Upload
farahazura
View
47
Download
10
Embed Size (px)
Citation preview
OVERVIEW OF HOSPITAL / OVERVIEW OF HOSPITAL / HEALTH FACILITY HEALTH FACILITY BUILDING NEEDSBUILDING NEEDS
ContentsContents Introduction Introduction
Type of Health Facilities in MOHType of Health Facilities in MOH
General Hospital Set – UpGeneral Hospital Set – Up
Health Building NeedsHealth Building Needs
EBDEBD
IntroductionIntroduction
Health / Hospital Building is complexHealth / Hospital Building is complex
Requires talents and expertise of many professionalsRequires talents and expertise of many professionals
Complexity of practice = complexity of designComplexity of practice = complexity of design
Need to understand hospital functions, operations which Need to understand hospital functions, operations which are complex and evolvingare complex and evolving
Complex variation of needs of various department Complex variation of needs of various department
IntroductionIntroduction Interdependence of departmentsInterdependence of departments
Controlled environmentsControlled environments
Compliance to Acts, standards, and other governmental Compliance to Acts, standards, and other governmental regulationsregulations
Need concerted and coordinated effort in designNeed concerted and coordinated effort in design
Types of Health Facilities in MOHTypes of Health Facilities in MOH HospitalHospital
Specialised Hospitals/Institutions eg. NCI, Specialised Hospitals/Institutions eg. NCI, Rehabilitation Hospital, Women & Children Rehabilitation Hospital, Women & Children HospitalHospital
Major Specialist Hospital – hospital with at Major Specialist Hospital – hospital with at least 14 specialties and 6 subspecialties least 14 specialties and 6 subspecialties eg. State Hospitals, some District Hospitalseg. State Hospitals, some District Hospitals
Minor Specialist Hospital – hospital with 10 Minor Specialist Hospital – hospital with 10 specialtiesspecialties
Non-Specialist Hospital / Hospital with Non-Specialist Hospital / Hospital with visiting specialists – no specialtiesvisiting specialists – no specialties
Standard MOH Hospital Scope / SizeStandard MOH Hospital Scope / Size
Purpose : to expedite the project implementationPurpose : to expedite the project implementation- standard MBOR- standard MBOR- standard costs- standard costs- standard plans?- standard plans?
Types :Types :
76 beds76 beds
108 beds108 beds
268 beds268 beds
306 beds306 beds
500 beds500 beds
Types of Health Facilities in MOHTypes of Health Facilities in MOH Health Clinics – run by Doctor / Medical Assistant Health Clinics – run by Doctor / Medical Assistant
& Nurses& NursesKK Type
Expected Workload (attendances)
Main Scope of Services
1 >800 OPD, MCH, Dental, Pharmacy, X-Ray, Lab, Rehab, Home Nursing, Admin, FMS
2 500-800 OPD, MCH, Dental, Pharmacy, X-Ray, Lab, Rehab, Home Nursing, Admin, FMS
3 300-500 OPD, MCH, Dental, Pharmacy, X-Ray, Lab, Rehab, Home Nursing, Admin, FMS
4 150-300 OPD, MCH, Dental, Pharmacy, X-Ray, Lab, Rehab, Home Nursing, Admin
5 100-150 OPD, MCH, Dental, Pharmacy, Lab, Home Nursing, Admin
6 <100 OPD, MCH, Pharmacy, Lab, Home Nursing, +/- ABC & Observation Bed
7 <50 OPD, MCH, Dental, Pharmacy, Lab, +/- ABC & Observation Bed
Types of Health Facilities in MOHTypes of Health Facilities in MOH
Rural Health Clinics / Klinik Rural Health Clinics / Klinik Desa (KD)Desa (KD) Run by Rural Health NurseRun by Rural Health Nurse
I Malaysia ClinicI Malaysia Clinic Run by Medical AssistantRun by Medical Assistant
GENERAL HOSPITAL GENERAL HOSPITAL Set-UpSet-Up
General Hospital Set-UpGeneral Hospital Set-Up Will depend various factors:Will depend various factors:
Level of medical servicesLevel of medical services secondary, tertiary, specialisedsecondary, tertiary, specialised primary care servicesprimary care services
