cheng, Anchi; Ebrahim, Mark; Eng, Edward T; Hagen, Wim J H; Koster, Abraham J; López, Claudia S; Lukoyanova, Natalya; Ortega, Joaquin; Renault, Ludovic; Reyntjens, Steve; Rice, William J; Scapin, Giovanna; Schrijver, Raymond; Siebert, Alistair; Stagg, Scott M; Grum-Tokars, Valerie; Wright, Elizabeth R; Wu, Shenping; Yu, Zhiheng; Zhou, Z Hong; Carragher, Bridget; Potter, Clinton S
2017-09-01
This paper provides an overview of the discussion and presentations from the Workshop on the Management of Large CryoEM Facilities held at the New York Structural Biology Center, New York, NY on February 6-7, 2017. A major objective of the workshop was to discuss best practices for managing cryoEM facilities. The discussions were largely focused on supporting single-particle methods for cryoEM and topics included: user access, assessing projects, workflow, sample handling, microscopy, data management and processing, and user training. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.
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Længerevarende samarbejder inden for Facilities Management
DEFF Research Database (Denmark)
Storgaard, Kresten; Friis, Freja
Længerevarende strategiske samarbejde er interessant, fordi det anses for en måde at fremme produktivitet og forretning for både kunder og leverandører. I rapportenfremlægges resultaterne fra en caseanalyse blandt leverandører og købere af Facilities Management.......Længerevarende strategiske samarbejde er interessant, fordi det anses for en måde at fremme produktivitet og forretning for både kunder og leverandører. I rapportenfremlægges resultaterne fra en caseanalyse blandt leverandører og købere af Facilities Management....
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Dillip, Angel; Kimatta, Suleiman; Embrey, Martha; Chalker, John C; Valimba, Richard; Malliwah, Mariam; Meena, John; Lieber, Rachel; Johnson, Keith
2017-06-19
In Tanzania, progress toward achieving the 2015 Millennium Development Goals for maternal and newborn health was slow. An intervention brought together community health workers, health facility staff, and accredited drug dispensing outlet (ADDO) dispensers to improve maternal and newborn health through a mechanism of collaboration and referral. This study explored barriers, successes, and promising approaches to increasing timely access to care by linking the three levels of health care provision. The study was conducted in the Kibaha district, where we applied qualitative approaches with in-depth interviews and focus group discussions. In-depth interview participants included retail drug shop dispensers (36), community health workers (45), and health facility staff members (15). We conducted one focus group discussion with district officials and four with mothers of newborns and children under 5 years old. Relationships among the three levels of care improved after the linkage intervention, especially for ADDO dispensers and health facility staff who previously had no formal communication pathway. The study participants perceptions of success included improved knowledge of case management and relationships among the three levels of care, more timely access to care, increased numbers of patients/customers, more meetings between community health workers and health facility staff, and a decrease in child and maternal mortality. Reported challenges included stock-outs of medicines at the health facility, participating ADDO dispensers who left to work in other regions, documentation of referrals, and lack of treatment available at health facilities on the weekend. The primary issue that threatens the sustainability of the intervention is that local council health management team members, who are responsible for facilitating the linkage, had not made any supervision visits and were therefore unaware of how the program was running. The study highlights the benefits of
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Federal facilities compliance act waste management
International Nuclear Information System (INIS)
Bowers, J.; Gates-Anderson, D.; Hollister, R.; Painter, S.
1999-01-01
Site Treatment Plans (STPs) developed through the Federal Facilities Compliance Act pose many technical and administrative challenges. Legacy wastes managed under these plans require Land Disposal Restriction (LDR) compliance through treatment and ultimate disposal. Although capacity has been defined for most of the Department of Energy wastes, many waste streams require further characterization and many need additional treatment and handling beyond LDR criteria to be able to dispose of the waste. At Lawrence Livermore National Laboratory (LLNL), the Hazardous Waste Management Division has developed a comprehensive Legacy Waste Program. The program directs work to manage low level and mixed wastes to ensure compliance with nuclear facility rules and its STP. This paper provides a survey of work conducted on these wastes at LLNL. They include commercial waste treatment and disposal, diverse forms of characterization, inventory maintenance and reporting, on-site treatment, and treatability studies. These activities are conducted in an integrated fashion to meet schedules defined in the STP. The processes managing wastes are dynamic due to required integration of administrative, regulatory, and technical concerns spanning the gamut to insure safe proper disposal
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SLIMarray: Lightweight software for microarray facility management
Directory of Open Access Journals (Sweden)
Marzolf Bruz
2006-10-01
Full Text Available Abstract Background Microarray core facilities are commonplace in biological research organizations, and need systems for accurately tracking various logistical aspects of their operation. Although these different needs could be handled separately, an integrated management system provides benefits in organization, automation and reduction in errors. Results We present SLIMarray (System for Lab Information Management of Microarrays, an open source, modular database web application capable of managing microarray inventories, sample processing and usage charges. The software allows modular configuration and is well suited for further development, providing users the flexibility to adapt it to their needs. SLIMarray Lite, a version of the software that is especially easy to install and run, is also available. Conclusion SLIMarray addresses the previously unmet need for free and open source software for managing the logistics of a microarray core facility.
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[Hospital governance: between crisis management and implementation of public health policy].
Bréchat, Pierre-Henri; Antoine, Leenhardt; Mathieu-Grenouilleau, Marie-Christine; Rymer, Roland; Matisse, François; Baraille, Denis; Beaufils, Philippe
2010-01-01
The implementation of the recent act to amend the law on hospitals, patient health and territories (HPST Law) completes the reform of the organization and governance of health facilities, which was announced in 2002 by the "Hospital 2007" plan. What kind of assessments and perspectives can be considered and envisaged for these Hospital Activity Poles? We compared our experience with a review of the professional and scientific literature in order to stimulate answers to these questions for advocacy purposes prior to the Act's implementation. The hospital's cluster of activities should reinforce--not call into question the core activities and the financial stability of the facility, while respecting the contract on agreed objectives and the necessary means and resources to meet the health needs of the catchment population as well as national priorities. Although significant, but limited, successes exist, five obstacles to hospital reorganization can be identified. These include, for example: lack of delegation of management and centralization of decisions, the heterogeneity of numerous Hospital Activity Poles or problems related to timing. These obstacles may cause strain, or put the Hospital Activity Poles and the health facilities in a difficult situation with respect to their dynamics. This may show that the State and social health insurance should steer and direct public health policy and that the delegation of management roles and responsibilities to the Hospital Activity Poles should be addressed.
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Facility Management as a Way of Reducing Costs in Transport Companies
Matusova, Dominika; Gogolova, Martina
2017-10-01
For facility management exists a several interpretations. These interpretations emerged progressively. At the time of the notion of facility management was designed to manage an administrative building, in the United States (US). They can ensure their operation and maintenance. From the US, this trend is further moved to Europe and now it start becoming a current and actual topic also in Slovakia. Facility management is contractually agreed scheme of services, semantically recalls traditional building management. There by finally pushed for activities related to real estates. For facility management is fundamental - certification and certification systems. Therefore, is essential to know, the cost structure of certification. The most commonly occurring austerity measures include: heat pumps, use of renewable energy, solar panels and water savings. These measures can reduce the cost.
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Muinga, Naomi; Magare, Steve; Monda, Jonathan; Kamau, Onesmus; Houston, Stuart; Fraser, Hamish; Powell, John; English, Mike; Paton, Chris
2018-04-18
The Kenyan government, working with international partners and local organizations, has developed an eHealth strategy, specified standards, and guidelines for electronic health record adoption in public hospitals and implemented two major health information technology projects: District Health Information Software Version 2, for collating national health care indicators and a rollout of the KenyaEMR and International Quality Care Health Management Information Systems, for managing 600 HIV clinics across the country. Following these projects, a modified version of the Open Medical Record System electronic health record was specified and developed to fulfill the clinical and administrative requirements of health care facilities operated by devolved counties in Kenya and to automate the process of collating health care indicators and entering them into the District Health Information Software Version 2 system. We aimed to present a descriptive case study of the implementation of an open source electronic health record system in public health care facilities in Kenya. We conducted a landscape review of existing literature concerning eHealth policies and electronic health record development in Kenya. Following initial discussions with the Ministry of Health, the World Health Organization, and implementing partners, we conducted a series of visits to implementing sites to conduct semistructured individual interviews and group discussions with stakeholders to produce a historical case study of the implementation. This case study describes how consultants based in Kenya, working with developers in India and project stakeholders, implemented the new system into several public hospitals in a county in rural Kenya. The implementation process included upgrading the hospital information technology infrastructure, training users, and attempting to garner administrative and clinical buy-in for adoption of the system. The initial deployment was ultimately scaled back due to a
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Sound & Vibration 20 Design Guidelines for Health Care Facilities
Tocci, Gregory; Cavanaugh, William
2013-01-01
Sound, vibration, noise and privacy have significant impacts on health and performance. As a result, they are recognized as essential components of effective health care environments. However, acoustics has only recently become a prominent consideration in the design, construction, and operation of healthcare facilities owing to the absence, prior to 2010, of clear and objective guidance based on research and best practices. Sound & Vibration 2.0 is the first publication to comprehensively address this need. Sound & Vibration 2.0 is the sole reference standard for acoustics in health care facilities and is recognized by: the 2010 FGI Guidelines for the Design and Construction of Health Care Facilities (used in 60 countries); the US Green Building Council’s LEED for Health Care (used in 87 countries); The Green Guide for Health Care V2.2; and the International Code Council (2011). Sound & Vibration 2.0 was commissioned by the Facility Guidelines Institute in 2005, written by the Health Care Acous...
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Oladipo, Jimoh Ayanda
2014-06-01
Disparities in use of healthcare services between rural and urban areas have been empirically attributed to several factors. This study explores the existence of this disparity and its implication for planning and managing healthcare delivery systems. The objectives determine the relative importance of the various predisposing, enabling, need and health services factors on utilization of health services; similarity between rural and urban areas; and major explanatory variables for utilization. A four-stage model of service utilization was constructed with 31 variables under appropriate model components. Data is collected using cross-sectional sample survey of 1086 potential health services consumers in selected health facilities and resident milieu via questionnaire. Data is analyzed using factor analysis and cross tabulation. The 4-stage model is validated for the aggregate data and data for the rural areas with 3-stage model for urban areas. The order of importance of the factors is need, enabling, predisposing and health services. 11 variables are found to be powerful predictors of utilization. Planning of different categories of health care facilities in different locations should be based on utilization rates while proper management of established facilities should aim to improve health seeking behavior of people.
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Boah, Michael; Mahama, Abraham B; Ayamga, Emmanuel A
2018-05-03
Research has shown that use of antenatal services by pregnant women and delivery in health facilities with skilled birth attendants contribute to better delivery outcomes. However, a gap exists in Ghana between the use of antenatal care provided by health facilities and delivery in health facilities with skilled birth attendants by pregnant women. This study sought to identify the predictors of health facility delivery by women in a rural district in Ghana. This was a cross-sectional study conducted in June 2016. Women who delivered in the past 6 months preceding the study were interviewed. Data on socio-demographic characteristics, use of antenatal care, place of delivery and reasons for home delivery were collected from study participants. Chi-square test and multiple logistic regression analysis were used to assess an association between women's socio-demographic and obstetric characteristics and place of delivery at 95% confidence interval. The study found that 98.8% of women received antenatal care services at least once during their recent pregnancy, and 67.9% attended antenatal care at least four times before delivery. However, 61.9% of the women delivered in a health facility with a skilled attendant. The frequently mentioned reason for home delivery was "unaware of onset of labour and delivery". The odds for delivery at a health facility were reduced among women with four living children [(AOR = 0.07, CI = 0.15-0.36, p = 0.001)], with no exposure to delivery care information [(AOR = 0.06, CI = 0.01-0.34, p = 0.002), who started their first ANC visit from the second trimester of pregnancy[(AOR = 0.003, CI = 0.01-0.15, p facilities although visits to antenatal care sessions were high, an indication that there was the need to intensify health education on early initiation of antenatal care, signs of labour and delivery, and importance of health facility delivery.
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Longe, Ezechiel O
2012-06-01
A survey of healthcare waste management practices and their implications for health and the environment was carried out. The study assessed waste management practices in 20 healthcare facilities ranging in capacity from 40 to 600 beds in Ikorodu and metropolitan Lagos, Lagos State, Nigeria. The prevailing healthcare waste management status was analysed. Management issues on quantities and proportion of different constituents of waste, segregation, collection, handling, transportation, treatment and disposal methods were assessed. The waste generation averaged 0.631 kg bed(-1) day(-1) over the survey area. The waste stream from the healthcare facilities consisted of general waste (59.0%), infectious waste (29.7%), sharps and pathological (8.9%), chemical (1.45%) and others (0.95%). Sharps/pathological waste includes disposable syringes. In general, the waste materials were collected in a mixed form, transported and disposed of along with municipal solid waste with attendant risks to health and safety. Most facilities lacked appropriate treatment systems for a variety of reasons that included inadequate funding and little or no priority for healthcare waste management as well as a lack of professionally competent waste managers among healthcare providers. Hazards associated with healthcare waste management and shortcomings in the existing system were identified.
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Waste management facility acceptance - some findings
International Nuclear Information System (INIS)
Sigmon, B.
1987-01-01
Acceptance of waste management facilities remains a significant problem, despite years of efforts to reassure potential host communities. The tangible economic benefits from jobs, taxes, and expenditures are generally small, while the intangible risks of environmental or other impacts are difficult to evaluate and understand. No magic formula for winning local acceptance has yet been found. Limited case study and survey work does suggest some pitfalls to be avoided and some directions to be pursued. Among the most significant is the importance that communities place on controlling their own destiny. Finding a meaningful role for communities in the planning and operation of waste management facilities is a challenge that would-be developers should approach with the same creativity that characterizes their technical efforts
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41 CFR 102-74.15 - What are the facility management responsibilities of occupant agencies?
2010-07-01
... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What are the facility management responsibilities of occupant agencies? 102-74.15 Section 102-74.15 Public Contracts and Property... PROPERTY 74-FACILITY MANAGEMENT Facility Management § 102-74.15 What are the facility management...
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Application of Facility Management in Brownfield Conversion
Directory of Open Access Journals (Sweden)
Wernerová Eva
2016-12-01
Full Text Available The subject of this paper covers two issues, namely the issue of brownfields and their conversion and the issue of Facility Management, which offers the possibility of applying its principles and tools for extending the benefit of the construction works as a tool for active access to care for the property. This paper aims to link these two topics and to identify the possibility of applying Facility Management in the conversation process of revitalization of brownfields so that subsequent commissioning eliminates the risk of future costly operation and relapse of the revitalized building into the category of brownfields.
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Energy Technology Data Exchange (ETDEWEB)
Wilson, A.
2001-05-16
Greening Federal Facilities, Second Edition, is a nuts-and-bolts resource guide compiled to increase energy and resource efficiency, cut waste, and improve the performance of Federal buildings and facilities. The guide highlights practical actions that facility managers, design and construction staff, procurement officials, and facility planners can take to save energy and money, improve the comfort and productivity of employees, and benefit the environment. It supports a national effort to promote energy and environmental efficiency in the nation's 500,000 Federal buildings and facilities. Topics covered include current Federal regulations; environmental and energy decision-making; site and landscape issues; building design; energy systems; water and wastewater; materials; waste management, and recycling; indoor environmental quality; and managing buildings.
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Bintabara, Deogratius; Mpondo, Bonaventura C T
2018-01-01
Sub-Saharan Africa is experiencing a rapid rise in the burden of non-communicable diseases in both urban and rural areas. Data on health system preparedness to manage hypertension and other non-communicable diseases remains scarce. This study aimed to assess the preparedness of lower-level health facilities for outpatient primary care of hypertension in Tanzania. This study used data from the 2014-2015 Tanzania Service Provision Assessment survey. The facility was considered as prepared for the outpatient primary care of hypertension if reported at least half (≥50%) of the items listed from each of the three domains (staff training and guideline, basic diagnostic equipment, and basic medicines) as identified by World Health Organization-Service Availability and Readiness Assessment manual. Data were analyzed using Stata 14. An unadjusted logistic regression model was used to assess the association between outcome and explanatory variables. All variables with a P value facilities involved in the current study, about 68% were public facilities and 73% located in rural settings. Only 28% of the assessed facilities were considered prepared for the outpatient primary care of hypertension. About 9% and 42% of the assessed facilities reported to have at least one trained staff and guidelines for hypertension respectively. In multivariate analysis, private facilities [AOR = 2.7, 95% CI; 1.2-6.1], urban location [AOR = 2.2, 95% CI; 1.2-4.2], health centers [AOR = 5.2, 95% CI; 3.1-8.7] and the performance of routine management meetings [AOR = 2.6, 95% CI; 1.1-5.9] were significantly associated with preparedness for the outpatient primary care of hypertension. The primary healthcare system in Tanzania is not adequately equipped to cope with the increasing burden of hypertension and other non-communicable diseases. Rural location, public ownership, and absence of routine management meetings were associated with being not prepared. There is a need to strengthen the primary
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Graphics-based nuclear facility modeling and management
International Nuclear Information System (INIS)
Rod, S.R.
1991-07-01
Nuclear waste management facilities are characterized by their complexity, many unprecedented features, and numerous competing design requirements. This paper describes the development of comprehensive descriptive databases and three-dimensional models of nuclear waste management facilities and applies the database/model to an example facility. The important features of the facility database/model are its abilities to (1) process large volumes of site data, plant data, and nuclear material inventory data in an efficient, integrated manner; (2) produce many different representations of the data to fulfill information needs as they arise; (3) create a complete three-dimensional solid model of the plant with all related information readily accessible; and (4) support complete, consistent inventory control and plant configuration control. While the substantive heart of the system is the database, graphic visualization of the data vastly improves the clarity of the information presented. Graphic representations are a convenient framework for the presentation of plant and inventory data, allowing all types of information to be readily located and presented in a manner that is easily understood. 2 refs., 5 figs., 1 tab
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Improvement of management systems for nuclear facilities
International Nuclear Information System (INIS)
2005-01-01
The area of Quality Management/ Quality Assurance has been changed dramatically over the past years. The nuclear facilities moved from the 'traditional' Quality Assurance approach towards Quality Management Systems, and later a new concept of Integrated Management Systems was introduced. The IAEA is developing a new set of Standards on Integrated Management Systems, which will replace the current 50-C-Q/SG-Q1-Q14 Code. The new set of document will require the integration of all management areas into one coherent management system. The new set of standards on Management Systems promotes the concept of the Integrated Management Systems. Based on new set a big number of documents are under preparation. These documents will address the current issues in the management systems area, e.g. Management of Change, Continuous Improvement, Self-assessment, and Attributes of effective management, etc. Currently NPES is providing a number of TC projects and Extra Budgetary Programmes to assist Member States in this area. The new Standards on Management Systems will be published in 2006. A number of Regulatory bodies already indicated that they would take the new Management System Standards as a basis for the national regulation. This fact will motivate a considerable change in the management of nuclear utilities, requiring a new approach. This activity is suitable for all IAEA Members States with large or limited nuclear capabilities. The service is directed to provide assistance for the management of all organizations carrying on or regulating nuclear activities and facilities
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Sarpin, Norliana; Kasim, Narimah; Zainal, Rozlin; Noh, Hamidun Mohd
2018-04-01
Facility management is the key phase in the development cycle of an assets and spans over a considerable length of time. Therefore, facility managers are in a commanding position to maximise the potential of sustainability through the development phases from construction, operation, maintenance and upgrade leading to decommission and deconstruction. Sustainability endeavours in facility management practices will contribute to reducing energy consumption, waste and running costs. Furthermore, it can also help in improving organisational productivity, financial return and community standing of the organisation. Facility manager should be empowered with the necessary knowledge and capabilities at the forefront facing sustainability challenge. However, literature studies show a gap between the level of awareness, specific knowledge and the necessary skills required to pursue sustainability in the facility management professional. People capability is considered as the key enabler in managing the sustainability agenda as well as being central to the improvement of competency and innovation in an organisation. This paper aims to develop a guidelines for interpersonal capabilities to support sustainability in facility management practice. Starting with a total of 7 critical interpersonal capabilities factors identified from previous questionnaire survey, the authors conducted an interview with 3 experts in facility management to assess the perceived importance of these factors. The findings reveal a set of guidelines for the enhancement of interpersonal capabilities among facility managers by providing what can be done to acquire these factors and how it can support the application of sustainability in their practice. The findings of this paper are expected to form the basis of a mechanism framework developed to equip facility managers with the right knowledge, to continue education and training and to develop new mind-sets to enhance the implementation of sustainability
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International Nuclear Information System (INIS)
Wilhelmsen, R.N.; Wright, K.C.; McBride, D.W.; Borsella, B.W.
1994-08-01
This report describes calendar year 1993 environmental surveillance activities of Environmental Monitoring of EG ampersand G Idaho, Inc., performed at EG ampersand G Idaho operated Waste Management facilities at the Idaho National Engineering Laboratory (INEL). The major facilities monitored include the Radioactive Waste Management Complex, the Waste Experimental Reduction Facility, the Mixed Waste Storage Facility, and two surplus facilities. Included are results of the sampling performed by the Radiological and Environmental Sciences Laboratory and the United States Geological Survey. The primary purposes of monitoring are to evaluate environmental conditions, to provide and interpret data, to ensure compliance with applicable regulations or standards, and to ensure protection of human health and the environment. This report compares 1993 environmental surveillance data with US Department of Energy derived concentration guides and with data from previous years
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International Nuclear Information System (INIS)
Wilhelmsen, R.N.; Wright, K.C.; McBride, D.W.
1993-08-01
This report describes the 1992 environmental surveillance activities of the Environmental Monitoring Unit of EG ampersand G Idaho, Inc., at EG ampersand G Idaho-operated Waste Management facilities at the Idaho National Engineering Laboratory (INEL). The major facilities monitored include the Radioactive Waste Management Complex, the Waste Experimental Reduction Facility, the Mixed Waste Storage Facility, and two surplus facilities. Included are some results of the sampling performed by the Radiological and Environmental Sciences Laboratory and the United States Geological Survey. The primary purposes of monitoring are to evaluate environmental conditions, to provide and interpret data, to ensure compliance with applicable regulations or standards, and to ensure protection of human health and the environment. This report compares 1992 environmental surveillance data with DOE derived concentration guides, and with data from previous years
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Facilities management and corporate real estate management : FM/CREM or FREM?
van der Voordt, Theo
2017-01-01
Purpose: This paper aims to explore similarities and dissimilarities between facilities management (FM) and corporate real estate management (CREM) regarding its history and key issues, and whether the similarities may result in a further integration of FM and CREM. Design/methodology/approach:
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Environment, Safety, Health and Waste Management Plan
International Nuclear Information System (INIS)
1988-01-01
The mission of the Feed Materials Production Center (FMPC) is the production of high qaulity uranium metal for use by the US Department of Energy (DOE) in Defense Programs. In order to accomplish this mission and to maintain the FMPC as a viable facility in the DOE production complex, the facility must be brought into full compliance with all federal and state regulations and industry standards for environmental protection and worker safety. Where past practices have resulted in environmental insult, a comprehensive program of remediation must be implemented. The purpose of this combined Environment, Safety, Health and Waste Management Plan is to provide a road map for achieving needed improvements. The plan is structured to provide a comprehensive projection from the current fiscal year (FY) through FY 1994 of the programs, projects and funding required to achieve compliance. To do this, the plan is subdivided into chapters which discuss the applicable regulations;project schedules and funding requirements;details of the various programs for environment, safety, health and waste management;details of the ongoing National Environmental Policy Act (NEPA);the quality assurance program and the environmental monitoring program. 14 refs., 30 figs., 29 tabs
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Improving water, sanitation and hygiene in health-care facilities, Liberia.
Abrampah, Nana Mensah; Montgomery, Maggie; Baller, April; Ndivo, Francis; Gasasira, Alex; Cooper, Catherine; Frescas, Ruben; Gordon, Bruce; Syed, Shamsuzzoha Babar
2017-07-01
The lack of proper water and sanitation infrastructures and poor hygiene practices in health-care facilities reduces facilities' preparedness and response to disease outbreaks and decreases the communities' trust in the health services provided. To improve water and sanitation infrastructures and hygiene practices, the Liberian health ministry held multistakeholder meetings to develop a national water, sanitation and hygiene and environmental health package. A national train-the-trainer course was held for county environmental health technicians, which included infection prevention and control focal persons; the focal persons acted as change agents. In Liberia, only 45% of 701 surveyed health-care facilities had an improved water source in 2015, and only 27% of these health-care facilities had proper disposal for infectious waste. Local ownership, through engagement of local health workers, was introduced to ensure development and refinement of the package. In-county collaborations between health-care facilities, along with multisectoral collaboration, informed national level direction, which led to increased focus on water and sanitation infrastructures and uptake of hygiene practices to improve the overall quality of service delivery. National level leadership was important to identify a vision and create an enabling environment for changing the perception of water, sanitation and hygiene in health-care provision. The involvement of health workers was central to address basic infrastructure and hygiene practices in health-care facilities and they also worked as stimulators for sustainable change. Further, developing a long-term implementation plan for national level initiatives is important to ensure sustainability.
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US DOE surplus facilities management program (SFMP). International technology exchange activities
International Nuclear Information System (INIS)
Broderick, J.
1986-01-01
The Surplus Facilities Management Program is one of five remedial action programs established by the US Department of Energy (DOE) to eliminate potential hazards to the public and environment from radioactive contamination. These programs provide remedial actions at various facilities and sites previously used by the US Government in national atomic energy programs. Included are uranium ore milling sites, nuclear materials production plants, and research and development facilities. The DOE's five remedial action programs are: the Grand Junction Remedial Action Project; the Formerly Utilized Sites Remedial Action Project; the West Valley Demonstration Project; and the Surplus Facilities Management Program. The Surplus Facilities Management Program (SWMP) was established by DOE in 1978. There are presently over 300 shutdown facilities in the SFMP located at sites across the United States and in Puerto Rico. In some cases, remedial action involves decontaminating and releasing a facility for some other use. In other instances, facilities are completely demolished and removed from the site
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Effectiveness of counseling at primary health facilities: Level of ...
African Journals Online (AJOL)
Effectiveness of counseling at primary health facilities: Level of knowledge of antenatal attendee and their ... Objectives: To determine the effectiveness of counseling on HIV done in primary health facilities ... AJOL African Journals Online.
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Distribution and Utilization of Health Facilities in Calabar Metropolis ...
African Journals Online (AJOL)
The level of accessibility increases with increasing utilization. Distance was a barrier to the utilization of health facilities due to the uneven distribution of health facilities and the inability of patients to overcome economic distance. Greater investment by government in the health sector would guarantee more equitable access ...
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International Nuclear Information System (INIS)
2016-01-01
This Safety Guide provides guidance on the predisposal management of all types of radioactive waste (including spent nuclear fuel declared as waste and high level waste) generated at nuclear fuel cycle facilities. These waste management facilities may be located within larger facilities or may be separate, dedicated waste management facilities (including centralized waste management facilities). The Safety Guide covers all stages in the lifetime of these facilities, including their siting, design, construction, commissioning, operation, and shutdown and decommissioning. It covers all steps carried out in the management of radioactive waste following its generation up to (but not including) disposal, including its processing (pretreatment, treatment and conditioning). Radioactive waste generated both during normal operation and in accident conditions is considered
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Olstad, Dana Lee; Raine, Kim D; McCargar, Linda J
2013-05-01
Little is known about how public entities can partner with industry to achieve public health goals. We investigated industry's perspective of factors that influenced their adoption and implementation of voluntary, government-issued nutrition guidelines (Alberta Nutrition Guidelines for Children and Youth, ANGCY) in recreational facilities. In-depth semi-structured interviews were conducted. Data were analysed using directed content analysis. Food services in recreational facilities. Seven managers from industry participated; five from companies that had adopted and implemented the ANGCY (adopters) in recreational facilities and two from companies that had not (non-adopters). Industry views nutrition guidelines through the lens of profitability. Non-adopters were unwilling to implement the ANGCY for fear of sacrificing short-term profitability, whereas adopters adhered to them in an attempt to position themselves for long-term profitability. Adopters faced barriers including few resources, no training, complex guidelines, low availability of and demand for ANGCY-compliant products, competitive pressures and substantial declines in revenue. Managers believed widespread voluntary adoption of the ANGCY was unlikely without government incentives and/or a mandate, as the environmental context for voluntary action was poor. All managers supported government-mandated implementation of the ANGCY to level the playing field upon which companies compete. Public-private partnerships in recreational facilities can embrace public health goals in the short term, provided industry perceives potential for long-term financial gain. Widespread uptake of voluntary nutrition guidelines in this setting is unlikely, however, as market mechanisms do not encourage industry to sell and promote healthier options. Government legislation may therefore be warranted.
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Adaptive management: a paradigm for remediation of public facilities
Energy Technology Data Exchange (ETDEWEB)
Janecky, David R [Los Alamos National Laboratory; Whicker, Jeffrey J [Los Alamos National Laboratory; Doerr, Ted B [NON LANL
2009-01-01
Public facility restoration planning traditionally focused on response to natural disasters and hazardous materials accidental releases. These plans now need to integrate response to terrorist actions. Therefore, plans must address a wide range of potential vulnerabilities. Similar types of broad remediation planning are needed for restoration of waste and hazardous material handling areas and facilities. There are strong similarities in damage results and remediation activities between unintentional and terrorist actions; however, the uncertainties associated with terrorist actions result in a re-evaluation of approaches to planning. Restoration of public facilities following a release of a hazardous material is inherently far more complex than in confined industrial settings and has many unique technical, economic, social, and political challenges. Therefore, they arguably involve a superset of drivers, concerns and public agencies compared to other restoration efforts. This superset of conditions increases complexity of interactions, reduces our knowledge of the initial conditions, and even condenses the timeline for restoration response. Therefore, evaluations of alternative restoration management approaches developed for responding to terrorist actions provide useful knowledge for large, complex waste management projects. Whereas present planning documents have substantial linearity in their organization, the 'adaptive management' paradigm provides a constructive parallel operations paradigm for restoration of facilities that anticipates and plans for uncertainty, multiple/simUltaneous public agency actions, and stakeholder participation. Adaptive management grew out of the need to manage and restore natural resources in highly complex and changing environments with limited knowledge about causal relationships and responses to restoration actions. Similarities between natural resource management and restoration of a facility and surrounding area
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Adaptive Management: A Paradigm for Remediation of Public Facilities
International Nuclear Information System (INIS)
Janecky, D.R.; Whicker, J.J.; Doerr, T.B.
2009-01-01
Public facility restoration planning traditionally focused on response to natural disasters and hazardous materials accidental releases. These plans now need to integrate response to terrorist actions. Therefore, plans must address a wide range of potential vulnerabilities. Similar types of broad remediation planning are needed for restoration of waste and hazardous material handling areas and facilities. There are strong similarities in damage results and remediation activities between unintentional and terrorist actions; however, the uncertainties associated with terrorist actions result in a re-evaluation of approaches to planning. Restoration of public facilities following a release of a hazardous material is inherently far more complex than in confined industrial settings and has many unique technical, economic, social, and political challenges. Therefore, they arguably involve a superset of drivers, concerns and public agencies compared to other restoration efforts. This superset of conditions increases complexity of interactions, reduces our knowledge of the initial conditions, and even condenses the timeline for restoration response. Therefore, evaluations of alternative restoration management approaches developed for responding to terrorist actions provide useful knowledge for large, complex waste management projects. Whereas present planning documents have substantial linearity in their organization, the 'adaptive management' paradigm provides a constructive parallel operations paradigm for restoration of facilities that anticipates and plans for uncertainty, multiple/simultaneous public agency actions, and stakeholder participation. Adaptive management grew out of the need to manage and restore natural resources in highly complex and changing environments with limited knowledge about causal relationships and responses to restoration actions. Similarities between natural resource management and restoration of a facility and surrounding area(s) after a
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Life Management and Safety of Nuclear Facilities
Energy Technology Data Exchange (ETDEWEB)
Fabbri, S.; Diluch, A.; Vega, G., E-mail: fabbri@cnea.gov.ar [Comisión Nacional de Energía Atómica, Buenos Aires (Argentina)
2014-10-15
The nuclear programme in Argentina includes: nuclear power and related supplies, medical and industrial applications, waste management, research and development and human training. Nuclear facilities require life management programs that allow a safe operation. Safety is the first priority for designers and operators. This can be attained with defence in depth: regular inspections and maintenance procedures to minimize failure risks. CNEA objectives in this area are to possess the necessary capability to give safe and fast technical support. Within this scheme, one of the main activities undertaken by CNEA is to provide technological assistance to the nuclear plants and research reactors. As a consequence of an increasing concern about safety and ageing a Life Management Department for safe operation was created to take care of these subjects. The goal is to elaborate a Safety Evaluation Process for the critical components of nuclear plants and other facilities. The overall objectives of a safety process are to ensure a continuous safe, reliable and effective operation of nuclear facilities and it means the implementation of the defence in deep concept to enhance safety for the protection of the public, the workers and the environment. (author)
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Directory of Open Access Journals (Sweden)
Deogratius Bintabara
Full Text Available Sub-Saharan Africa is experiencing a rapid rise in the burden of non-communicable diseases in both urban and rural areas. Data on health system preparedness to manage hypertension and other non-communicable diseases remains scarce. This study aimed to assess the preparedness of lower-level health facilities for outpatient primary care of hypertension in Tanzania.This study used data from the 2014-2015 Tanzania Service Provision Assessment survey. The facility was considered as prepared for the outpatient primary care of hypertension if reported at least half (≥50% of the items listed from each of the three domains (staff training and guideline, basic diagnostic equipment, and basic medicines as identified by World Health Organization-Service Availability and Readiness Assessment manual. Data were analyzed using Stata 14. An unadjusted logistic regression model was used to assess the association between outcome and explanatory variables. All variables with a P value < 0.2 were fitted into the multiple logistic regression models using a 5% significance level.Out of 725 health facilities involved in the current study, about 68% were public facilities and 73% located in rural settings. Only 28% of the assessed facilities were considered prepared for the outpatient primary care of hypertension. About 9% and 42% of the assessed facilities reported to have at least one trained staff and guidelines for hypertension respectively. In multivariate analysis, private facilities [AOR = 2.7, 95% CI; 1.2-6.1], urban location [AOR = 2.2, 95% CI; 1.2-4.2], health centers [AOR = 5.2, 95% CI; 3.1-8.7] and the performance of routine management meetings [AOR = 2.6, 95% CI; 1.1-5.9] were significantly associated with preparedness for the outpatient primary care of hypertension.The primary healthcare system in Tanzania is not adequately equipped to cope with the increasing burden of hypertension and other non-communicable diseases. Rural location, public ownership
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The mixed waste management facility
International Nuclear Information System (INIS)
Streit, R.D.
1995-10-01
During FY96, the Mixed Waste Management Facility (MWMF) Project has the following major objectives: (1) Complete Project Preliminary Design Review (PDR). (2) Complete final design (Title II) of MWMF major systems. (3) Coordinate all final interfaces with the Decontamination and Waste Treatment Facility (DWTF) for facility utilities and facility integration. (4) Begin long-lead procurements. (5) Issue Project Baseline Revision 2-Preliminary Design (PB2), modifying previous baselines per DOE-requested budget profiles and cost reduction. Delete Mediated Electrochemical Oxidation (MEO) as a treatment process for initial demonstration. (6) Complete submittal of, and ongoing support for, applications for air permit. (7) Begin detailed planning for start-up, activation, and operational interfaces with the Laboratory's Hazardous Waste Management Division (HWM). In achieving these objectives during FY96, the Project will incorporate and implement recent DOE directives to maximize the cost savings associated with the DWTF/MWMF integration (initiated in PB1.2); to reduce FY96 new Budget Authority to ∼$10M (reduced from FY97 Validation of $15.3M); and to keep Project fiscal year funding requirements largely uniform at ∼$10M/yr. A revised Project Baseline (i.e., PB2), to be issued during the second quarter of FY96, will address the implementation and impact of this guidance from an overall Project viewpoint. For FY96, the impact of this guidance is that completion of final design has been delayed relative to previous baselines (resulting from the delay in the completion of preliminary design); ramp-up in staffing has been essentially eliminated; and procurements have been balanced through the Project to help balance budget needs to funding availability
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Au, Lucy
2012-01-01
Rural Health Facility Management Training is a training program developed by the National Department of Health in collaboration with AUSAID through the office of the Capacity Building Service Centre. The purpose of the training is to train officers-in-charge who did not acquire knowledge and skills of managing a health facility. As part of this study, it is essential to assess whether the cell phone is a better mode of communication between the participants and the facilitators compared with other modes of communication from a distance. The study used the cross-sectional method to collect 160 samples from 12 provinces and the statistical software Stata (version 8) was used to analyse the data. The results showed that mobile coverage is not very effective in most rural areas, though, it is efficient and accessible. Furthermore, it is expensive to make a call compared with sending text massages. In spite of the high cost involved, most health managers prefer to use the cell phone compared to normal post, email, or fax. This clearly shows that the mobile phone is a better device for distant learning in rural Papua New Guinea compared to other modes of communication.
