Yes / The effective reverse exchange of healthcare products such as laundry within a hospital environment can support the health system, for achieving the highest goal: ‘to provide regular and timely supply of clean linen to the satisfaction of patients and staff’ (Srikar et al., 2015, p. 593). Previous studies by Bandoophanit et al. (2015, 2017) assert there are constant shortages of linen availability in many Thai public hospitals which can undermine the efficacy of laundry management and quality of medical treatment. This study investigates the practices, culture, and operational performance of three large-sized public hospitals (700-2,000 beds) located in Thailand reflecting on the application of Reverse Exchanges (R/E) theory. This study contributes to the Thai healthcare agenda, a core mission of which is to “Develop the health system with quality, efficiency and equality; with participation of the people, communities and all sectors for good health of all Thai people in order to achieve a good and sustainable society following the King’s Sufficiency Economy philosophy” (Ministry of Public Health, 2018).

Yes / Purpose Previous research (Bandoophanit et al, 2017) has shown that pharmaceuticals are a key input into effective healthcare operations but other equally important inputs are medical supplies, food, utilities, equipment and linen. As stated by the Twelfth National Economic and Social Development Plan (2017-2021) of Thailand, to attempt to deliver national Sustainable Development Goals (SDGs) organisations should preserve resources and minimize waste-generation in all aspects. The principal aim of this research project was to identify green practices and develop a model which supported and promoted healthcare efficiencies. Research Approach This was a mixed methods multi-site study using both qualitative and quantitative data collection and analysis methods. Six public hospitals were selected as case organizations, covering different types/sizes, locations, and environmental performance expertise. The data collection methods included interviews, documentation reviews and in situ observations. Respondents’ selection was purposive and a bespoke form of content analysis was used for the data review before further cross-case analysis, resulting in the identification of best practices using key indicators. Findings and Originality In spite of facing financial crisis, by reviewing key logistical processes and lifecycle, the overuse of healthcare resources and the poor management of waste, were clearly identified within in this study. This had a negative effect on personnel and patient hygiene. The result of identifying effective GL practices were reported as: (i) promoting the usage of multiple-use medical devices that can minimize inputs, waste, and cost, and (ii) producing/selecting organic food materials and fruits and reusing these waste byproducts to create secondary products e.g. fertilizer, biogas and electricity and cleaning/sterilizing liquid. The results also indicated that there was a drive from leaders to introduce green and efficient systems to improve staff personnel awareness and engagement in this area. The output of this study presents a model for GL implementation guidance, grounded in Thailand’s Sufficiency Economy Philosophy (SEP) concept. Research Impacts Currently, healthcare green logistics has received limited attention in developing nations and this study contributes to the reduction of these gaps. The SEP concept promotes sustainable health standards and underpins the focus and the originality/impact of this study. Practical Impacts This study recommends that staff in Thai hospitals focus on effective resource and waste management to contribute to sustainable sufficiency. This allows Thailand to offer an effective healthcare service to its patients. The study presents guidance and support to do this.

Pain management in hospitalized infants in the Neonatal Intensive Care Unit continues to be substandard despite the development and availability of evidence-based guidelines. The Evidence-based Practice Identification and Change (Lee et al., 2009) strategy is a multifaceted tailored intervention that has been used to promote evidence-based practice. However, the process of delivering the components of the intervention is not well understood and no valid measure for evaluating the fidelity of intervention implementation exists. The overall objective was to develop and determine the face validity, content validity, construct validity, feasibility, and clinical utility of the Process Evaluation Checklist. Three prospective studies were conducted. In Study 1, the face and content validity of the Process Evaluation Checklist was determined. In Study 2, the construct validity of the Process Evaluation Checklist was examined by assessing the fidelity of implementing the Evidence-based Practice Identification and Change intervention in a clinical setting. In Study 3, the feasibility and clinical utility of the Process Evaluation Checklist was determined. Overall, the face and content validity of the Process Evaluation Checklist was achieved. The intervention was implemented with high fidelity, supporting the construct validity of the measure. A Research Practice Council, with assistance from an external facilitator and internal facilitators, implemented multifaceted knowledge translation strategies in the form of constant reminders to improve sucrose administration practices. Post intervention admission orders were significantly more likely to include sucrose, and odds of being administered sucrose were 13 times greater compared to baseline. Beginning support was provided for the content and construct validity, feasibility, and clinical utility of the Process Evaluation Checklist for use with complex interventions. Using this measure to monitor intervention fidelity in different contexts and with different users over longer periods of time will provide additional support to the validity of the Process Evaluation Checklist.

Pain management in hospitalized infants in the Neonatal Intensive Care Unit continues to be substandard despite the development and availability of evidence-based guidelines. The Evidence-based Practice Identification and Change (Lee et al., 2009) strategy is a multifaceted tailored intervention that has been used to promote evidence-based practice. However, the process of delivering the components of the intervention is not well understood and no valid measure for evaluating the fidelity of intervention implementation exists. The overall objective was to develop and determine the face validity, content validity, construct validity, feasibility, and clinical utility of the Process Evaluation Checklist. Three prospective studies were conducted. In Study 1, the face and content validity of the Process Evaluation Checklist was determined. In Study 2, the construct validity of the Process Evaluation Checklist was examined by assessing the fidelity of implementing the Evidence-based Practice Identification and Change intervention in a clinical setting. In Study 3, the feasibility and clinical utility of the Process Evaluation Checklist was determined. Overall, the face and content validity of the Process Evaluation Checklist was achieved. The intervention was implemented with high fidelity, supporting the construct validity of the measure. A Research Practice Council, with assistance from an external facilitator and internal facilitators, implemented multifaceted knowledge translation strategies in the form of constant reminders to improve sucrose administration practices. Post intervention admission orders were significantly more likely to include sucrose, and odds of being administered sucrose were 13 times greater compared to baseline. Beginning support was provided for the content and construct validity, feasibility, and clinical utility of the Process Evaluation Checklist for use with complex interventions. Using this measure to monitor intervention fidelity in different contexts and with different users over longer periods of time will provide additional support to the validity of the Process Evaluation Checklist.