Operational policies Operational policies privatisation privatisation outsourcingoutsourcing
Special needs Special needs hospitalhospital community community
General Hospital Set-UpGeneral Hospital Set-UpOutpatient ServicesOutpatient Services
Emergency Dept.Emergency Dept. Clinic – GOPD, Specialist ClinicClinic – GOPD, Specialist Clinic Day CareDay Care Dialysis (Haemo-dialysis & PD)Dialysis (Haemo-dialysis & PD)
General Hospital Set-UpGeneral Hospital Set-UpInpatient ServicesInpatient Services
WardsWards Standard ward for various discipline Standard ward for various discipline
22ndnd & 3 & 3rdrd Class Class Paeds ward – classless & with MAC facilitiesPaeds ward – classless & with MAC facilities
Multidiscipline 1Multidiscipline 1stst Class & VIP, Royal Class & VIP, Royal Intensive Care (ICU,CCU,HDW, NICU, SCN)Intensive Care (ICU,CCU,HDW, NICU, SCN) Special Ward ie isolation wardSpecial Ward ie isolation ward
Operating Theatre SuitesOperating Theatre Suites Double corridorDouble corridor Single corridorSingle corridor
Labour & Delivery SuitesLabour & Delivery Suites Single roomSingle room
General Hospital Set-UpGeneral Hospital Set-UpDiagnostic & TreatmentDiagnostic & Treatment
General Hospital Set-UpGeneral Hospital Set-UpDiagnostic & TreatmentDiagnostic & Treatment
Imaging (X-Ray)Imaging (X-Ray)
Pathology (Lab)Pathology (Lab)
Forensic Forensic (Mortuary)(Mortuary)
Rehabilitation Rehabilitation (OT & PT)(OT & PT)
General Hospital Set-UpGeneral Hospital Set-UpMedical Support ServicesMedical Support Services
PharmacyPharmacy Inpatient Inpatient Out-patient PharmacyOut-patient Pharmacy
Medical StoreMedical Store
General Hospital Set-UpGeneral Hospital Set-UpMedical Support ServicesMedical Support Services
Central Sterile Central Sterile Supply (CSSD)Supply (CSSD)
Haemodynamic Haemodynamic RespiratoryRespiratory
General Hospital Set-UpGeneral Hospital Set-UpMedical Support Services – Medical Support Services –
cont…cont… Medical RecordMedical Record ITDITD Medical Social ServicesMedical Social Services Infant Nutrition (Milk Infant Nutrition (Milk
Kitchen)Kitchen) DietaticsDietatics
General Hospital Set-UpGeneral Hospital Set-UpNon-Medical Support ServicesNon-Medical Support Services
Catering/KitchenCatering/Kitchen
Linen holdingLinen holding
Waste disposalWaste disposal GeneralGeneral Clinical/BiohazardClinical/Biohazard ChemicalChemical
General Maintenance/Cleaning General Maintenance/Cleaning & Housekeeping& Housekeeping
EngineeringEngineering
Porter/TransportPorter/Transport
HelipadHelipad
General Hospital Set-UpGeneral Hospital Set-UpTraining Education & ResearchTraining Education & Research
CME – seminar room, auditoriumCME – seminar room, auditorium LibraryLibrary Clinical ResearchClinical Research Quality AssuranceQuality Assurance
General Hospital Set-UpGeneral Hospital Set-UpAdministrationAdministration
General AdministrationGeneral Administration Nursing AdministrationNursing Administration Admission & Revenue CollectionAdmission & Revenue Collection Telephone Operator & PABXTelephone Operator & PABX
General Hospital Set-UpGeneral Hospital Set-UpStaff FacilitiesStaff Facilities
Specialist & Doctors OfficesSpecialist & Doctors Offices On-call complexOn-call complex Staff changeStaff change Staff restStaff rest Prayer roomsPrayer rooms Recreational facilitiesRecreational facilities Staff accommodation – quarters, nurses Staff accommodation – quarters, nurses
hostel & housemen quartershostel & housemen quarters
General Hospital Set-UpGeneral Hospital Set-UpPublic AmenitiesPublic Amenities
Main entrance & hospital streetMain entrance & hospital street Shops & kiosksShops & kiosks Information counterInformation counter CafeteriaCafeteria Visitors loungeVisitors lounge Prayer roomsPrayer rooms Public ParkingPublic Parking Public Phones etc.Public Phones etc.