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ART Attrition across Health Facilities Implementing Option B+ in Haiti.
Myrtil, Martine Pamphile; Puttkammer, Nancy; Gloyd, Stephen; Robinson, Julia; Yuhas, Krista; Domercant, Jean Wysler; Honoré, Jean Guy; Francois, Kesner
2018-01-01
Describing factors related to high attrition is important in order to improve the implementation of the Option B+ strategy in Haiti. We conducted a retrospective cohort study to describe the variability of antiretroviral therapy (ART) retention across health facilities among pregnant and lactating women and assess for differences in ART retention between Option B+ clients and other ART patients. There were 1989 Option B+ clients who initiated ART in 45 health facilities. The percentage of attrition varied from 9% to 81% across the facilities. The largest health facilities had 38% higher risk of attrition (relative risk [RR]: 1.38, 95% confidence interval [CI]: 1.08-1.77, P = .009). Private institutions had 18% less risk of attrition (RR: 0.82, 95% CI: 0.70-0.96, P = .020). Health facilities located in the West department and the South region had lower risk of attrition. Being on treatment in a large or public health facility or a facility located in the North region was a significant risk factor associated with high attrition among Option B+ clients. The implementation of the Option B+ strategy must be reevaluated in order to effectively eliminate mother-to-child HIV transmission.
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Delivering Sustainable Facilities Management in Danish Housing Estates
DEFF Research Database (Denmark)
Nielsen, Susanne Balslev; Jensen, Jesper Ole; Jensen, Per Anker
2009-01-01
Housing plays a central role in sustainable development due to large resource consumption and as transition agent towards sustainable lifestyles. The aim is to evaluate current practice of housing administration in Denmark in order to evaluate if and how sustainable facilities management is suppo......Housing plays a central role in sustainable development due to large resource consumption and as transition agent towards sustainable lifestyles. The aim is to evaluate current practice of housing administration in Denmark in order to evaluate if and how sustainable facilities management...... is supporting social, economical and environmental sustainable development. Sustainable facility management (SFM) is as an 'umbrella' for various ways of reducing flows of energy, water and waste in the daily operation of the buildings, for instance by regular monitoring the consumption, by using 'green......-setting including the ownership of the building, the organisation of daily operation, the roles and relation between stakeholders are equally important in order to utilise the monitoring as a mean for transformation towards sustainable buildings and lifestyles....
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Hanson, Claudia; Waiswa, Peter; Marchant, Tanya; Marx, Michael; Manzi, Fatuma; Mbaruku, Godfrey; Rowe, Alex; Tomson, Göran; Schellenberg, Joanna; Peterson, Stefan
2014-04-02
Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality
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40 CFR 271.12 - Requirements for hazardous waste management facilities.
2010-07-01
... Requirements for Final Authorization § 271.12 Requirements for hazardous waste management facilities. The State shall have standards for hazardous waste management facilities which are equivalent to 40 CFR parts 264... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Requirements for hazardous waste...
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Figueroa, Fernando; Morris, Jon; Turowski, Mark; Franzl, Richard; Walker, Mark; Kapadia, Ravi; Venkatesh, Meera; Schmalzel, John
2010-01-01
Severe weather events are likely occurrences on the Mississippi Gulf Coast. It is important to rapidly diagnose and mitigate the effects of storms on Stennis Space Center's rocket engine test complex to avoid delays to critical test article programs, reduce costs, and maintain safety. An Integrated Systems Health Management (ISHM) approach and technologies are employed to integrate environmental (weather) monitoring, structural modeling, and the suite of available facility instrumentation to provide information for readiness before storms, rapid initial damage assessment to guide mitigation planning, and then support on-going assurance as repairs are effected and finally support recertification. The system is denominated Katrina Storm Monitoring System (KStorMS). Integrated Systems Health Management (ISHM) describes a comprehensive set of capabilities that provide insight into the behavior the health of a system. Knowing the status of a system allows decision makers to effectively plan and execute their mission. For example, early insight into component degradation and impending failures provides more time to develop work around strategies and more effectively plan for maintenance. Failures of system elements generally occur over time. Information extracted from sensor data, combined with system-wide knowledge bases and methods for information extraction and fusion, inference, and decision making, can be used to detect incipient failures. If failures do occur, it is critical to detect and isolate them, and suggest an appropriate course of action. ISHM enables determining the condition (health) of every element in a complex system-of-systems or SoS (detect anomalies, diagnose causes, predict future anomalies), and provide data, information, and knowledge (DIaK) to control systems for safe and effective operation. ISHM capability is achieved by using a wide range of technologies that enable anomaly detection, diagnostics, prognostics, and advise for control: (1
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International Nuclear Information System (INIS)
2014-06-01
IAEA Safety Standards Series No. GS-R-3, The Management System for Facilities and Activities, defines the requirements for establishing, implementing, assessing and continually improving a management system that integrates safety, health, environmental, security, quality and economical elements. It details the need to grade the application of the management system requirements to ensure that resources are deployed and appropriate controls are applied on the basis of the consideration of: the significance and complexity of each product or activity; the hazards and the magnitude of the potential impact (risks) associated with the safety, health, environmental, security, quality and economical elements of each product or activity; and the possible consequences if a product fails or an activity is carried out incorrectly. The grading of the application of the requirements detailed in IAEA Safety Standards Series No. GS-R-3 is especially essential when they are implemented in smaller facilities and activities. The grading is done to ensure that the management system for smaller facilities and activities are suitably tailored to the hazards and the magnitude of the potential impact of the facilities and activities. Detailed guidance on how the grading requirements of IAEA Safety Standards Series No. GS-R-3 can be met and how to ensure that grading is performed in a consistent manner can be found in IAEA Safety Standards Series No. GS-G-3.1, Application of the Management System for Facilities and Activities. In addition, it contains guidance on systematic grading methods which will reduce the likelihood and consequences of improper grading. This publication provides an overview of grading fundamentals, the grading process, the role of classification in the process and the typical controls that can be graded. It also provides practical guidance and examples of grading as required by IAEA Safety Standards Series No. GS-R-3 to develop and apply a method of grading
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SNL/CA Facilities Management Design Standards Manual
Energy Technology Data Exchange (ETDEWEB)
Rabb, David [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Clark, Eva [Sandia National Lab. (SNL-CA), Livermore, CA (United States)
2014-12-01
At Sandia National Laboratories in California (SNL/CA), the design, construction, operation, and maintenance of facilities is guided by industry standards, a graded approach, and the systematic analysis of life cycle benefits received for costs incurred. The design of the physical plant must ensure that the facilities are "fit for use," and provide conditions that effectively, efficiently, and safely support current and future mission needs. In addition, SNL/CA applies sustainable design principles, using an integrated whole-building design approach, from site planning to facility design, construction, and operation to ensure building resource efficiency and the health and productivity of occupants. The safety and health of the workforce and the public, any possible effects on the environment, and compliance with building codes take precedence over project issues, such as performance, cost, and schedule.
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Carvajal-Aguirre, Liliana; Mehra, Vrinda; Amouzou, Agbessi; Khan, Shane M; Vaz, Lara; Guenther, Tanya; Kalino, Maggie; Zaka, Nabila
2017-12-01
Health facility service environment is an important factor for newborns survival and well-being in general and in particular in high mortality settings such as Malawi where despite high coverage of essential interventions, neonatal mortality remains high. The aim of this study is to assess whether the quality of the health service environment at birth is associated with quality of care received by the newborn. We used data from the Malawi Millennium Development Goals Endline household survey conducted as part of MICS survey program and Service Provision Assessment Survey carried out in 2014. The analysis is based on 6218 facility births that occurred during the past 2 years. Descriptive statistics, bivariate and multivariate random effect models are used to assess the association of health facility service readiness score for normal deliveries and newborn care with newborns receiving appropriate newborn care, defined for this analysis as receiving 5 out of 6 recommended interventions during the first 2 days after birth. Newborns in districts with top facility service readiness score have 1.5 higher odds of receiving appropriate newborn care (adjusted odds ratio (aOR) = 1.52, 95% confidence interval CI = 1.19-1.95, P = 0.001), as compared to newborns in districts with a lower facility score after adjusting for potential confounders. Newborns in the Northern region were two times more likely to receive 5 newborn care interventions as compared to newborns in the Southern region (aOR = 2.06, 95% CI = 1.50-2.83, P < 0.001). Living in urban or rural areas did not have an impact on receiving appropriate newborn care. There is need to increase the level of service readiness across all facilities, so that all newborns irrespective of the health facility, district or region of delivery are able to receive all recommended essential interventions. Investments in health systems in Malawi should concentrate on increasing training and availability of
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A research-based profile of a Dutch excellent facility manager
Roos-Mink, Anke; Offringa, Johan; de Boer, Esther; Heijne-Penninga, Marjolein; Mobach, Mark P.; Wolfensberger, Marca; Balslev Nielsen, S.; Anker Jensen, P.
2016-01-01
Purpose - This paper aims to establish the profile of an excellent facility manager in The Netherlands.Design/methodology/approach − As part of a large-scale study on profiles of excellent professionals, a study was carried out to find the key characteristics of an excellent facility manager. Three
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Software application for a total management of a radioactive facility
International Nuclear Information System (INIS)
Mirpuri, E.; Escudero, R.; Macias, M.T.; Perez, J.; Sanchez, A.; Usera, F.
2008-01-01
The use of radiological material and/or equipment that generate ionizing radiation is widely extended in biological research. In every laboratory there are a large variety of methods, operations, techniques, equipment, radioisotopes and users related to the work with ionizing radiation. In order to control the radioactive material, users and the whole facility a large number of documents, databases and information is necessary to be created by the manager of the Radioactivity Facility. This kind of information is characterized by a constant and persistent manipulation and includes information of great importance such as the general management of the radioactive material and waste management, exposed workers vigilance, controlled areas access, laboratory and equipment reservations, radiological inspections, etc. These activities are often complicated by the fact that the main manager of the radioactive facility is also in charge of bio-safety and working prevention issues so the documents to generate and manipulate and the procedures to develop are multiplied. A procedure to access and manage all these files is highly recommended in order to optimize the general management of the facility, avoiding loss of information, automating all the activities and allowing data necessary for control easily accessible. In this work we present a software application for a total management of the facility. This software has been developed by the collaboration of six of the most important research centers from Spain in coordination with the company 'Appize soluciones'. This is a flexible and versatile application that adapts to any specific need of every research center, providing the appropriate reports and checklist that speed up to general management and increase the ease of writing the official documents, including the Operations Book. (author)
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Radioactive Waste Management and Nuclear Facility Decommissioning Progress in Iraq - 13216
Energy Technology Data Exchange (ETDEWEB)
Al-Musawi, Fouad; Shamsaldin, Emad S.; Jasim, Hadi [Ministry of Science and Technology (MoST), Al-Jadraya, P.O. Box 0765, Baghdad (Iraq); Cochran, John R. [Sandia National Laboratories1, New Mexico, Albuquerque New Mexico 87185 (United States)
2013-07-01
Management of Iraq's radioactive wastes and decommissioning of Iraq's former nuclear facilities are the responsibility of Iraq's Ministry of Science and Technology (MoST). The majority of Iraq's former nuclear facilities are in the Al-Tuwaitha Nuclear Research Center located a few kilometers from the edge of Baghdad. These facilities include bombed and partially destroyed research reactors, a fuel fabrication facility and radioisotope production facilities. Within these facilities are large numbers of silos, approximately 30 process or waste storage tanks and thousands of drums of uncharacterised radioactive waste. There are also former nuclear facilities/sites that are outside of Al-Tuwaitha and these include the former uranium processing and waste storage facility at Jesira, the dump site near Adaya, the former centrifuge facility at Rashdiya and the former enrichment plant at Tarmiya. In 2005, Iraq lacked the infrastructure needed to decommission its nuclear facilities and manage its radioactive wastes. The lack of infrastructure included: (1) the lack of an organization responsible for decommissioning and radioactive waste management, (2) the lack of a storage facility for radioactive wastes, (3) the lack of professionals with experience in decommissioning and modern waste management practices, (4) the lack of laws and regulations governing decommissioning or radioactive waste management, (5) ongoing security concerns, and (6) limited availability of electricity and internet. Since its creation eight years ago, the MoST has worked with the international community and developed an organizational structure, trained staff, and made great progress in managing radioactive wastes and decommissioning Iraq's former nuclear facilities. This progress has been made, despite the very difficult implementing conditions in Iraq. Within MoST, the Radioactive Waste Treatment and Management Directorate (RWTMD) is responsible for waste management and the
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Radioactive Waste Management and Nuclear Facility Decommissioning Progress in Iraq - 13216
International Nuclear Information System (INIS)
Al-Musawi, Fouad; Shamsaldin, Emad S.; Jasim, Hadi; Cochran, John R.
2013-01-01
Management of Iraq's radioactive wastes and decommissioning of Iraq's former nuclear facilities are the responsibility of Iraq's Ministry of Science and Technology (MoST). The majority of Iraq's former nuclear facilities are in the Al-Tuwaitha Nuclear Research Center located a few kilometers from the edge of Baghdad. These facilities include bombed and partially destroyed research reactors, a fuel fabrication facility and radioisotope production facilities. Within these facilities are large numbers of silos, approximately 30 process or waste storage tanks and thousands of drums of uncharacterised radioactive waste. There are also former nuclear facilities/sites that are outside of Al-Tuwaitha and these include the former uranium processing and waste storage facility at Jesira, the dump site near Adaya, the former centrifuge facility at Rashdiya and the former enrichment plant at Tarmiya. In 2005, Iraq lacked the infrastructure needed to decommission its nuclear facilities and manage its radioactive wastes. The lack of infrastructure included: (1) the lack of an organization responsible for decommissioning and radioactive waste management, (2) the lack of a storage facility for radioactive wastes, (3) the lack of professionals with experience in decommissioning and modern waste management practices, (4) the lack of laws and regulations governing decommissioning or radioactive waste management, (5) ongoing security concerns, and (6) limited availability of electricity and internet. Since its creation eight years ago, the MoST has worked with the international community and developed an organizational structure, trained staff, and made great progress in managing radioactive wastes and decommissioning Iraq's former nuclear facilities. This progress has been made, despite the very difficult implementing conditions in Iraq. Within MoST, the Radioactive Waste Treatment and Management Directorate (RWTMD) is responsible for waste management and the Iraqi Decommissioning
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Utilizing Interns in Facilities Management
Judkins, Clarissa; Morris, John P.; Molocznik, Chuck
2011-01-01
Facilities management is rapidly changing and developing from a position an individual stumbles into--or work one's way up through--to a discipline and vocation all of its own. There is a need for a collaborative strategy among leaders in practice, education, and research to share knowledge and experience and to establish professional and ethical…
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Retention of health workers in Malawi: perspectives of health workers and district management.
Manafa, Ogenna; McAuliffe, Eilish; Maseko, Fresier; Bowie, Cameron; MacLachlan, Malcolm; Normand, Charles
2009-07-28
Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques.Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource management practices such as performance appraisal and the
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Retention of health workers in Malawi: perspectives of health workers and district management
Directory of Open Access Journals (Sweden)
MacLachlan Malcolm
2009-07-01
Full Text Available Abstract Background Shortage of human resources is a major problem facing Malawi, where more than 50% of the population lives in rural areas. Most of the district health services are provided by clinical health officers specially trained to provide services that would normally be provided by fully qualified doctors or specialists. As this cadre and the cadre of enrolled nurses are the mainstay of the Malawian health service at the district level, it is important that they are supported and motivated to deliver a good standard of service to the population. This study explores how these cadres are managed and motivated and the impact this has on their performance. Methods A quantitative survey measured health workers' job satisfaction, perceptions of the work environment and sense of justice in the workplace, and was reported elsewhere. It emerged that health workers were particularly dissatisfied with what they perceived as unfair access to continuous education and career advancement opportunities, as well as inadequate supervision. These issues and their contribution to demotivation, from the perspective of both management and health workers, were further explored by means of qualitative techniques. Focus group discussions were held with health workers, and key-informant interviews were conducted with members of district health management teams and human resource officers in the Ministry of Health. The focus groups used convenience sampling that included all the different cadres of health workers available and willing to participate on the day the research team visited the health facility. The interviews targeted district health management teams in three districts and the human resources personnel in the Ministry of Health, also sampling those who were available and agreed to participate. Results The results showed that health workers consider continuous education and career progression strategies to be inadequate. Standard human resource
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Kanoh, Asako; Kizawa, Yoshiyuki; Tsuneto, Satoru; Yokoya, Shoji
2018-01-01
Geriatric health service facilities (GHSFs) play important roles as intermediate care facilities for elderly individuals temporarily when they need rehabilitation before returning home. However, the number of residents spending their end-of-life (EOL) period in such facilities is increasing. To improve the quality of EOL care, end-of-life discussions (EOLDs) are recommended by some guidelines and studies. This study aimed to clarify the current practice of EOL care and EOLDs in GHSFs in Japan. We conducted a nationwide cross-sectional survey by mailing questionnaires about EOL care and EOLDs to 3437 GHSF managing directors. The questionnaire was developed through a literature review and discussion among the researchers and experts. Descriptive statistics summarized the data. We also analyzed the factors related to GHSFs conducting EOLDs using Fisher exact tests. The response rate was 20.7% (713 of 3437). Among the respondents, 75.2% (536 of 713) of GHSFs provided EOL care and 73.1% (521 of 713) conducted EOLDs. The most common reasons for difficulties in providing EOL care included the lack of EOL education for nurses and care workers, and their fear about caring for dying residents. End-of-life discussions were mostly initiated after the deterioration of a resident's condition and were conducted with families by physicians. Statistically significant factors of GHSFs conducting EOLDs included providing EOL education for nurses and care workers, availability of private room for critically ill residents, emergency on-call doctors, and EOL care. Adequate practical staff education programs for EOL care including EOLDs may be crucial for quality of end-of-life care in aged care facilities.
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Health information management using optical storage technology: case studies.
Kohn, D
1992-05-01
All the health care facilities examined in the case studies addressed several important organizational issues before and during the installation of their systems. All the facilities examined employee commitment. The prudent managers considered how easily their employees adapt to changes in their jobs and work environment. They considered how enthusiastic cooperation can be fostered in the creation of a liberated and reengineered office. This was determined not only by each individual's reaction to change, but also by the health care facility's track record with other system installations. For example, document image, diagnostic image, and coded data processing systems allow the integration of divergent health care information systems within complex institutions. Unfortunately, many institutions are currently struggling with how to create an information management architecture that will integrate their mature systems, such as their patient care and financial systems. Information managers must realize that if optical storage technology-based systems are used in a strategic and planned fashion, these systems can act as focal points for systems integration, not as promises to further confuse the issue. Another issue that needed attention in all the examples was the work environment. The managers considered how the work environment was going to affect the ability to integrate optical image and data systems into the institution. For example, many of these medical centers have created alliances with clinics, HMOs, and large corporate users of medical services. This created a demand for all or part of the health information outside the confines of the original institution. Since the work environment is composed of a handful of factors such as merged medical services, as many work environment factors as possible were addressed before application of the optical storage technology solution in the institutions. And finally, the third critical issue was the organization of work
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Opwora, Antony; Kabare, Margaret; Molyneux, Sassy; Goodman, Catherine
2010-09-01
There is increasing pressure for reduction of user fees, but this can have adverse effects by decreasing facility-level funds. To address this, direct facility funding (DFF) was piloted in Coast Province, Kenya, with health facility committees (HFCs) responsible for managing the funds. We evaluated the implementation and perceived impact 2.5 years after DFF introduction. Quantitative data collection at 30 public health centres and dispensaries included a structured interview with the in-charge, record reviews and exit interviews. In addition, in-depth interviews were conducted with the in-charge and HFC members at 12 facilities, and with district staff and other stakeholders. DFF procedures were well established: HFCs met regularly and accounting procedures were broadly followed. DFF made an important contribution to facility cash income, accounting for 47% in health centres and 62% in dispensaries. The main items of expenditure were wages for support staff (32%), travel (21%), and construction and maintenance (18%). DFF was perceived to have a highly positive impact through funding support staff such as cleaners and patient attendants, outreach activities, renovations, patient referrals and increasing HFC activity. This was perceived to have improved health worker motivation, utilization and quality of care. A number of problems were identified. HFC training was reportedly inadequate, and no DFF documentation was available at facility level, leading to confusion. Charging user fees above those specified in the national policy remained common, and understanding of DFF among the broader community was very limited. Finally, relationships between HFCs and health workers were sometimes characterized by mistrust and resentment. Relatively small increases in funding may significantly affect facility performance when the funds are managed at the periphery. Kenya plans to scale up DFF nationwide. Our findings indicate this is warranted, but should include improved training
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DEFF Research Database (Denmark)
Facilities Management (FM) and Corporate Real Estate Management (CREM) are two closely related and relatively new management disciplines with developing international professions and increasing academic attention. Both disciplines have from the outset a strong focus on controlling and reducing cost...... for real estate, facilities and related services. In recent years there has been a change towards putting more focus on how FM/CREM can add value to the organisation. The book is research based with a focus on guidance to practice. It offers a transdisciplinary approach, integrating academic knowledge from...
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Mangham, Lindsay J; Cundill, Bonnie; Achonduh, Olivia A; Ambebila, Joel N; Lele, Albertine K; Metoh, Theresia N; Ndive, Sarah N; Ndong, Ignatius C; Nguela, Rachel L; Nji, Akindeh M; Orang-Ojong, Barnabas; Wiseman, Virginia; Pamen-Ngako, Joelle; Mbacham, Wilfred F
2012-03-01
To investigate the quality of malaria case management in Cameroon 5 years after the adoption of artemisinin-based combination therapy (ACT). Treatment patterns were examined in different types of facility, and the factors associated with being prescribed or receiving an ACT were investigated. A cross-sectional cluster survey was conducted among individuals of all ages who left public and private health facilities and medicine retailers in Cameroon and who reported seeking treatment for a fever. Prevalence of malaria was determined by rapid diagnostic tests (RDTs) in consenting patients attending the facilities and medicine retailers. Among the patients, 73% were prescribed or received an antimalarial, and 51% were prescribed or received an ACT. Treatment provided to patients significantly differed by type of facility: 65% of patients at public facilities, 55% of patients at private facilities and 45% of patients at medicine retailers were prescribed or received an ACT (P = 0.023). The odds of a febrile patient being prescribed or receiving an ACT were significantly higher for patients who asked for an ACT (OR = 24.1, P < 0.001), were examined by the health worker (OR = 1.88, P = 0.021), had not previously sought an antimalarial for the illness (OR = 2.29, P = 0.001) and sought treatment at a public (OR = 3.55) or private facility (OR = 1.99, P = 0.003). Malaria was confirmed in 29% of patients and 70% of patients with a negative result were prescribed or received an antimalarial. Malaria case management could be improved. Symptomatic diagnosis is inefficient because two-thirds of febrile patients do not have malaria. Government plans to extend malaria testing should promote rational use of ACT; though, the introduction of rapid diagnostic testing needs to be accompanied by updated clinical guidelines that provide clear guidance for the treatment of patients with negative test results. © 2011 Blackwell Publishing Ltd.
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Townend, William K; Cheeseman, Christopher R
2005-10-01
This paper presents guidelines that can be used by managers of healthcare facilities to evaluate and assess the quality of resources and waste management at their facilities and enabling the principles of sustainable development to be addressed. The guidelines include the following key aspects which need to be considered when completing an assessment. They are: (a) general management; (b) social issues; (c) health and safety; (d) energy and water use; (e) purchasing and supply; (f) waste management (responsibility, segregation, storage and packaging); (g) waste transport; (h) recycling and re-use; (i) waste treatment; and (j) final disposal. They identify actions required to achieve a higher level of performance which can readily be applied to any healthcare facility, irrespective of the local level of social, economic and environmental development. The guidelines are presented, and the characteristics of facilities associated with sustainable (level 4) and unsustainable (level 0) healthcare resource and wastes management are outlined. They have been used to assess a major London hospital, and this highlighted a number of deficiencies in current practice, including a lack of control over purchasing and supply, and very low rates of segregation of municipal solid waste from hazardous healthcare waste.
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Barlow, James; Roehrich, Jens; Wright, Steve
2013-01-01
Prompted in part by constrained national budgets, European governments are increasingly partnering with the private sector to underwrite the costs of constructing and operating public hospitals and other health care facilities and delivering services. Through such public-private partnerships, governments hope to avoid up-front capital expenditure and to harness private-sector efficiencies, while private-sector partners aim for a return on investment. Our research indicates that to date, experience with these partnerships has been mixed. Early models of these partnerships-for example, in which a private firm builds a hospital and carries out building maintenance, which we term an "accommodation-only" model-arguably have not met expectations for achieving greater efficiencies at lower costs. Newer models described in this article offer greater opportunities for efficiency gains but are administratively harder to set up and manage. Given the shortages in public capital for new infrastructure, it seems likely that the attractiveness of these partnerships to European governments will grow.
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Predictive Analytics to Support Real-Time Management in Pathology Facilities.
Lessard, Lysanne; Michalowski, Wojtek; Chen Li, Wei; Amyot, Daniel; Halwani, Fawaz; Banerjee, Diponkar
2016-01-01
Predictive analytics can provide valuable support to the effective management of pathology facilities. The introduction of new tests and technologies in anatomical pathology will increase the volume of specimens to be processed, as well as the complexity of pathology processes. In order for predictive analytics to address managerial challenges associated with the volume and complexity increases, it is important to pinpoint the areas where pathology managers would most benefit from predictive capabilities. We illustrate common issues in managing pathology facilities with an analysis of the surgical specimen process at the Department of Pathology and Laboratory Medicine (DPLM) at The Ottawa Hospital, which processes all surgical specimens for the Eastern Ontario Regional Laboratory Association. We then show how predictive analytics could be used to support management. Our proposed approach can be generalized beyond the DPLM, contributing to a more effective management of pathology facilities and in turn to quicker clinical diagnoses.
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National Ignition Facility Configuration Management Plan
International Nuclear Information System (INIS)
Cabral, S G; Moore, T L
2002-01-01
This Configuration Management Plan (CMP) describes the technical and administrative management process for controlling the National Ignition Facility (NIF) Project configuration. The complexity of the NIF Project (i.e., participation by multiple national laboratories and subcontractors involved in the development, fabrication, installation, and testing of NIF hardware and software, as well as construction and testing of Project facilities) requires implementation of the comprehensive configuration management program defined in this plan. A logical schematic illustrating how the plan functions is provided in Figure 1. A summary of the process is provided in Section 4.0, Configuration Change Control. Detailed procedures that make up the overall process are referenced. This CMP is consistent with guidance for managing a project's configuration provided in Department of Energy (DOE) Order 430.1, Guide PMG 10, ''Project Execution and Engineering Management Planning''. Configuration management is a formal discipline comprised of the following four elements: (1) Identification--defines the functional and physical characteristics of a Project and uniquely identifies the defining requirements. This includes selection of components of the end product(s) subject to control and selection of the documents that define the project and components. (2) Change management--provides a systematic method for managing changes to the project and its physical and functional configuration to ensure that all changes are properly identified, assessed, reviewed, approved, implemented, tested, and documented. (3) Data management--ensures that necessary information on the project and its end product(s) is systematically recorded and disseminated for decision-making and other uses. Identifies, stores and controls, tracks status, retrieves, and distributes documents. (4) Assessments and validation--ensures that the planned configuration requirements match actual physical configurations and
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Miller, Jane; Lee, Amanda; Obersky, Natalie; Edwards, Rachael
2015-06-01
The present paper reports on a quality improvement activity examining implementation of A Better Choice Healthy Food and Drink Supply Strategy for Queensland Health Facilities (A Better Choice). A Better Choice is a policy to increase supply and promotion of healthy foods and drinks and decrease supply and promotion of energy-dense, nutrient-poor choices in all food supply areas including food outlets, staff dining rooms, vending machines, tea trolleys, coffee carts, leased premises, catering, fundraising, promotion and advertising. An online survey targeted 278 facility managers to collect self-reported quantitative and qualitative data. Telephone interviews were sought concurrently with the twenty-five A Better Choice district contact officers to gather qualitative information. Public sector-owned and -operated health facilities in Queensland, Australia. One hundred and thirty-four facility managers and twenty-four district contact officers participated with response rates of 48.2% and 96.0%, respectively. Of facility managers, 78.4% reported implementation of more than half of the A Better Choice requirements including 24.6% who reported full strategy implementation. Reported implementation was highest in food outlets, staff dining rooms, tea trolleys, coffee carts, internal catering and drink vending machines. Reported implementation was more problematic in snack vending machines, external catering, leased premises and fundraising. Despite methodological challenges, the study suggests that policy approaches to improve the food and drink supply can be implemented successfully in public-sector health facilities, although results can be limited in some areas. A Better Choice may provide a model for improving food supply in other health and workplace settings.
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Protection of environment, health and safety using risk management
Energy Technology Data Exchange (ETDEWEB)
Abraham, G [Ghafari Associates, Inc. 17101 Michegan Avenue Dearborn, MI 48126-2736 (United States); Kummler, R H [Department of Chemical engineering Wayne Stae University Detroit, MI 48202 (United States); louvar, J [Research Services Basf Corporation Wyandotte, MI 48192 (United States)
1997-12-31
Section 304 of the 1990 clean air amendments (CAAA) directed the US occupational safety and health administration (OSFA) to develop a chemical process safety standard to protect workers on-site from accidents involving hazardous substances. OSHA issued 29 CFR 1910.119, process safety management of Highly hazardous chemicals (PSM) in 1992. Section 112 r of the CAAA further mandated that a standard be developed to protect the environment from accidental releases of hazardous substances. The US environmental protection agency (EPA) proposed such a standard in 1993 (58 Fr 54190) and revised their proposal in 1995). The final rule for risk management and accidental release prevention is more comprehensive and extensive than OSHA`s PSM standard. In this paper we will discuss the concepts of both programs, the classes of substances that would trigger a facility`s need for compliance and review the regulations for risk management.
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International Nuclear Information System (INIS)
1995-01-01
The purpose of the Isotopes Facilities Deactivation Project (IFDP) is to place nineteen former isotopes production facilities at the Oak Ridge National Laboratory in a safe, stable, and environmentally sound condition suitable for an extended period of minimum surveillance and maintenance (S ampersand M) and as quickly and economically as possible. Implementation and completion of the deactivation project win further reduce the already small risks to the environment and to public safety and health. Furthermore, the project should result in significant S ampersand M cost savings in the future. The IFDP management plan has been prepared to document the project objectives, define organizational relationships and responsibilities, and outline the management control systems to be employed in the management of the project. The project has adopted a strategy to deactivate the simple facilities first, to reduce the scope of the project, and to gain experience before addressing more difficult facilities. A decision support system is being developed to identify those activities that best promote the project mission and result in largest cost savings. The Work Plan for the Isotopes Facilities Deactivation Project at Oak Ridge National Laboratory (Energy Systems 1994) defines the project schedule, the cost estimate, and the technical approach for the project
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Uplatnění metody benchmarking v rámci Facility management
Jiroutová, Monika
2009-01-01
This bachelor study dissertates about the possibilities of benchmarking application in the field of Facility Management. Theoretical part describes basic characteristics and elementary terms and methods of benchmarking process in Facility Management. In the practical part ten companies providing facility services are compared on the basis of a number of indices. Every company is briefly described. On the results of performed analysis the evolution of the Facility Management in Czech Republic ...
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A distributed data base management facility for the CAD/CAM environment
Balza, R. M.; Beaudet, R. W.; Johnson, H. R.
1984-01-01
Current/PAD research in the area of distributed data base management considers facilities for supporting CAD/CAM data management in a heterogeneous network of computers encompassing multiple data base managers supporting a variety of data models. These facilities include coordinated execution of multiple DBMSs to provide for administration of and access to data distributed across them.
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Directory of Open Access Journals (Sweden)
Adwoa Serwaa-Bonsu
2010-02-01
Full Text Available Background: In developing countries, Health and Demographic Surveillance Systems (HDSSs provide a framework for tracking demographic and health dynamics over time in a defined geographical area. Many HDSSs co-exist with facility-based data sources in the form of Health Management Information Systems (HMIS. Integrating both data sources through reliable record linkage could provide both numerator and denominator populations to estimate disease prevalence and incidence rates in the population and enable determination of accurate health service coverage. Objective: To measure the acceptability and performance of fingerprint biometrics to identify individuals in demographic surveillance populations and those attending health care facilities serving the surveillance populations. Methodology: Two HDSS sites used fingerprint biometrics for patient and/or surveillance population participant identification. The proportion of individuals for whom a fingerprint could be successfully enrolled were characterised in terms of age and sex. Results: Adult (18–65 years fingerprint enrolment rates varied between 94.1% (95% CI 93.6–94.5 for facility-based fingerprint data collection at the Africa Centre site to 96.7% (95% CI 95.9–97.6 for population-based fingerprint data collection at the Agincourt site. Fingerprint enrolment rates in children under 1 year old (Africa Centre site were only 55.1% (95% CI 52.7–57.4. By age 5, child fingerprint enrolment rates were comparable to those of adults. Conclusion: This work demonstrates the feasibility of fingerprint-based individual identification for population-based research in developing countries. Record linkage between demographic surveillance population databases and health care facility data based on biometric identification systems would allow for a more comprehensive evaluation of population health, including the ability to study health service utilisation from a population perspective, rather than the
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Serwaa-Bonsu, Adwoa; Herbst, Abraham J; Reniers, Georges; Ijaa, Wilfred; Clark, Benjamin; Kabudula, Chodziwadziwa; Sankoh, Osman
2010-02-24
In developing countries, Health and Demographic Surveillance Systems (HDSSs) provide a framework for tracking demographic and health dynamics over time in a defined geographical area. Many HDSSs co-exist with facility-based data sources in the form of Health Management Information Systems (HMIS). Integrating both data sources through reliable record linkage could provide both numerator and denominator populations to estimate disease prevalence and incidence rates in the population and enable determination of accurate health service coverage. To measure the acceptability and performance of fingerprint biometrics to identify individuals in demographic surveillance populations and those attending health care facilities serving the surveillance populations. Two HDSS sites used fingerprint biometrics for patient and/or surveillance population participant identification. The proportion of individuals for whom a fingerprint could be successfully enrolled were characterised in terms of age and sex. Adult (18-65 years) fingerprint enrolment rates varied between 94.1% (95% CI 93.6-94.5) for facility-based fingerprint data collection at the Africa Centre site to 96.7% (95% CI 95.9-97.6) for population-based fingerprint data collection at the Agincourt site. Fingerprint enrolment rates in children under 1 year old (Africa Centre site) were only 55.1% (95% CI 52.7-57.4). By age 5, child fingerprint enrolment rates were comparable to those of adults. This work demonstrates the feasibility of fingerprint-based individual identification for population-based research in developing countries. Record linkage between demographic surveillance population databases and health care facility data based on biometric identification systems would allow for a more comprehensive evaluation of population health, including the ability to study health service utilisation from a population perspective, rather than the more restrictive health service perspective.
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Risk management study for the retired Hanford Site facilities: Risk management executive summary
International Nuclear Information System (INIS)
Coles, G.A.; Shultz, M.V.; Taylor, W.E.
