Based on the ratings and rankings provided by the symposium participants, outboard bathroom locations were found to be most suitable, followed by nested and inboard configurations. Furthermore, configurations with patient bathrooms located on the footwall were rated as more suitable than headwall locations. The authors recommend, however, that the framework be used to determine a suitable room configuration in a specific context, rather than to identify configurations that will perform well universally.
Study data show that standardized same-handed configurations may not contribute to process and workflow standardization--hence, to safety and efficiency--any more than standardized mirror-image configurations in acute medical-surgical settings. Data suggest that a global view of the patient care environment upon entry is the most sought-after familiarization factor to reduce cognitive load.
The purpose of this study was to collect the perceptions of design professionals and clinicians regarding design process success strategies and elements of interprofessional engagement and communication during healthcare design and construction projects. Additional objectives were to gather best practices to maximize clinician engagement and provide tools and techniques to improve interdisciplinary collaboration for future projects. Strategies are needed to enhance the design and construction process and create interactions that benefit not only the project but the individuals working to see its completion. Meaningful interprofessional collaboration is essential to any healthcare design project and making sure the various players communicate is a critical element. This was a qualitative study conducted via an online survey. Respondents included architects, construction managers, interior designers, and healthcare personnel who had recently been involved in a building renovation or new construction project for a healthcare facility. Responses to open-ended questions were analyzed for themes, and descriptive statistics were used to provide insight into participant demographics. Information on the impressions, perceptions, and opportunities related to clinician involvement in design projects was collected from nurses, architects, interior designers, and construction managers. Qualitative analysis revealed themes of clinician input, organizational dynamics, and a variety of communication strategies to be the most frequently mentioned elements of successful interprofessional collaboration. This study validates the need to include clinician input in the design process, to consider the importance of organizational dynamics on design team functioning, and to incorporate effective communication strategies during design and construction projects.
Should power, medical gases, and monitoring and communications systems be located in a headwall or a ceiling-mounted boom in intensive care unit (ICU) rooms? Often, only the financial costs could be determined for the options, whereas data regarding its potential influence on teamwork, safety, and efficiency are lacking. Hence, purchase decisions are more arbitrary than evidence based. This study simulated care delivery in settings with a traditional headwall and a ceiling boom. Observed were the way the following elements were managed and the extent either system affected flexibility, ergonomics, and teamwork: tubing for intravenous fluids, medical gases, and suction drainage; monitoring leads and equipment power cords; and the medical equipment itself. Simulation runs involving 6 scenarios were conducted with the voluntary participation of 2 physicians, 2 nurse practitioners, 2 respiratory therapists, and 4 registered nurses at a children's tertiary care center in December 2007. Analysis suggests that booms have an advantage over headwalls in case of high-acuity ICU patients and when procedures are performed inside patient rooms. However, in case of lower-acuity ICU patients, as well as when procedures are not typically conducted in the patient room, booms may not provide a proportionate level of advantage when compared with the additional cost involved in its procurement.
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