Health Facility PlanningHealth Facility Planning Most complex Most complex
buildingbuilding Wide range of Wide range of
services & services & functional unitsfunctional units
Governed by Governed by various various regulations, codes, regulations, codes, guidelines etc.guidelines etc.
Health Facility PlanningHealth Facility Planning Requires specialised Requires specialised
knowledge & expertise knowledge & expertise Competing needs & Competing needs &
priorities among various priorities among various functional unitsfunctional units
Ideal & strong individual Ideal & strong individual preference VS mandatory preference VS mandatory requirements, functional requirements, functional needs & financial statusneeds & financial status
Health Facility PlanningHealth Facility Planning Serve & support many Serve & support many
different users & different users & stakeholdersstakeholders
Design process to Design process to incorporated direct input incorporated direct input from owner & key hospital from owner & key hospital staffstaff
Good hospital design Good hospital design integrates functional integrates functional requirements with the requirements with the human needs of its varied human needs of its varied usersusers
Hospital/Health Facility Hospital/Health Facility Building NeedsBuilding Needs
Regardless of their site, Regardless of their site, size, budget, size, budget, hospital/health facility hospital/health facility have certain common have certain common needs :needs : Efficiency & Cost Efficiency & Cost
EffectivenessEffectiveness Flexibility & ExpandabilityFlexibility & Expandability Therapeutic EnvironmentTherapeutic Environment Cleanliness & SanitationCleanliness & Sanitation
Hospital/Health Facility Hospital/Health Facility Building NeedsBuilding Needs
AccessibilityAccessibility Controlled Controlled
circulationcirculation RedundancyRedundancy AestheticAesthetic Security & SafetySecurity & Safety SustainabilitySustainability
Efficiency & Cost-Efficiency & Cost-EffectivenessEffectiveness
Promote staff efficiency Promote staff efficiency eg. reduce walking eg. reduce walking distancedistance
Easy visual supervision of Easy visual supervision of patients by limited staffpatients by limited staff
Efficient logistics system-Efficient logistics system-lifts, pneumatic tube, lifts, pneumatic tube, conveyorsconveyors
Efficient use of space & Efficient use of space & prudent use of prudent use of multipurpose spacemultipurpose space
Efficiency & Cost-Efficiency & Cost-EffectivenessEffectiveness
Group functional Group functional areas with similar areas with similar system requirementssystem requirements
Encourage sharing of Encourage sharing of resources & avoid resources & avoid duplicationduplication
Provide optimal Provide optimal functional functional adjacencies eg. ICU adjacencies eg. ICU next to OTnext to OT
Flexibility & ExpandabilityFlexibility & Expandability Follow modular Follow modular
concepts of space concepts of space planning & layoutplanning & layout
Use generic room sizes Use generic room sizes and plans as much as and plans as much as possiblepossible
Be open ended, well Be open ended, well planned directions for planned directions for future expansion eg. future expansion eg. soft space next to hard soft space next to hard spacespace
Therapeutic EnvironmentTherapeutic Environment Unthreatening, Unthreatening,
comfortable and stress comfortable and stress freefree
Using familiar & Using familiar & culturally relevant culturally relevant materials materials
Using cheerful and Using cheerful and varied colours & varied colours & texture (note: some texture (note: some colours are colours are inappropriate)inappropriate)
Therapeutic EnvironmentTherapeutic Environment Ample natural lightAmple natural light External views for External views for
patient bedpatient bed Designing a ‘way Designing a ‘way
finding’ process – finding’ process – making spaces making spaces easy to find, easy to find, identify and useidentify and use