1994-02-01
This document provides a cost-comparison evaluation for implementing certain risk-reduction measures and their effect on the overall risk of the 100 and 200 Area retired, surplus facilities. The evaluation is based on conditions that existed at the time the risk evaluation team performed facility investigations, and does not acknowledge risk-reduction measures that occurred soon after risk identification. This evaluation is one part of an overall risk management study for these facilities. The retired facilities investigated for this evaluation are located in the 100 and 200 Areas of the 1450-km 2 Hanford Site. The Hanford Site is a semiarid tract of land in southeastern Washington State. The nearest population center is Richland, Washington, (population 32,000) 30 km southeast of the 200 Area. This document is the first in a four volume series that comprise the risk management study for the retired, surplus facilities. Volume 2 is the risk evaluation work procedure; volume 3 provides the results for the risk evaluation; and volume 4 is the risk-reduction cost comparison
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Dixon, Brian E; Colvard, Cyril; Tierney, William M
2014-06-24
Objective: To support collation of data for disability determination, we sought to accurately identify facilities where care was delivered across multiple, independent hospitals and clinics. Methods: Data from various institutions' electronic health records were merged and delivered as continuity of care documents to the United States Social Security Administration (SSA). Results: Electronic records for nearly 8000 disability claimants were exchanged with SSA. Due to the lack of standard nomenclature for identifying the facilities in which patients received the care documented in the electronic records, SSA could not match the information received with information provided by disability claimants. Facility identifiers were generated arbitrarily by health care systems and therefore could not be mapped to the existing international standards. Discussion: We propose strategies for improving facility identification in electronic health records to support improved tracking of a patient's care between providers to better serve clinical care delivery, disability determination, health reform and meaningful use. Conclusion: Accurately identifying the facilities where health care is delivered to patients is important to a number of major health reform and improvement efforts underway in many nations. A standardized nomenclature for identifying health care facilities is needed to improve tracking of care and linking of electronic health records.
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Khan, M Mahmud; Hotchkiss, David R; Dmytraczenko, Tania; Zunaid Ahsan, Karar
2013-01-01
This paper illustrates the importance of collecting facility-based data through regular surveys to supplement the administrative data, especially for developing countries of the world. In Bangladesh, measures based on facility survey indicate that only 70% of very basic medical instruments and 35% of essential drugs were available in health facilities. Less than 2% of officially designated obstetric care facilities actually had required drugs, injections and personnel on-site. Majority of (80%) referral hospitals at the district level were not ready to provide comprehensive emergency obstetric care. Even though the Management Information System reports availability of diagnostic machines in all district-level and sub-district-level facilities, it fails to indicate that 50% of these machines are not functional. In terms of human resources, both physicians and nurses are in short supply at all levels of the healthcare system. The physician-nurse ratio also remains lower than the desirable level of 3.0. Overall job satisfaction index was less than 50 for physicians and 66 for nurses. Patient satisfaction score, however, was high (86) despite the fact that process indicators of service quality were poor. Facility surveys can help strengthen not only the management decision-making process but also the quality of administrative data. Copyright © 2012 John Wiley & Sons, Ltd.
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National Ignition Facility Site Management Plan
International Nuclear Information System (INIS)
Roberts, V.
1997-01-01
The purpose of the NIF Site Management Plan is to describe the roles, responsibilities, and interfaces for the major NIF Project organizations involved in construction of the facility, installation and acceptance testing of special equipment, and the NIF activation. The plan also describes the resolution of priorities and conflicts. The period covered is from Critical Decision 3 (CD3) through the completion of the Project. The plan is to be applied in a stepped manner. The steps are dependent on different elements of the project being passed from the Conventional Facilities (CF) Construction Manager (CM), to the Special Equipment (SE) CMs, and finally to the Activation/ Start-Up (AS) CM. These steps are defined as follows: The site will be coordinated by CF through Project Milestone 310, end of conventional construction. The site is defined as the fenced area surrounding the facility and the CF laydown and storage areas. The building utilities that are installed by CF will be coordinated by CF through the completion of Project Milestone 310, end of conventional construction. The building utilities are defined as electricity, compressed air, de-ionized water, etc. Upon completion of the CF work, the Optics Assembly Building/Laser and Target Area Building (OAB/LTAB) will be fully operational. At that time, an Inertial Confinement Fusion (ICF) Program building coordinator will become responsible for utilities and site activities. * Step 1. Mid-commissioning (temperature stable, +1 degree C) of an area (e.g., Laser Bay 2, OAB) will precipitate the turnover of that area (within the four walls) from CF to SE. * Step 2. Interior to the turned-over space, SE will manage all interactions, including those necessary by CF. * Step 3. As the SE acceptance testing procedures (ATPS) are completed, AS will take over the management of the area and coordinate all interactions necessary by CF and SE. For each step, the corresponding CMs for CF, SE, or AS will be placed in charge of
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National Ignition Facility Site Management Plan
Energy Technology Data Exchange (ETDEWEB)
Roberts, V.
1997-09-01
The purpose of the NIF Site Management Plan is to describe the roles, responsibilities, and interfaces for the major NIF Project organizations involved in construction of the facility, installation and acceptance testing of special equipment, and the NIF activation. The plan also describes the resolution of priorities and conflicts. The period covered is from Critical Decision 3 (CD3) through the completion of the Project. The plan is to be applied in a stepped manner. The steps are dependent on different elements of the project being passed from the Conventional Facilities (CF) Construction Manager (CM), to the Special Equipment (SE) CMs, and finally to the Activation/ Start-Up (AS) CM. These steps are defined as follows: The site will be coordinated by CF through Project Milestone 310, end of conventional construction. The site is defined as the fenced area surrounding the facility and the CF laydown and storage areas. The building utilities that are installed by CF will be coordinated by CF through the completion of Project Milestone 310, end of conventional construction. The building utilities are defined as electricity, compressed air, de-ionized water, etc. Upon completion of the CF work, the Optics Assembly Building/Laser and Target Area Building (OAB/LTAB) will be fully operational. At that time, an Inertial Confinement Fusion (ICF) Program building coordinator will become responsible for utilities and site activities. * Step 1. Mid-commissioning (temperature stable, +1{degree}C) of an area (e.g., Laser Bay 2, OAB) will precipitate the turnover of that area (within the four walls) from CF to SE. * Step 2. Interior to the turned-over space, SE will manage all interactions, including those necessary by CF. * Step 3. As the SE acceptance testing procedures (ATPS) are completed, AS will take over the management of the area and coordinate all interactions necessary by CF and SE. For each step, the corresponding CMs for CF, SE, or AS will be placed in charge of
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Predictive Analytics to Support Real-Time Management in Pathology Facilities
Lessard, Lysanne; Michalowski, Wojtek; Chen Li, Wei; Amyot, Daniel; Halwani, Fawaz; Banerjee, Diponkar
2016-01-01
Predictive analytics can provide valuable support to the effective management of pathology facilities. The introduction of new tests and technologies in anatomical pathology will increase the volume of specimens to be processed, as well as the complexity of pathology processes. In order for predictive analytics to address managerial challenges associated with the volume and complexity increases, it is important to pinpoint the areas where pathology managers would most benefit from predictive capabilities. We illustrate common issues in managing pathology facilities with an analysis of the surgical specimen process at the Department of Pathology and Laboratory Medicine (DPLM) at The Ottawa Hospital, which processes all surgical specimens for the Eastern Ontario Regional Laboratory Association. We then show how predictive analytics could be used to support management. Our proposed approach can be generalized beyond the DPLM, contributing to a more effective management of pathology facilities and in turn to quicker clinical diagnoses. PMID:28269873
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Biosafety and biosecurity measures: management of biosafety level 3 facilities.
Zaki, Adel N
2010-11-01
With the increasing biological threat from emerging infectious diseases and bioterrorism, it has become essential for governments around the globe to increase awareness and preparedness for identifying and containing those agents. This article introduces the basic concepts of laboratory management, laboratory biosafety and laboratory biosecurity. Assessment criteria for laboratories' biorisk should include both biosafety and biosecurity measures. The assessment requires setting specific goals and selecting management approaches. In order to implement technologies at the laboratory working level, a management team should be created whose role is to implement biorisk policies, rules and regulations appropriate for that facility. Rules and regulations required by government authorities are presented, with special emphasis on methods for air control, and liquid and solid waste management. Management and biorisk measures and appropriate physical facilities must keep pace, ensuring efficient facilities that protect workers, the environment, the product (research, diagnostic and/or vaccine) and the biological pathogen. Published by Elsevier B.V.
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A review of waste management practices and their impact on human health
International Nuclear Information System (INIS)
Giusti, L.
2009-01-01
This work reviews (i) the most recent information on waste arisings and waste disposal options in the world, in the European Union (EU), in Organisation for Economic Co-operation and Development (OEDC) countries, and in some developing countries (notably China) and (ii) the potential direct and indirect impact of waste management activities on health. Though the main focus is primarily on municipal solid waste (MSW), exposure to bioaerosols from composting facilities and to pathogens from sewage treatment plants are considered. The reported effects of radioactive waste are also briefly reviewed. Hundreds of epidemiological studies reported on the incidence of a wide range of possible illnesses on employees of waste facilities and on the resident population. The main conclusion of the overall assessment of the literature is that the evidence of adverse health outcomes for the general population living near landfill sites, incinerators, composting facilities and nuclear installations is usually insufficient and inconclusive. There is convincing evidence of a high risk of gastrointestinal problems associated with pathogens originating at sewage treatment plants. In order to improve the quality and usefulness of epidemiological studies applied to populations residing in areas where waste management facilities are located or planned, preference should be given to prospective cohort studies of sufficient statistical power, with access to direct human exposure measurements, and supported by data on health effect biomarkers and susceptibility biomarkers.
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NIF conventional facilities construction health and safety plan
International Nuclear Information System (INIS)
Benjamin, D W
1998-01-01
The purpose of this Plan is to outline the minimum health and safety requirements to which all participating Lawrence Livermore National Laboratory (LLNL) and non-LLNL employees (excluding National Ignition Facility [NIF] specific contractors and subcontractors covered under the construction subcontract packages (e.g., CSP-9)-see Construction Safety Program for the National Ignition Facility [CSP] Section I.B. ''NIF Construction Contractors and Subcontractors'' for specifics) shall adhere to for preventing job-related injuries and illnesses during Conventional Facilities construction activities at the NIF Project. For the purpose of this Plan, the term ''LLNL and non-LLNL employees'' includes LLNL employees, LLNL Plant Operations staff and their contractors, supplemental labor, contract labor, labor-only contractors, vendors, DOE representatives, personnel matrixed/assigned from other National Laboratories, participating guests, and others such as visitors, students, consultants etc., performing on-site work or services in support of the NIF Project. Based upon an activity level determination explained in Section 1.2.18, in this document, these organizations or individuals may be required by site management to prepare their own NIF site-specific safety plan. LLNL employees will normally not be expected to prepare a site-specific safety plan. This Plan also outlines job-specific exposures and construction site safety activities with which LLNL and non-LLNL employees shall comply
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Kim, Joyce J; Basu, Mohua; Plantinga, Laura; Pastan, Stephen O; Mohan, Sumit; Smith, Kayla; Melanson, Taylor; Escoffery, Cam; Patzer, Rachel E
2018-05-07
Despite the important role that health care providers at dialysis facilities have in reducing racial disparities in access to kidney transplantation in the United States, little is known about provider awareness of these disparities. We aimed to evaluate health care providers' awareness of racial disparities in kidney transplant waitlisting and identify factors associated with awareness. We conducted a cross-sectional analysis of a survey of providers from low-waitlisting dialysis facilities ( n =655) across all 18 ESRD networks administered in 2016 in the United States merged with 2014 US Renal Data System and 2014 US Census data. Awareness of national racial disparity in waitlisting was defined as responding "yes" to the question: "Nationally, do you think that African Americans currently have lower waitlisting rates than white patients on average?" The secondary outcome was providers' perceptions of racial difference in waitlisting at their own facilities. Among 655 providers surveyed, 19% were aware of the national racial disparity in waitlisting: 50% (57 of 113) of medical directors, 11% (35 of 327) of nurse managers, and 16% (35 of 215) of other providers. In analyses adjusted for provider and facility characteristics, nurse managers (versus medical directors; odds ratio, 7.33; 95% confidence interval, 3.35 to 16.0) and white providers (versus black providers; odds ratio, 2.64; 95% confidence interval, 1.39 to 5.02) were more likely to be unaware of a national racial disparity in waitlisting. Facilities in the South (versus the Northeast; odds ratio, 3.05; 95% confidence interval, 1.04 to 8.94) and facilities with a low percentage of blacks (versus a high percentage of blacks; odds ratio, 1.86; 95% confidence interval, 1.02 to 3.39) were more likely to be unaware. One quarter of facilities had >5% racial difference in waitlisting within their own facilities, but only 5% were aware of the disparity. Among a limited sample of dialysis facilities with low
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communicable diseases at health facilities in Ethiopia
African Journals Online (AJOL)
user
unsatisfactory and it varied between urban (34%) and rural (5%) health facilities. In general, cervical ... data for planning and monitoring scale-up intervention ... authority, Ethiopia, 2016. Regions. Number of facilities Percentage. Tigray. 42. 8. Afar. 38. 7. Amhara. 61. 11. Oromiya. 99. 18. Somali. 43. 8. Beni. Gumuz. 30. 5.
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Managing Educational Facilities and Students' Enrolment in ...
African Journals Online (AJOL)
DR Nneka
Indexed African Journals Online: www.ajol.info. An International ... Key Words: Students Enrolment, Managing, Educational Facilities, Nigeria ... positive relationship with standard and quality of educational system (Nwagwu, 1978: Adesina ...
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Radioactive waste management from nuclear facilities
International Nuclear Information System (INIS)
2005-06-01
This report has been published as a NSA (Nuclear Systems Association, Japan) commentary series, No. 13, and documents the present status on management of radioactive wastes produced from nuclear facilities in Japan and other countries as well. Risks for radiation accidents coming from radioactive waste disposal and storage together with risks for reactor accidents from nuclear power plants are now causing public anxiety. This commentary concerns among all high-level radioactive waste management from nuclear fuel cycle facilities, with including radioactive wastes from research institutes or hospitals. Also included is wastes produced from reactor decommissioning. For low-level radioactive wastes, the wastes is reduced in volume, solidified, and removed to the sites of storage depending on their radioactivities. For high-level radioactive wastes, some ten thousand years must be necessary before the radioactivity decays to the natural level and protection against seismic or volcanic activities, and terrorist attacks is unavoidable for final disposals. This inevitably results in underground disposal at least 300 m below the ground. Various proposals for the disposal and management for this and their evaluation techniques are described in the present document. (S. Ohno)
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Medlin, E. Lander; Judd, R. Holly
2013-01-01
APPA's Facilities Management Evaluation Program (FMEP) provides an integrated system to optimize organizational performance. The criteria for evaluation not only provide a tool for organizational continuous improvement, they serve as a compelling leadership development tool essential for today's facilities management professional. The senior…
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Understanding and Managing Aging of Spent Nuclear Fuel and Facility Components in Wet Storage
International Nuclear Information System (INIS)
Johnson, A. B.
2007-01-01
Storage of nuclear fuel after it has been discharged from reactors has become the leading spent fuel management option. Many storage facilities are being required to operate longer than originally anticipated. Aging is a term that has emerged to focus attention on the consequences of extended operation on systems, structures, and components that comprise the storage facilities. The key to mitigation of age-related degradation in storage facilities is to implement effective strategies to understand and manage aging of the facility materials. A systematic approach to preclude serious effects of age-related degradation is addressed in this paper, directed principally to smaller facilities (test and research reactors). The first need is to assess the materials that comprise the facility and the environments that they are subject to. Access to historical data on facility design, fabrication, and operation can facilitate assessment of expected materials performance. Methods to assess the current condition of facility materials are summarized in the paper. Each facility needs an aging management plan to define the scope of the management program, involving identification of the materials that need specific actions to manage age-related degradation. For each material identified, one or more aging management programs are developed and become part of the plan Several national and international organizations have invested in development of comprehensive and systematic approaches to aging management. A method developed by the US Nuclear Regulatory Commission is recommended as a concise template to organize measures to effectively manage age-related degradation of storage facility materials, including the scope of inspection, surveillance, and maintenance that is needed to assure successful operation of the facility over its required life. Important to effective aging management is a staff that is alert for evidence of materials degradation and committed to carry out the aging
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Availability of medicines in public sector health facilities of two North Indian States.
Prinja, Shankar; Bahuguna, Pankaj; Tripathy, Jaya Prasad; Kumar, Rajesh
2015-12-23
Access to free essential medicines is a critical component of universal health coverage. However availability of essential medicines is poor in India with more than two-third of the people having limited or no access. This has pushed up private out-of-pocket expenditure due to medicines. The states of Punjab and Haryana are in the process of institutionalizing drug procurement models to provide uninterrupted access to essential medicines free of cost in all public hospitals and health centres. We undertook this study to assess the availability of medicines in public sector health facilities in the 2 states. Secondly, we also ascertained the quality of storage and inventory management systems in health facilities. The present study was carried out in 80 public health facilities across 12 districts in Haryana and Punjab states. Overall, within each state 1 MC, 6 DHs, 11 CHCs and 22 PHCs were selected for the study. Drug procurement mechanisms in both the states were studied through document reviews and in-depth interviews with key stakeholders. Stock registers were reviewed to collect data on availability of a basket of essential medicines -92 at Primary Health Centre (PHC) level, 132 at Community Health Centre (CHC) level and 160 at tertiary care (District Hospital/Medical College) level. These essential medicines were selected based on the Essential Medicine List (EML) of the Department of Health (DOH). Overall availability of medicines was 45.2% and 51.1% in Punjab and Haryana respectively. Availability of anti-hypertensives was around 60% in both the states whereas for anti-diabetics it was 44% and 47% in Punjab and Haryana respectively. Atleast one drug in each of the categories including analgesic/antipyretic, anti-helminthic, anti-spasmodic, anti-emetic, anti-hypertensive and uterotonics were nearly universally available in public sector facilities. On the contrary, medicines such as thrombolytics, anti-cancer and endocrine medicines were available in less
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Information security management system planning for CBRN facilities
Energy Technology Data Exchange (ETDEWEB)
Lenaeu, Joseph D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); O' Neil, Lori Ross [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Leitch, Rosalyn M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Glantz, Clifford S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Landine, Guy P. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Bryant, Janet L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Lewis, John [National Nuclear Lab., Workington (United Kingdom); Mathers, Gemma [National Nuclear Lab., Workington (United Kingdom); Rodger, Robert [National Nuclear Lab., Workington (United Kingdom); Johnson, Christopher [National Nuclear Lab., Workington (United Kingdom)
2015-12-01
The focus of this document is to provide guidance for the development of information security management system planning documents at chemical, biological, radiological, or nuclear (CBRN) facilities. It describes a risk-based approach for planning information security programs based on the sensitivity of the data developed, processed, communicated, and stored on facility information systems.
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Information security management system planning for CBRN facilities
International Nuclear Information System (INIS)
Lenaeu, Joseph D.; O'Neil, Lori Ross; Leitch, Rosalyn M.; Glantz, Clifford S.; Landine, Guy P.; Bryant, Janet L.; Lewis, John; Mathers, Gemma; Rodger, Robert; Johnson, Christopher
2015-01-01
The focus of this document is to provide guidance for the development of information security management system planning documents at chemical, biological, radiological, or nuclear (CBRN) facilities. It describes a risk-based approach for planning information security programs based on the sensitivity of the data developed, processed, communicated, and stored on facility information systems.
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Environmental Management Assessment of the Continuous Electron Beam Accelerator Facility (CEBAF)
International Nuclear Information System (INIS)
1993-03-01
This report documents the results of the Environmental Management Assessment performed at the Continuous Electron Beam Accelerator Facility (CEBAF) in Newport News, Virginia. During this assessment, activities and records were reviewed and interviews were conducted with personnel from the CEBAF Site Office; the CEBAF management and operating contractor (M ampersand O), Southeastern Universities Research Association, Inc. (SURA); the Oak Ridge Field Office (OR); and the responsible DOE Headquarters Program Office, the Office of Energy Research (ER). The onsite portion of the assessment was conducted from March 8 through March 19, 1993, by the US Department of Energy's (DOE's) Office of Environmental Audit (EH-24) located within the office of Environment, Safety and Health (EH). DOE 5482.1 B, ''Environment, Safety and Health Appraisal Program,'' and Secretary of Energy Notice (SEN)-6E-92, ''Departmental Organizational and Management Arrangements,'' establish the mission of EH-24 to provide comprehensive, independent oversight of Department-wide environmental programs on behalf of the Secretary of Energy. The ultimate goal of EH-24 is enhancement of environmental protection and minimization of risk to public health and the environment. EH-24 accomplishes its mission utilizing systematic and periodic evaluations of the Department's environmental programs within line organizations, and through use of supplemental activities which serve to strengthen self-assessment and oversight functions within program, field, and contractor organizations
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Directory of Open Access Journals (Sweden)
Andreas Dittmar Weise
2014-01-01
Full Text Available Words like Business Management (BM and Facility Management (FM are well known as separate management methods. FM offers transparency about their property costs and exploitation, starting from the planning phase until its demolition. The investor sees this in the property invested capital and its recoverable yield. This means they also want a profit with their real estates. Besides this, changes in the social and environmental requirements become necessary to adapt the properties. The solution is called Intelligent Building. Its primary aim is to collect and select previous knowledge and information about Facility Management and Business Management. It is an application, mainly with sight to characterize and describe the possibilities of use of intelligent buildings as a combination of Facility and Business Management. This paper is an indirect survey carried out through a documental procedure in the form of a bibliographic research and theoretician study. Intelligent Building as combination of FM and BM is new, but in our times necessary to satisfy the needs of the demand. This type of building needs to be flexible in its structure and services, open for changes in environmental requirements, e.g. saving energy, and needs a lot of technology to realize their functions. Consequently, it will be sustainable for a value enhancement. With a Computer Aided Facilities Management system this is possible and the company will be more flexible in relation to the competitors and future changes.
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International Nuclear Information System (INIS)
Seino, Satoshi; Ujihara, Satoshi; Kikuyama, Kaoru
2009-01-01
European and US plant owners have attached importance to plant maintenance, such as prompt grasp of plant states, implementation of maintenance and planning of maintenance programs, as one of asset management. The US advanced trend was introduced in this feature article through the applications of IBM Maximo Asset Management for nuclear facilities maintenance. World trends of nuclear power and related problems, need of nuclear facilities management, key items for introduction of maintenance management systems, required systems for nuclear maintenance management and introduction of functions of the IBM strategic asset management solution-Maximo were described respectively. (T. Tanaka)
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Tynan, Anna; Deeth, Lisa; McKenzie, Debra; Bourke, Carolyn; Stenhouse, Shayne; Pitt, Jacinta; Linneman, Helen
2018-04-16
Residents of residential aged care facilities are at very high risk of developing complex oral diseases and dental problems. Key barriers exist in delivering oral health services to residential aged care facilities, particularly in regional and rural areas. A quality improvement study incorporating pre- and post chart audits and pre- and post consultation with key stakeholders, including staff and residents, expert opinion on cost estimates and field notes were used. One regional and three rural residential aged care facilities situated in a non-metropolitan hospital and health service in Queensland. Number of appointments avoided at an oral health facility Feedback on program experience by staff and residents Compliance with oral health care plan implementation Observations of costs involved to deliver new service. The model developed incorporated a visit by an oral health therapist for screening, education, simple intervention and referral for a teledentistry session if required. Results showed an improvement in implementation of oral health care plans and a minimisation of need for residents to attend an oral health care facility. Potential financial and social cost savings for residents and the facilities were also noted. Screening via the oral health therapist and teledentistry appointment minimises the need for a visit to an oral health facility and subsequent disruption to residents in residential aged care facilities. © 2018 National Rural Health Alliance Ltd.
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Characteristics of U.S. Mental Health Facilities That Offer Suicide Prevention Services.
Kuramoto-Crawford, S Janet; Smith, Kelley E; McKeon, Richard
2016-01-01
This study characterized mental health facilities that offer suicide prevention services or outcome follow-up after discharge. The study analyzed data from 8,459 U.S. mental health facilities that participated in the 2010 National Mental Health Services Survey. Logistic regression analyses were used to compare facilities that offered neither of the prevention services with those that offered both or either service. About one-fifth of mental health facilities reported offering neither suicide prevention services nor outcome follow-up. Approximately one-third offered both, 25% offered suicide prevention services only, and 21% offered only outcome follow-up after discharge. Facilities that offered neither service were less likely than facilities that offered either to offer comprehensive support services or special programs for veterans; to offer substance abuse services; and to be accredited, licensed, or certified. Further examination of facilitators and barriers in implementing suicide prevention services in mental health facilities is warranted.
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Revolving drug funds at front-line health facilities in Vientiane, Lao PDR.
Murakami, H; Phommasack, B; Oula, R; Sinxomphou, S
2001-03-01
Pharmaceutical cost recovery programmes, which have been mainly implemented in Africa, are gradually spreading to Southeast Asian countries that formerly belonged to the socialist bloc. This report describes the economic and operational realities of revolving drug funds (RDFs) at district hospitals and health centres in the capital of the Lao PDR by reviewing research conducted by the implementing department. People in the municipality spent an average of US$11 on drugs in 1996. The RDFs comprised only 3% of the total yearly drug sales in the municipality, whereas private pharmacies accounted for 75%. The RDFs were forced to operate in conjunction with the remaining government drug endowment and the thriving private pharmacies. This scheme has provided a stable supply of essential drugs. The assurance of drug availability at the front-line health facilities has resulted in increased utilization of the facilities despite the introduction of a drug fee. The cost recovery rate was 107% at health centres and 108% at district hospitals in two monitored districts during the 10 months from November 1997. Decentralized financial management was essential for cost recovery, allowing timely adjustment of selling prices as purchase prices rapidly inflated after the Asian economic crisis. The health staff observed that the people perceived drugs as everyday commodities that they should buy and take based on self-diagnosis and personal preference. Adaptation of the public health authorities to market-oriented thinking along with the establishment of pharmaceutical cost recovery occurred with few problems. However, both financial and operational management capacity at the municipal level pose a major challenge to policy clarification and scheme setting, especially in procurement, control of prescribing practices and the integration of drug dispensing with other components of quality clinical care.
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A Study on Governance and Human Resources for Cooperative Road Facilities Management
Ohno, Sachiko; Takagi, Akiyoshi; Kurauchi, Fumitaka; Demura, Yoshifumi
Within today's infrastructure management, Asset Management systems are becoming a mainstream feature. For region where the risk is low, it is necessary to create a "cooperative road facilities management system". This research both examined and suggested what kind of cooperative road facilities management system should be promoted by the regional society. Concretely, this study defines the operational realities of a previous case. It discusses the problem of the road facilities management as a governance. Furthermore, its realization depends on "the cooperation between municipalities", "the private-sector initiative", and "residents participation" .Also, it discusses the problem of human resources for governance. Its realization depends on "the engineers' promotion", and "creation of a voluntary activity of the resident" as a human resources. Moreover, it defines that the intermediary is important because the human resources tied to the governance. As a result, the prospect of the road facilities management is shown by the role of the player and the relation among player.
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Operational experiences and upgradation of waste management facilities Trombay, India
International Nuclear Information System (INIS)
Chander, Mahesh; Bodke, S.B.; Bansal, N.K.
2001-01-01
Full text: Waste Management Facilities Trombay provide services for the safe management of radioactive wastes generated from the operation of non power sources at Bhabha Atomic Research Centre, India. The paper describes in detail the current operational experience and facility upgradation by way of revamping of existing processes equipment and systems and augmentation of the facility by way of introducing latest processes and technologies to enhance the safety. Radioactive wastes are generated from the operation of research reactors, fuel fabrication, spent fuel reprocessing, research labs. manufacture of sealed sources and labeled compounds. Use of radiation sources in the field of medical, agriculture and industry also leads to generation of assorted solid waste and spent sealed radiation sources which require proper waste management. Waste Management Facilities Trombay comprise of Effluent Treatment Plant (ETP), Decontamination Centre (DC) and Radioactive Solid Waste Management Site (RSMS). Low level radioactive liquid effluents are received at ETP. Plant has 100 M 3 /day treatment capacity. Decontamination of liquid effluents is effected by chemical treatment method using co- precipitation as a process. Plant has 1800 M 3 of storage capacity. Chemical treatment system comprises of clarifloculator, static mixer and chemical feed tanks. Plant has concentrate management facility where chemical sludge is centrifuged to effect volume reduction of more that 15. Thickened sludge is immobilized in cement matrix. Decontamination Centre caters to the need of equipment decontamination from research reactors. Process used is ultrasonic chemical decontamination. Besides this DC provides services for decontamination of protective wears. Radioactive Solid Waste Management Site is responsible for the safe management of solid waste generated at various research reactors, plants, laboratories in Bhabha Atomic Research Centre. Spent sealed radiation sources are also stored
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International Nuclear Information System (INIS)
Manchev, B.; Nenkova, B.; Tomov, E.
2012-01-01
Risk Engineering Ltd is a Bulgarian private company founded in 1990 to provide engineering and consulting services applicable to each and every field of the energy sector. Since its establishment Risk Engineering Ltd develops, implement and apply a System for quality assurance, certified for the first time by BVQI (now Bureau Veritas Certification) in 1999 for conformity with the standard ISO 9001:1994. Later on, in connection with the revision of the standards of ISO 9000 series and introduction of the standard ISO 9001:2000 a Quality Management System in conformity with the standard ISO 9001:2000 was developed, introduced and certified. At present, Risk Engineering Ltd has got developed, documented, introduced and certified by Lloyd's Register Quality Assurance (LRQA) Quality Management System in compliance with ISO 9001:2008 on the process approach basis. On this basis and including the requirements of the ISO 14001:2004 (regarding the environment) and OHSAS 18001:2007 (regarding the health and occupational safety), Risk Engineering Ltd has developed and introduced Integrated Management System aim at achieving and demonstrating good results regarding protection of the environment, health and occupational safety. The processes under control by the Integrated Management System and applicable at the company are divided in two general types: A) Management processes: Strategic management and Management of the human resources. B) Processes describing the main activities: design/development process; project management; management of industrial projects and technical infrastructure project; construction, installation, repair and operation of power industry facilities; commercial activities and marketing; investigation of energy efficiency of industrial systems and certification of buildings regarding energy efficiency; consulting activity in the field of industry and energy as well as consultant in accordance with the Law of the Spatial Planning; management of the
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The grand challenge of managing the petascale facility.
Energy Technology Data Exchange (ETDEWEB)
Aiken, R. J.; Mathematics and Computer Science
2007-02-28
This report is the result of a study of networks and how they may need to evolve to support petascale leadership computing and science. As Dr. Ray Orbach, director of the Department of Energy's Office of Science, says in the spring 2006 issue of SciDAC Review, 'One remarkable example of growth in unexpected directions has been in high-end computation'. In the same article Dr. Michael Strayer states, 'Moore's law suggests that before the end of the next cycle of SciDAC, we shall see petaflop computers'. Given the Office of Science's strong leadership and support for petascale computing and facilities, we should expect to see petaflop computers in operation in support of science before the end of the decade, and DOE/SC Advanced Scientific Computing Research programs are focused on making this a reality. This study took its lead from this strong focus on petascale computing and the networks required to support such facilities, but it grew to include almost all aspects of the DOE/SC petascale computational and experimental science facilities, all of which will face daunting challenges in managing and analyzing the voluminous amounts of data expected. In addition, trends indicate the increased coupling of unique experimental facilities with computational facilities, along with the integration of multidisciplinary datasets and high-end computing with data-intensive computing; and we can expect these trends to continue at the petascale level and beyond. Coupled with recent technology trends, they clearly indicate the need for including capability petascale storage, networks, and experiments, as well as collaboration tools and programming environments, as integral components of the Office of Science's petascale capability metafacility. The objective of this report is to recommend a new cross-cutting program to support the management of petascale science and infrastructure. The appendices of the report document current and projected
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Investigation of health care waste management in Binzhou District, China
International Nuclear Information System (INIS)
Ruoyan, Gai; Xu Lingzhong; Li Huijuan; Zhou Chengchao; He Jiangjiang; Yoshihisa, Shirayama; Tang Wei; Chushi, Kuroiwa
2010-01-01
In China, national regulations and standards for health care waste management were implemented in 2003. To investigate the current status of health care waste management at different levels of health care facilities (HCF) after the implementation of these regulations, one tertiary hospital, one secondary hospital, and four primary health care centers from Binzhou District were visited and 145 medical staff members and 24 cleaning personnel were interviewed. Generated medical waste totaled 1.22, 0.77, and 1.17 kg/bed/day in tertiary, secondary, and primary HCF, respectively. The amount of medical waste generated in primary health care centers was much higher than that in secondary hospitals, which may be attributed to general waste being mixed with medical waste. This study found that the level of the HCF, responsibility for medical waste management in departments and wards, educational background and training experience can be factors that determine medical staff members' knowledge of health care waste management policy. Regular training programs and sufficient provision of protective measures are urgently needed to improve occupational safety for cleaning personnel. Financing and administrative monitoring by local authorities is needed to improve handling practices and the implementation of off-site centralized disposal in primary health care centers.
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Springer, Judy B; Eickhoff-Shemek, JoAnn M; Zuberbuehler, Ernest J
2009-01-01
The purpose of this study was to explore the rationale provided by program directors and general managers of health/fitness facilities for low adherence to nationally accepted standards related to pre-activity cardiovascular screening procedures (PACSPs) for members and clients of personal trainers. Qualitative interviews were conducted with the directors/managers in a Midwest region representing 76 facilities who indicated they did not conduct PACSPs for members and clients of personal trainers. Analysis of the rationale provided revealed 6 major clusters: (1) Purpose or need for screening; (2) time and staffing; (3) barrier to participation; (4) personal responsibility for health and actions; (5) legal issues; and (6) company or franchise policy that categorized the reasons for low adherence to PACSPs. These findings highlight the need to increase awareness of the relevance of PACSPs among health/fitness managers, staff members, and current exercise science students as well as engage those in risk management for informed dialogue for consistent application of the standard of care. Copyright 2009 Wiley Periodicals, Inc.
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Location - Managed Facility - St. Paul District (MVP)
Army Corps of Engineers, Department of the Army, Department of Defense — St. Paul District - US Army Corps of Engineers Managed Facility locations. District headquarters, Natural Resource, Recreation, Lock and Dam, and Regulatory offices...
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Life cycle cost estimation and systems analysis of Waste Management Facilities
International Nuclear Information System (INIS)
Shropshire, D.; Feizollahi, F.
1995-01-01
This paper presents general conclusions from application of a system cost analysis method developed by the United States Department of Energy (DOE), Waste Management Division (WM), Waste Management Facilities Costs Information (WMFCI) program. The WMFCI method has been used to assess the DOE complex-wide management of radioactive, hazardous, and mixed wastes. The Idaho Engineering Laboratory, along with its subcontractor Morrison Knudsen Corporation, has been responsible for developing and applying the WMFCI cost analysis method. The cost analyses are based on system planning level life-cycle costs. The costs for life-cycle waste management activities estimated by WMFCI range from bench-scale testing and developmental work needed to design and construct a facility, facility permitting and startup, operation and maintenance, to the final decontamination, decommissioning, and closure of the facility. For DOE complex-wide assessments, cost estimates have been developed at the treatment, storage, and disposal module level and rolled up for each DOE installation. Discussions include conclusions reached by studies covering complex-wide consolidation of treatment, storage, and disposal facilities, system cost modeling, system costs sensitivity, system cost optimization, and the integration of WM waste with the environmental restoration and decontamination and decommissioning secondary wastes
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Westinghouse Hanford Company risk management strategy for retired surplus facilities
International Nuclear Information System (INIS)
Taylor, W.E.; Coles, G.A.; Shultz, M.V.; Egge, R.G.
1993-09-01
This paper describes an approach that facilitates management of personnel safety and environmental release risk from retired, surplus Westinghouse Hanford Company-managed facilities during the predemolition time frame. These facilities are located in the 100 and 200 Areas of the 1,450-km 2 (570-mi 2 ) Hanford Site in Richland, Washington. The production reactors are located in the 100 Area and the chemical separation facilities are located in the 200 Area. This paper also includes a description of the risk evaluation process, shows applicable results, and includes a description of comparison costs for different risk reduction options
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The Management System for the Development of Disposal Facilities for Radioactive Waste
International Nuclear Information System (INIS)
2011-01-01
Currently, many Member States are safely operating near surface disposal facilities and some are in the initial or advanced stages of planning geological repositories. As for other nuclear facilities and their operational phase, all activities associated with the disposal of radioactive waste need to be carefully planned and systematic actions undertaken in order to maintain adequate confidence that disposal systems will meet performance as well as prescribed safety requirements and objectives. The effective development and application of a management system (integrating requirements for safety, protection of health and the environment, security, quality and economics into one coherent system) which addresses every stage of repository development is essential. It provides assurance that the objectives for repository performance and safety, as well as environmental and quality criteria, will be met. For near surface repositories, a management system also provides the opportunity to re-evaluate existing disposal systems with respect to new safety, environmental or societal requirements which could arise during the operational period of a facility. The topic of waste management and disposal continues to generate public interest and scrutiny. Implementation of a formal management system provides documentation, transparency and accountability for the various activities and processes associated with radioactive waste disposal. This information can contribute to building public confidence and acceptance of disposal facilities. The objective of this report is to provide Member States with practical guidance and relevant information on management system principles and expectations for management systems that can serve as a basis for developing and implementing a management system for three important stages; the design, construction/upgrading and operation of disposal facilities. To facilitate the understanding of management system implementation at the different stages of a
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Cost recovery of NGO primary health care facilities: a case study in Bangladesh
Alam, Khurshid; Ahmed, Shakil
2010-01-01
Abstract Background Little is known about the cost recovery of primary health care facilities in Bangladesh. This study estimated the cost recovery of a primary health care facility run by Building Resources Across Community (BRAC), a large NGO in Bangladesh, for the period of July 2004 - June 2005. This health facility is one of the seven upgraded BRAC facilities providing emergency obstetric care and is typical of the government and private primary health care facilities in Bangladesh. Give...
