Environmental Design Strategies to Decrease the Risk of Nosocomial Infection in Medical Buildings Using a Hybrid MCDM Model

Abstract

The prevention and control of nosocomial infection (NI) are becoming increasingly difficult, and its mechanism is becoming increasingly complex. A globally aging population means that an increasing proportion of patients have a susceptible constitution, and the frequent occurrence of severe infectious diseases has also led to an increase in the cost of prevention and control of NI. Medical buildings’ spatial environment design for the prevention of NI has been a hot subject of considerable research, but few previous studies have summarized the design criteria for a medical building environment to control the risk of NI. Thus, there is no suitable evaluation framework to determine whether the spatial environment of a medical building is capable of inhibiting the spread of NI. In the context of the global spread of COVID-19, it is necessary to evaluate the performance of the existing medical building environment in terms of inhibiting the spread of NI and to verify current environmental improvement strategies for the efficient and rational use of resources. This study determines the key design elements for the spatial environment of medical buildings, constructs an evaluation framework using exploratory factor analysis, verifies the complex dominant influence relationship, and prioritizes criteria in the evaluation framework using the decision-making trial and evaluation laboratory- (DEMATEL-) based analytical network process (ANP) (DANP). Using representative real cases, this study uses the technique for order preference by similarity to ideal solution (TOPSIS) to evaluate and analyze the performance with the aspiration level of reducing the NI risk. A continuous and systematic transformation design strategy for these real cases is proposed. The main contributions of this study include the following: (1) it creates a systematic framework that allows hospital decision-makers to evaluate the spatial environment of medical buildings; (2) it provides a reference for making design decisions to improve the current situation using the results of a performance evaluation; (3) it draws an influential network relation map (INRM) and the training of influence weights (IWs) for criteria. The sources of practical problems can be identified by the proposed evaluation framework, and the corresponding strategy can be proposed to avoid the waste of resources for the prevention of epidemics.

Urban Farming Development Strategy to Achieve Sustainable Agriculture in Magelang, Indonesia

“…Furthermore, multiplying the unweighted supermatrix with the weights of each cluster obtained the weighted supermatrix. After obtaining the results of the weighted supermatrix, then it raised to the power to obtain a stable result to produce the limit matrix and the normalized result (normalized by cluster) as the weight of importance [29]. Based on Table 4, the synthesis results show that the node in the sustainability dimension that has the most priority in the development of urban farming in Magelang is the social dimension with a value of 0.221783.…”

A Hybrid Multiple-Attribute Decision-Making Model for Evaluating the Esthetic Expression of Environmental Design Schemes

“…The decision making trial and evaluation laboratory (DEMATEL) method responds to the requirement to identify priorities from a systematic perspective, rather than by "treating symptoms but not the disease" (Zhang et al, 2021). To construct the influential relationships among evaluation criteria, DEMATEL has been widely applied in the evaluation and improvement of physical environments, such as green open spaces (Li et al, 2021), medical buildings (Xiong et al, 2021), and tourist attractions (Zhu et al, 2020). Consequently, in this study, DEMATEL was introduced in the last step of this hybrid MADM model to build a systematic framework providing a key discussion basis for the in-depth analysis of evaluation elements to explore how to improve the esthetic expression of environmental design from a systematic perspective.…”

“…The complex logical relationships (e.g., hierarchical relationships and cause-effect relationships) among the elements of environmental design require further clarification (Chen et al, 2019). Clarifying the system structure of these evaluation elements can reduce the risk of inefficiency in the overall scheme improvement resulting from negligence that is referred to as “treating the symptoms but not the disease” (which means attending to certain elements with the worst performance and highest weight and losing sight of elements in influential relationships with them; Tzeng & Shen, 2017; Xiong et al, 2021; Zhu et al, 2020).…”

Safety of transportation buildings against vehicle bomb attacks with multi-criteria decision-making

“…The TOPSIS method is a very simple method without complex algorithms and mathematical models (Yoon and Hwang, 2022). It is seen that the TOPSIS technique is used in almost any area as it is easy to understand, and the results are not difficult to interpret (Lee et al, 2021;Rashid et al, 2020;Xiong et al, 2021;Zoghi et al, 2021).…”