Cleanliness & SanitationCleanliness & Sanitation Easy to clean & Easy to clean &
maintainmaintain Appropriate & Appropriate &
durable finishesdurable finishes Careful details to Careful details to
avoid dirt-catching avoid dirt-catching and hard to clean and hard to clean surfacessurfaces
Cleanliness & SanitationCleanliness & Sanitation
Adequate & Adequate & appropriately located appropriately located housekeeping spaceshousekeeping spaces
Special materials, Special materials, finishes, and detail of finishes, and detail of spaces for sterile spaces for sterile areasareas
AccessibilityAccessibility Disable friendly facilitiesDisable friendly facilities Does not hinder trolley Does not hinder trolley
movementsmovements Corridors are wide Corridors are wide
enoughenough Marking glass walls & Marking glass walls &
doors to make their doors to make their presence obviouspresence obvious
Direct Vehicular access Direct Vehicular access to eg. A&E, L&D, to eg. A&E, L&D, MortuaryMortuary
Controlled CirculationControlled Circulation Typical outpatient route Typical outpatient route
simple & well definedsimple & well defined Avoid unnecessary Avoid unnecessary
movement through inpatient movement through inpatient functional areas functional areas
Visitors have simple & direct Visitors have simple & direct route to each patient nursing route to each patient nursing unit without penetrating unit without penetrating other functional areasother functional areas
Separate patients & visitors Separate patients & visitors from support services & from support services & engineering areasengineering areas
Controlled CirculationControlled Circulation Dirty material flows Dirty material flows
separated from separated from movement of food movement of food & clean supplies& clean supplies
Transfer of Transfer of cadavers to & from cadavers to & from Morgue should be Morgue should be out of sight of out of sight of patients & visitorspatients & visitors
Redundancy/Back-up PlanRedundancy/Back-up Plan Able to service/maintain Able to service/maintain
systems without greatly systems without greatly affecting serviceaffecting service
Able to tolerate certain Able to tolerate certain degree of system failuredegree of system failure Medical gas zoningsMedical gas zonings Water supplyWater supply Electrical supplyElectrical supply Air-condition systemAir-condition system
AestheticsAesthetics Use natural light, Use natural light,
materials & texturesmaterials & textures Use artworksUse artworks Attention to proportions, Attention to proportions,
colour, scale & detailscolour, scale & details Bright, open, Bright, open,
generously-scaled public generously-scaled public spacesspaces
Homelike & intimate Homelike & intimate scale in patient rooms, scale in patient rooms, day rooms etc.day rooms etc.
Compatible exterior Compatible exterior design with physical design with physical surroundingssurroundings
Security & SafetySecurity & Safety Protection of Protection of
hospital property hospital property & assets& assets
Protection of Protection of patients & staffpatients & staff
Safe control of Safe control of violent or violent or unstable patientsunstable patients
SustainabilitySustainability Operational CostsOperational Costs Maintenance CostsMaintenance Costs Energy saving featuresEnergy saving features
Basic PrincipleBasic PrincipleSmall vs Bigger Hospitals / Non Specialist vs Small vs Bigger Hospitals / Non Specialist vs Specialist HospitalsSpecialist Hospitals
Small Hospital (<150 beds)
Bigger Hospital(>300 beds)
Combine out-patient & inpatient pharmacy
-May be separated-May have satellite pharmacy
Combine L&D with Obstetric Ward on GF
-May be separated-PAC if L&D located on higher floor
Centralised OT Complex -May separate main OT, Daycare OT and Maternity OT
Multidisciplinary Ward eg Obst + Pediatric Ward; Female Ward
- May be dedicated eg. Male Medical, Pediatric, Female Obstetric etc.