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A spatial national health facility database for public health sector planning in Kenya in 2008
Directory of Open Access Journals (Sweden)
Gething Peter W
2009-03-01
Full Text Available Abstract Background Efforts to tackle the enormous burden of ill-health in low-income countries are hampered by weak health information infrastructures that do not support appropriate planning and resource allocation. For health information systems to function well, a reliable inventory of health service providers is critical. The spatial referencing of service providers to allow their representation in a geographic information system is vital if the full planning potential of such data is to be realized. Methods A disparate series of contemporary lists of health service providers were used to update a public health facility database of Kenya last compiled in 2003. These new lists were derived primarily through the national distribution of antimalarial and antiretroviral commodities since 2006. A combination of methods, including global positioning systems, was used to map service providers. These spatially-referenced data were combined with high-resolution population maps to analyze disparity in geographic access to public health care. Findings The updated 2008 database contained 5,334 public health facilities (67% ministry of health; 28% mission and nongovernmental organizations; 2% local authorities; and 3% employers and other ministries. This represented an overall increase of 1,862 facilities compared to 2003. Most of the additional facilities belonged to the ministry of health (79% and the majority were dispensaries (91%. 93% of the health facilities were spatially referenced, 38% using global positioning systems compared to 21% in 2003. 89% of the population was within 5 km Euclidean distance to a public health facility in 2008 compared to 71% in 2003. Over 80% of the population outside 5 km of public health service providers was in the sparsely settled pastoralist areas of the country. Conclusion We have shown that, with concerted effort, a relatively complete inventory of mapped health services is possible with enormous potential for
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A spatial national health facility database for public health sector planning in Kenya in 2008.
Noor, Abdisalan M; Alegana, Victor A; Gething, Peter W; Snow, Robert W
2009-03-06
Efforts to tackle the enormous burden of ill-health in low-income countries are hampered by weak health information infrastructures that do not support appropriate planning and resource allocation. For health information systems to function well, a reliable inventory of health service providers is critical. The spatial referencing of service providers to allow their representation in a geographic information system is vital if the full planning potential of such data is to be realized. A disparate series of contemporary lists of health service providers were used to update a public health facility database of Kenya last compiled in 2003. These new lists were derived primarily through the national distribution of antimalarial and antiretroviral commodities since 2006. A combination of methods, including global positioning systems, was used to map service providers. These spatially-referenced data were combined with high-resolution population maps to analyze disparity in geographic access to public health care. The updated 2008 database contained 5,334 public health facilities (67% ministry of health; 28% mission and nongovernmental organizations; 2% local authorities; and 3% employers and other ministries). This represented an overall increase of 1,862 facilities compared to 2003. Most of the additional facilities belonged to the ministry of health (79%) and the majority were dispensaries (91%). 93% of the health facilities were spatially referenced, 38% using global positioning systems compared to 21% in 2003. 89% of the population was within 5 km Euclidean distance to a public health facility in 2008 compared to 71% in 2003. Over 80% of the population outside 5 km of public health service providers was in the sparsely settled pastoralist areas of the country. We have shown that, with concerted effort, a relatively complete inventory of mapped health services is possible with enormous potential for improving planning. Expansion in public health care in Kenya has
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Baseline results of the first malaria indicator survey in Iran at the health facility level
Directory of Open Access Journals (Sweden)
Taghizadeh-Asl Rahim
2011-10-01
Full Text Available Abstract Background Malaria continues to be a global public health challenge, particularly in developing countries. Delivery of prompt and effective diagnosis and treatment of malaria cases, detection of malaria epidemics within one week of onset and control them in less than a month, regular disease monitoring and operational classification of malaria are among the major responsibilities of the national malaria programme. The study was conducted to determine these indicators at the different level of primary health care facilities in malaria-affected provinces of Iran Methods In this survey, data was collected from 223 health facilities including health centres, malaria posts, health houses and hospitals as well as the profile of all 5, 836 recorded malaria cases in these facilities during the year preceding the survey. Descriptive statistics (i.e. frequencies, percentages were used to summarize the results and Chi square test was used to analyse data. Results All but one percent of uncomplicated cases took appropriate and correctly-dosed of anti-malarial drugs in accordance to the national treatment guideline. A larger proportion of patients [85.8%; 95% CI: 84.8 - 86.8] were also given complete treatment including anti-relapse course, in line with national guidelines. About one third [35.0%; 95% CI: 33.6 - 36.4] of uncomplicated malaria cases were treated more than 48 hours after first symptoms onset. Correspondingly, half of severe malaria cases took recommended anti-malarial drugs for severe or complicated disease more than 48 hours of onset of first symptoms. The latter cases had given regular anti-malarial drugs promptly. The majority of malaria epidemics [97%; 95% CI: 90.6 - 100] in study areas were detected within one week of onset, but only half of epidemics were controlled within four weeks of detection. Just half of target districts had at least one health facility/emergency site with adequate supply and equipment stocks. Nevertheless
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Quality of the delivery services in health facilities in Northern Ethiopia.
Fisseha, Girmatsion; Berhane, Yemane; Worku, Alemayehu; Terefe, Wondwossen
2017-03-09
Substantial improvements have been observed in the coverage of and access to maternal health service, especially in skilled birth attendants, in Ethiopia. However, the quality of care has been lagging behind. Therefore, this study investigated the status of the quality of delivery services in Northern Ethiopia. A facility based survey was conducted from December 2014 to February 2015 in Northern Ethiopia. The quality of delivery service was assessed in 32 health facilities using a facility audit checklist, by reviewing delivery, by conducting in-depth interview and observation, and by conducting exit interviews with eligible mothers. Facilities were considered as 'good quality' if they scored positively on 75% of the quality indicators set in the national guidelines for all the three components; input (materials, infrastructure, and human resource), process (adherence to standard care procedures during intrapartum and immediate postpartum periods) and output (the mothers' satisfaction and utilization of lifesaving procedures). Overall 2 of 32 (6.3%) of the study facilities fulfilled all the three quality components; input, process and output. Two of the three components were assessed as good in 11 of the 32 (34.4%) health facilities. The input quality was the better of the other quality components; which was good in 21 out of the 32 (65.6%) health facilities. The process and output quality was good in only 10 of the 32 (31.3%) facilities. Only 6.3% of the studied health facilities had good quality in all three dimensions of quality measures that was done in accordance to the national delivery service guidelines. The most compromised quality component was the process. Systematic and sustained efforts need to be strengthened to improve all dimensions of quality in order to achieve the desired quality of delivery services and increase the proportion of births occurring in health facilities.
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The Added Value of Facilities Management: Concepts, Findings and Perspectives
DEFF Research Database (Denmark)
expertise, the involvement in the process leading to this the book including a number of workshops, and a literature review of the development of their disciplinary fields: Facilities Management (FM), Corporate Real Estate Management (CREM) and Business to Business (B2B) Marketing. Findings: The difference...... by their particular theories and conceptual analyses, data, tools, and best practices, with a focus on respectively costs and benefits of facilities and services, alignment of corporate and public real estate to organizational objectives and organisational performance, and relationship management in market...
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25 CFR 170.806 - What is an IRR Transportation Facilities Maintenance Management System?
2010-04-01
... AND WATER INDIAN RESERVATION ROADS PROGRAM BIA Road Maintenance § 170.806 What is an IRR Transportation Facilities Maintenance Management System? An IRR Transportation Facilities Maintenance Management... 25 Indians 1 2010-04-01 2010-04-01 false What is an IRR Transportation Facilities Maintenance...
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Use of fire hazard analysis to cost effectively manage facility modifications
Energy Technology Data Exchange (ETDEWEB)
Krueger, K., E-mail: kkruger@plcfire.com [PLC Fire Safety Solutions, Fredericton, NB (Canada); Cronk, R., E-mail: rcronk@plcfire.com [PLC Fire Safety Solutions, Mississauga, ON (Canada)
2014-07-01
In Canada, licenced Nuclear power facilities, or facilities that process, handle or store nuclear material are required by the Canadian Nuclear Safety Commission to have a change control process in place. These processes are in place to avoid facility modifications that could result in an increase in fire hazards, or degradation of fire protection systems. Change control processes can have a significant impact on budgets associated with plant modifications. A Fire Hazard Analysis (FHA) is also a regulatory requirement for licenced facilities in Canada. An FHA is an extensive evaluation of a facility's construction, nuclear safety systems, fire hazards, and fire protection features. This paper is being presented to outline how computer based data management software can help organize facilities' fire safety information, manage this information, and reduce the costs associated with preparation of FHAs as well as facilities' change control processes. (author)
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41 CFR 102-192.135 - Must we have a mail center manager at our facility?
2010-07-01
... center manager at our facility? 102-192.135 Section 102-192.135 Public Contracts and Property Management... PROGRAMS 192-MAIL MANAGEMENT Mail Center Manager Requirements § 102-192.135 Must we have a mail center manager at our facility? Yes, every facility that has more than two full time people dedicated to...
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Application of the management system for facilities and activities. Safety guide
International Nuclear Information System (INIS)
2006-01-01
This Safety Guide supports the Safety Requirements publication on The Management System for Facilities and Activities. It provides generic guidance to aid in establishing, implementing, assessing and continually improving a management system that complies with the requirements established. In addition to this Safety Guide, there are a number of Safety Guides for specific technical areas. Together these provide all the guidance necessary for implementing these requirements. This publication supersedes Safety Series No. 50-SG-Q1-Q7 (1996). The guidance provided here may be used by organizations in the following ways: - To assist in the development of the management systems of organizations directly responsible for operating facilities and activities and providing services for: Nuclear facilities; Activities using sources of ionizing radiation; Radioactive waste management; The transport of radioactive material; Radiation protection activities; Any other practices or circumstances in which people may be exposed to radiation from naturally occurring or artificial sources; The regulation of such facilities and activities; - To assist in the development of the management systems of the relevant regulatory bodies; - By the operator, to specify to a supplier, via contractual documentation, any guidance of this Safety Guide that should be included in the supplier's management system for the supply and delivery of products
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Occupational Health and Safety Management and Turnover Intention in the Ghanaian Mining Sector.
Amponsah-Tawiah, Kwesi; Ntow, Michael Akomeah Ofori; Mensah, Justice
2016-03-01
The mining industry is considered as one of the most dangerous and hazardous industries and the need for effective and efficient occupational health and safety management is critical to safeguard workers and the industry. Despite the dangers and hazards present in the mining industry, only few studies have focused on how occupational health and safety and turnover intentions in the mines. The study suing a cross-sectional survey design collected quantitative data from the 255 mine workers that were conveniently sampled from the Ghanaian mining industry. The data collection tools were standardized questionnaires that measured occupational health and safety management and turnover intentions. These scales were also pretested before their usage in actual data collection. The correlation coefficient showed that a negative relationship existed between dimensions of occupational health and safety management and turnover intention; safety leadership (r = -0.33, p safety facilities and equipment (r = -0.32, p safety procedure (r = -0.27, p safety leadership and safety facility were significant predictors of turnover intention, (β = -0.28, p safety leadership in ensuring the effective formulation of policies and supervision of occupational health and safety at the workplace. The present study demonstrates that safety leadership is crucial in the administration of occupational health and safety and reducing turnover intention in organizations.
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Directory of Open Access Journals (Sweden)
J Murphy
2013-09-01
Full Text Available Data use and data quality continue to be a challenge for government sector health facilities and districts across South Africa. Led by the National Department of Health, key stakeholders, such as the Anova Health Institute and district health management teams, are aligning efforts to address these gaps. Coverage and correct implementation of existing tools – including TIER.net, routine data collection forms and the South African District Health Information System – must be ensured. This conference report provides an overview of such tools and summarises suggestions for quality improvement, data use and systematic evaluation of data-related interventions.
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Challenges Associated With Managing Suicide Risk in Long-Term Care Facilities.
O'Riley, Alisa; Nadorff, Michael R; Conwell, Yeates; Edelstein, Barry
2013-06-01
Little information about suicidal ideation and behavior in long-term care (LTC) facilities is available. Nonetheless, the implementation of the Minimum Data Set 3.0 requires that LTC facilities screen their residents for suicide risk and have protocols in place to effectively manage residents' responses. In this article, the authors briefly discuss the risk factors of suicide in the elderly and the problems that suicidal ideation and behavior pose in the LTC environment. The authors explain issues that arise when trying to manage suicide risk in the elderly LTC population with general, traditional approaches. These inherent issues make it difficult to develop an effective protocol for managing suicide risk in LTC facilities, leading the authors to propose their own framework for assessing and managing suicide risk in the LTC setting.
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Improving heart failure disease management in skilled nursing facilities: lessons learned.
Dolansky, Mary A; Hitch, Jeanne A; Piña, Ileana L; Boxer, Rebecca S
2013-11-01
The purpose of the study was to design and evaluate an improvement project that implemented HF management in four skilled nursing facilities (SNFs). Kotter's Change Management principles were used to guide the implementation. In addition, half of the facilities had an implementation coach who met with facility staff weekly for 4 months and monthly for 5 months. Weekly and monthly audits were performed that documented compliance with eight key aspects of the protocol. Contextual factors were captured using field notes. Adherence to the HF management protocols was variable ranging from 17% to 82%. Facilitators of implementation included staff who championed the project, an implementation coach, and physician involvement. Barriers were high staff turnover and a hierarchal culture. Opportunities exist to integrate HF management protocols to improve SNF care.
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Patient-driven resource planning of a health care facility evacuation.
Petinaux, Bruno; Yadav, Kabir
2013-04-01
The evacuation of a health care facility is a complex undertaking, especially if done in an immediate fashion, ie, within minutes. Patient factors, such as continuous medical care needs, mobility, and comprehension, will affect the efficiency of the evacuation and translate into evacuation resource needs. Prior evacuation resource estimates are 30 years old. Utilizing a cross-sectional survey of charge nurses of the clinical units in an urban, academic, adult trauma health care facility (HCF), the evacuation needs of hospitalized patients were assessed periodically over a two-year period. Survey data were collected on 2,050 patients. Units with patients having low continuous medical care needs during an emergency evacuation were the postpartum, psychiatry, rehabilitation medicine, surgical, and preoperative anesthesia care units, the Emergency Department, and Labor and Delivery Department (with the exception of patients in Stage II labor). Units with patients having high continuous medical care needs during an evacuation included the neonatal and adult intensive care units, special procedures unit, and operating and post-anesthesia care units. With the exception of the neonate group, 908 (47%) of the patients would be able to walk out of the facility, 492 (25.5%) would require a wheelchair, and 530 (27.5%) would require a stretcher to exit the HCF. A total of 1,639 patients (84.9%) were deemed able to comprehend the need to evacuate and to follow directions; the remainder were sedated, blind, or deaf. The charge nurses also determined that 17 (6.9%) of the 248 adult intensive care unit patients were too ill to survive an evacuation, and that in 10 (16.4%) of the 61 ongoing surgery cases, stopping the case was not considered to be safe. Heath care facilities can utilize the results of this study to model their anticipated resource requirements for an emergency evacuation. This will permit the Incident Management Team to mobilize the necessary resources both within
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Bohomaz, V M; Rymarenko, P V
2014-01-01
In this study we tested methods of facility learning of health care workers as part of a modern model of quality management of medical services. The statistical and qualitative analysis of the effectiveness of additional training in emergency medical care at the health facility using an adapted curriculum and special mannequins. Under the guidance of a certified instructor focus group of 53 doctors and junior medical specialists studied 22 hours. According to a survey of employees trained their level of selfassessment of knowledge and skills sigificantly increased. Also significantly increased the proportion of correct answers in a formalized testing both categories of workers. Using androgological learning model, mannequins simulators and training in small groups at work create the most favorable conditions for effective individual and group practical skills of emergency medicine.
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Development of aging management standard guidelines for HVAC facilities of NPPs in Korea
International Nuclear Information System (INIS)
Won, Se Youl; Lee, Jae Gon; Oh, Seung Jin
2014-01-01
Inspection and maintenance activities for air conditioning facilities within the plant are managed mainly for active facilities, and as the years of operation pass, a method for detecting in advance aging-related integrity problems of passive facilities and taking necessary measures against them is required. Therefore, this paper establishes a standard aging management guideline for air conditioning facilities by selecting systems for which those facilities are to be managed, analyzing degradation mechanisms and reviewing the current status of aging degradation management. According to the review of additional equipment-specific aging degradation mechanisms and the current status of management to apply the aging degradation program to air conditioning facilities, it has been found that internal and external visual inspection procedures for fans, dampers, coils, filters and housings have to be added. It has been confirmed that among additional equipment s, fire dampers, fan bearings and belts and air cleaning/conditioning units with charcoal filters do not require additional inspection as they are periodically inspected. It has been found, however, that air cleaning/conditioning units without charcoal filters are to be inspected along with fans, ducts and coils
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Wasunna, Beatrice; Zurovac, Dejan; Bruce, Jane; Jones, Caroline; Webster, Jayne; Snow, Robert W
2010-09-18
Improving the way artemether-lumefantrine (AL) is provided to patients attending clinics is critical to maximize the benefit of this new medicine. In 2007, a new initiative was launched in one part of Kenya to improve malaria case-management through enhanced in-service training and provision of job aids. An evaluation of the intervention using pre- and post-intervention cross sectional health facility surveys was conducted in Bondo district. The surveys included: audit of government health facilities, health worker structured interviews and exit interviews with caretakers of sick children below five years of age. The outcome indicators were the proportions of febrile children who had AL prescribed, AL dispensed, and four different dispensing and counseling tasks performed. At baseline 33 government health facilities, 48 health workers and 386 febrile child consultations were evaluated. At follow-up the same health facilities were surveyed and 36 health workers and 390 febrile child consultations evaluated. The findings show: 1) no health facility or health worker was exposed to all components of the intervention; 2) the proportion of health workers who received the enhanced in-service training was 67%; 3) the proportion of febrile children with uncomplicated malaria treated with the first-line anti-malarial drug, artemether-lumefantrine (AL), at health facilities where AL was in stock increased from 76.9% (95%CI: 69.4, 83.1) to 87.6% (95% CI: 82.5, 91.5); 4) there were modest but non-significant improvements in dispensing and counseling practices; and 5) when the analyses were restricted to health workers who received the enhanced in-service training and/or had received new guidelines and job aids, no significant improvements in reported case-management tasks were observed compared to baseline. In-service training and provision of job aids alone may not be adequate to improve the prescribing, dispensing and counseling tasks necessary to change malaria case-management
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Directory of Open Access Journals (Sweden)
Bruce Jane
2010-09-01
Full Text Available Abstract Background Improving the way artemether-lumefantrine (AL is provided to patients attending clinics is critical to maximize the benefit of this new medicine. In 2007, a new initiative was launched in one part of Kenya to improve malaria case-management through enhanced in-service training and provision of job aids. Methods An evaluation of the intervention using pre- and post-intervention cross sectional health facility surveys was conducted in Bondo district. The surveys included: audit of government health facilities, health worker structured interviews and exit interviews with caretakers of sick children below five years of age. The outcome indicators were the proportions of febrile children who had AL prescribed, AL dispensed, and four different dispensing and counseling tasks performed. Results At baseline 33 government health facilities, 48 health workers and 386 febrile child consultations were evaluated. At follow-up the same health facilities were surveyed and 36 health workers and 390 febrile child consultations evaluated. The findings show: 1 no health facility or health worker was exposed to all components of the intervention; 2 the proportion of health workers who received the enhanced in-service training was 67%; 3 the proportion of febrile children with uncomplicated malaria treated with the first-line anti-malarial drug, artemether-lumefantrine (AL, at health facilities where AL was in stock increased from 76.9% (95%CI: 69.4, 83.1 to 87.6% (95% CI: 82.5, 91.5; 4 there were modest but non-significant improvements in dispensing and counseling practices; and 5 when the analyses were restricted to health workers who received the enhanced in-service training and/or had received new guidelines and job aids, no significant improvements in reported case-management tasks were observed compared to baseline. Conclusion In-service training and provision of job aids alone may not be adequate to improve the prescribing, dispensing and
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Killaspy, Helen; Cardoso, Graca; White, Sarah; Wright, Christine; Caldas de Almeida, Jose Miguel; Turton, Penny; Taylor, Tatiana L.; Schuetzwohl, Matthias; Schuster, Mirjam; Cervilla, Jorge A.; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Adamowski, Tomasz; Ploumpidis, Dimitris; Gonidakis, Fragiskos; King, Michael
2016-01-01
Background: The Quality Indicator for Rehabilitative Care (QuIRC) is an international, standardised quality tool for the evaluation of mental health facilities that provide longer term care. Completed by the service manager, it comprises 145 items that assess seven domains of care: living
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The strategic facilities management organisation in housing
DEFF Research Database (Denmark)
Nielsen, Susanne Balslev; Jensen, Per Anker; Jensen, Jesper Ole
2012-01-01
implementation of sustainable facilities management in housing administration. The concept provides a frame for understanding the roles and relations of tenants, owners, administrators and operators. The paper is based on a Danish research project on environmentally sound building operation including literature...
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Directory of Open Access Journals (Sweden)
Jeannie Samuel
2016-12-01
Full Text Available Background and objective: Peru's Ministry of Health has made efforts to increase the cultural inclusiveness of maternal health services. In 2005, the Ministry adopted an intercultural birthing policy (IBP that authorizes and encourages the use of culturally acceptable birthing practices in government-run health facilities. However, studies suggest that indigenous women may receive inconsistent benefits from these kinds of policies. This article examines whether a grassroots accountability initiative based on citizen monitoring of local health facilities by indigenous women can help to promote the objectives of the IBP and improve intercultural maternal health care. Design: Findings are drawn from a larger qualitative research study completed in 2015 that included fieldwork done between 2010 and 2011. Semi-structured interviews were conducted with 23 women working as citizen monitors in local health facilities in Puno and 30 key informants, including frontline health workers, health officials, and civil society actors in Puno and Lima, and human rights lawyers from the Defensoría del Pueblo Office in Puno. Results: Monitors confirmed from their own personal experiences in the 1990s and early 2000s that respect for intercultural aspects of maternal health care, including traditional indigenous birthing practices, were not readily accepted in publicly funded health facilities. It was also common for indigenous women to face discrimination when seeking health service provided by the state. Although the government's adoption of the IBP in 2005 was a positive step, considerable efforts are still needed to ensure high-quality, culturally appropriate maternal health care is consistently available in local health facilities. Conclusions: Despite important progress in the past two decades, policies aimed at improving intercultural maternal health care are unevenly implemented in local health facilities. Civil society, in particular indigenous women
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Samuel, Jeannie
2016-01-01
Background and objective Peru's Ministry of Health has made efforts to increase the cultural inclusiveness of maternal health services. In 2005, the Ministry adopted an intercultural birthing policy (IBP) that authorizes and encourages the use of culturally acceptable birthing practices in government-run health facilities. However, studies suggest that indigenous women may receive inconsistent benefits from these kinds of policies. This article examines whether a grassroots accountability initiative based on citizen monitoring of local health facilities by indigenous women can help to promote the objectives of the IBP and improve intercultural maternal health care. Design Findings are drawn from a larger qualitative research study completed in 2015 that included fieldwork done between 2010 and 2011. Semi-structured interviews were conducted with 23 women working as citizen monitors in local health facilities in Puno and 30 key informants, including frontline health workers, health officials, and civil society actors in Puno and Lima, and human rights lawyers from the Defensoría del Pueblo Office in Puno. Results Monitors confirmed from their own personal experiences in the 1990s and early 2000s that respect for intercultural aspects of maternal health care, including traditional indigenous birthing practices, were not readily accepted in publicly funded health facilities. It was also common for indigenous women to face discrimination when seeking health service provided by the state. Although the government's adoption of the IBP in 2005 was a positive step, considerable efforts are still needed to ensure high-quality, culturally appropriate maternal health care is consistently available in local health facilities. Conclusions Despite important progress in the past two decades, policies aimed at improving intercultural maternal health care are unevenly implemented in local health facilities. Civil society, in particular indigenous women themselves, can play an
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Energy Technology Data Exchange (ETDEWEB)
Lisa Harvego; Brion Bennett
2011-09-01
Department of Energy Order 435.1, 'Radioactive Waste Management,' along with its associated manual and guidance, requires development and maintenance of a radioactive waste management basis for each radioactive waste management facility, operation, and activity. This document presents a radioactive waste management basis for Idaho National Laboratory's Materials and Fuels Complex facilities that manage radioactive waste. The radioactive waste management basis for a facility comprises existing laboratory-wide and facility-specific documents. Department of Energy Manual 435.1-1, 'Radioactive Waste Management Manual,' facility compliance tables also are presented for the facilities. The tables serve as a tool for developing the radioactive waste management basis.
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International Nuclear Information System (INIS)
Harvego, Lisa; Bennett, Brion
2011-01-01
Department of Energy Order 435.1, 'Radioactive Waste Management,' along with its associated manual and guidance, requires development and maintenance of a radioactive waste management basis for each radioactive waste management facility, operation, and activity. This document presents a radioactive waste management basis for Idaho National Laboratory's Materials and Fuels Complex facilities that manage radioactive waste. The radioactive waste management basis for a facility comprises existing laboratory-wide and facility-specific documents. Department of Energy Manual 435.1-1, 'Radioactive Waste Management Manual,' facility compliance tables also are presented for the facilities. The tables serve as a tool for developing the radioactive waste management basis.
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van Wijk, Evalina; Traut, Annalene; Julie, Hester
2014-08-14
Aggressive and violent behaviour of inpatients in mental health facilities disrupts the therapeutic alliance and hampers treatment. The aim of the study was to describe patients' perceptions of the possible environmental and staff factors that might contribute to their aggressive and violent behaviour after admission to a mental health facility; and to propose strategies to prevent and manage such behaviour. A qualitative, phenomenological study was utilised, in which purposefully sampled inpatients were interviewed over a six-month period. Inpatients were invited to participate if they had been admitted for at least seven days and were in touch with reality. Forty inpatients in two mental health facilities in Cape Town participated in face-to-face, semi-structured interviews over a period of six months. Tesch's descriptive method of open coding formed the framework for the data analysis and presentation of the results. Trustworthiness was ensured in accordance with the principles of credibility, confirmability, transferability and dependability. Analysis of the data indicates two central categories in the factors contributing to patients' aggressive and violent behaviour, namely, environmental factors and the attitude and behaviour of staff. From the perspective of the inpatients included in this study, aggressive and violent episodes are common and require intervention. Specific strategies for preventing such behaviour are proposed and it is recommended that these strategies be incorporated into the in-service training programmes of the staff of mental health facilities. These strategies could prevent, or reduce, aggressive and violent behaviour in in-patient facilities.
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Pollution prevention opportunity assessment for the SNL/California waste management facilities
International Nuclear Information System (INIS)
Braye, S.; Phillips, N.M.
1995-01-01
SNL/California's waste management facilities, Bldgs. 961 and 962-2, generate a secondary stream of hazardous and radioactive waste. This waste stream is generated mainly during the processing and handling of hazardous, radioactive, and mixed wastes (primary waste stream), which are generated by the laboratories, and when cleaning up spills. The secondary waste stream begins with the removal of a generator's hazardous, radioactive, and mixed waste from specified collection areas. The waste stream ends when the containers of processed waste are loaded for shipment off-site. The total amount of secondary hazardous waste generated in the waste management facilities from January 1993 to July 1994 was 1,160.6 kg. The total amount of secondary radioactive waste generated during the same period was 1,528.8 kg (with an activity of 0.070 mCi). Mixed waste usually is not generated in the secondary waste stream. This pollution prevention opportunity assessment (PPOA) was conducted using the graded approach methodology developed by the Department of Energy (DOE) PPOA task group. The original method was modified to accommodate the needs of Sandia's site-specific processes. The options generated for potential hazardous waste minimization, cost savings, and environmental health and safety were the result of a waste minimization team effort. The results of the team efforts are summarized
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Kinnevey, Christina; Kawooya, Michael; Tumwesigye, Tonny; Douglas, David; Sams, Sarah
2016-01-01
Like much of Sub-Saharan Africa, Uganda is facing significant maternal and fetal health challenges. Despite the fact that the majority of the Uganda population is rural and the major obstetrical care provider is the midwife, there is a lack of data in the literature regarding rural health facilities' and midwives' knowledge of ultrasound technology and perspectives on important maternal health issues such as deficiencies in prenatal services. A survey of the current antenatal diagnostic and management capabilities of midwives at 12 rural Ugandan health facilities was performed as part of an international program initiated to provide ultrasound machines and formal training in their use to midwives at antenatal care clinics. The survey revealed that the majority of pregnant women attend less than the recommended minimum of four antenatal care visits. There were significant knowledge deficits in many prenatal conditions that require ultrasound for early diagnosis, such as placenta previa and macrosomia. The cost of providing ultrasound machines and formal training to 12 midwives was $6,888 per powered rural health facility and $8,288 for non-powered rural health facilities in which solar power was required to maintain ultrasound. In order to more successfully meet Millennium Development Goal 4 (reduce child mortality), 5 (improve maternal health) and 6 (combat HIV) through decreasing maternal to child transmission of HIV, the primary healthcare provider, which is the midwife in Uganda, must be competent at the diagnosis and management of a wide spectrum of obstetrical challenges. A trained ultrasound-based approach to obstetrical care is a cost effective method to take on these goals.
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Wahid, Fathul; Teduh Dirgahayu, Raden; Hamzah, Almed; Setiaji, Hari
2018-03-01
The clear majority of previous studies have found that the absence of information systems to properly manage data is one of the main challenges in improving public health management. The present study offers an alternate perspective, revealing other emerging problems in cases where there are many information systems in place but without sufficient orchestration. The national government of Indonesia has been coercive in its implementation of various information systems without involving users at public health facilities, which has created many problems on the ground. The problems identified relate to the quality of the disconnected information systems currently in use, the lack of human resource development, unclear procedures, uncoordinated reports and the absence of an incentive scheme. The present study also highlights some practical implications, including the use of a more holistic perspective in designing and developing an integrated public health information infrastructure.
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Referral of children seeking care at private health facilities in Uganda
DEFF Research Database (Denmark)
Mbonye, Anthony K.; Buregyeya, Esther; Rutebemberwa, Elizeus
2017-01-01
Background In Uganda, referral of sick children seeking care at public health facilities is poor and widely reported. However, studies focusing on the private health sector are scanty. The main objective of this study was to assess referral practices for sick children seeking care at private health...... facilities in order to explore ways of improving treatment and referral of sick children in this sector. Methods A survey was conducted from August to October 2014 in Mukono district, central Uganda. Data was collected using a structured questionnaire supplemented by Focus Group Discussions and Key Informant...... interviews with private providers and community members. Results A total of 241 private health facilities were surveyed; 170 (70.5%) were registered drug shops, 59 (24.5%) private clinics and 12 (5.0%) pharmacies. Overall, 104/241 (43.2%) of the private health facilities reported that they had referred sick...
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75 FR 54627 - Best Management Practices for Unused Pharmaceuticals at Health Care Facilities
2010-09-08
... at very low concentrations. EPA has been studying unused pharmaceutical disposal practices at health... avoiding pharmaceutical waste; Practices for identifying and managing types of unused pharmaceuticals; and...: September 1, 2010. Ephraim S. King, Director, Office of Science and Technology. [FR Doc. 2010-22325 Filed 9...
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A Supply Chain Design Problem Integrated Facility Unavailabilities Management
Directory of Open Access Journals (Sweden)
Fouad Maliki
2016-08-01
Full Text Available A supply chain is a set of facilities connected together in order to provide products to customers. The supply chain is subject to random failures caused by different factors which cause the unavailability of some sites. Given the current economic context, the management of these unavailabilities is becoming a strategic choice to ensure the desired reliability and availability levels of the different supply chain facilities. In this work, we treat two problems related to the field of supply chain, namely the design and unavailabilities management of logistics facilities. Specifically, we consider a stochastic distribution network with consideration of suppliers' selection, distribution centres location (DCs decisions and DCs’ unavailabilities management. Two resolution approaches are proposed. The first approach called non-integrated consists on define the optimal supply chain structure using an optimization approach based on genetic algorithms (GA, then to simulate the supply chain performance with the presence of DCs failures. The second approach called integrated approach is to consider the design of the supply chain problem and unavailabilities management of DCs in the same model. Note that, we replace each unavailable DC by performing a reallocation using GA in the two approaches. The obtained results of the two approaches are detailed and compared showing their effectiveness.
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Managing Human Performance to Improve Nuclear Facility Operation
International Nuclear Information System (INIS)
2013-01-01
One of the IAEA's statutory objectives is to 'seek to accelerate and enlarge the contribution of atomic energy to peace, health and prosperity throughout the world.' One way this objective is achieved is through the publication of a range of technical series. Two of these are the IAEA Nuclear Energy Series and the IAEA Safety Standards Series. According to Article III.A.6 of the IAEA Statute, the safety standards establish 'standards of safety for protection of health and minimization of danger to life and property'. The safety standards include the Safety Fundamentals, Safety Requirements and Safety Guides. These standards are written primarily in a regulatory style, and are binding on the IAEA for its own programmes. The principal users are the regulatory bodies in Member States and other national authorities. The IAEA Nuclear Energy Series comprises reports designed to encourage and assist R and D on, and application of, nuclear energy for peaceful uses. This includes practical examples to be used by owners and operators of utilities in Member States, implementing organizations, academia, and government officials, among others. This information is presented in guides, reports on technology status and advances, and best practices for peaceful uses of nuclear energy based on inputs from international experts. The IAEA Nuclear Energy Series complements the IAEA Safety Standards Series. IAEA Nuclear Energy Series No. NG-G-2.1, Managing Human Resources in the Field of Nuclear Energy, was published in 2009. In that publication, four interrelated objectives of the management of human resources were identified and discussed: ensuring that nuclear industry personnel have the necessary competence for their jobs; effectively organizing work activities; anticipating human resource needs; and monitoring and continually improving performance. This publication addresses the fourth objective and, in particular, summarizes good practices in the area of managing human performance
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A Framework for Managing Core Facilities within the Research Enterprise
Haley, Rand
2009-01-01
Core facilities represent increasingly important operational and strategic components of institutions' research enterprises, especially in biomolecular science and engineering disciplines. With this realization, many research institutions are placing more attention on effectively managing core facilities within the research enterprise. A framework is presented for organizing the questions, challenges, and opportunities facing core facilities and the academic units and institutions in which th...
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Conceptual development of a test facility for spent fuel management
Energy Technology Data Exchange (ETDEWEB)
Park, S.W.; Lee, H.H.; Lee, J.Y.; Lee, J.S.; Ro, S.G. [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)
1997-12-31
Spent fuel management is an important issue for nuclear power program, requiring careful planning and implementation. With the wait-and-see policy on spent fuel management in Korea, research efforts are directed at KAERI to develop advanced technologies for safer and more efficient management of the accumulating spent fuels. In support of these research perspectives, a test facility of pilot scale is being developed with provisions for integral demonstration of a multitude of technical functions required for spent fuel management. The facility, baptized SMART (Spent fuel MAnagement technology Research and Test facility), is to be capable of handling full size assembly of spent PWR fuel (as well as CANDU fuel) with a maximum capacity of 10 MTU/y (about 24 assemblies of PWR type). Major functions of the facility are consolidation of spent PWR fuel assembly into a half-volume package and optionally transformation of the fuel rod into a fuel of CANDU type (called DUPIC). Objectives of these functions are to demonstrate volume reduction of spent fuel (for either longer-term dry storage or direct disposal ) in the former case and direct refabrication of the spent PWR fuel into CANDU-type DUPIC fuel for reuse in CANDU reactors in the latter case, respectively. In addition to these major functions, there are other associated technologies to be demonstrated : such as waste treatment, remote maintenance, safeguards, etc. As the facility is to demonstrate not only the functional processes but also the safety and efficiency of the test operations, engineering criteria equivalent to industrial standards are incorporated in the design concept. The hot cell structure enclosing the radioactive materials is configured in such way to maximize costs within the given functional and operational requirements. (author). 3 tabs., 4 figs.
