2020, Vol.26, No.3

JOURNAL OF THE KOREA INSTITUTE OF HEALTHCARE ARCHITECTURE 2023 KCI Impact Factor : 0.46

pISSN : 2733-8649 / eISSN : 2733-8657
https://journal.kci.go.kr/ikiha

Purpose: As communicable disease, COVID-19, pandemic strikes over the world, it is critically bewared that air travel possibly be a major pass way to deliver the infectious disease virus. Especially the airplane could be an unique environment to cultivate the virus spreaders. In order to keep the continuous safe airway as well as the industry, related international associations and organizations have been published the guidelines for the prevention and control the infectious disease through the all aspects of aviation. By reviewing the guidelines, focusing on the in-flight infection prevention and control, this study would not only inform a summary of the international guidelines but also provide an essential and general consideration for related research or guideline study. Methods: Guidelines of 5 major countries are reviewed, which has been seriously influenced by COVID-19 : U.S., Canada, E.U., Australia and China. The items of the guidelines are re-categorized as its similarity and structure by applicable cases. Results: The result of this study shows that each guideline seems to share a major structure and issue such as identifying sick traveler, sick passenger care, and cleaning even though that of China has a different since it used to consider the flight conditions based on 3 levels of infection risk. For sick passenger care, the guidelines includes crew safety, service level, sick passenger isolation, and cleaning. Implications: A published guideline as a public manual could be to prevent and control the in-flight infection efficiently and promptly. It also could provide a confidence of knowledge and educate for all users to prepare the in-flight emergency as well.

Purpose: This paper presents research evidence that the environmental design of the doffing area in a biocontainment unit (BCU) can have a measurable impact on increasing the safety of frontline healthcare workers (HCW) during doffing of high-level personal protective equipment (PPE), and proposes optimized biocontainment unit design. Methods: From 2016 to 2019, The SimTigrate Design Lab conducted 3 consecutive studies, focusing on ways in which the built environment may support or hinder safe doffing. In the first study, to identify the risky behaviors, we observed 56 simulation exercises with HCWs in 4 BCUs and 1 high-fidelity BCU mockup. In the second study, we tested the effectiveness of a redesigned doffing area on improving the HCWs performance and used simulation, observation, and rapid prototyping in 1 high-fidelity mockup of a doffing area. In a follow-up study, we used simulation and co-design with HCWs to optimize the design of a safer doffing area in a full-size pediatric BCU mock-up. Results: We identified 11 specific risky behaviors potentially leading to occupational injury, or contamination of the PPE, or of the environment. We developed design strategies to create a space for safer doffing. In the second study, in a redesigned doffing area, the overall performance of HCW improved, and we observed a significant decrease in the number of risky behaviors; some risky behaviors were eliminated. There was a significant decrease in physical and cognitive load for the HCWs. Finally, we propose an optimized layout of a BCU for a safer process of PPE doffing. Implications: The proposed BCU design supports better staff communication, efficiency, and automates safer behaviors. Our findings can be used to develop design guidelines for spaces where patients with other highly infectious diseases are treated when the safety of the patient-facing HCWs is of critical importance.

Purpose: A solid system in the process of establishing guidelines can increase social acceptance and utilization. The paper aims to comparatively analyze the system in which guidelines for health care facilities in the US, Australia, and the UK and suggest implications for Korea. Method: It conducted literature analysis of the system in the framework of composition, governance, and procedure for the Facility Guidelines Institute's Guideline for US, Australia's Australasian Health Facility Guidelines for Australia, and Health Building Notes for UK. Results and Implications: First, in terms of composition, the guidelines for health care facilities can be divided into composition by space and composition by issue. It is proposed to establish a system that space and issues are clearly separated, such as Australia's AusHGF, and complete it step by step. Second, in terms of governance, despite the fact that the medical supply is privately oriented, the medical system is controlled by the government in Korea. Therefore, it is suggested to form a separate organization in the public sector that establishes, researches, and revises the guideline that will serve as a focal point for experts in various fields to participate. Third, in terms of procedure, it is suggested to establish a guideline that reflects the experiences and demands of consumers by clearly organizing procedures including collecting opinions.