Centralised Pathology / Lab
-May have satellite lab
Basic Principle Basic Principle Doctors examine Doctors examine
patient on the right patient on the right side; hence it shall be side; hence it shall be the basis for the the basis for the orientation of patient orientation of patient bed, examination bed, examination couches and procedure couches and procedure table within a room table within a room etc.etc.
Lessons Learned (Architecture)Lessons Learned (Architecture)No wet areas above ‘clean/sterile’ No wet areas above ‘clean/sterile’ areas eg OT, CSSD packing & sterile areas eg OT, CSSD packing & sterile stores, clean roomsstores, clean rooms
Corridors where there are patient Corridors where there are patient /trolley movement shall be wide enough /trolley movement shall be wide enough and with no hindrance eg fire doors.and with no hindrance eg fire doors.
All room doors where patient enters All room doors where patient enters shall be wide enough for wheelchair and shall be wide enough for wheelchair and able to be hold opened.able to be hold opened.
Lessons Learned (Architecture)Lessons Learned (Architecture) Doors into rooms where patients are Doors into rooms where patients are
being examined shall have no glazing.being examined shall have no glazing.
All patient’s toilet with shower facilities All patient’s toilet with shower facilities shall have textured non slipped floor shall have textured non slipped floor tiles.tiles.
ALL sinks (clinical/non clinical/built-in) ALL sinks (clinical/non clinical/built-in) shall have sufficient backsplash.shall have sufficient backsplash.
Provide seamless finishes to floor and Provide seamless finishes to floor and wall in clinical areas.wall in clinical areas.
Lessons Learned (Architecture)Lessons Learned (Architecture)
Use washable paint in all clinical Use washable paint in all clinical areas.areas.
ALL windows shall be lockable.ALL windows shall be lockable.
Avoid ledges (surface) especially Avoid ledges (surface) especially in clean rooms.in clean rooms.
Avoid grey colored flooring in Avoid grey colored flooring in Operating Rooms.Operating Rooms.
Lessons Learned (M&E)Lessons Learned (M&E) Filtered water supply for autoclaves, Filtered water supply for autoclaves,
haemodialysis, kitchen.haemodialysis, kitchen.
Dedicated water tank for haemodialysis.Dedicated water tank for haemodialysis.
Special treatment for laboratory sewer Special treatment for laboratory sewer i.e dilution tanks.i.e dilution tanks.
Task light at nurses counter/stationTask light at nurses counter/station
Sufficient & appropriately located floor Sufficient & appropriately located floor traps.traps.
Easy to maintain materials.Easy to maintain materials.
Avoid sprinkler at ‘clean/sterile’ Avoid sprinkler at ‘clean/sterile’ areas and areas with expensive areas and areas with expensive equipment eg ICU, CCU, Burns etc.equipment eg ICU, CCU, Burns etc.
Digital Calling system shall be Digital Calling system shall be provided for ALL rooms where provided for ALL rooms where patient need to queue eg. CE rooms, patient need to queue eg. CE rooms, Treatment, Procedure, Assessment, Treatment, Procedure, Assessment, ECG etc.ECG etc.
Lessons Learned (M&E)Lessons Learned (M&E) Room air flow shall be from the Room air flow shall be from the
doctor/medical staff to the patient doctor/medical staff to the patient before being exhausted out.before being exhausted out.
Provide dedicated plug point for Provide dedicated plug point for electric beds in 1electric beds in 1stst class. class.