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Conceptual development of a test facility for spent fuel management
International Nuclear Information System (INIS)
Park, S.W.; Lee, H.H.; Lee, J.Y.; Lee, J.S.; Ro, S.G.
1997-01-01
Spent fuel management is an important issue for nuclear power program, requiring careful planning and implementation. With the wait-and-see policy on spent fuel management in Korea, research efforts are directed at KAERI to develop advanced technologies for safer and more efficient management of the accumulating spent fuels. In support of these research perspectives, a test facility of pilot scale is being developed with provisions for integral demonstration of a multitude of technical functions required for spent fuel management. The facility, baptized SMART (Spent fuel MAnagement technology Research and Test facility), is to be capable of handling full size assembly of spent PWR fuel (as well as CANDU fuel) with a maximum capacity of 10 MTU/y (about 24 assemblies of PWR type). Major functions of the facility are consolidation of spent PWR fuel assembly into a half-volume package and optionally transformation of the fuel rod into a fuel of CANDU type (called DUPIC). Objectives of these functions are to demonstrate volume reduction of spent fuel (for either longer-term dry storage or direct disposal ) in the former case and direct refabrication of the spent PWR fuel into CANDU-type DUPIC fuel for reuse in CANDU reactors in the latter case, respectively. In addition to these major functions, there are other associated technologies to be demonstrated : such as waste treatment, remote maintenance, safeguards, etc. As the facility is to demonstrate not only the functional processes but also the safety and efficiency of the test operations, engineering criteria equivalent to industrial standards are incorporated in the design concept. The hot cell structure enclosing the radioactive materials is configured in such way to maximize costs within the given functional and operational requirements. (author). 3 tabs., 4 figs
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OPP og indkøb af Facilities Management ydelser
DEFF Research Database (Denmark)
Kristiansen, Kristian
Dette er den 3. og sidste rapport i forskningsprojektet om OPP og indkøb af Facilities Management ydelser. Fokus er denne gang rettet mod bestræbelserne på at skabe større integration i byggeprocessen. Det vil blive undersøgt, hvorvidt sådanne bestræbelser – som der kan findes eksempler på både i...... UK og i Danmark – vil kunne fremme en inddragelse af Facilities Management viden i planlægning, projektering og udførelse. Denne problemstilling skal ses i forlængelse af det forudgående arbejde i forskningsprojektet....
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Eidhammer, Gunnar; Fluttert, Frans A J; Bjørkly, Stål
2014-10-01
To examine empirical literature on user involvement in collaboration between patients and nurses. The scope of the review was limited to structured violence risk management interventions in forensic mental health settings. Violence in forensic mental health settings represents a significant problem for patients and staff. Structured violence risk management interventions in forensic mental health have been reported to ignore patient participation, despite the growing attention on user involvement in clinical practice. A systematic review. Searches were conducted in six databases: the Cochrane Systematic Reviews, MEDLINE, CINAHL, ProQuest, ScienceDirect and PsycINFO. Papers were assessed according to a predetermined set of inclusion and exclusion criteria. After searches of the reference lists of retrieved articles were conducted, only three papers met the inclusion criteria. This review has shown that empirical research on the topic of risk management interventions in which patients are involved is scarce. There is barely any research evidence of the clinical effect of user involvement approaches on violence risk management in forensic mental health practice. Therefore, we suggest that clinicians may learn from positive experiences concerning user involvement in general psychiatry and carefully adapt and test them out in the forensic treatment context. © 2014 John Wiley & Sons Ltd.
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Directory of Open Access Journals (Sweden)
Muhammad Ashraf Majrooh
Full Text Available BACKGROUND: Antenatal care is a very important component of maternal health services. It provides the opportunity to learn about risks associated with pregnancy and guides to plan the place of deliveries thereby preventing maternal and infant morbidity and mortality. In 'Pakistan' antenatal services to rural population are being provided through a network of primary health care facilities designated as 'Basic Health Units and Rural Health Centers. Pakistan is a developing country, consisting of four provinces and federally administered areas. Each province is administratively subdivided in to 'Divisions' and 'Districts'. By population 'Punjab' is the largest province of Pakistan having 36 districts. This study was conducted to assess the coverage and quality antenatal care in the primary health care facilities in 'Punjab' province of 'Pakistan'. METHODS: Quantitative and Qualitative methods were used to collect data. Using multistage sampling technique nine out of thirty six districts were selected and 19 primary health care facilities of public sector (seventeen Basic Health Units and two Rural Health Centers were randomly selected from each district. Focus group discussions and in-depth interviews were conducted with clients, providers and health managers. RESULTS: The overall enrollment for antenatal checkup was 55.9% and drop out was 32.9% in subsequent visits. The quality of services regarding assessment, treatment and counseling was extremely poor. The reasons for low coverage and quality were the distant location of facilities, deficiency of facility resources, indifferent attitude and non availability of the staff. Moreover, lack of client awareness about importance of antenatal care and self empowerment for decision making to seek care were also responsible for low coverage. CONCLUSION: The coverage and quality of the antenatal care services in 'Punjab' are extremely compromised. Only half of the expected pregnancies are enrolled and
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202-S Hexone Facility supplemental information to the Hanford Facility Contingency Plan
International Nuclear Information System (INIS)
Ingle, S.J.
1996-03-01
This document is a unit-specific contingency plan for the 202-S Hexone Facility and is intended to be used as a supplement to the Hanford Facility Contingency Plan. This unit-specific plan is to be used to demonstrate compliance with the contingency plan requirements of WAC 173-303 for certain Resource Conservation and Recovery Act of 1976 (RCRA) waste management units. The 202-S Hexone Facility is not used to process radioactive or nonradioactive hazardous material. Radioactive, dangerous waste material is contained in two underground storage tanks, 276-S-141 and 276-S-142. These tanks do not present a significant hazard to adjacent facilities, personnel, or the environment. Currently, dangerous waste management activities are not being applied at the tanks. It is unlikely that any incidents presenting hazards to public health or the environment would occur at the 202-S Hexone Facility
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Manthalu, Gerald; Yi, Deokhee; Farrar, Shelley; Nkhoma, Dominic
2016-11-01
The Government of Malawi has signed contracts called service level agreements (SLAs) with mission health facilities in order to exempt their catchment populations from paying user fees. Government in turn reimburses the facilities for the services that they provide. SLAs started in 2006 with 28 out of 165 mission health facilities and increased to 74 in 2015. Most SLAs cover only maternal, neonatal and in some cases child health services due to limited resources. This study evaluated the effect of user fee exemption on the utilization of maternal health services. The difference-in-differences approach was combined with propensity score matching to evaluate the causal effect of user fee exemption. The gradual uptake of the policy provided a natural experiment with treated and control health facilities. A second control group, patients seeking non-maternal health care at CHAM health facilities with SLAs, was used to check the robustness of the results obtained using the primary control group. Health facility level panel data for 142 mission health facilities from 2003 to 2010 were used. User fee exemption led to a 15% (P fee exemption is an important policy for increasing maternal health care utilization. For certain maternal services, however, other determinants may be more important. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
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Hospital-acquired infections in a Nigerian tertiary health facility: An ...
African Journals Online (AJOL)
Hospital-acquired infections in a Nigerian tertiary health facility: An audit of surveillance reports. ... This study evaluated the occurrence of HAI in a foremost tertiary health facility over a 5-year period for the purpose of reinforcing control efforts. Materials and Methods: A retrospective survey of records from the infection control ...
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PIMS sequencing extension: a laboratory information management system for DNA sequencing facilities
Directory of Open Access Journals (Sweden)
Baldwin Stephen A
2011-03-01
Full Text Available Abstract Background Facilities that provide a service for DNA sequencing typically support large numbers of users and experiment types. The cost of services is often reduced by the use of liquid handling robots but the efficiency of such facilities is hampered because the software for such robots does not usually integrate well with the systems that run the sequencing machines. Accordingly, there is a need for software systems capable of integrating different robotic systems and managing sample information for DNA sequencing services. In this paper, we describe an extension to the Protein Information Management System (PIMS that is designed for DNA sequencing facilities. The new version of PIMS has a user-friendly web interface and integrates all aspects of the sequencing process, including sample submission, handling and tracking, together with capture and management of the data. Results The PIMS sequencing extension has been in production since July 2009 at the University of Leeds DNA Sequencing Facility. It has completely replaced manual data handling and simplified the tasks of data management and user communication. Samples from 45 groups have been processed with an average throughput of 10000 samples per month. The current version of the PIMS sequencing extension works with Applied Biosystems 3130XL 96-well plate sequencer and MWG 4204 or Aviso Theonyx liquid handling robots, but is readily adaptable for use with other combinations of robots. Conclusions PIMS has been extended to provide a user-friendly and integrated data management solution for DNA sequencing facilities that is accessed through a normal web browser and allows simultaneous access by multiple users as well as facility managers. The system integrates sequencing and liquid handling robots, manages the data flow, and provides remote access to the sequencing results. The software is freely available, for academic users, from http://www.pims-lims.org/.
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PIMS sequencing extension: a laboratory information management system for DNA sequencing facilities.
Troshin, Peter V; Postis, Vincent Lg; Ashworth, Denise; Baldwin, Stephen A; McPherson, Michael J; Barton, Geoffrey J
2011-03-07
Facilities that provide a service for DNA sequencing typically support large numbers of users and experiment types. The cost of services is often reduced by the use of liquid handling robots but the efficiency of such facilities is hampered because the software for such robots does not usually integrate well with the systems that run the sequencing machines. Accordingly, there is a need for software systems capable of integrating different robotic systems and managing sample information for DNA sequencing services. In this paper, we describe an extension to the Protein Information Management System (PIMS) that is designed for DNA sequencing facilities. The new version of PIMS has a user-friendly web interface and integrates all aspects of the sequencing process, including sample submission, handling and tracking, together with capture and management of the data. The PIMS sequencing extension has been in production since July 2009 at the University of Leeds DNA Sequencing Facility. It has completely replaced manual data handling and simplified the tasks of data management and user communication. Samples from 45 groups have been processed with an average throughput of 10000 samples per month. The current version of the PIMS sequencing extension works with Applied Biosystems 3130XL 96-well plate sequencer and MWG 4204 or Aviso Theonyx liquid handling robots, but is readily adaptable for use with other combinations of robots. PIMS has been extended to provide a user-friendly and integrated data management solution for DNA sequencing facilities that is accessed through a normal web browser and allows simultaneous access by multiple users as well as facility managers. The system integrates sequencing and liquid handling robots, manages the data flow, and provides remote access to the sequencing results. The software is freely available, for academic users, from http://www.pims-lims.org/.
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Newcomer, Robert J; Ko, Michelle; Kang, Taewoon; Harrington, Charlene; Hulett, Denis; Bindman, Andrew B
2016-03-01
Individuals who receive long-term services and supports (LTSS) are among the most costly participants in the Medicare and Medicaid programs. To compare health care expenditures among users of Medicaid home and community-based services (HCBS) versus those using extended nursing facility care. Retrospective cohort analysis of California dually eligible adult Medicaid and Medicare beneficiaries who initiated Medicaid LTSS, identified as HCBS or extended nursing facility care, in 2006 or 2007. Propensity score matching for demographic, health, and functional characteristics resulted in a subsample of 34,660 users who initiated Medicaid HCBS versus extended nursing facility use. Those with developmental disabilities or in managed care plans were excluded. Average monthly adjusted acute, postacute, long-term, and total Medicare and Medicaid expenditures for the 12 months following initiation of either HCBS or extended nursing facility care. Those initiating extended nursing facility care had, on average, $2919 higher adjusted total health care expenditures per month compared with those who initiated HCBS. The difference was primarily attributable to spending on LTSS $2855. On average, the monthly LTSS expenditures were higher for Medicare $1501 and for Medicaid $1344 when LTSS was provided in a nursing facility rather than in the community. The higher cost of delivering LTSS in a nursing facility rather than in the community was not offset by lower acute and postacute spending. Medicare and Medicaid contribute similar amounts to the LTSS cost difference and both could benefit financially by redirecting care from institutions to the community.
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Facilities management innovation in public-private collaborations: Danish ESCO projects
DEFF Research Database (Denmark)
Nardelli, Giulia; Jensen, Jesper Ole; Nielsen, Susanne Balslev
2015-01-01
The purpose of the article is to investigate how Facilities Management (FM) units navigate Energy Service Company (ESCO) collaborations, here defined as examples of public collaborative innovation within the context of FM. The driving motivation is to inform and inspire internal FM units of local...... institutions on how to navigate and manage collaboration of different, intra- and inter-organisational actors throughout ESCO projects.......The purpose of the article is to investigate how Facilities Management (FM) units navigate Energy Service Company (ESCO) collaborations, here defined as examples of public collaborative innovation within the context of FM. The driving motivation is to inform and inspire internal FM units of local...
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Tailings management best practice: a case study of the McClean Lake JEB Tailings Management Facility
International Nuclear Information System (INIS)
Tremblay, M.A.J.; Rowson, J.
2005-01-01
COGEMA Resources Inc. (which is part of the Areva Group) is a Canadian company with its head office in Saskatoon, Saskatchewan. It owns and operates mining and milling facilities in Northern Saskatchewan, which produce uranium concentrate. McClean Lake Operation commenced production in 1999 and its tailings management facility represents the state of the art for tailings management in the uranium industry in Canada. Tailings disposal has the potential to cause effects in the surrounding receiving environment primarily through migration of soluble constituents from the facility to surface water receptors. In-pit disposal or mill tailings has become the standard in the uranium mining industry in Northern Saskatchewan. This method or tailings management demonstrates advances in terms of worker radiation protection and containment of soluble constituents both during operations and into the long term. Sub-aqueous deposition of tailings protects personnel from exposure to radiation and airborne emissions and prevents freezing of tailings, which can hinder consolidation. The continuous inflow of groundwater to the facility is achieved during operations, through control of water levels within the facility. This ensures hydrodynamic containment, which prevents migration of soluble radionuclides and heavy metals into the surrounding aquifer during operations. The environmental performance of the decommissioned facility depends upon the rate of release of contaminants to the receiving environment. The rate of constituent loading to the receiving environment will ultimately be governed by the concentrations of soluble constituents within the tailings mass, the mechanisms for release from the tailings to the surrounding groundwater system, and transport of constituents within the groundwater pathway to the receiving environment. The tailings preparation process was designed to convert arsenic into a stable form to reduce soluble concentrations within the tailings mass. The
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Spatial Distribution and Accessibility of Health Facilities in Akwa ...
African Journals Online (AJOL)
This paper therefore analyzed the spatial patterns of healthcare facilities in Akwa ... Data on six health indicator variables were obtained and analyzed to assess ... of healthcare facilities and thus hinders good access to high quality healthcare ...
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Health physics manual of good practices for accelerator facilities
International Nuclear Information System (INIS)
Casey, W.R.; Miller, A.J.; McCaslin, J.B.; Coulson, L.V.
1988-04-01
It is hoped that this manual will serve both as a teaching aid as well as a useful adjunct for program development. In the context of application, this manual addresses good practices that should be observed by management, staff, and designers since the achievement of a good radiation program indeed involves a combined effort. Ultimately, radiation safety and good work practices become the personal responsibility of the individual. The practices presented in this manual are not to be construed as mandatory rather they are to be used as appropriate for the specific case in the interest of radiation safety. As experience is accrued and new data obtained in the application of this document, ONS will update the guidance to assure that at any given time the guidance reflects optimum performance consistent with current technology and practice.The intent of this guide therefore is to: define common health physics problems at accelerators; recommend suitable methods of identifying, evaluating, and managing accelerator health physics problems; set out the established safety practices at DOE accelerators that have been arrived at by consensus and, where consensus has not yet been reached, give examples of safe practices; introduce the technical literature in the accelerator health physics field; and supplement the regulatory documents listed in Appendix D. Many accelerator health physics problems are no different than those at other kinds of facilities, e.g., ALARA philosophy, instrument calibration, etc. These problems are touched on very lightly or not at all. Similarly, this document does not cover other hazards such as electrical shock, toxic materials, etc. This does not in any way imply that these problems are not serious. 160 refs
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International Nuclear Information System (INIS)
Dionne, B.J.; Morris, S. III; Baum, J.W.
1998-03-01
The Department of Energy's (DOE) Office of Environment, Safety, and Health (EH) sought examples of risk-based approaches to environmental restoration to include in their guidance for DOE nuclear facilities. Extensive measurements of radiological contamination in soil and ground water have been made at Brookhaven National Laboratory's Hazardous Waste Management Facility (HWMF) as part of a Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) remediation process. This provided an ideal opportunity for a case study. This report provides a risk assessment and an open-quotes As Low as Reasonably Achievableclose quotes (ALARA) analysis for use at other DOE nuclear facilities as an example of a risk-based decision technique
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History of health studies around nuclear facilities: a methodologival consideration
International Nuclear Information System (INIS)
Tokuhata, G.K.; Smith, M.W.
1981-01-01
A brief historical review was made of low-level radiation studies for general populations living around nuclear facilities. In addition, technical and methodological problems were identified and discussed which often arise in all epidemiological studies designed to determine the possible health effects of low-level radiation released from nuclear facilities. Need for extremely large populations for prospective cancer studies was discussed, but accompanying ascertainment difficulties were also emphasized. More epidemiological studies are needed to provide adequate assessment of the potential health hazards of nuclear facilities
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Weiner, Bryan J; Haynes-Maslow, Lindsey; Kahwati, Leila C; Kinsinger, Linda S; Campbell, Marci K
2012-01-01
One-third of US veterans receiving care at Veterans Health Administration (VHA) medical facilities are obese and, therefore, at higher risk for developing multiple chronic diseases. To address this problem, the VHA designed and nationally disseminated an evidence-based weight-management program (MOVE!). The objective of this study was to examine the organizational factors that aided or inhibited the implementation of MOVE! in 10 VHA medical facilities. Using a multiple, holistic case study design, we conducted 68 interviews with medical center program coordinators, physicians formally appointed as program champions, managers directly responsible for overseeing the program, clinicians from the program's multidisciplinary team, and primary care physicians identified by program coordinators as local opinion leaders. Qualitative data analysis involved coding, memorandum writing, and construction of data displays. Organizational readiness for change and having an innovation champion were most consistently the 2 factors associated with MOVE! implementation. Other organizational factors, such as management support and resource availability, were barriers to implementation or exerted mixed effects on implementation. Barriers did not prevent facilities from implementing MOVE! However, they were obstacles that had to be overcome, worked around, or accepted as limits on the program's scope or scale. Policy-directed implementation of clinical weight-management programs in health care facilities is challenging, especially when no new resources are available. Instituting powerful, mutually reinforcing organizational policies and practices may be necessary for consistent, high-quality implementation.
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LDS hospital, a facility of Intermountain Health Care, Salt Lake City, Utah.
Peck, M; Nelson, N; Buxton, R; Bushnell, J; Dahle, M; Rosebrock, B; Ashton, C A
1997-01-01
On-line documentation by nurses and a comprehensive text management system are functional in several facilities of intermountain Health Care (IHC). The following articles detail factors in the design and implementation of this computerized network as experienced at LDS Hospital, part of the IHC system. Areas discussed are the system's applications for medical decision support, communication, patient classification, nurse staffing versus cost, emergency department usage, patient problem/event recording, clinical outcomes, and text publication. Users express satisfaction with the time saving, consistency of reporting, and cohesiveness of these applications.
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Larsen, David A; Winters, Anna; Cheelo, Sanford; Hamainza, Busiku; Kamuliwo, Mulakwa; Miller, John M; Bridges, Daniel J
2017-11-02
Malaria is a significant burden to health systems and is responsible for a large proportion of outpatient cases at health facilities in endemic regions. The scale-up of community management of malaria and reactive case detection likely affect both malaria cases and outpatient attendance at health facilities. Using health management information data from 2012 to 2013 this article examines health trends before and after the training of volunteer community health workers to test and treat malaria cases in Southern Province, Zambia. An estimated 50% increase in monthly reported malaria infections was found when community health workers were involved with malaria testing and treating in the community (incidence rate ratio 1.52, p malaria testing and treating in the community. These results suggest a large public health benefit to both community case management of malaria and reactive case detection. First, the capacity of the malaria surveillance system to identify malaria infections was increased by nearly one-third. Second, the outpatient attendance at health facilities was modestly decreased. Expanding the capacity of the malaria surveillance programme through systems such as community case management and reactive case detection is an important step toward malaria elimination.
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Steps for safety. Radioactive waste management facilities and Y2K
International Nuclear Information System (INIS)
Warnecke, E.
1999-01-01
As part of the IAEA activities concerned with Year 2000 (Y2K) problem special attention is paid to operation of radioactive waste management facilities although, fortunately, in the management of radioactive materials the response of a process or activity to a failure would be slow in many instance, providing more time to resolve the issue before any radiological consequences occur. To facilitate greater cooperation, the IAEA organized an international workshop on the exchange of information concerning safety measure to address the Y2K issues on radioactive waste management and nuclear fuel cycle facilities
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The Mixed Waste Management Facility. Preliminary design review
International Nuclear Information System (INIS)
1995-01-01
This document presents information about the Mixed Waste Management Facility. Topics discussed include: cost and schedule baseline for the completion of the project; evaluation of alternative options; transportation of radioactive wastes to the facility; capital risk associated with incineration; radioactive waste processing; scaling of the pilot-scale system; waste streams to be processed; molten salt oxidation; feed preparation; initial operation to demonstrate selected technologies; floorplans; baseline revisions; preliminary design baseline; cost reduction; and project mission and milestones
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Mixed Waste Management Facility
International Nuclear Information System (INIS)
Brummond, W.; Celeste, J.; Steenhoven, J.
1993-08-01
The DOE has developed a National Mixed Waste Strategic Plan which calls for the construction of 2 to 9 mixed waste treatment centers in the Complex in the near future. LLNL is working to establish an integrated mixed waste technology development and demonstration system facility, the Mixed Waste Management Facility (MWMF), to support the DOE National Mixed Waste Strategic Plan. The MWMF will develop, demonstrate, test, and evaluate incinerator-alternatives which will comply with regulations governing the treatment and disposal of organic mixed wastes. LLNL will provide the DOE with engineering data for design and operation of new technologies which can be implemented in their mixed waste treatment centers. MWMF will operate under real production plant conditions and process samples of real LLNL mixed waste. In addition to the destruction of organic mixed wastes, the development and demonstration will include waste feed preparation, material transport systems, aqueous treatment, off-gas treatment, and final forms, thus making it an integrated ''cradle to grave'' demonstration. Technologies from offsite as well as LLNL's will be tested and evaluated when they are ready for a pilot scale demonstration, according to the needs of the DOE
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Primary health care facility infrastructure and services and the ...
African Journals Online (AJOL)
... Research Council ae Currently from Cape Peninsula University of Technology ... Keywords: primary health care facilities; nutritional status; children; caregivers' rural; South Africa ... underlying causes of malnutrition in children, while poor food quality, .... Information on PHC facility infrastructure and services was obtained.
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Mahan, Bruce; Maclin, Reggie; Ruttenberg, Ruth; Mundy, Keith; Frazee, Tom; Schwartzkopf, Randy; Morawetz, John
2018-01-01
This study of Afton Chemical Corporation's Sauget facility and its International Chemical Workers Union Council (ICWUC) Local 871C demonstrates how significant safety improvements can be made when committed leadership from both management and union work together, build trust, train the entire work force in U.S. Occupational Safety and Health Administration 10-hour classes, and communicate with their work force, both salaried and hourly. A key finding is that listening to the workers closest to production can lead to solutions, many of them more cost-efficient than top-down decision-making. Another is that making safety and health an authentic value is hard work, requiring time, money, and commitment. Third, union and management must both have leadership willing to take chances and learn to trust one another. Fourth, training must be for everyone and ongoing. Finally, health and safety improvements require dedicated funding. The result was resolution of more than one hundred safety concerns and an ongoing institutionalized process for continuing improvement.
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Institutional Management of Core Facilities during Challenging Financial Times
Haley, Rand
2011-01-01
The economic downturn is likely to have lasting effects on institutions of higher education, prioritizing proactive institutional leadership and planning. Although by design, core research facilities are more efficient and effective than supporting individual pieces of research equipment, cores can have significant underlying financial requirements and challenges. This paper explores several possible institutional approaches to managing core facilities during challenging financial times.
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Institutional management of core facilities during challenging financial times.
Haley, Rand
2011-12-01
The economic downturn is likely to have lasting effects on institutions of higher education, prioritizing proactive institutional leadership and planning. Although by design, core research facilities are more efficient and effective than supporting individual pieces of research equipment, cores can have significant underlying financial requirements and challenges. This paper explores several possible institutional approaches to managing core facilities during challenging financial times.
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2010-07-01
... policy must Federal agencies follow in the management of facilities? 102-74.155 Section 102-74.155 Public... MANAGEMENT REGULATION REAL PROPERTY 74-FACILITY MANAGEMENT Facility Management Energy Conservation § 102-74.155 What energy conservation policy must Federal agencies follow in the management of facilities...
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Janowski, John Patrick B; Garrett, William S; Feller, Daniel J; Hathaway, Rebecca; Kushner, John; Pelish, Matthew; Agins, Bruce D
2014-09-01
Rising rates of sexually transmitted infections (STIs) warrant a renewed focus on the management of STIs in health care organizations. The extent to which hospitals and community health centers (CHCs) have established processes and allocated staff for the management of STIs within their organizations remains poorly understood. A New York State Department of Health survey was distributed electronically through a closed state communication network to targeted administrators at New York State hospitals and CHCs. The survey asked if STI management in their facilities included the following: the ability to measure and report rates of STIs, a process to assess the quality of STI care and treatment outcomes, and a centralized person/unit to coordinate its work throughout the facility. Multivariate analysis was performed to identify whether organizational characteristics were associated with survey findings. Ninety-five percent (243/256) of hospitals and CHCs responded to the survey. Fifty percent of respondents had a person or unit to report rates of STIs; 30% reported an organization-wide process for monitoring the quality of STI care, which, according to the multivariate analysis, was associated with CHCs; only 23% reported having a centralized person or unit for coordinating STI management. Most facilities report STI cases to comply with public health surveillance requirements but do not measure infection rates, assess the quality of STI care, or coordinate its work throughout the facility. The development of this organizational capacity would likely decrease STI rates, improve treatment outcomes, and address local public health goals.
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International Nuclear Information System (INIS)
2011-01-01
Department of Energy Order 435.1, 'Radioactive Waste Management,' along with its associated manual and guidance, requires development and maintenance of a radioactive waste management basis for each radioactive waste management facility, operation, and activity. This document presents a radioactive waste management basis for Idaho National Laboratory's Materials and Security Consolidation Center facilities that manage radioactive waste. The radioactive waste management basis for a facility comprises existing laboratory-wide and facility-specific documents. Department of Energy Manual 435.1-1, 'Radioactive Waste Management Manual,' facility compliance tables also are presented for the facilities. The tables serve as a tool for developing the radioactive waste management basis.
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Co-ordinated management of two underground gas facilities in aquifer
International Nuclear Information System (INIS)
D'Haussy, P.L.
1990-01-01
Coordinated management of two underground natural gas storage facilities which are approximately 10 km apart is described. The essential part of service installations allowing their operation is provided at a single location and is common to both facilities, which contributes to ensuring safety gas supply in France
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Facilities Management research in the Nordic Countries
DEFF Research Database (Denmark)
Jensen, Per Anker
2011-01-01
to the establishment of the Centre for Facilities Management – Realdania Research (CFM), and updated information from keynote contributions to CFM’s Nordic FM Conference on 22-23 August 2011 by Suvi Nenonen (Finland), Jan Bröchner (Sweden), Geir K Hansen (Norway) and Per Anker Jensen (Denmark)....
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Referral of children seeking care at private health facilities in Uganda.
Mbonye, Anthony K; Buregyeya, Esther; Rutebemberwa, Elizeus; Clarke, Siân E; Lal, Sham; Hansen, Kristian S; Magnussen, Pascal; LaRussa, Philip
2017-02-14
In Uganda, referral of sick children seeking care at public health facilities is poor and widely reported. However, studies focusing on the private health sector are scanty. The main objective of this study was to assess referral practices for sick children seeking care at private health facilities in order to explore ways of improving treatment and referral of sick children in this sector. A survey was conducted from August to October 2014 in Mukono district, central Uganda. Data was collected using a structured questionnaire supplemented by Focus Group Discussions and Key Informant interviews with private providers and community members. A total of 241 private health facilities were surveyed; 170 (70.5%) were registered drug shops, 59 (24.5%) private clinics and 12 (5.0%) pharmacies. Overall, 104/241 (43.2%) of the private health facilities reported that they had referred sick children to higher levels of care in the two weeks prior to the survey. The main constraints to follow referral advice as perceived by caretakers were: not appreciating the importance of referral, gender-related decision-making and negotiations at household level, poor quality of care at referral facilities, inadequate finances at household level; while the perception that referral leads to loss of prestige and profit was a major constraint to private providers. In conclusion, the results show that referral of sick children at private health facilities faces many challenges at provider, caretaker, household and community levels. Thus, interventions to address constraints to referral of sick children are urgently needed.
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Implementing an environmental management system in a irradiation facility
International Nuclear Information System (INIS)
O'Doherty, James
1998-01-01
Environmental management is at different stages in the countries where there are commercial irradiation facilities. There are therefore differing perspectives on the role of an Environmental Management System, ranging from compliance with the Regulatory framework to a desire to be proactive. An effective Environmental Management System (EMS) facilitates compliance, while also providing the framework for assessment and improvement of a company's environmental impact and overall performance
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Essendi, Hildah; Johnson, Fiifi Amoako; Madise, Nyovani; Matthews, Zoe; Falkingham, Jane; Bahaj, Abubakr S; James, Patrick; Blunden, Luke
2015-11-09
The efforts and commitments to accelerate progress towards the Millennium Development Goals for maternal and newborn health (MDGs 4 and 5) in low and middle income countries have focused primarily on providing key medical interventions at maternity facilities to save the lives of women at the time of childbirth, as well as their babies. However, in most rural communities in sub-Saharan, access to maternal and newborn care services is still limited and even where services are available they often lack the infrastructural prerequisites to function at the very basic level in providing essential routine health care services, let alone emergency care. Lists of essential interventions for normal and complicated childbirth, do not take into account these prerequisites, thus the needs of most health facilities in rural communities are ignored, although there is enough evidence that maternal and newborn deaths continue to remain unacceptably high in these areas. This study uses data gathered through qualitative interviews in Kitonyoni and Mwania sub-locations of Makueni County in Eastern Kenya to understand community and provider perceptions of the obstacles faced in providing and accessing maternal and newborn care at health facilities in their localities. The study finds that the community perceives various challenges, most of which are infrastructural, including lack of electricity, water and poor roads that adversely impact the provision and access to essential life-saving maternal and newborn care services in the two sub-locations. The findings and recommendations from this study are important for the attention of policy makers and programme managers in order to improve the state of lower-tier health facilities serving rural communities and to strengthen infrastructure with the aim of making basic routine and emergency obstetric and newborn care services more accessible.
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Computerized health physics record system at a Canadian fabrication facility
International Nuclear Information System (INIS)
Thind, K.S.
1984-01-01
This poster session will describe the types of Health Physics data input into a Hewlett-Packard 3000 computer. The Health Physics data base at this facility includes the following: employee hours data, airborne uranium concentrations, external dosemetry (badge readings), internal dosemetry (bioassay) and environmental health physics (stack sample results) data. It will describe the types of outputs achievable in the form of various reports, such as: individual employee health physics report for a given period, a general health physics summary report for a given period, individual urinalysis report, local air concentration report and graphs. The use of this computerized health physics record system in the overall radiation protection program at this facility is discussed
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Migrating the facility profile information management system into the world wide web
Energy Technology Data Exchange (ETDEWEB)
Kero, R.E.; Swietlik, C.E.
1994-09-01
The Department of Energy - Office of Special Projects and Argonne National Laboratory (ANL), along with the Department of Energy - office of Scientific and Technical Information have previously designed and implemented the Environment, Safety and Health Facility Profile Information Management System (FPIMS) to facilitate greater efficiency in searching, analyzing and disseminating information found within environment, safety and health oversight documents. This information retrieval based system serves as a central repository for full-text electronic oversight documents, as well as a management planning and decision making tool that can assist in trend and root cause analyses. Continuous improvement of environment, safety and health programs are currently aided through this personal computer-based system by providing a means for the open communication of lessons learned across the department. Overall benefits have included reductions in costs and improvements in past information management capabilities. Access to the FPIMS has been possible historically through a headquarters-based local area network equipped with modems. Continued demand for greater accessibility of the system by remote DOE field offices and sites, in conjunction with the Secretary of Energy` s call for greater public accessibility to Department of Energy (DOE) information resources, has been the impetus to expand access through the use of Internet technologies. Therefore, the following paper will discuss reasons for migrating the FPIMS system into the World Wide Web (Web), various lessons learned from the FPIMS migration effort, as well as future plans for enhancing the Web-based FPIMS.
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[Autonomy for financial management in public and private healthcare facilities in Brazil].
Santos, Maria Angelica Borges dos; Madeira, Fátima Carvalho; Passos, Sonia Regina Lambert; Bakr, Felipe; Oliveira, Klivia Brayner de; Andreazzi, Marco Antonio Ratzsch de
2014-01-01
Autonomy in financial management is an advantage in public administration. A 2009 National Healthcare Facility Survey showed that 3.9% of Brazil's 52,055 public healthcare facilities had some degree of financial autonomy. Such autonomy was more common in inpatient facilities (17.8%), those managed by State governments (26.3%), and in Southern Brazil (6.6%). Autonomy was mainly partial (for resources in specific areas, relating to small outlays, consumables and capital goods, and outsourced services or personnel). 74.3% of 2,264 public facilities with any financial autonomy were under direct government administration. Financial autonomy in public healthcare facilities appears to be linked to local political decisions and not necessarily to the facility's specific legal and administrative status. However, legal status displays distinct scopes of autonomy - those under direct government administration tend to be less autonomous, and those under private businesses more autonomous; 85.8% of the 45,394 private healthcare facilities reported that they were financially autonomous.
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Waste management practices in decommissioning nuclear facilities
International Nuclear Information System (INIS)
Dickson, H.W.
1979-01-01
Several thousand sites exist in the United States where nuclear activities have been conducted over the past 30 to 40 years. Questions regarding potential public health hazards due to residual radioactivity and radiation fields at abandoned and inactive sites have prompted careful ongoing review of these sites by federal agencies including the Department of Energy (DOE) and the Nuclear Regulatory Commission (NRC). In some instances, these reviews are serving to point out poor low-level waste management practices of the past. Many of the sites in question lack adequate documentation on the radiological conditions at the time of release for unrestricted use or were released without appropriate restrictions. Recent investigations have identified residual contamination and radiation levels on some sites which exceed present-day standards and guidelines. The NRC, DOE, and Environmental Protection Agency are all involved in developing decontamination and decommissioning (D and D) procedures and guidelines which will assure that nuclear facilities are decommissioned in a manner that will be acceptable to the nuclear industry, various regulatory agencies, other stakeholders, and the general public
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International Nuclear Information System (INIS)
Kallweit, A.; Schumacher, F.
1977-01-01
A high reliability is called for waste management facilities within the fuel cycle of nuclear power stations which can be fulfilled by providing intermediate storage facilities and reserve capacities. In this report a model based on the theory of Markov processes is described which allows computation of reliability characteristics of waste management facilities containing intermediate storage facilities. The application of the model is demonstrated by an example. (orig.) [de
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BIM Guidelines Inform Facilities Management Databases: A Case Study over Time
Directory of Open Access Journals (Sweden)
Karen Kensek
2015-08-01
Full Text Available A building information model (BIM contains data that can be accessed and exported for other uses during the lifetime of the building especially for facilities management (FM and operations. Working under the guidance of well-designed BIM guidelines to insure completeness and compatibility with FM software, architects and contractors can deliver an information rich data model that is valuable to the client. Large owners such as universities often provide these detailed guidelines and deliverable requirements to their building teams. Investigation of the University of Southern California (USC Facilities Management Service’s (FMS website showed a detailed plan including standards, file names, parameter lists, and other requirements of BIM data, which were specifically designated for facilities management use, as deliverables on new construction projects. Three critical details were also unearthed in the reading of these documents: Revit was the default BIM software; COBie was adapted to help meet facilities management goals; and EcoDomus provided a display of the collected data viewed through Navisworks. Published accounts about the Cinema Arts Complex developed with and under these guidelines reported positive results. Further examination with new projects underway reveal the rapidly changing relational database landscape evident in the new USC “Project Record Revit Requirement Execution Plan (PRxP”.
