Using modeling as a co-design approach in the planning process of new care environments

Current research shows a relationship between healthcare architecture and patient-related Outcomes. The planning and designing of new healthcare environments is a complex process; the needs of the various end-users of the environment must be considered, including the patients, the patients’ significant others, and the staff. The aim of this study was to explore the experiences of healthcare professionals participating in group modelling utilizing system dynamics in the pre-design phase of new healthcare environments. We engaged healthcare professionals in a series of workshops using system dynamics to discuss the planning of healthcare environments in the beginning of a construction, and then interviewed them about their experience. An explorative and qualitative design was used to describe participants’ experiences of participating in the group modelling projects. Participants (n=20) were recruited from a larger intervention study using group modeling and system dynamics in planning and designing projects. The interviews were analysed by qualitative content analysis. Two themes were formed, representing the experiences in the group modeling process: ‘Partaking in the G-M created knowledge and empowerment’and ‘Partaking in the G-M was different from what was expected and required time and skills’. The method can support participants in design teams to focus more on their healthcare organization, their care activities and their aims rather than focusing on detailed layout solutions. This clarification is important when decisions about the design are discussed and prepared and will most likely lead to greater readiness for future building process.

Evaluation of a versatile energy auditing tool

Energy auditing can be an important contribution for identification and assessment of energy conservation measures (ECMs) in buildings. Numerous tools and software have been developed, with varying degree of precision and complexity and different areas of use.   This paper evaluates PHPP as a versatile, easy-to-use energy auditing tool and gives examples of how it has been compared to a dynamic simulation tool, within the EU-project iNSPiRe. PHPP is a monthly balance energy calculation tool based on EN13790. It is intended for assisting the design of Passive Houses and energy renovation projects and as guidance in the choice of appropriate ECMs.   PHPP was compared against the transient simulation software TRNSYS for a single family house and a multi-family house. It should be mentioned that dynamic building simulations might strongly depend on the model assumptions and simplifications compared to reality, such as ideal heating or real heat emission system. Setting common boundary conditions for both PHPP and TRNSYS, the ideal heating and cooling loads and demands were compared on monthly and annual basis for seven European locations and buildings with different floor area, S/V ratio, U-values and glazed area of the external walls.   The results show that PHPP can be used to assess the heating demand of single-zone buildings and the reduction of heating demand with ECMs with good precision. The estimation of cooling demand is also acceptable if an appropriate shading factor is applied in PHPP. In general, PHPP intentionally overestimates heating and cooling loads, to be on the safe side for system sizing. Overall, the agreement with TRNSYS is better in cases with higher quality of the envelope as in cold climates and for good energy standards. As an energy auditing tool intended for pre-design it is a good, versatile and easy-to-use alternative to more complex simulation tools.

Pre-diabetes i fokus : Patienters förståelse och upplevelse av pre-diabetes i mötet med personer i samma situation

Syfte: Att beskriva personers upplever att få pre-diabetes som en del av livet. Metod: Kvalitativ design. Studien genomfördes med fokusgrupper bestående av personer med pre-diabetes. Tre olika grupper med totalt 12 personer ingick i studien. Resultat: Ur diskussionerna kunde tre olika kategorier urskiljas. Pre-diabetes som en del av livet, egen erfarenhet och kunskap om tillståndet samt behov av information och stöd för ökad kunskap om livsstilsförändringar. Pre-diabetes var för de flesta studiedeltagare ett okänt begrepp. Känslor som osäkerhet och rädsla för tillståndet, samt för eventuell utveckling till manifest diabetes var vanligt. Det ansågs värdefullt att få besked i tidigt skede om förhöjda blodsockervärden, eftersom individen då hade möjlighet att påverka sin livsstil och förebygga annan sjukdom. Alla deltagare önskade mer kunskap och stöd kring pre-diabetes och livsstilsåtgärder. Respondenterna beskrev besvikelse över vårdpersonalens bemötande i samband med beskedet om förhöjda blodsockervärden. Informationen ansågs vara för knapphändig vilket gav uppfattning om att tillståndet inte var något att bry sig om. Konklusion: Respondenterna ville i största möjligaste utsträckning förhindra utvecklingen av T2DM genom egenvårdsinsater i form livsstilsförändringar. För att lyckas med det uppgav studiedeltagarna behov av information om vad tillståndet pre-diabetes innebär. Personer som får pre-diabetes bör få saklig information, råd och stöd om tillståndet i samband med beskedet.