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Service quality in contracted facilities.
Rabbani, Fauziah; Pradhan, Nousheen Akber; Zaidi, Shehla; Azam, Syed Iqbal; Yousuf, Farheen
2015-01-01
The purpose of this paper is to explore the readiness of contracted and non-contracted first-level healthcare facilities in Pakistan to deliver quality maternal and neonatal health (MNH) care. A balanced scorecard (BSC) was used as the assessment framework. Using a cross-sectional study design, two rural health centers (RHCs) contracted out to Aga Khan Health Service, Pakistan were compared with four government managed RHCs. A BSC was designed to assess RHC readiness to deliver good quality MNH care. In total 20 indicators were developed, representing five BSC domains: health facility functionality, service provision, staff capacity, staff and patient satisfaction. Validated data collection tools were used to collect information. Pearson χ2, Fisher's Exact and the Mann-Whitney tests were applied as appropriate to detect significant service quality differences among the two facilities. Contracted facilities were generally found to be better than non-contracted facilities in all five BSC domains. Patients' inclination for facility-based delivery at contracted facilities was, however, significantly higher than non-contracted facilities (80 percent contracted vs 43 percent non-contracted, p=0.006). The study shows that contracting out initiatives have the potential to improve MNH care. This is the first study to compare MNH service delivery quality across contracted and non-contracted facilities using BSC as the assessment framework.
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Innovative Procurement and Partnerships in Facilities Management
DEFF Research Database (Denmark)
Jensen, Per Anker
2010-01-01
strong requirements on the management style and company culture. Limitations of the research: The research is only based on two case studies, which obviously limits the possibility to generalize the results. Practical applications: The research presents two specific examples of innovative procurement......Aim: The aim of the paper is to present, analyse and identify learning from two case studies of innovative procurement in Facilities Management (FM) concerning the establishments of partnerships between clients and providers. Approach and methodology: A major study of FM best practice covering 36...
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Zakumumpa, Henry; Bennett, Sara; Ssengooba, Freddie
2016-10-18
Uganda implemented a national ART scale-up program at public and private health facilities between 2004 and 2009. Little is known about how and why some health facilities have sustained ART programs and why others have not sustained these interventions. The objective of the study was to identify facilitators and barriers to the long-term sustainability of ART programs at six health facilities in Uganda which received donor support to commence ART between 2004 and 2009. A case-study approach was adopted. Six health facilities were purposively selected for in-depth study from a national sample of 195 health facilities across Uganda which participated in an earlier study phase. The six health facilities were placed in three categories of sustainability; High Sustainers (2), Low Sustainers (2) and Non- Sustainers (2). Semi-structured interviews with ART Clinic managers (N = 18) were conducted. Questionnaire data were analyzed (N = 12). Document review augmented respondent data. Based on the data generated, across-case comparative analyses were performed. Data were collected between February and June 2015. Several distinguishing features were found between High Sustainers, and Low and Non-Sustainers' ART program characteristics. High Sustainers had larger ART programs with higher staffing and patient volumes, a broader 'menu' of ART services and more stable program leadership compared to the other cases. High Sustainers associated sustained ART programs with multiple funding streams, robust ART program evaluation systems and having internal and external program champions. Low and Non Sustainers reported similar barriers of shortage and attrition of ART-proficient staff, low capacity for ART program reporting, irregular and insufficient supply of ARV drugs and a lack of alignment between ART scale-up and their for-profit orientation in three of the cases. We found that ART program sustainability was embedded in a complex system involving dynamic interactions
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ACP Facility Safety Surveillance System Installation
International Nuclear Information System (INIS)
You, Gil Sung; Kook, D. H.; Choung, W. M.; Ku, J. H.; Cho, I. J.; You, G. S.; Kwon, K. C.; Lee, W. K.; Lee, E. P.
2006-10-01
The Advanced spent fuel Conditioning Process is under development for effective management of spent fuel by converting UO 2 into U-metal. For demonstration of this process, α-γ type new hotcell was built in the IMEF basement. All facilities which treat radioactive materials must manage CCTV system which is under control of Health Physics department. Three main points (including hotcell rear door area) have each camera, but operators who are in charge of facility management need to check the safety of the facility immediately through the network in his office. This needs introduce additional network cameras installation and this new surveillance system is expected to update the whole safety control ability with existing system
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National Ignition Facility risk management plan, rev. 1
International Nuclear Information System (INIS)
Brereton, S J; Lane, M A
1998-01-01
The initial release of the National Ignition Facility (AUF) Risk Management Plan (LLNL, 1997a) was prepared in accordance with the DOE Life Cycle Asset Management Good Practice Guide (DOE, 1996a) and supported Critical Decision 3 (CD3), Approval to Initiate Construction (DOE, 1997a). The objectives of the plan were to: (1) Identify the risks to the completion of the Project in terms of meeting technical and regulatory requirements, cost, and schedule. (2) Assess the risks in terms of likelihood of occurrence and their impact potential relative to technical performance, ES and H (environmental, safety and health), costs, and schedule. (3) Address suitable risk mitigation measures for each identified risk. This revision of the Risk Management Plan considers project risks and vulnerabilities after CD3 (DOE, 1997a) was approved by the Secretary of Energy. During the one-year period since the initial release, the vulnerabilities of greatest concern have been the litigation of the Programmatic Environmental Impact Statement (PEIS) (DOE, 1996b) by a group of environmental organizations led by the Natural Resources Defense Council; the finding and successful clean-up of polychlorinated biphenyl (PCB)-filled electrical capacitors at the NIF site excavation; the FY98 congressional budget authorization and request for the FY99 budget authorization; funding for Inertial Confinement Fusion (ICF)/NIF programmatic activities (including French and other sources of funding); and finally, progress in the core science and technology, and optics program that form the basis for the NIF design
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Enge, M; Koch, A; Müller, T; Vorländer, T
2010-12-01
The legal responsibilities imposed upon rehabilitation facilities under section 20 (2a) SGB IX, necessitate fundamental decisions to be taken regarding the development of quality management systems over and above the existing framework. This article is intended to provide ideas and suggestions to assist rehabilitation facilities in implementing a quality management system, which is required in addition to participation in the quality assurance programmes stipulated by the rehabilitation carriers. In this context, the additional internal benefit a functioning quality management system can provide for ensuring a high level of quality and for maintaining the competitiveness of the rehabilitation facility should be taken into account. The core element of these observations, hence, is a list of requirements which enables assessment of the quality of consultants' performance in setting up a quality management system. © Georg Thieme Verlag KG Stuttgart · New York.
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Conceptual design of an in-space cryogenic fluid management facility, executive summary
Willen, G. S.; Riemer, D. H.; Hustvedt, D. C.
1981-01-01
The conceptual design of a Spacelab experiment to develop the technology associated with low gravity propellant management is summarized. The preliminary facility definition, conceptual design and design analysis, and facility development plan, including schedule and cost estimates for the facility, are presented.
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Drainage facility management system : final report, June 2009.
2009-06-01
This research project identified requirements for a drainage facility management system for the Oregon Department of Transportation. It also estimated the personnel resources needed to collect the inventory to populate such a system with data. A tota...
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Ireen, Santhia; Raihan, Mohammad Jyoti; Choudhury, Nuzhat; Islam, M Munirul; Hossain, Md Iqbal; Islam, Ziaul; Rahman, S M Mustafizur; Ahmed, Tahmeed
2018-04-10
Severe acute malnutrition (SAM) in children is the most serious form of malnutrition and is associated with very high rates of morbidity and mortality. For sustainable SAM management, United Nations recommends integration of community based management of acute malnutrition (CMAM) into the health system. The objective of the study was to assess the preparedness of the health system to implement CMAM in Bangladesh. The assessment was undertaken during January to May 2014 by conducting document review, key informant interviews, and direct observation. A total of 38 key informant interviews were conducted among government policy makers and program managers (n = 4), nutrition experts (n = 2), health and nutrition implementing partners (n = 2), development partner (n = 1), government health system staff (n = 5), government front line field workers (n = 22), and community members (n = 2). The assessment was based on: workforce, service delivery, financing, governance, information system, medical supplies, and the broad socio-political context. The government of Bangladesh has developed inpatient and outpatient guidelines for the management of SAM. There are cadres of community health workers of government and non-government actors who can be adequately trained to conduct CMAM. Inpatient management of SAM is available in 288 facilities across the country. However, only 2.7% doctors and 3.3% auxiliary staff are trained on facility based management of SAM. In functional facilities, uninterrupted supply of medicines and therapeutic diet are not available. There is resistance and disagreement among nutrition stakeholders regarding import or local production of ready-to-use therapeutic food (RUTF). Nutrition coordination is fragile and there is no functional supra-ministerial coordination platform for multi-sectoral and multi-stakeholder nutrition. There is an enabling environment for CMAM intervention in Bangladesh although health system
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Challenges in the management of decommission waste of nuclear facilities in Ghana
International Nuclear Information System (INIS)
Glover, E.T.; Fletcher, J.J.
2002-01-01
It is inevitable that every nuclear facility must one day be safely decommissioned. When considering decommissioning, large amounts of radioactive and non-radioactive waste have to be taken into account. Disposal of such materials can have large economic impact on the overall decommissioning cost. In developing countries like Ghana, the perception of environmental protection through waste management, is often not very high as compared to many other pressing needs. Therefore limited resources are allocated for environmental problems. Ghana operates a tank-in- pool type research reactor, 30kW output for research in neutron activation analysis, radioisotope preparation, education and training, a radiotherapy unit that utilizes a 185TBq Co-60 radioactive sources for the treatment of cancer and a gamma irradiation facility which utilizes 1.85PBq Co-60 radioactive source for the irradiation of various materials. All these facilities are operating without designed decommissioning in mind, an inadequate waste management infrastructure as well as a lack of a repository to handling the resulting waste. It is today's beneficials of the nuclear facility that has to deal with the legacies of the future decommissioning activities. The paper outlines some of the challenges and issues to be expected in the management of waste from future decommissioning of nuclear facilities in Ghana with the absence of a waste management infrastructure and inadequate financial resources. The paper puts forth a concept to perform meaningful and significant plans whilst the facilities are still operating. (author)
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Outcome of 7-S, TQM technique for health care waste management
International Nuclear Information System (INIS)
Ullah, J.H.; Malik, J.I.
2011-01-01
To assess the present waste management system of health care facilities (HCFs) attached with Shalamar Hospital, Lahore by applying the 7-S technique of Total Quality Management (TQM) and to find out the outcome after imparting training. Study Design: Interventional quasi-experimental study. Place and Duration of Study: The Shalamar Hospital, Lahore, Punjab, Pakistan, November, 2009 to November, 2010. Methodology: Mckinsey's 7-S, technique of TQM was applied to assess the 220 HCFs from Lahore, Gujranwala and Sheikhupura districts for segregation, collection, transportation and disposal (SCTD) of hospital waste. Direct interview method was applied. Trainings were provided in each institution. After one year action period, the status of four areas of concern was compared before and after training. The parameters studied were segregation, collection, transportation and disposal systems in the 220 HCFs. Each of these were further elaborated by strategy, structure, system, staff, skill, style and stake holder/shared value factors. Standard error of difference of proportion was applied to assess significance using 95% confidence level. Results: There was marked improvement in all these areas ranging from 20% to 77% following a training program of 3 months. In case of disposal of the waste strategy, structure and system an increase of 60%, 65% and 75% was observed after training. Conclusion: The 7-S technique played a vital role in assessing the hospital waste management system. Training for the health care workers played a significant role in health care facilities. (author)
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The added value of Facility management in the educational environment
Kok, H.B.; Mobach, M.; Omta, S.W.F.
2011-01-01
Purpose – The purpose of this paper is to define the added value of facility management (FM) in general and to develop a typology of facility services based on their added value in the educational environment. Design/methodology/approach – This paper is based on a literature review and first
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International Nuclear Information System (INIS)
Dionne, B.J.; Morris, S.C. III; Baum, J.W.
1998-01-01
The Department of Energy's (DOE) Office of Environment, Safety, and Health (EH) sought examples of risk-based approaches to environmental restoration to include in their guidance for DOE nuclear facilities. Extensive measurements of radiological contamination in soil and ground water have been made at Brookhaven National Laboratory's Hazardous Waste Management Facility (HWMF) as part of a Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) remediation process. This provided an ideal opportunity for a case study. This report provides a risk assessment and an open-quotes As Low as Reasonably Achievableclose quotes (ALARA) analysis for use at other DOE nuclear facilities as an example of a risk-based decision technique. This document contains the Appendices for the report
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Supervision of Waste Management and Environmental Protection at the Swedish Nuclear Facilities 2001
Persson, M
2003-01-01
The report summarizes the supervision of waste management and environmental protection at the nuclear facilities that was carried out by the Swedish Radiation Protection Authority in 2001. A summary of the inspections and a description of important issues connected with the supervision of the nuclear facilities are given.The inspections during 2001 have focused on theme inspections of waste management, environmental inspections considering the environmental monitoring at the Swedish nuclear facilities and review safety analysis and research programs from the Swedish Nuclear Fuel and Waste Management Co.The Swedish Radiation Protection Authority finds that the operations are mainly performed according to current regulations
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Grout Treatment Facility Land Disposal Restriction Management Plan
International Nuclear Information System (INIS)
Hendrickson, D.W.
1991-01-01
This document establishes management plans directed to result in the land disposal of grouted wastes at the Hanford Grout Facilities in compliance with Federal, State of Washington, and Department of Energy land disposal restrictions. 9 refs., 1 fig
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Waste management facilities cost information: System cost model product description. Revision 2
International Nuclear Information System (INIS)
Lundeen, A.S.; Hsu, K.M.; Shropshire, D.E.
1996-02-01
In May of 1994, Lockheed Idaho Technologies Company (LITCO) in Idaho Falls, Idaho and subcontractors developed the System Cost Model (SCM) application. The SCM estimates life-cycle costs of the entire US Department of Energy (DOE) complex for designing; constructing; operating; and decommissioning treatment, storage, and disposal (TSD) facilities for mixed low-level, low-level, transuranic, and mixed transuranic waste. The SCM uses parametric cost functions to estimate life-cycle costs for various treatment, storage, and disposal modules which reflect planned and existing facilities at DOE installations. In addition, SCM can model new facilities based on capacity needs over the program life cycle. The SCM also provides transportation costs for DOE wastes. Transportation costs are provided for truck and rail and include transport of contact-handled, remote-handled, and alpha (transuranic) wastes. The user can provide input data (default data is included in the SCM) including the volume and nature of waste to be managed, the time period over which the waste is to be managed, and the configuration of the waste management complex (i.e., where each installation's generated waste will be treated, stored, and disposed). Then the SCM uses parametric cost equations to estimate the costs of pre-operations (designing), construction costs, operation management, and decommissioning these waste management facilities
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Hydrologic management at the Hanford nuclear waste facility
International Nuclear Information System (INIS)
Deju, R.A.; Gephart, R.E.
1975-05-01
Since 1944 the Hanford Reservation, located in south-central Washington, has been a site for radioactive waste storage and disposal. Many Hanford research programs are directed toward minimizing and managing the release of radionuclides into the environment. Hydrologic management of the Hanford facility involves such activities as regional and local geohydrologic characterization studies, environmental monitoring, groundwater management, and specific hydrologic research programs. This paper briefly examines each of these activities and reviews the progress to date in understanding the hydrologic flow regime existing beneath the Reservation. (U.S.)
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Energy Technology Data Exchange (ETDEWEB)
Wilen, C. [VTT Processes, Espoo (Finland)
2005-07-01
New directives and laws will increase the utilization of wastes in the near future. At the same time the number of people employed in waste handling will increase. The aim of this study is to compare manual sorting in demolition waste handling facility to automatic sorting system in commercial and industrial waste facility. Many studies have shown, for example Danish, Dutch and German investigations that waste handling workers have problems especially in occupational health issues. Symptoms like headache, tiredness, joint pain, chest tightens, fever, diarrhea have been reported. Diseases reported are respiratory (asthma, ODTS), muscular, gastroinsteal diseases. Accident risk among waste workers is six times more common that among occupations usually. Finnish Institute of Occupational health carried out the occupational measurements together with VTT Processes. The EU directive accepted in 1999 requires for new waste handling facilities a work space and equipment hazardous classification until 2003 and based on it, an explosion protection document. An example for required actions and documents has been prepared in this project, which can be used as a tool and model in waste management companies and REF production facilities. A dust explosion risks analyse, a work space and equipment classifications and explosion protection document have been done for the Lohja REF-production facility. (orig.)
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Development of a Commonwealth Radioactive Waste Management Facility in Australia
International Nuclear Information System (INIS)
Hesterman, R.
2006-01-01
Full text: The Australian Government has commenced a process to build a Commonwealth Radioactive Waste Management Facility in the Northern Territory for management of radioactive wastes produced by Australian Government agencies. The Government is committed to safely managing its relatively small volume of low level radioactive waste (approximately 3800 cubic metres) and even smaller volume of intermediate level waste (around 400 cubic metres) that have been generated since the early 1950s from the research, medical and industrial use of radioactive materials. Australia has no high level radioactive waste as it does not have any nuclear power reactors. Australian states and territories are responsible for the safe and secure management of low level and intermediate level waste generated within their jurisdictions. They have jointly generated approximately 200 cubic metres of low level radioactive waste and under 100 cubic metres of intermediate level for the same period. In July 2004, the Prime Minister announced that the Australian Government would examine the suitability of Commonwealth land holdings, both onshore and offshore, for establishing the Facility. An initial assessment of offshore territories by the Department of Education, Science and Training (DEST) did not find any sufficiently suitable sites for hosting the Facility. This was due to the low elevation of most territories, inadequate infrastructure and incompatibility with existing land uses. In July 2005, Dr Nelson, then the Minister for Education, Science and Training, announced that three Department of Defence properties in the Northern Territory would be investigated for siting the Facility. The three properties are Fishers Ridge, about 43 kilometres southeast of Katherine; Harts Range, 100 kilometres directly northeast of Alice Springs; and Mt Everard, about 27 kilometres directly northwest of Alice Springs. In addition, the Commonwealth Radioactive Waste Management Act 2005, enacted in December
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Parr, Eric Shannon
2017-01-01
Facility managers have the challenge of adhering to community college policies and procedures while fulfilling requirements of administration, students, and teachers concerning specific needs of classroom aesthetics. The role of facility manager and how specific entities affect perceptions of the design and implementation of classroom aesthetics…
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Effective and Innovative Practices for Stronger Facilities Management.
Banick, Sarah
2002-01-01
Describes the five winners of the APPA's Effective & Innovative Practices Award. These facilities management programs and processes were recognized for enhancing service delivery, lowering costs, increasing productivity, improving customer service, generating revenue, or otherwise benefiting the educational institution. (EV)
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Karanja, Sarah; Gichuki, Richard; Igunza, Patrick; Muhula, Samuel; Ofware, Peter; Lesiamon, Josephine; Leshore, Lepantas; Kyomuhangi-Igbodipe, Lenny Bazira; Nyagero, Josephat; Binkin, Nancy; Ojakaa, David
2018-01-03
In response to poor maternal, newborn, and child health indicators in Magadi sub-county, the "Boma" model was launched to promote health facility delivery by establishing community health units and training community health volunteers (CHVs) and traditional birth attendants (TBAs) as safe motherhood promoters. As a result, health facility delivery increased from 14% to 24%, still considerably below the national average (61%). We therefore conducted this study to determine factors influencing health facility delivery and describe barriers and motivators to the same. A mixed methods cross-sectional study involving a survey with 200 women who had delivered in the last 24 months, 3 focus group discussions with health providers, chiefs and CHVs and 26 in-depth interviews with mothers, key decision influencers and TBAs. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) using logistic regression were calculated to identify predictive factors for health facility delivery. Thematic analysis was done to describe barriers and motivators to the same. Of the women interviewed, 39% delivered at the health facility. Factors positively associated with health facility deliveries included belonging to the highest wealth quintiles [aOR 4.9 (95%CI 1.5-16.5)], currently not married [aOR 2.4 (95%CI 1.1-5.4)] and living near the health facility [aOR 2.2 (95%CI 1.1 = 4.4)]. High parity [aOR 0.7 (95%CI 0.5-0.9)] was negatively associated with health facility delivery. Barriers to health facility delivery included women not being final decision makers on place of birth, lack of a birth plan, gender of health provider, unfamiliar birthing position, disrespect and/or abuse, distance, attitude of health providers and lack of essential drugs and supplies. Motivators included proximity to health facility, mother's health condition, integration of TBAs into the health system, and health education/advice received. Belonging to the highest wealth quintile, currently not married and
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Sandia National Laboratories Facilities Management and Operations Center Design Standards Manual
Energy Technology Data Exchange (ETDEWEB)
Peterson, Timothy L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)
2014-09-01
At Sandia National Laboratories in New Mexico (SNL/NM), the design, construction, operation, and maintenance of facilities is guided by industry standards, a graded approach, and the systematic analysis of life cycle benefits received for costs incurred. The design of the physical plant must ensure that the facilities are "fit for use," and provide conditions that effectively, efficiently, and safely support current and future mission needs. In addition, SNL/NM applies sustainable design principles, using an integrated whole-building design approach, from site planning to facility design, construction, and operation to ensure building resource efficiency and the health and productivity of occupants. The safety and health of the workforce and the public, any possible effects on the environment, and compliance with building codes take precedence over project issues, such as performance, cost, and schedule. These design standards generally apply to all disciplines on all SNL/NM projects. Architectural and engineering design must be both functional and cost-effective. Facility design must be tailored to fit its intended function, while emphasizing low-maintenance, energy-efficient, and energy-conscious design. Design facilities that can be maintained easily, with readily accessible equipment areas, low maintenance, and quality systems. To promote an orderly and efficient appearance, architectural features of new facilities must complement and enhance the existing architecture at the site. As an Architectural and Engineering (A/E) professional, you must advise the Project Manager when this approach is prohibitively expensive. You are encouraged to use professional judgment and ingenuity to produce a coordinated interdisciplinary design that is cost-effective, easily contractible or buildable, high-performing, aesthetically pleasing, and compliant with applicable building codes. Close coordination and development of civil, landscape, structural, architectural, fire
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Cost recovery of NGO primary health care facilities: a case study in Bangladesh
Directory of Open Access Journals (Sweden)
Alam Khurshid
2010-06-01
Full Text Available Abstract Background Little is known about the cost recovery of primary health care facilities in Bangladesh. This study estimated the cost recovery of a primary health care facility run by Building Resources Across Community (BRAC, a large NGO in Bangladesh, for the period of July 2004 - June 2005. This health facility is one of the seven upgraded BRAC facilities providing emergency obstetric care and is typical of the government and private primary health care facilities in Bangladesh. Given the current maternal and child mortality in Bangladesh and the challenges to addressing health-related Millennium Development Goal (MDG targets the financial sustainability of such facilities is crucial. Methods The study was designed as a case study covering a single facility. The methodology was based on the 'ingredient approach' using the allocation techniques by inpatient and outpatient services. Cost recovery of the facility was estimated from the provider's perspective. The value of capital items was annualized using 5% discount rate and its market price of 2004 (replacement value. Sensitivity analysis was done using 3% discount rate. Results The cost recovery ratio of the BRAC primary care facility was 59%, and if excluding all capital costs, it increased to 72%. Of the total costs, 32% was for personnel while drugs absorbed 18%. Capital items were17% of total costs while operational cost absorbed 12%. Three-quarters of the total cost was variable costs. Inpatient services contributed 74% of total revenue in exchange of 10% of total utilization. An average cost per patient was US$ 10 while it was US$ 67 for inpatient and US$ 4 for outpatient. Conclusion The cost recovery of this NGO primary care facility is important for increasing its financial sustainability and decreasing donor dependency, and achieving universal health coverage in a developing country setting. However, for improving the cost recovery of the health facility, it needs to increase
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Song, Mi-Kyung; Hanson, Laura C; Gilet, Constance A; Jo, Minjeong; Reed, Teresa J; Hladik, Gerald A
2014-09-01
There are few data on the frequency and current management of clinical ethical issues related to care of seriously ill dialysis patients in free-standing dialysis facilities. To examine the extent of clinical ethical challenges experienced by care providers in free-standing facilities and their perceptions about how those issues are managed. A total of 183 care providers recruited from 15 facilities in North Carolina completed a survey regarding the occurrence and management of ethical issues in the past year. Care plan meetings were observed at four of the facilities for three consecutive months. Also, current policies and procedures at each of the facilities were reviewed. The two most frequently experienced challenges involved dialyzing frail patients with multiple comorbidities and caring for disruptive/difficult patients. The most common ways of managing ethical issues were discussions in care plan meetings (n = 47) or discussions with the clinic manager (n = 47). Although policies were in place to guide management of some of the challenges, respondents were often not aware of those policies. Also, although participants reported that ethical issues related to dialyzing undocumented immigrants were fairly common, no facility had a policy for managing this challenge. Participants suggested that all staff obtain training in clinical ethics and communication skills, facilities develop ethics teams, and there be clear policies to guide management of ethical challenges. The scope of ethical challenges was extensive, how these challenges were managed varied widely, and there were limited resources for assistance. Multifaceted efforts, encompassing endeavors at the individual, facility, organization, and national levels, are needed to support staff in improving the management of ethical challenges in dialysis facilities. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
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NSGIC State | GIS Inventory — Mental Health Facilities dataset current as of 2010. This file contains the name, address, contact and some licensing information for the Mental Health facilities in...
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International Nuclear Information System (INIS)
Oh, Yon Woo; Kim, S. D.; Soong, W. S.; Kim, G. H.; Oh, W. H.; Kim, Y. G.
2000-12-01
Normal operation of the facility is one of the key factors in the accomplishments of research goals. As confirmed by a case study of the influence of the facility operation condition on the research results, emphasis should be put on the facility preserve management. Facilities should be maintained in solid operational condition and their malfunctions should be repaired as soon as possible. The purpose of this project is to make propositions on the development of the facility Preserve management system which is to maximize the efficiency of the budget execution, manpower organization and maintenance planning, and is to minimize the duration of the operational pause due to malfunctions with the least disbursement
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Energy Technology Data Exchange (ETDEWEB)
Oh, Yon Woo; Kim, S D; Soong, W S; Kim, G H; Oh, W H; Kim, Y G
2000-12-01
Normal operation of the facility is one of the key factors in the accomplishments of research goals. As confirmed by a case study of the influence of the facility operation condition on the research results, emphasis should be put on the facility preserve management. Facilities should be maintained in solid operational condition and their malfunctions should be repaired as soon as possible. The purpose of this project is to make propositions on the development of the facility Preserve management system which is to maximize the efficiency of the budget execution, manpower organization and maintenance planning, and is to minimize the duration of the operational pause due to malfunctions with the least disbursement.
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Readiness of Ugandan health services for the management of outpatients with chronic diseases.
Katende, David; Mutungi, Gerald; Baisley, Kathy; Biraro, Samuel; Ikoona, Eric; Peck, Robert; Smeeth, Liam; Hayes, Richard; Munderi, Paula; Grosskurth, Heiner
2015-10-01
Traditionally, health systems in sub-Saharan Africa have focused on acute conditions. Few data exist on the readiness of African health facilities (HFs) to address the growing burden of chronic diseases (CDs), specifically chronic, non-communicable diseases (NCDs). A stratified random sample of 28 urban and rural Ugandan HFs was surveyed to document the burden of selected CDs by analysing the service statistics, service availability and service readiness using a modified WHO Service Availability and Readiness Assessment questionnaire. Knowledge, skills and practice in the management of CDs of 222 health workers were assessed through a self-completed questionnaire. Among adult outpatient visits at hospitals, 33% were for CDs including HIV vs. 14% and 4% at medium-sized and small health centres, respectively. Many HFs lacked guidelines, diagnostic equipment and essential medicines for the primary management of CDs; training and reporting systems were weak. Lower-level facilities routinely referred patients with hypertension and diabetes. HIV services accounted for most CD visits and were stronger than NCD services. Systems were weaker in lower-level HFs. Non-doctor clinicians and nurses lacked knowledge and experience in NCD care. Compared with higher level HFs, lower-level ones are less prepared and little used for CD care. Health systems in Uganda, particularly lower-level HFs, urgently need improvement in managing common NCDs to cope with the growing burden. This should include the provision of standard guidelines, essential diagnostic equipment and drugs, training of health workers, supportive supervision and improved referral systems. Substantially better HIV basic service readiness demonstrates that improved NCD care is feasible. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
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Strategic aspects on waste management in decommissioning of nuclear facilities
International Nuclear Information System (INIS)
Rannemalm, T.; Eliasson, S.; Larsson, A.; Lidar, P.; Bergh, N.; Hedin, G.
2017-01-01
A team composed of experts from the facility owner OKG, Westinghouse and Studsvik (today Cyclife Sweden and Studsvik Consulting) was asked to develop a basis for decision on an overall strategy for the management of the material and waste arising from the decommissioning of two BWR NPPs at the Oskarshamn site in Sweden. To be able to provide a good basis for decision the full waste management chain from generation to disposition, i.e. clearance or disposal had to be assessed, categorised, quantified and analysed with regards to costs, environmental impact and risks. A systematic approach was applied taking benefit of the decommissioning studies made previously for the two facilities, the decommissioning concepts developed by Ndcon (the partnership in decommissioning between Studsvik and Westinghouse) and the combined knowledge and experience in the project team. In total 4 different waste management concepts were compared individually and in combinations. The four concepts evaluated were based on: direct disposal in the national geological repository; treatment of the waste for volume reduction and where applicable clearance in an external waste treatment facility; decontamination and clearance in an on-site waste treatment facility; direct disposal in a near surface repository at the NPP site. It was important to be able to compare the different options in a quantifiable way. Therefore the project team set up a matrix with parameters for the different options gained from the utility, the national waste management company, external vendors and the experience of the team. In this way a quantitative analysis could be done with the four different waste management options. In addition to the quantitative analysis the team summarised decades of experience in radioactive waste management and decommissioning recommendations and risk analyses. Special attention was given to risk mitigation and redundancy in the waste management chain. The development of an overall waste
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Directory of Open Access Journals (Sweden)
Aveledi Blandine
2009-12-01
Full Text Available Abstract Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC. Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC and family planning (FP. Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive. Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1 providing necessary equipment and renovations to health facilities; 2 improving supply management systems; 3 providing comprehensive competency
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Kelbiso, Lolemo; Belay, Admasu; Woldie, Mirkuzie
2017-01-01
A high quality of work life (QWL) is a crucial issue for health care facilities to have qualified, dedicated, and inspired employees. Among different specialties in health care settings, nurses have a major share among other health care providers. So, they should experience a better QWL to deliver high-quality holistic care to those who need help. To assess the level of quality of work life and its predictors among nurses working in Hawassa town public health facilities, South Ethiopia. A facility based cross-sectional study was conducted on 253 nurses of two hospitals and nine health centers. The total sample size was allocated to each facility based on the number of nurses in each facility. Data were collected using a structured questionnaire. The interitem consistency of the scale used to measure QWL had Cronbach's alpha value of 0.86. A multinomial logistic regression model was fitted to identify significant predictors of quality of work life using SPSS version 20. The study showed that 67.2% of the nurses were dissatisfied with the quality of their work life. We found that educational status, monthly income, working unit, and work environment were strong predictors of quality of work life among nurses ( p quality of their work life. The findings in this study and studies reported from elsewhere pinpoint that perception of nurses about the quality of their work life can be modified if health care managers are considerate of the key issues surrounding QWL.
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Facilities Management and Value Adding - The LEGO case
DEFF Research Database (Denmark)
Jensen, Per Anker; Katchamart, Akarapong
on the management model for FM included in the European FM standards, recent theories on added value of FM and real estate and the related concept of Value Management from building projects. The paper outlines a preliminary theoretical based management concept, which is investigated, tested and discussed based...... on a case study of LEGO. Results: The study shows that the management model for FM creates a relevant starting point but also that stakeholder and relationship management is an essential aspect of Value Adding Management. The case study confirms the relevance of the basic concept and provides an important...... example of how Value Adding Management can be implemented and added value measured. Practical Implications: The concept of Value Adding Management is expected to increase the awareness of the impacts and strategic importance of FM for organisations and can be a practical tool for facilities managers...
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Investigating the Optimal Management Strategy for a Healthcare Facility Maintenance Program
National Research Council Canada - National Science Library
Gaillard, Daria
2004-01-01
...: strategic partnering with an equipment management firm. The objective of this study is to create a decision-model for selecting the optimal management strategy for a healthcare organization's facility maintenance program...
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Bonstingl, Martina
2014-01-01
The health care facility "Breitenstein" makes use of a hospital information system to coordinate clinical processes and document medical health data. So as to comply with novel Austrian legislation and fit the "ELGA" architecture, the system has to be adapted. This paper is based on a literature research and gives answers to technical and legal aspects of "ELGA". The introduction of an IHE connector and a CDA manager are the main changes to the current hospital information system. The implementation of interfaces that allow an integration of further "ELGA" features possible are the next step of the project.
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Adding Value to Facilities Management with Information Technology
DEFF Research Database (Denmark)
Ebbesen, Poul
2016-01-01
This PhD project investigates implementation and use of Information Systems (IS) and Information Technologies (IT) in the Facilities management (FM) business domain. This investigation is relevant because implementation and use of IS/IT in FM has potentials for improvements which can provide...
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Usability: managing facilities for social outcomes
DEFF Research Database (Denmark)
Alexander, Keith; Blakstad, Siri; Hansen, Geir
2013-01-01
The paper argues for the development of usability concepts, methodologies and tools, in considering the effects of the built environment from a user, organisational and community perspective, in order to have a positive influence on social outcomes. Since it was formed over ten years ago, the CIB W......111 on Usability has been exploring concepts, methods and tools, developed in the evaluation of all kinds of consumer products, applied to the built environment. In the most recent phase of this work, conducted over the past three years, an international network of partners has collaborated to focus...... properties of a workplace, they could better manage and design the facilities for improved social outcomes. Interpretation and analysis of the built environment (and support services) based on how it is socially constructed will enable integration of organisational use and the facilities provided to arrive...
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The Practice of Sustainable Facilities Management: Design Sentiments and the Knowledge Chasm
Directory of Open Access Journals (Sweden)
Abbas Elmualim
2009-12-01
Full Text Available The construction industry with its nature of project delivery is very fragmented in terms of the various processes that encompass design, construction, facilities and assets management. Facilities managers are in the forefront of delivering sustainable assets management and hence further the venture for mitigation and adaptation to climate change. A questionnaire survey was conducted to establish perceptions, level of commitment and knowledge chasm in practising sustainable facilities management (FM. This has significant implications for sustainable design management, especially in a fragmented industry. The majority of questionnaire respondents indicated the importance of sustainability for their organization. Many of them stated that they reported on sustainability as part of their organization annual reporting with energy efficiency, recycling and waste reduction as the main concern for them. The overwhelming barrier for implementing sound, sustainable FM is the lack of consensual understanding and focus of individuals and organizations about sustainability. There is a knowledge chasm regarding practical information on delivering sustainable FM. Sustainability information asymmetry in design, construction and FM processes render any sustainable design as a sentiment and mere design aspiration. Skills and training provision, traditionally offered separately to designers and facilities managers, needs to be re-evaluated. Sustainability education and training should be developed to provide effective structures and processes to apply sustainability throughout the construction and FM industries coherently and as common practice. Published in the Journal AEDM - Volume 5, Numbers 1-2, 2009 , pp. 91-102(12
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2012-09-11
... of Facilities Management and Program Services; Submission for OMB Review; Background Investigations for Child Care Workers AGENCY: Office of Facilities Management and Program Services, Public Building... Act, the Regulatory Secretariat will be submitting to the Office of Management and Budget (OMB) a...
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Barriers and commitment of facilities management profession to the sustainability agenda
Energy Technology Data Exchange (ETDEWEB)
Elmualim, Abbas; Shockley, Daniel [ICRC, The School of Construction Management and Engineering University of Reading, Whiteknights, PO BOX 219 (United Kingdom); Valle, Roberto [ICRC, The School of Construction Management and Engineering University of Reading, Whiteknights, PO BOX 219 (United Kingdom); British Institute of Facilities Management (BIFM) (United Kingdom); Ludlow, Gordon [British Institute of Facilities Management (BIFM) (United Kingdom); Shah, Sunil [Jacobs, Reading (United Kingdom)
2010-01-15
The practice of sustainable facilities management (FM) is rapidly evolving with the increasing interest in the discourse of sustainable development. This paper examines a recent survey of the experiences of facilities managers in the rapidly growing and evolving industry in regard to the barriers and their commitment to the sustainability agenda. The survey results show that time constraints, lack of knowledge and lack of senior management commitment are the main barriers for the implementation of consistent and comprehensive sustainable FM policy and practice. The paper concludes that the diversity of the FM role and the traditional undervaluation of the contribution it makes to the success of organisations are partially responsible for lack of success in achieving sustainable facilities. The overwhelming barrier for sustainable FM practice is the lack of understanding, focus and commitment of senior executives in appreciating the opportunities, threats and need for strategic leadership and direction in driving essential change, and hence further the sustainability agenda. (author)
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Nnebue, Chinomnso C.; Onwasigwe, Chika N.; Adogu, Prosper O. U; Onyeonoro, Ugochukwu U.
2012-01-01
Background: Disease surveillance and notification (DSN) is part of the Health Management Information System (HMIS) which comprises databases, personnel, and materials that are organized to collect data which are utilized for informed decision making. The knowledge about DSN is very important for the reporting of notifiable diseases. Objective: The aim of this study is to examine the awareness and knowledge of health-care workers about DSN, and availability of facility records in Anambra State, Nigeria. Materials and Methods: The study was a descriptive cross-sectional one in which relevant data were collected from health-care workers selected by a multistage sampling technique. Qualitative information was also elicited by key informant interviews, whereas an observational checklist, preceded by a desk review was used to examine the availability of facility records. Results: Although 89.8% of the health-care workers were aware of the DSN system, only 33.3, 31.1, and 33.7% of them knew the specific uses of forms IDSR 001, IDSR 002, and IDSR 003 (IDSR: Integrated Diseases Surveillance and Response), respectively. Knowledge of use of the various forms at the facility and local government area (LGA) levels were generally low, although the observational checklist revealed that IDSR 001 and IDSR 002 forms were predominantly found in primary health-care facilities. HMIS forms were less likely to be available in secondary health-care facilities (χ2=7.67, P=0.005). Conclusions: Regular training and retraining of concerned health-care workers on DSN at the LGA level is recommended. This should run concurrently with adequate and regular provision of IDSR forms, copies of the standard case definitions, and other necessary logistics to the health-care facilities by the local and state governments. PMID:23661882
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Facilities Management and Added Value
DEFF Research Database (Denmark)
Jensen, Per Anker
2010-01-01
Aim: This paper aims to present different models of the concept of the added value of Facilities Management (FM), including the FM Value Map, which forms the basis of research group in EuroFM, and to present some of the results of this research collaboration. Approach and methodology: The paper...... is based on literature reviews of the most influential journals within the academic fields of FM, Corporate Real Estate Management and Business to Business Marketing and discussions between participants of the research group working on a further exploration and testing of the FM Value Map. Conclusions......: The research shows a number of different definitions and focus points of Added Value of FM, dependent on the academic field and the area of application. The different research perspectives explored a holistic view on the added value of FM by the integration of an external market based view (with a focus...
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International Nuclear Information System (INIS)
1998-05-01
This Department of Energy (DOE) technical standard (referred to as the Standard) provides guidance for integrating and enhancing worker, public, and environmental protection during facility disposition activities. It provides environment, safety, and health (ES and H) guidance to supplement the project management requirements and associated guidelines contained within DOE O 430.1A, Life-Cycle Asset Management (LCAM), and amplified within the corresponding implementation guides. In addition, the Standard is designed to support an Integrated Safety Management System (ISMS), consistent with the guiding principles and core functions contained in DOE P 450.4, Safety Management System Policy, and discussed in DOE G 450.4-1, Integrated Safety Management System Guide. The ISMS guiding principles represent the fundamental policies that guide the safe accomplishment of work and include: (1) line management responsibility for safety; (2) clear roles and responsibilities; (3) competence commensurate with responsibilities; (4) balanced priorities; (5) identification of safety standards and requirements; (6) hazard controls tailored to work being performed; and (7) operations authorization. This Standard specifically addresses the implementation of the above ISMS principles four through seven, as applied to facility disposition activities
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[Quality Indicators of Primary Health Care Facilities in Austria].
Semlitsch, Thomas; Abuzahra, Muna; Stigler, Florian; Jeitler, Klaus; Posch, Nicole; Siebenhofer, Andrea
2017-07-11
Background The strengthening of primary health care is one major goal of the current national health reform in Austria. In this context, a new interdisciplinary concept was developed in 2014 that defines structures and requirements for future primary health care facilities. Objective The aim of this project was the development of quality indicators for the evaluation of the scheduled primary health care facilities in Austria, which are in accordance with the new Austrian concept. Methods We used the RAND/NPCRDC method for the development and selection of the quality indicators. We conducted systematic literature searches for existing measures in international databases for quality indicators as well as in bibliographic databases. All retrieved measures were evaluated and rated by an expert panel in a 2-step process regarding relevance and feasibility. Results Overall, the literature searches yielded 281 potentially relevant quality indicators, which were summarized to 65 different quality measures for primary health care. Out of these, the panel rated and accepted 30 measures as relevant and feasible for use in Austria. Five of these indicators were structure measures, 14 were process measures and the remaining 11 were outcome measures. Based on the Austrian primary health care concept, the final set of quality indicators was grouped in the 5 following domains: Access to primary health care (5), quality of care (15), continuity of care (5), coordination of care (4), and safety (1). Conclusion This set of quality measures largely covers the four defined functions of primary health care. It enables standardized evaluation of primary health care facilities in Austria regarding the implementation of the Austrian primary health care concept as well as improvement in healthcare of the population. © Georg Thieme Verlag KG Stuttgart · New York.
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Management and Development of the RT Research Facilities and Infrastructures
International Nuclear Information System (INIS)
Kim, Won Ho; Nho, Young Chang; Kim, Jae Sung
2009-01-01
The purpose of this project are to operate the core facilities of the research for the Radiation Technology in stable and to assist the research activities efficiently in the industry, academic, and research laboratory. By developing the infrastructure of the national radio technology industry, we can activate the researching area of the RT and the related industry, and obtain the primary and original technology. The key point in the study of the RT and the assistance of the industry, academic, and research laboratory for the RT area smoothly, is managing the various of unique radiation facilities in our country. The gamma Phytotron and Gene Bank are essential in the agribiology because these facilities are used to preserve and utilize the genes and to provide an experimental field for the environment and biotechnology. The Radiation Fusion Technology research supporting facilities are the core support facilities, and are used to develop the high-tech fusion areas. In addition, the most advanced analytical instruments, whose costs are very high, should be managed in stable and be utilized in supporting works, and the experimental animal supporting laboratory and Gamma Cell have to be maintained in high level and managed in stable also. The ARTI have been developed the 30MeV cyclotron during 2005∼2006, aimed to produce radioisotopes and to research the beam applications as a result of the project, 'Establishment of the Infrastructure for the Atomic Energy Research Expansion', collaborated with the Korea Institute of Radiological and Medical Sciences. In addition, the ARTI is in the progress of establishing cyclotron integrated complex as a core research facility, using a proton beam to produce radioisotopes and to support a various research areas. The measurement and evaluation of the irradiation dose, and irradiation supporting technology of the Good Irradiation Practice(GIP) are essential in various researching areas. One thing to remember is that the publicity
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Innovation process and innovativeness of facility management organizations
Mudrak, T.; Wagenberg, van A.F.; Wubben, E.F.M.
2005-01-01
Purpose - The innovation patterns and processes in facility management (FM) organizations are crucial for the development of FM as a discipline, but they are not yet fully explored and understood. This paper aims to clarify FM innovation from the perspective of innovation processes and the
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Systems engineering applied to integrated safety management for high consequence facilities
International Nuclear Information System (INIS)
Barter, R; Morais, B.
1998-01-01
Integrated Safety Management is a concept that is being actively promoted by the U.S. Department of Energy as a means of assuring safe operation of its facilities. The concept involves the integration of safety precepts into work planning rather than adjusting for safe operations after defining the work activity. The system engineering techniques used to design an integrated safety management system for a high consequence research facility are described. An example is given to show how the concepts evolved with the system design
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The European HST Science Data Archive. [and Data Management Facility (DMF)
Pasian, F.; Pirenne, B.; Albrecht, R.; Russo, G.
1993-01-01
The paper describes the European HST Science Data Archive. Particular attention is given to the flow from the HST spacecraft to the Science Data Archive at the Space Telescope European Coordinating Facility (ST-ECF); the archiving system at the ST-ECF, including the hardware and software system structure; the operations at the ST-ECF and differences with the Data Management Facility; and the current developments. A diagram of the logical structure and data flow of the system managing the European HST Science Data Archive is included.
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Supervision of waste management and environmental protection at the Swedish nuclear facilities 1999
International Nuclear Information System (INIS)
2000-03-01
The report summarizes the supervision of waste management and environmental protection at the nuclear facilities that was carried out by the Swedish Radiation Protection Institute in 1999. A summary of the inspections during 1999 and a description of important issues connected with the supervision of the nuclear facilities are given. The inspections during 1999 have focused on the management of liquid discharges and components containing induced activity at some of the nuclear facilities. Also, routines for filing environmental samples, discharge water samples and documents were inspected at all the different nuclear facilities. The Swedish Radiation Protection Institute finds that the operations are mainly performed according to current regulations
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Determinants of use of health facility for childbirth in rural Hadiya zone, Southern Ethiopia.
Asseffa, Netsanet Abera; Bukola, Fawole; Ayodele, Arowojolu
2016-11-16
Maternal mortality remains a major global public health concern despite many international efforts. Facility-based childbirth increases access to appropriate skilled attendance and emergency obstetric care services as the vast majority of obstetric complications occur during delivery. The purpose of the study was to determine the proportion of facility delivery and assess factors influencing utilization of health facility for childbirth. A cross-sectional study was conducted in two rural districts of Hadiya zone, southern Ethiopia. Participants who delivered within three years of the survey were selected by stratified random sampling. Trained interviewers administered a pre-tested semi-structured questionnaire. We employed bivariate analysis and logistic regression to identify determinants of facility-based delivery. Data from 751 participants showed that 26.9% of deliveries were attended in health facilities. In bivariate analysis, maternal age, education, husband's level of education, possession of radio, antenatal care, place of recent ANC attended, planned pregnancy, wealth quintile, parity, birth preparedness and complication readiness, being a model family and distance from the nearest health facility were associated with facility delivery. On multiple logistic regression, age, educational status, antenatal care, distance from the nearest health facility, wealth quintile, being a model family, planned pregnancy and place of recent ANC attended were the determinants of facility-based childbirth. Efforts to improve institutional deliveries in the region must strengthen initiatives that promote female education, opportunities for wealth creation, female empowerment and increased uptake of family planning among others. Service related barriers and cultural influences on the use of health facility for childbirth require further evaluation.
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Energy Technology Data Exchange (ETDEWEB)
Dionne, B.J.; Morris, S. III; Baum, J.W. [and others
1998-03-01
The Department of Energy`s (DOE) Office of Environment, Safety, and Health (EH) sought examples of risk-based approaches to environmental restoration to include in their guidance for DOE nuclear facilities. Extensive measurements of radiological contamination in soil and ground water have been made at Brookhaven National Laboratory`s Hazardous Waste Management Facility (HWMF) as part of a Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) remediation process. This provided an ideal opportunity for a case study. This report provides a risk assessment and an {open_quotes}As Low as Reasonably Achievable{close_quotes} (ALARA) analysis for use at other DOE nuclear facilities as an example of a risk-based decision technique.
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Management of the high-level nuclear power facilities
International Nuclear Information System (INIS)
Preda, Marin
2003-05-01
This thesis approaches current issues in the management of the high power nuclear facilities and as such it appears to be important particularly for nuclear power plant operation topics. Of special interest are the failure events entailing possible catastrophic situations. The contents is structured onto ten chapters. The first chapter describes the operation regimes of the nuclear high power facilities. Highlighted here are the thesis scope and the original features of the work. The second chapter deals with operational policies developed in order to ensure the preventive maintenance of the nuclear installations. Also managing structures are described devoted to practical warranting the equipment safety function of non-classical power stations. In the third chapter cases of nuclear accidents are analyzed especially stressing the probabilistic risk and the operation regimes having in view the elimination of catastrophic events. In the fourth and fifth chapters the control of nuclear radiation emission is treated focusing the quality issue of nuclear installations required to avoid hazardous effects at level of nuclear reactor operation stage. At the same time set of operational measures is given here for preventing risks, catastrophes and chaotic situations. The chapter five presents both theoretical and practical approaches of the nuclear reactor core management concerning particularly the fuel testing, the water primary system and the quality of the involved equipment. In the sixth and seventh chapters issues of risk-quality correlations are approached as well as the structure of expert systems for monitoring the operational regimes of nuclear facilities. The efficiency of the power systems with nuclear injection is discussed and some original ideas developed in this work are evidenced in the eighth and ninth chapters. Presented are here both the operational principles and models of raising the efficiency of the interconnected nuclear stations and prices' policy
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DEFF Research Database (Denmark)
Ahiabu, Mary-Anne; Tersbøl, Britt Pinkowski; Biritwum, Richard
2016-01-01
with the national average estimated in 2008. Interventions that reduce diagnostic uncertainty in illness management should be considered. The National Health Insurance Scheme, as the main purchaser of health services in Ghana, offers an opportunity that should be exploited to introduce policies in support......Resistance to antibiotics is increasing globally and is a threat to public health. Research has demonstrated a correlation between antibiotic use and resistance development. Developing countries are the most affected by resistance because of high infectious disease burden, limited access to quality...... assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern...
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42 CFR 476.78 - Responsibilities of health care facilities.
2010-10-01
... SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) General Provisions... 42 Public Health 4 2010-10-01 2010-10-01 false Responsibilities of health care facilities. 476.78...
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42 CFR 476.76 - Cooperation with health care facilities.
2010-10-01
... SERVICES (CONTINUED) QUALITY IMPROVEMENT ORGANIZATIONS UTILIZATION AND QUALITY CONTROL REVIEW Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) General Provisions... 42 Public Health 4 2010-10-01 2010-10-01 false Cooperation with health care facilities. 476.76...
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Wooten, Nikki R; Brittingham, Jordan A; Pitner, Ronald O; Tavakoli, Abbas S; Jeffery, Diana D; Haddock, K Sue
2018-02-06
Behavioral health conditions are a significant concern for the U.S. military and the Military Health System (MHS) because of decreased military readiness and increased health care utilization. Although MHS beneficiaries receive direct care in military treatment facilities, a disproportionate majority of behavioral health treatment is purchased care received in civilian facilities. Yet, limited evidence exists about purchased behavioral health care received by MHS beneficiaries. This longitudinal study (1) estimated the prevalence of purchased behavioral health care and (2) identified patient and visit characteristics predicting receipt of purchased behavioral health care in acute care facilities from 2000 to 2014. Medical claims with Major Diagnostic Code 19 (mental disorders/diseases) or 20 (alcohol/drug disorders) as primary diagnoses and TRICARE as the primary/secondary payer were analyzed for MHS beneficiaries (n = 17,943) receiving behavioral health care in civilian acute care facilities from January 1, 2000, to December 31, 2014. The primary dependent variable, receipt of purchased behavioral health care, was modeled for select mental health and substance use disorders from 2000 to 2014 using generalized estimating equations. Patient characteristics included time, age, sex, and race/ethnicity. Visit types included inpatient hospitalization and emergency department (ED). Time was measured in days and visits were assumed to be correlated over time. Behavioral health care was described by both frequency of patients and visit type. The University of South Carolina Institutional Review Board approved this study. From 2000 to 2014, purchased care visits increased significantly for post-traumatic stress disorder, adjustment, anxiety, mood, bipolar, tobacco use, opioid/combination opioid dependence, nondependent cocaine abuse, psychosocial problems, and suicidal ideation among MHS beneficiaries. The majority of care was received for mental health disorders (78
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High level radioactive waste management facility design criteria
International Nuclear Information System (INIS)
Sheikh, N.A.; Salaymeh, S.R.
1993-01-01
This paper discusses the engineering systems for the structural design of the Defense Waste Processing Facility (DWPF) at the Savannah River Site (SRS). At the DWPF, high level radioactive liquids will be mixed with glass particles and heated in a melter. This molten glass will then be poured into stainless steel canisters where it will harden. This process will transform the high level waste into a more stable, manageable substance. This paper discuss the structural design requirements for this unique one of a kind facility. A special emphasis will be concentrated on the design criteria pertaining to earthquake, wind and tornado, and flooding
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Implementation of a quality management system at the PHOENIX facility (CryoMaK)
International Nuclear Information System (INIS)
Urbach, Elisabeth; Bagrets, Nadezda; Weiss, Klaus-Peter
2013-01-01
Within a variety of mechanical tests in the Cryogenic Material Test Facility Karlsruhe (CryoMaK) at Karlsruhe Institute of Technology (KIT) the PHOENIX facility was prepared for multiple standard tensile tests in liquid helium, liquid nitrogen and at room temperature. With the multiple specimens holder 10 specimens can be tested within one cool down one after another. A quality management system is needed for ensuring reproducible preconditions. For the guarantee of the competence of the laboratory and the measurement equipment, a quality management system was implemented and prepared for accreditation according to DIN EN ISO/IEC 17025 (ISO 17025). The implementation of a quality management system allows high precision test results included the estimation of measurement uncertainty. This paper gives an overview of the management and technical requirements for the accreditation of the PHOENIX testing facility
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Implementation of a quality management system at the PHOENIX facility (CryoMaK)
Energy Technology Data Exchange (ETDEWEB)
Urbach, Elisabeth, E-mail: elisabeth.urbach@kit.edu; Bagrets, Nadezda; Weiss, Klaus-Peter
2013-10-15
Within a variety of mechanical tests in the Cryogenic Material Test Facility Karlsruhe (CryoMaK) at Karlsruhe Institute of Technology (KIT) the PHOENIX facility was prepared for multiple standard tensile tests in liquid helium, liquid nitrogen and at room temperature. With the multiple specimens holder 10 specimens can be tested within one cool down one after another. A quality management system is needed for ensuring reproducible preconditions. For the guarantee of the competence of the laboratory and the measurement equipment, a quality management system was implemented and prepared for accreditation according to DIN EN ISO/IEC 17025 (ISO 17025). The implementation of a quality management system allows high precision test results included the estimation of measurement uncertainty. This paper gives an overview of the management and technical requirements for the accreditation of the PHOENIX testing facility.
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Health and safety impacts related to the management of spent nuclear fuels
International Nuclear Information System (INIS)
Jilek, D.C.
1996-01-01
Under the Nuclear Waste Policy Act of 1982, as amended, the U.S. Department of Energy is responsible for managing the disposal of spent nuclear fuel from civilian nuclear power plants. Deployment of a multipurpose canister (MPC) system for dry storage of commercial spent nuclear fuel at reactor sites was determined to be an option for managing spent nuclear fuel until either a permanent repository or interim central storage facility (commonly called a Monitored Retrievable Storage Facility, or MRS) becomes available. Routine health and safety impacts to workers from handling and storage operations at nuclear facilities for four separate scenarios were evaluated for the MPC system: an on-time repository with an MRS; an on-time repository with no MRS; a delayed repository with an MRS; and a delayed repository with no MRS. In addition to evaluating the MPC system, five alternatives were analyzed. These included the No Action Alternative (NAA), Current Technology (CTr), the Transposable Storage Cask (TSC), the Dual-Purpose Canister (DPC), and the Small MPC (SmMPC). Health effects are expressed as collective doses in person- rem per year and risks as latent cancer fatalities per year for incident-free operations for each alternative and scenario. Results show that both dose and risks to workers vary as much as 68% among scenarios and alternatives. Although dose estimates and risks fall below limits for radiation dose to workers as specified in Title 10, Part 20, of the Code of Federal Regulations, additional measures could be applied to reduce potential doses and resultant health risk. 5 refs., 2 tabs
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Cost-of-illness of cholera to households and health facilities in rural Malawi.
Directory of Open Access Journals (Sweden)
Patrick G Ilboudo
Full Text Available Cholera remains an important public health problem in many low- and middle-income countries. Vaccination has been recommended as a possible intervention for the prevention and control of cholera. Evidence, especially data on disease burden, cost-of-illness, delivery costs and cost-effectiveness to support a wider use of vaccine is still weak. This study aims at estimating the cost-of-illness of cholera to households and health facilities in Machinga and Zomba Districts, Malawi. A cross-sectional study using retrospectively collected cost data was undertaken in this investigation. One hundred patients were purposefully selected for the assessment of the household cost-of-illness and four cholera treatment centres and one health facility were selected for the assessment conducted in health facilities. Data collected for the assessment in households included direct and indirect costs borne by cholera patients and their families while only direct costs were considered for the assessment conducted in health facilities. Whenever possible, descriptive and regression analysis were used to assess difference in mean costs between groups of patients. The average costs to patients' households and health facilities for treating an episode of cholera amounted to US$65.6 and US$59.7 in 2016 for households and health facilities, respectively equivalent to international dollars (I$ 249.9 and 227.5 the same year. Costs incurred in treating a cholera episode were proportional to duration of hospital stay. Moreover, 52% of households used coping strategies to compensate for direct and indirect costs imposed by the disease. Both households and health facilities could avert significant treatment expenditures through a broader use of pre-emptive cholera vaccination. These findings have direct policy implications regarding priority investments for the prevention and control of cholera.
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Cost-of-illness of cholera to households and health facilities in rural Malawi.
Ilboudo, Patrick G; Huang, Xiao Xian; Ngwira, Bagrey; Mwanyungwe, Abel; Mogasale, Vittal; Mengel, Martin A; Cavailler, Philippe; Gessner, Bradford D; Le Gargasson, Jean-Bernard
2017-01-01
Cholera remains an important public health problem in many low- and middle-income countries. Vaccination has been recommended as a possible intervention for the prevention and control of cholera. Evidence, especially data on disease burden, cost-of-illness, delivery costs and cost-effectiveness to support a wider use of vaccine is still weak. This study aims at estimating the cost-of-illness of cholera to households and health facilities in Machinga and Zomba Districts, Malawi. A cross-sectional study using retrospectively collected cost data was undertaken in this investigation. One hundred patients were purposefully selected for the assessment of the household cost-of-illness and four cholera treatment centres and one health facility were selected for the assessment conducted in health facilities. Data collected for the assessment in households included direct and indirect costs borne by cholera patients and their families while only direct costs were considered for the assessment conducted in health facilities. Whenever possible, descriptive and regression analysis were used to assess difference in mean costs between groups of patients. The average costs to patients' households and health facilities for treating an episode of cholera amounted to US$65.6 and US$59.7 in 2016 for households and health facilities, respectively equivalent to international dollars (I$) 249.9 and 227.5 the same year. Costs incurred in treating a cholera episode were proportional to duration of hospital stay. Moreover, 52% of households used coping strategies to compensate for direct and indirect costs imposed by the disease. Both households and health facilities could avert significant treatment expenditures through a broader use of pre-emptive cholera vaccination. These findings have direct policy implications regarding priority investments for the prevention and control of cholera.
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Radiation safety management system in a radioactive facility
International Nuclear Information System (INIS)
Amador, Zayda H.
2008-01-01
Full text: This paper illustrates the Cuban experience in implementing and promoting an effective radiation safety system for the Centre of Isotopes, the biggest radioactive facility of our country. Current management practice demands that an organization inculcate culture of safety in preventing radiation hazard. The aforementioned objectives of radiation protection can only be met when it is implemented and evaluated continuously. Commitment from the workforce to treat safety as a priority and the ability to turn a requirement into a practical language is also important to implement radiation safety policy efficiently. Maintaining and improving safety culture is a continuous process. There is a need to establish a program to measure, review and audit health and safety performance against predetermined standards. All those areas of the radiation protection program are considered (e.g. licensing and training of the staff, occupational exposure, authorization of the practices, control of the radioactive material, radiological occurrences, monitoring equipment, radioactive waste management, public exposure due to airborne effluents, audits and safety costs). A set of indicators designed to monitor key aspects of operational safety performance are used. Their trends over a period of time are analyzed with the modern information technologies, because this can provide an early warning to plant management for searching causes behind the observed changes. In addition to analyze the changes and trends, these indicators are compared against identified targets and goals to evaluate performance strengths and weaknesses. A structured and proper radiation self-auditing system is seen as a basic requirement to meet the current and future needs in sustainability of radiation safety. The integrated safety management system establishment has been identified as a goal and way for the continuous improvement. (author)
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Directory of Open Access Journals (Sweden)
Nale Jennifer
2010-05-01
Full Text Available Abstract Background Shared-usage high throughput screening (HTS facilities are becoming more common in academe as large-scale small molecule and genome-scale RNAi screening strategies are adopted for basic research purposes. These shared facilities require a unique informatics infrastructure that must not only provide access to and analysis of screening data, but must also manage the administrative and technical challenges associated with conducting numerous, interleaved screening efforts run by multiple independent research groups. Results We have developed Screensaver, a free, open source, web-based lab information management system (LIMS, to address the informatics needs of our small molecule and RNAi screening facility. Screensaver supports the storage and comparison of screening data sets, as well as the management of information about screens, screeners, libraries, and laboratory work requests. To our knowledge, Screensaver is one of the first applications to support the storage and analysis of data from both genome-scale RNAi screening projects and small molecule screening projects. Conclusions The informatics and administrative needs of an HTS facility may be best managed by a single, integrated, web-accessible application such as Screensaver. Screensaver has proven useful in meeting the requirements of the ICCB-Longwood/NSRB Screening Facility at Harvard Medical School, and has provided similar benefits to other HTS facilities.
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Tolopko, Andrew N; Sullivan, John P; Erickson, Sean D; Wrobel, David; Chiang, Su L; Rudnicki, Katrina; Rudnicki, Stewart; Nale, Jennifer; Selfors, Laura M; Greenhouse, Dara; Muhlich, Jeremy L; Shamu, Caroline E
2010-05-18
Shared-usage high throughput screening (HTS) facilities are becoming more common in academe as large-scale small molecule and genome-scale RNAi screening strategies are adopted for basic research purposes. These shared facilities require a unique informatics infrastructure that must not only provide access to and analysis of screening data, but must also manage the administrative and technical challenges associated with conducting numerous, interleaved screening efforts run by multiple independent research groups. We have developed Screensaver, a free, open source, web-based lab information management system (LIMS), to address the informatics needs of our small molecule and RNAi screening facility. Screensaver supports the storage and comparison of screening data sets, as well as the management of information about screens, screeners, libraries, and laboratory work requests. To our knowledge, Screensaver is one of the first applications to support the storage and analysis of data from both genome-scale RNAi screening projects and small molecule screening projects. The informatics and administrative needs of an HTS facility may be best managed by a single, integrated, web-accessible application such as Screensaver. Screensaver has proven useful in meeting the requirements of the ICCB-Longwood/NSRB Screening Facility at Harvard Medical School, and has provided similar benefits to other HTS facilities.
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INFRASTRUCTURE FACILITIES FOR MONITORING AND INTELLECTUAL ROAD TRAFFIC MANAGEMENT
Directory of Open Access Journals (Sweden)
G. Belov
2014-10-01
Full Text Available Review of automatic management of road traffic technologies in major cities of Ukraine is carried out in the given article. Priority directions of studies are determined for producing modern and perspective technologies in the given area. The facilities for monitoring and intelligence management of the road traffic on the basis of the programmed logical controller, using the device of fuzzy logic are considered.
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Guiquan, Xi; Lin, Cong; Xuehui, Jin
2018-05-01
As an important platform for scientific and technological development, large -scale scientific facilities are the cornerstone of technological innovation and a guarantee for economic and social development. Researching management of large-scale scientific facilities can play a key role in scientific research, sociology and key national strategy. This paper reviews the characteristics of large-scale scientific facilities, and summarizes development status of China's large-scale scientific facilities. At last, the construction, management, operation and evaluation of large-scale scientific facilities is analyzed from the perspective of sustainable development.
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Investing in health information management: The right people, in the right place, at the right time.
Ayodeji Makinde, Olusesan; Mami, Mohammed Ibrahim; Oweghoro, Benson Macaulay; Oyediran, Kolawole Azeez; Mullen, Stephanie
2016-08-01
To describe the process adopted to review the academic curriculum for training health information management professionals in Nigeria. Health information management professionals are responsible for managing patients' health service records and hospital information systems across health facilities in Nigeria. An assessment found many are inadequately skilled in information and communications technology (ICT) skills believed to be needed for them to play leadership roles in hospital information systems and function effectively. This was traced to a dearth of relevant ICT courses in their academic training curriculum. A review of the curriculum for training health information management professionals was instituted following an agreed need to address these issues. Health records management is evolving across the world including the developing countries. This advancement requires evolution of training programs to meet the increasing application of ICT in this sector. After several sessions, a new curriculum that addresses all the identified educational deficiencies has been developed. It is believed that this step will help improve the quality of training programs. © The Author(s) 2016.
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2017-01-23
Commands, that originally purchased the material from the command’s operational and maintenance fund. A flowchart of the RRAM material management process...streamlines business operations for financial and supply chain management . 22 SECNAVINST 4440.33A. The Navy retained excess material stored in 10 of...No. DODIG-2017-043 J A N U A R Y 2 3 , 2 0 1 7 Management of Excess Material in the Navy’s Real-Time Reutilization Asset Management Facilities
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Directory of Open Access Journals (Sweden)
Saliku Teresa
2009-03-01
Full Text Available Abstract Background Maternal mortality in Sub-Saharan Africa remains a challenge with estimates exceeding 1,000 maternal deaths per 100,000 live births in some countries. Successful prevention of maternal deaths hinges on adequate and quality emergency obstetric care. In addition to skilled personnel, there is need for a supportive environment in terms of essential drugs and supplies, equipment, and a referral system. Many household surveys report a reasonably high proportion of women delivering in health facilities. However, the quality and adequacy of facilities and personnel are often not assessed. The three delay model; 1 delay in making the decision to seek care; 2 delay in reaching an appropriate obstetric facility; and 3 delay in receiving appropriate care once at the facility guided this project. This paper examines aspects of the third delay by assessing quality of emergency obstetric care in terms of staffing, skills equipment and supplies. Methods We used data from a survey of 25 maternity health facilities within or near two slums in Nairobi that were mentioned by women in a household survey as places that they delivered. Ethical clearance was obtained from the Kenya Medical Research Institute. Permission was also sought from the Ministry of Health and the Medical Officer of Health. Data collection included interviews with the staff in-charge of maternity wards using structured questionnaires. We collected information on staffing levels, obstetric procedures performed, availability of equipment and supplies, referral system and health management information system. Results Out of the 25 health facilities, only two met the criteria for comprehensive emergency obstetric care (both located outside the two slums while the others provided less than basic emergency obstetric care. Lack of obstetric skills, equipment, and supplies hamper many facilities from providing lifesaving emergency obstetric procedures. Accurate estimation of burden
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International Nuclear Information System (INIS)
Beckman, W.H.; Cossel, S.C.; Alhadeff, N.; Lindamood, S.B.; Beers, J.A.
1994-01-01
This presentation will describe the Fernald Environmental Restoration Management Corporation's (FERMCO) Standards/Requirements Identification Documents (S/RlDs) Program, the unique process used to implement it, and the status of the program. We will also discuss the lessons learned as the program was implemented. The Department of Energy (DOE) established the Fernald site to produce uranium metals for the nation's defense programs in 1953. In 1989, DOE suspended production and, in 1991, the mission of the site was formally changed to one of environmental cleanup and restoration. The site was renamed the Fernald Environmental Management Project (FEMP). FERMCO's mission is to provide safe, early, and least-cost final clean-up of the site in compliance with all regulations and commitments. DOE has managed nuclear facilities primarily through its oversight of Management and Operating contractors. Comprehensive nuclear industry standards were absent when most DOE sites were first established, Management and Operating contractors had to apply existing non-nuclear industry standards and, in many cases, formulate new technical standards. Because it was satisfied with the operation of its facilities, DOE did not incorporate modern practices and standards as they became available. In March 1990, the Defense Nuclear Facilities Safety Board issued Recommendation 90-2, which called for DOE to identify relevant standards and requirements, conduct adequacy assessments of requirements in protecting environmental, public, and worker health and safety, and determine the extent to which the requirements are being implemented. The Environmental Restoration and Waste Management Office of DOE embraced the recommendation for facilities under its control. Strict accountability requirements made it essential that FERMCO and DOE clearly identify applicable requirements necessary, determine the requirements' adequacy, and assess FERMCO's level of compliance
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Caldararo, Kristi L; Nash, David B
2017-10-01
As health care delivery systems adapt to the changing marketplace, many struggle to define a clear strategy that will prove successful in managing the health of entire populations. The federal government continues to put increasing pressure on organizations to shift away from the traditional way of delivering episodic care and move toward managing populations as a whole-before, during, and after a patient presents in a health care facility. Private payers have begun to follow suit as risk-based payer contracts and bundled payment models become increasingly popular. For organizations to adequately influence the health outcomes of a population, they must be responsible for more than just a patient's medical care. They must partner with the community to create a strategy that encompasses the psychosocial and environmental factors that contribute to one's health. Although health care leaders know this industry transformation is imminent, there is minimal research that shares best practices in regard to designing and implementing a successful population health management strategy. Interviews were conducted with leadership from 10 organizations in order to understand the strategic approach taken by delivery systems and health care institutions that view population health as a key aspect of their overall mission. Responses were recorded and outlined in a detailed response grid. The objective is to provide a qualitative overview of how industry leaders are currently responding to population health. Additionally, common themes and recommendations are presented to serve as guidance for other health care organizations that are at the start of their journey toward population health management.
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Information Technology in Facilities Management - A Literature Review
DEFF Research Database (Denmark)
Ebbesen, Poul
2015-01-01
Purpose : The aim of this paper is to present the state of the art of research in Information Technology (IT) in Facilities Management (FM). Background : Initial studies indicate that investments into IT in FM often do not add the expected value, neither to the FM department itself nor...
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Dao, Blami; Ngabo, Fidele; Zoungrana, Jeremie; Rawlins, Barbara; Mukarugwiro, Beata; Musoni, Pascal; Favero, Rachel; MacDowell, Juliet; Eugene, Kanyamanza
2015-12-01
To assess coverage, acceptability, and feasibility of a program to prevent postpartum hemorrhage (PPH) at community and facility levels, a study was conducted in 60 health facilities and their catchment areas in four districts in Rwanda. A total of 220 skilled birth attendants at these facilities were trained to provide active management of the third stage of labor and 1994 community health workers (ASMs) were trained to distribute misoprostol at home births. A total of 4,074 pregnant women were enrolled in the program (20.5% of estimated deliveries). Overall uterotonic coverage was 82.5%: 85% of women who delivered at a facility received a uterotonic to prevent PPH; 76% of women reached at home at the time of birth by an ASM ingested misoprostol--a 44.3% coverage rate. Administration of misoprostol at the time of birth for home births achieved moderate uterotonic coverage. Advancing the distribution of misoprostol through antenatal care services could further increase coverage.
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Conjunctive operation of river facilities for integrated water resources management in Korea
Directory of Open Access Journals (Sweden)
H. Kim
2016-10-01
Full Text Available With the increasing trend of water-related disasters such as floods and droughts resulting from climate change, the integrated management of water resources is gaining importance recently. Korea has worked towards preventing disasters caused by floods and droughts, managing water resources efficiently through the coordinated operation of river facilities such as dams, weirs, and agricultural reservoirs. This has been pursued to enable everyone to enjoy the benefits inherent to the utilization of water resources, by preserving functional rivers, improving their utility and reducing the degradation of water quality caused by floods and droughts. At the same time, coordinated activities are being conducted in multi-purpose dams, hydro-power dams, weirs, agricultural reservoirs and water use facilities (featuring a daily water intake of over 100 000 m3 day−1 with the purpose of monitoring the management of such facilities. This is being done to ensure the protection of public interest without acting as an obstacle to sound water management practices. During Flood Season, each facilities contain flood control capacity by limited operating level which determined by the Regulation Council in advance. Dam flood discharge decisions are approved through the flood forecasting and management of Flood Control Office due to minimize flood damage for both upstream and downstream. The operational plan is implemented through the council's predetermination while dry season for adequate quantity and distribution of water.
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Directory of Open Access Journals (Sweden)
A. C. Hauptfleisch
2010-01-01
Full Text Available Globally the development of property and infrastructure, being part of the creation of fixed investment and wealth, is taking place unabated. In support of this process is a multitude of highly skilled built environment professionals such as engineers, architects, quantity surveyors, construction managers, town and regional planners, land surveyors, etc. The absence of a universally acknowledged profession of the same standing, designated to manage and optimise the utilisation of the ever-compounding fixed investments in the products of the collective built environment (buildings, engineering structures and infrastructure, is observed. In practice it manifests itself in the attempts, by the previously mentioned professionals and others, to cast themselves into the role of facilities managers. Of concern is the resultant diverse group of “facilities management” practitioners, sometimes without basic built environment education, often lacking any noteworthy specialised education or experience. For obvious reasons, the more developed a country, the more evident it becomes that a specific facilities management profession is taking root and is practised at various managerial levels. The term “facilities management” reportedly came into use in the United States of America during the 1970’s when a Facility Management Institute was founded in the USA and the first known formal symposium was held in Washington DC in 1989. Although perhaps lacking some of the prestige associated with other professions, there are reasons to believe that facilities management is in the process of becoming a driving force, not only in the scientific management and optimisation of fixed assets, but as a knowledge-based initiator of development in the built environment. The lack of a highly developed facilities management profession manifests itself in the alarming rate at which infrastructure and buildings are deteriorating in South Africa. This situation
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Directory of Open Access Journals (Sweden)
Nyamtema Angelo S
2010-06-01
Full Text Available Abstract Background The Health Management Information System (HMIS is crucial for evidence-based policy-making, informed decision-making during planning, implementation and evaluation of health programs; and for appropriate use of resources at all levels of the health system. This study explored the gaps and factors influencing HMIS in the context of a changing health sector in Tanzania. Methods A cross sectional descriptive study was conducted in 11 heath facilities in Kilombero district between January and February 2008. A semi-structured questionnaire was used to interview 43 health workers on their knowledge, attitude, practice and factors for change on HMIS and HMIS booklets from these facilities were reviewed for completeness. Results Of all respondents, 81% had never been trained on HMIS, 65% did not properly define this system, 54% didn't know who is supposed to use the information collected and 42% did not use the collected data for planning, budgeting and evaluation of services provision. Although the attitude towards the system was positive among 91%, the reviewed HMIS booklets were never completed in 25% - 55% of the facilities. There were no significant differences in knowledge, attitude and practice on HMIS between clinicians and nurses. The most common type of HMIS booklets which were never filled were those for deliveries (55%. The gaps in the current HMIS were linked to lack of training, inactive supervision, staff workload pressure and the lengthy and laborious nature of the system. Conclusions This research has revealed a state of poor health data collection, lack of informed decision-making at the facility level and the factors for change in the country's HMIS. It suggests need for new innovations including incorporation of HMIS in the ongoing reviews of the curricula for all cadres of health care providers, development of more user-friendly system and use of evidence-based John Kotter's eight-step process for implementing
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prevalence and correlates of utilization of health facilities in ...
African Journals Online (AJOL)
Musumali
2007-10-11
Oct 11, 2007 ... of the expectant women did not deliver at a health facility ... health service utilization for childbirth such as education5-8, maternal age 3,6, parity6,8, economic status7, cultural factors and beliefs, lack of skilled staff at primary.
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Directory of Open Access Journals (Sweden)
Evalina van Wijk
2014-08-01
Objectives: The aim of the study was to describe patients’ perceptions of the possible environmental and staff factors that might contribute to their aggressive and violent behaviour after admission to a mental health facility; and to propose strategies to prevent and manage such behaviour. Research design: A qualitative, phenomenological study was utilised, in which purposefully sampled inpatients were interviewed over a six-month period. Inpatients were invited to participate if they had been admitted for at least seven days and were in touch with reality. Method: Forty inpatients in two mental health facilities in Cape Town participated in face-to-face, semi-structured interviews over a period of six months. Tesch’s descriptive method of open coding formed the framework for the data analysis and presentation of the results. Trustworthiness was ensured in accordance with the principles of credibility, confirmability, transferability and dependability. Results: Analysis of the data indicates two central categories in the factors contributing to patients’ aggressive and violent behaviour, namely, environmental factors and the attitude and behaviour of staff. Conclusion: From the perspective of the inpatients included in this study, aggressive and violent episodes are common and require intervention. Specific strategies for preventing such behaviour are proposed and it is recommended that these strategies be incorporated into the in-service training programmes of the staff of mental health facilities. These strategies could prevent, or reduce, aggressive and violent behaviour in in-patient facilities.
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Facility location of organ procurement organisations in Indian health care supply chain management
Rajmohan, M.; Theophilus, C.; Sumalatha, M.R.; Saravanakumar, S.
2017-01-01
In health care supply chain management, particularly in the area of organ transplantation, organ procurement and the transplantation network play an important role. The organ procurement organisation (OPO) should coordinate so that organs are prepared and transported to the recipients when donors become available. The scarcity of organ supply leads to life-challenging issues for the organ recipient. In this research, the importance of the location of OPOs to coordinate with the transplant cen...
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Regional governance: strategies and disputes in health region management
Directory of Open Access Journals (Sweden)
Adriano Maia dos Santos
2014-08-01
Full Text Available OBJECTIVE To analyze the regional governance of the health systemin relation to management strategies and disputes. METHODOLOGICAL PROCEDURES A qualitative study with health managers from 19 municipalities in the health region of Bahia, Northeastern Brazil. Data were drawn from 17 semi-structured interviews of state, regional, and municipal health policymakers and managers; a focus group; observations of the regional interagency committee; and documents in 2012. The political-institutional and the organizational components were analyzed in the light of dialectical hermeneutics. RESULTS The regional interagency committee is the chief regional governance strategy/component and functions as a strategic tool for strengthening governance. It brings together a diversity of members responsible for decision making in the healthcare territories, who need to negotiate the allocation of funding and the distribution of facilities for common use in the region. The high turnover of health secretaries, their lack of autonomy from the local executive decisions, inadequate technical training to exercise their function, and the influence of party politics on decision making stand as obstacles to the regional interagency committee’s permeability to social demands. Funding is insufficient to enable the fulfillment of the officially integrated agreed-upon program or to boost public supply by the system, requiring that public managers procure services from the private market at values higher than the national health service price schedule (Brazilian Unified Health System Table. The study determined that “facilitators” under contract to health departments accelerated access to specialized (diagnostic, therapeutic and/or surgical services in other municipalities by direct payment to physicians for procedure costs already covered by the Brazilian Unified Health System. CONCLUSIONS The characteristics identified a regionalized system with a conflictive pattern of
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McCue, Michael J; Thompson, Jon M
2010-05-01
To assess the financial and operational differences in freestanding inpatient rehabilitation facilities (IRFs) that are operated by HealthSouth Corporation relative to other for-profit and nonprofit system-affiliated ownership groups. Since 2003, when it faced fraud charges and financial penalties, HealthSouth has experienced new management and refocused its business strategy. Because HealthSouth is the largest provider of freestanding IRF services, it is important to understand how their performance may differ relative to other ownership groups. We used the Mann-Whitney U test to assess differences in median values for financial and operational variables of HealthSouth-owned IRFs compared with other for-profit system IRFs and nonprofit system IRFs. System-affiliated freestanding IRFs in the United States. Sixty-four HealthSouth IRFs, 18 nonprofit system-affiliated IRFs, and 18 for-profit system-affiliated IRFs. Not applicable. Net patient revenue per adjusted discharge, operating expense per adjusted discharge, salary expense per full-time equivalent, and cash flow margin. HealthSouth IRFs had significantly lower net patient revenue per adjusted discharge and operating expense per adjusted discharge; however, its cash flow margin was significantly higher than other comparison groups. HealthSouth IRFs treated a higher case mix of patients relative to these comparison groups. The financial and operating performance of HealthSouth IRFs is stronger than other ownership groups. Strong cash flow will enable HealthSouth to pay down long-term debt.
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Thomasson, Anna; Carlile, Colin
2017-06-01
This is the story of how a large research facility of broad European and global interest, the European Spallation Source (ESS), ended up in the small university town of Lund in Sweden. This happened in spite of the fact that a number of influential European countries were at one time or another competitors to host the facility. It is also a story about politics which attempts to illustrate how closely intertwined politics and science are, and how the interplay between those interests affects scientific progress. ESS became an arena for individual ambitions and political manoeuvring. The different stakeholders, in their striving to ensure that their own interests were realised, in various ways and with different degrees of success over the years, have influenced the key decisions that, during the already 30 year history of ESS, have driven the course that this project has taken. What emerges is that the interests of the stakeholders and the interests of the project itself are frequently not in harmony. This imposes challenges on the management of large research facilities as they have to not only navigate in the scientific landscape, which they often are more familiar with, but also in the political landscape. This story is therefore an attempt to shed light on the role of managers of large research facilities and the often delicate balancing act they have to perform when trying to comply with the different and often conflicting stakeholder interests. What is especially worthwhile examining, as we do in this paper, is the role that individuals, and the interaction between individuals, have played in the process. This shows that the focus of stakeholder theory on organisations, rather than the people in the organisations, needs to be redirected on to the individuals representing those organisations and their inter-relationships. At the same time it is clear that the developing field of stakeholder management theory has not emerged into the consciousness of science
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CSIR Research Space (South Africa)
Saidi, M
2007-05-01
Full Text Available The objective of the study is to develop a systems framework for the implementation and management of sustainable infrastructure technologies in the built environment with specific focus on health facilities. It look at the global trends and drivers...
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Water, sanitation and hygiene in Jordan's healthcare facilities.
Khader, Yousef Saleh
2017-08-14
Purpose The purpose of this paper is to determine water availability, sanitation and hygiene (WSH) services, and healthcare waste management in Jordan healthcare facilities. Design/methodology/approach In total, 19 hospitals (15 public and four private) were selected. The WSH services were assessed in hospitals using the WSH in health facilities assessment tool developed for this purpose. Findings All hospitals (100 percent) had a safe water source and most (84.2 percent) had functional water sources to provide enough water for users' needs. All hospitals had appropriate and sufficient gender separated toilets in the wards and 84.2 percent had the same in outpatient settings. Overall, 84.2 percent had sufficient and functioning handwashing basins with soap and water, and 79.0 percent had sufficient showers. Healthcare waste management was appropriately practiced in all hospitals. Practical implications Jordan hospital managers achieved major achievements providing access to drinking water and improved sanitation. However, there are still areas that need improvements, such as providing toilets for patients with special needs, establishing handwashing basins with water and soap near toilets, toilet maintenance and providing sufficient trolleys for collecting hazardous waste. Efforts are needed to integrate WSH service policies with existing national policies on environmental health in health facilities, establish national standards and targets for the various healthcare facilities to increase access and improve services. Originality/value There are limited WSH data on healthcare facilities and targets for basic coverage in healthcare facilities are also lacking. A new assessment tool was developed to generate core WSH indicators and to assess WSH services in Jordan's healthcare facilities. This tool can be used by a non-WSH specialist to quickly assess healthcare facility-related WSH services and sanitary hazards in other countries. This tool identified some areas
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International Nuclear Information System (INIS)
Pham Van Lam; Ong Van Ngoc; Nguyen Thi Nang
2000-01-01
The Dalat Nuclear Research Reactor was reconstructed from the former TRIGA MARK-II in 1982 and put into operation in March 1984. The combined technology for radioactive waste management was newly designed and put into operation in 1984. The system for radioactive waste management at the Dalat Nuclear Research Institute (DNRI) consists of radioactive liquid waste treatment station and disposal facilities. The treatment methods used for radioactive liquid waste are coagulation and precipitation, mechanical filtering and ion- exchange. Near-surface disposal of radioactive wastes is practiced at DNRI In the disposal facilities eight concrete pits are constructed for solidification and disposal of low level radioactive waste. Many types of waste generated in DNRI and in some Nuclear Medicine Departments in the South of Vietnam are stored in the disposal facilities. The solidification of sludge has been done by cementation. Hydraulic compactor has done volume reduction of compatible waste. This paper presents fifteen-years of safe operation of radioactive waste management facilities at DNRI. (author)
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Managing LLRW from decommissioning of nuclear facilities - a Canadian perspective
Energy Technology Data Exchange (ETDEWEB)
Donders, R E [Atomic Energy of Canada Ltd., Chalk River, ON (Canada). Chalk River Nuclear Labs.; Hardy, D G [Frontenac Consulting Services, Deep River, ON (Canada); De, P L [Low-Level Radioactive Waste Management Office, Gloucester, ON (Canada)
1994-03-01
In Canada, considerable experience has been gained recently in decommissioning nuclear facilities and managing the resulting waste. This experience has raised important issues from both the decommissioning and waste management perspectives. This paper focuses on the waste management aspects of decommissioning. Past experience is reviewed, preliminary estimates of waste volumes and characteristics are provided, and the major technical and regulatory issues are discussed. (author). 5 refs., 1 tab., 2 figs.
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Directory of Open Access Journals (Sweden)
Yannick Tousignant-Laflamme
2012-01-01
Full Text Available BACKGROUND: The prevalence of chronic pain ranges from 40% to 80% in long-term care facilities (LTCF, with the highest proportion being found among older adults and residents with dementia. Unfortunately, pain in older adults is underdiagnosed, undertreated, inadequately treated or not treated at all. A solution to this problem would be to provide effective and innovative interdisciplinary continuing education to health care providers (HCPs.
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Regulatory inspection practices for radioactive and non-radioactive waste management facilities
International Nuclear Information System (INIS)
Roy, Amitava
2017-01-01
Management of nuclear waste plays an important role in the nuclear energy programme of the country. India has adopted the Closed Fuel Cycle option, where the spent nuclear fuel is treated as a material of resource and the nuclear waste is wealth. Closed fuel cycle aims at recovery and recycle of valuable nuclear materials in to reactors as fuel and also separation of useful radio isotopes for the use in health care, agriculture and industry. India has taken a lead role in the waste management activities and has reached a level of maturity over a period of more than forty decades. The nuclear waste management primarily comprises of waste characterization, segregation, conditioning, treatment, immobilization of radionuclides in stable and solid matrices and interim retrievable storage of conditioned solid waste under surveillance. The waste generated in a nuclear facility is in the form of liquid and solid, and it's classification depends on the content of radioactivity. The liquid waste is characterized as Low level (LLW), Intermediate level (ILW) and High Level (HLW). The LLW is relatively large in volume and much lesser radioactive. The LLW is subjected to chemical precipitation using various chemicals based on the radionuclides present, followed by filtration, settling, ion exchange and cement fixation. The conditioning and treatment processes of ILW uses ion exchange, alkali hydrolysis for spent solvent, phase separation and immobilization in cement matrix. The High Level Waste (HLW), generated during spent fuel reprocessing and containing more than 99 percent of the total radioactivity is first subjected to volume reduction/concentration by evaporation and then vitrified in a meIter using borosilicate glass. Presently, Joule Heated Ceramic Meter is used in India for Vitrification process. Vitrified waste products (VWP) are stored for interim period in a multibarrier, air cooled facility under surveillance
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Jackson, Ruth; Hailemariam, Assefa
2016-09-01
Women's preference to give birth at home is deeply embedded in Ethiopian culture. Many women only go to health facilities if they have complications during birth. Health Extension Workers (HEWs) have been deployed to improve the utilization of maternal health services by bridging the gap between communities and health facilities. This study examined the barriers and facilitators for HEWs as they refer women to mid-level health facilities for birth. A qualitative study was conducted in three regions: Afar Region, Southern Nations Nationalities and People's Region and Tigray Region between March to December 2014. Interviews and focus group discussions were conducted with 45 HEWs, 14 women extension workers (employed by Afar Pastoralist Development Association, Afar Region) and 11 other health workers from health centers, hospitals or health offices. Data analysis was done based on collating the data and identifying key themes. Barriers to health facilities included distance, lack of transportation, sociocultural factors and disrespectful care. Facilitators for facility-based deliveries included liaising with Health Development Army (HDA) leaders to refer women before their expected due date or if labour starts at home; the introduction of ambulance services; and, provision of health services that are culturally more acceptable for women. HEWs can effectively refer more women to give birth in health facilities when the HDA is well established, when health staff provide respectful care, and when ambulance is available at any time.
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International Nuclear Information System (INIS)
Sztanyik, L.B.
1986-01-01
It is required by the Hungarian Atomic Energy Act and its enacting clause of 1980 that facilities established for the application of atomic energy be designed, constructed and operated in such a manner that abnormal operational occurrences can be avoided and unplanned exposures to radiation and radioactive substances can be prevented. The primary responsibility for planning and implementing emergency actions rests with the management of the operating organization. Thus one of the prerequisites of licensing the first nuclear power plant in Hungary was the preparation and submission for approval of an emergency plan by the operating organization. In addition to this, the council of the county where the power plant is located has also been obliged to prepare a complementary emergency plan, in co-operation with other regional and national authorities, for the prevention of consequences from an emergency that may extend beyond the site boundary of the plant. In preparing the complementary plan, the emergency plan of the facility had to be taken into account. Unlike most national authorities involved in nuclear matters, the Public Health Authority is involved in the preparation of plans for every kind of emergency in a nuclear facility, including even those whose consequences can probably be confined to the plant site. The paper discusses in detail the role and responsibility of the Public Health Authority in emergency planning and preparedness for nuclear facilities. (author)
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International Nuclear Information System (INIS)
Denney, R.D.
1995-10-01
The CPP-603 Underwater Fuel Storage Facility (UFSF) Site Integrated Stabilization Management Plan (SISMP) has been constructed to describe the activities required for the relocation of spent nuclear fuel (SNF) from the CPP-603 facility. These activities are the only Idaho National Engineering Laboratory (INEL) actions identified in the Implementation Plan developed to meet the requirements of the Defense Nuclear Facilities Safety Board (DNFSB) Recommendation 94-1 to the Secretary of Energy regarding an improved schedule for remediation in the Defense Nuclear Facilities Complex. As described in the DNFSB Recommendation 94-1 Implementation Plan, issued February 28, 1995, an INEL Spent Nuclear Fuel Management Plan is currently under development to direct the placement of SNF currently in existing INEL facilities into interim storage, and to address the coordination of intrasite SNF movements with new receipts and intersite transfers that were identified in the DOE SNF Programmatic and INEL Environmental Restoration and Waste Management Environmental Impact Statement Record, of Decision. This SISMP will be a subset of the INEL Spent Nuclear Fuel Management Plan and the activities described are being coordinated with other INEL SNF management activities. The CPP-603 relocation activities have been assigned a high priority so that established milestones will be meet, but there will be some cases where other activities will take precedence in utilization of available resources. The Draft INEL Site Integrated Stabilization Management Plan (SISMP), INEL-94/0279, Draft Rev. 2, dated March 10, 1995, is being superseded by the INEL Spent Nuclear Fuel Management Plan and this CPP-603 specific SISMP
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ETHEL's systems and facilities for safe management of tritiated wastes
International Nuclear Information System (INIS)
Mannone, F.; Dworschak, H.; Vassallo, G.
1992-01-01
The European Tritium Handling Experimental Laboratory (ETHEL) is a new tritium facility at the Commission of the European Community's Joint Research Centre, Ispra Site. The laboratory, destined to handle multigram amounts of tritium for safety related R and D purposes, is foreseen to start radioactive operations in late 1992. The general operation and maintenance of laboratory systems and future experiments will generate tritiated wastes in gaseous, liquid and solid forms. The management of such wastes under safe working conditions is a stringent laboratory requirement aimed at minimizing the risk of unacceptable tritium exposures to workers and the general public. This paper describes the main systems and facilities installed in ETHEL for the safe management of tritiated wastes
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International Nuclear Information System (INIS)
Galloway, K.J.; Jolley, J.G.
1994-06-01
This monitoring plan provides the information necessary to perform routine organic air emissions monitoring at the Waste Storage Facilities located at the Transuranic Storage Area of the Radioactive Waste Management Complex at the Idaho National Engineering Laboratory. The Waste Storage Facilities include both the Type I and II Waste Storage Modules. The plan implements a dual method approach where two dissimilar analytical methodologies, Open-Path Fourier Transform Infrared Spectroscopy (OP-FTIR) and ancillary SUMMA reg-sign canister sampling, following the US Environmental Protection Agency (EPA) analytical method TO-14, will be used to provide qualitative and quantitative volatile organic concentration data. The Open-Path Fourier Transform Infrared Spectroscopy will provide in situ, real time monitoring of volatile organic compound concentrations in the ambient air of the Waste Storage Facilities. To supplement the OP-FTIR data, air samples will be collected using SUMMA reg-sign, passivated, stainless steel canisters, following the EPA Method TO-14. These samples will be analyzed for volatile organic compounds with gas chromatograph/mass spectrometry analysis. The sampling strategy, procedures, and schedules are included in this monitoring plan. The development of this monitoring plan is driven by regulatory compliance to the Resource Conservation and Recovery Act, State of Idaho Toxic Air Pollutant increments, Occupational Safety and Health Administration. The various state and federal regulations address the characterization of the volatile organic compounds and the resultant ambient air emissions that may originate from facilities involved in industrial production and/or waste management activities
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Stress and Coping among Owners and Managers of Residential Care Facilities.
Walker, Hollie; And Others
Stress and burnout are common in the caregiving professions. Stress negatively affects both the caregivers and patients. In order to help caregivers deal with stress effectively and to improve the care in residential care facilities, it is essential to learn more about the particular stressors that managers of such facilities experience. In this…
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Characteristics of Chinese m-Health Applications for Diabetes Self-Management.
Nie, Lisa; Xie, Bo; Yang, Yan; Shan, Yan Min
2016-07-01
To examine the features and types of health information provided in Chinese diabetes mobile applications (apps) for patients' self-management. Through multiple rounds of screening, we identified a total of 95 relevant iOS (Apple, Cupertino, CA) and Android™ (Google, Mountain View, CA) apps and examined each app's features and health information types based on each app's description in the app stores. We used a 15-feature algorithm to evaluate the apps' abilities for supporting diabetic patients' self-management, based on U.S. national standards for diabetes self-management. We also adapted the health information wants framework to analyze the types of information that the apps provided for diabetic patients. Diabetes education was the most common feature, provided by 75% of the apps. Blood glucose checking was enabled by 65% of the apps. Diet management, insulin checking, and physical activity monitoring were enabled by 53%, 49%, and 44% of the apps, respectively. Only a small percentage of the apps enabled psychosocial support (29%) or tracking of blood pressure (14%), cholesterol (14%), or body mass index (11%). None of the apps provided all seven types of information posited by the health information wants framework. Only a small percentage of the apps provided information about psychosocial support (29%), healthcare providers (24%), or healthcare facilities (24%). Information about complementary and alternative medicine was the least likely type of information provided in the apps, with only 7% of the apps providing this type of information. Our findings have important implications for improving the quality of Chinese diabetes mobile apps to facilitate patients' self-management.
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Directory of Open Access Journals (Sweden)
Robin C Nesbitt
Full Text Available To evaluate quality of routine and emergency intrapartum and postnatal care using a health facility assessment, and to estimate "effective coverage" of skilled attendance in Brong Ahafo, Ghana.We conducted an assessment of all 86 health facilities in seven districts in Brong Ahafo. Using performance of key signal functions and the availability of relevant drugs, equipment and trained health professionals, we created composite quality categories in four dimensions: routine delivery care, emergency obstetric care (EmOC, emergency newborn care (EmNC and non-medical quality. Linking the health facility assessment to surveillance data we estimated "effective coverage" of skilled attendance as the proportion of births in facilities of high quality.Delivery care was offered in 64/86 facilities; only 3-13% fulfilled our requirements for the highest quality category in any dimension. Quality was lowest in the emergency care dimensions, with 63% and 58% of facilities categorized as "low" or "substandard" for EmOC and EmNC, respectively. This implies performing less than four EmOC or three EmNC signal functions, and/or employing less than two skilled health professionals, and/or that no health professionals were present during our visit. Routine delivery care was "low" or "substandard" in 39% of facilities, meaning 25/64 facilities performed less than six routine signal functions and/or had less than two skilled health professionals and/or less than one midwife. While 68% of births were in health facilities, only 18% were in facilities with "high" or "highest" quality in all dimensions.Our comprehensive facility assessment showed that quality of routine and emergency intrapartum and postnatal care was generally low in the study region. While coverage with facility delivery was 68%, we estimated "effective coverage" of skilled attendance at 18%, thus revealing a large "quality gap." Effective coverage could be a meaningful indicator of progress towards
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Radioactive Waste Management at the New Conversion Facility of 'TVEL'R Fuel Company - 13474
International Nuclear Information System (INIS)
Indyk, S.I.; Volodenko, A.V.; Tvilenev, K.A.; Tinin, V.V.; Fateeva, E.V.
2013-01-01
The project on the new conversion facility construction is being implemented by Joint Stock Company (JSC) 'Siberian Group of Chemical Enterprises' (SGChE) within TVEL R Fuel Company. The objective is to construct the up-to-date facility ensuring the industrial and environmental safety with the reduced impact on the community and environment in compliance with the Russian new regulatory framework on radioactive waste (RW) management. The history of the SGChE development, as well as the concepts and approaches to RW management implemented by now are shown. The SGChE future image is outlined, together with its objectives and concept on RW management in compliance with the new act 'On radioactive waste management' adopted in Russia in 2011. Possible areas of cooperation with international companies are discussed in the field of RW management with the purpose of deploying the best Russian and world practices on RW management at the new conversion facility. (authors)
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2010-10-01
...-Office of Construction and Facilities Management and National Cemetery Administration. 801.602-80 Section... Responsibilities 801.602-80 Legal and technical review-Office of Construction and Facilities Management and National Cemetery Administration. An Office of Construction and Facilities Management or National Cemetery...
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International Nuclear Information System (INIS)
Paige, H.W.; Numark, N.J.
1985-01-01
This report is the fourth in a series of periodic surveys of approaches and progress in other countries in dealing with the problems of obtaining local acceptance for siting of waste management facilities. This volume contains the following sections: Nation's political/industrial structure for obtaining waste management siting decisions; and Nation's formal legal procedure for obtaining necessary approvals for siting nuclear waste management facilities. Two of the countries visited, Finland and Sweden, have had major changes in the past two years in their formal/legal procedures for obtaining waste management siting decisions. (LM)
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Energy Technology Data Exchange (ETDEWEB)
Dionne, B.J.; Morris, S.C. III; Baum, J.W. [and others
1998-01-01
The Department of Energy`s (DOE) Office of Environment, Safety, and Health (EH) sought examples of risk-based approaches to environmental restoration to include in their guidance for DOE nuclear facilities. Extensive measurements of radiological contamination in soil and ground water have been made at Brookhaven National Laboratory`s Hazardous Waste Management Facility (HWMF) as part of a Comprehensive Environmental Response, Compensation and Liability Act (CERCLA) remediation process. This provided an ideal opportunity for a case study. This report provides a risk assessment and an {open_quotes}As Low as Reasonably Achievable{close_quotes} (ALARA) analysis for use at other DOE nuclear facilities as an example of a risk-based decision technique. This document contains the Appendices for the report.
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Iyengar, Kirti; Jain, Motilal; Thomas, Sunil; Dashora, Kalpana; Liu, William; Saini, Paramsukh; Dattatreya, Rajesh; Parker, Indrani; Iyengar, Sharad
2014-08-13
After the launch of Janani Suraksha Yojana, a conditional cash transfer scheme in India, the proportion of women giving birth in institutions has rapidly increased. However, there are important gaps in quality of childbirth services during institutional deliveries. The aim of this intervention was to improve the quality of childbirth services in selected high caseload public health facilities of 10 districts of Rajasthan. This intervention titled "Parijaat" was designed by Action Research & Training for Health, in partnership with the state government and United Nations Population Fund. The intervention was carried out in 44 public health facilities in 10 districts of Rajasthan, India. These included district hospitals (9), community health centres (32) and primary health centres (3). The main intervention was orientation training of doctors and program managers and regular visits to facilities involving assessment, feedback, training and action. The adherence to evidence based practices before, during and after this intervention were measured using structured checklists and scoring sheets. Main outcome measures included changes in practices during labour, delivery or immediate postpartum period. Use of several unnecessary or harmful practices reduced significantly. Most importantly, proportion of facilities using routine augmentation of labour reduced (p = 0), episiotomy for primigravidas (p = 0.0003), fundal pressure (p = 0.0003), and routine suction of newborns (0 = 0.0005). Among the beneficial practices, use of oxytocin after delivery increased (p = 0.0001) and the practice of listening foetal heart sounds during labour (p = 0.0001). Some practices did not show any improvements, such as dorsal position for delivery, use of partograph, and hand-washing. An intervention based on repeated facility visits combined with actions at the level of decision makers can lead to substantial improvements in quality of childbirth practices at health facilities.
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Realising the potential of shared space in facilities management
DEFF Research Database (Denmark)
Brinkø, Rikke
individuals or groups from different organisational contexts, and this PhD investigates the intricate processes con-cerning shared space in a facilities management context. The overall aim is divided in a theoretical and a practical part, with the theoretical focused on contributing with new knowledge...... of shared space, building towards a new method for efficient and sustainable facilities management operation of buildings and properties. The practical part is focused on connecting this new knowledge to practical applications and developing tools that can be used to work with shared spaces in a practice...... categories according to degree of sharing, and lists a number of characteristics of shared spaces to provide a starting point for discussing, developing and working with shared space in both academia and practice. The guide on the other hand synthesises the theoretical knowledge resulting from the study...
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Munshi, Medha N; Florez, Hermes; Huang, Elbert S; Kalyani, Rita R; Mupanomunda, Maria; Pandya, Naushira; Swift, Carrie S; Taveira, Tracey H; Haas, Linda B
2016-02-01
Diabetes is more common in older adults, has a high prevalence in long-term care (LTC) facilities, and is associated with significant disease burden and higher cost. The heterogeneity of this population with regard to comorbidities and overall health status is critical to establishing personalized goals and treatments for diabetes. The risk of hypoglycemia is the most important factor in determining glycemic goals due to the catastrophic consequences in this population. Simplified treatment regimens are preferred, and the sole use of sliding scale insulin (SSI) should be avoided. This position statement provides a classification system for older adults in LTC settings, describes how diabetes goals and management should be tailored based on comorbidities, delineates key issues to consider when using glucose-lowering agents in this population, and provides recommendations on how to replace SSI in LTC facilities. As these patients transition from one setting to another, or from one provider to another, their risk for adverse events increases. Strategies are presented to reduce these risks and ensure safe transitions. This article addresses diabetes management at end of life and in those receiving palliative and hospice care. The integration of diabetes management into LTC facilities is important and requires an interprofessional team approach. To facilitate this approach, acceptance by administrative personnel is needed, as are protocols and possibly system changes. It is important for clinicians to understand the characteristics, challenges, and barriers related to the older population living in LTC facilities as well as the proper functioning of the facilities themselves. Once these challenges are identified, individualized approaches can be designed to improve diabetes management while lowering the risk of hypoglycemia and ultimately improving quality of life. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly
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Mixed Waste Management Facility closure at the Savannah River Site
International Nuclear Information System (INIS)
Bittner, M.F.
1991-08-01
The Mixed Waste Management Facility of the Savannah River Plant received hazardous and solid low level radioactive wastes from 1972 until 1986. Because this facility did not have a permit to receive hazardous wastes, a Resource Conservation and Recovery Act closure was performed between 1987 and 1990. This closure consisted of dynamic compaction of the waste trenches and placement of a 3-foot clay cap, a 2-foot soil cover, and a vegetative layer. Operations of the waste disposal facility, tests performed to complete the closure design, and the construction of the closure cap are discussed herein
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Practical considerations for disaster preparedness and continuity management in research facilities.
Mortell, Norman; Nicholls, Sam
2013-10-01
Many research facility managers, veterinarians and directors are familiar with the principles of Good Laboratory Practice, requirements of the Association for Assessment and Accreditation of Laboratory Animal Care International, tenets of biosecurity and standards of animal welfare and housing but may be less familiar with the ideas of business continuity. But business continuity considerations are as applicable to research facilities as they are to other institutions. The authors discuss how business continuity principles can be applied in the research context and propose that such application, or 'research continuity management,' enables a focused but wide-reaching approach to disaster preparedness.
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International Nuclear Information System (INIS)
Genser, J.R.
1992-01-01
The Westinghouse Savannah River Company (WSRC) is aggressively applying environmental remediation and radioactive waste management activities at the US Department of Energy's Savannah River Site (SRS) to ensure compliance with today's challenging governmental laws and regulatory requirements. This report discusses a computer-based Nuclear Facility Isotopic Content (NFIC) Waste Management System developed to provide input for the safety envelope definition and assessment of site-wide facilities. Information was formulated describing the SRS ''Nuclear Facilities'' and their respective bounding inventories of nuclear materials and radioactive waste using the NFIC Waste Management System
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Ureterolithiasis: Management in an environment with limited facilities
African Journals Online (AJOL)
Background: In the past 2–3 decades, there has been a dramatic development in the techniques of stone removal. This study highlights the management of symptomatic ureteral stones in an environment without such facilities. Materials and Methods: Sixty‑nine patients, comprising 53 (76.8%) males and 16 (23.2%) females ...
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Biosecurity measures in 48 isolation facilities managing highly infectious diseases.
Puro, Vincenzo; Fusco, Francesco M; Schilling, Stefan; Thomson, Gail; De Iaco, Giuseppina; Brouqui, Philippe; Maltezou, Helena C; Bannister, Barbara; Gottschalk, René; Brodt, Hans-Rheinhard; Ippolito, Giuseppe
2012-06-01
Biosecurity measures are traditionally applied to laboratories, but they may also be usefully applied in highly specialized clinical settings, such as the isolation facilities for the management of patients with highly infectious diseases (eg, viral hemorrhagic fevers, SARS, smallpox, potentially severe pandemic flu, and MDR- and XDR-tuberculosis). In 2009 the European Network for Highly Infectious Diseases conducted a survey in 48 isolation facilities in 16 European countries to determine biosecurity measures for access control to the facility. Security personnel are present in 39 facilities (81%). In 35 facilities (73%), entrance to the isolation area is restricted; control methods include electronic keys, a PIN system, closed-circuit TV, and guards at the doors. In 25 facilities (52%), identification and registration of all staff entering and exiting the isolation area are required. Access control is used in most surveyed centers, but specific lacks exist in some facilities. Further data are needed to assess other biosecurity aspects, such as the security measures during the transportation of potentially contaminated materials and measures to address the risk of an "insider attack."
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International Nuclear Information System (INIS)
Al-Khatib, Issam A.; Sato, Chikashi
2009-01-01
Health care waste is considered a major public health hazard. The objective of this study was to assess health care waste management (HCWM) practices currently employed at health care centers (HCCs) in the West Bank - Palestinian Territory. Survey data on solid health care waste (SHCW) were analyzed for generated quantities, collection, separation, treatment, transportation, and final disposal. Estimated 4720.7 m 3 (288.1 tons) of SHCW are generated monthly by the HCCs in the West Bank. This study concluded that: (i) current HCWM practices do not meet HCWM standards recommended by the World Health Organization (WHO) or adapted by developed countries, and (ii) immediate attention should be directed towards improvement of HCWM facilities and development of effective legislation. To improve the HCWM in the West Bank, a national policy should be implemented, comprising a comprehensive plan of action and providing environmentally sound and reliable technological measures.
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Babu, Giridhara R; Tejaswi, B; Kalavathi, M; Vatsala, G M; Murthy, G V S; Kinra, Sanjay; Neelon, Sara E Benjamin
2015-02-20
Screening and timely treatment of gestational hyperglycaemia (GH) is proved to be beneficial and improves maternal and foetal health outcomes. To understand screening practices, we explored the knowledge and perceptions of doctors working in public health facilities in Bangalore, India. We also studied participation factors by examining whether undergoing glucose estimation tests affects morning sickness in pregnant women. We aimed to understand the screening practices and knowledge of doctors. A semi-structured questionnaire was self-administered by the 50 participant doctors, selected from the sampling frame comprising of all the doctors working in public health facilities. We included 105 pregnant women for baseline assessment, in whom a well-structured questionnaire was used. We reported that gestational diabetes mellitus (GDM) screening was done in nearly all the health centres (96%). However, only 12% of the doctors could provide all components of GDM diagnosis and management correctly and 46% would diagnose by using a random blood glucose test. A majority (92%) of the doctors had poor knowledge (68%) about the cut-off values of glucose tests. More than 80% of pregnant women experienced some discomfort mostly due to rapid ingestion glucose in short span of time. Our study established that screening for GH is done in most public health facilities. Nonetheless, knowledge of doctors on the glucose tests and their interpretation needs improvement. Re-orientation trainings of the doctors can improve their knowledge and thereby can efficiently screen for GH. Further, adequate planning prior to the tests can aid successful completion of them. Significance for public healthRising burden of hyperglycaemia in pregnancy is a cause for concern and is associated with short and long term deleterious consequences for mother and offspring. Hence, there is an urgent need to explore the screening practices for gestational hyperglycaemia (GH). The current study considers