Provide sufficient & appropriate Provide sufficient & appropriate power supply:power supply: eg. essential supply for all medical eg. essential supply for all medical
fridgesfridges eg. UPS for life supporting eg. UPS for life supporting
equipment ie. ventilators, equipment ie. ventilators, angiography etcangiography etc
Dr Maarof SudinPlanning & Development DivisionMinistry of Health Malaysia
EVIDENCE BASED DESIGN (EBD)
Introduction
• Healthcare business is about “selling care experiences”
‘An aesthetically pleasing facility is a key aspect of the perceived quality of care’
• Does health facility design really have impact on patients and staff outcome?
Growing evidence - design can produce positive impact on the desired outcomes
Introduction• Impact of building on people/occupantsImpact of building on people/occupants
““Second to fresh air, I should be inclined to rank Second to fresh air, I should be inclined to rank light in importance for the sicklight in importance for the sick. Direct sunlight, . Direct sunlight, not only light is not only light is necessary for speedy recovery.necessary for speedy recovery. I mention from experience, as quite perceptible I mention from experience, as quite perceptible in promoting recovery, the being able to see in promoting recovery, the being able to see out of a window, instead of looking against a out of a window, instead of looking against a dead wall”dead wall”- Florence Nightingale on Light, 1860- Florence Nightingale on Light, 1860
““First we shape the building; thereafter, they First we shape the building; thereafter, they shape us”shape us”-- Sir Winston Churchill, May 10, 1941 Sir Winston Churchill, May 10, 1941
Well Designed Hospitals
Create a built environment that take into consideration patient and staff requirements that can have positive impact on patient outcome, staff performance and staff and patient safety
No Environment is Neutral• The design of facilities,
organizations, work processes, and equipment impact one another as well as patient outcomes, safety and staff satisfaction
• Either positively or negatively, the design will exert its impact
Connecting Environmental Design to Quality Improvement
Hospital Built Environment
Safety and QualityOf Patients Care
Patient’s PerceptionOf Care Given / Care Experiences
Staffs Job Satisfaction And Stress
How supportive healthcare design improve outcomes?
Ability to alleviate STRESSPromoting stress reduction, buffering and coping
Patient can use their limited energy to get better, instead of having to fight the environment
Stress in itself is a negative health outcome AND detrimental to psychological, physical, and behavioral effects that worsened other outcomes
EVOLUTION OF HOSPITAL DESIGN
Traditional New
Approach
Narrow ‘wellness’ perspective
Emphasis on functional efficiencies
Pathogenic conception-reduction of infection and disease risk exposure-prevent illness and physical harm
Holistic ‘wellness’ perspective
Also include:-psychological needs-social needs-spiritual needs
of patient, staff and improve medical outcomes
HospitalOutlook
Institutional
Stressful
Detrimental to care quality
Patient and Family Centred
Healing Environment
Friendly
Quality Care
Institutional & Stressful
Traditional Hospitals New Hospitals
Patient Centred & Promote Healing
Reasons For Change In Design Approach
• High demand to increase patient satisfaction
• Growing stress, work demands for healthcare staffs– Declining staff / patient ratios– Need to attract and retain quality employees
• Advances in mind/body medicine– Stress and psychological factors impact on
health
• Increase adoption of patient centred and family centred care philosophies
• Mounting scientific researches linking well-designed healthcare environments to improved outcomes
New Health Facility Design Approach
Evidence Based Design / EBD
“Design is less of an art BUT more of a SCIENCE”
- Empirical Approach / Engineering-style Approach“Measure first then fix”
Architects / designers and informed clients make decisionsguided by credible evidence
Evidence Based Design (EBD) DefinitionEvidence Based Design (EBD) Definition
General :
“Evidence based design is the conscientious, explicit and judicious use of current best evidence from research and practice in making critical decisions, about the design of each individual and unique project”
Hamilton, DK & DH Watkins 2009
“A process of basing decision about the built environment on credible research to achieve the best possible outcome”
The Centre for Health Design, 2008
EBD in Healthcare SettingEBD in Healthcare Setting
In Healthcare Buildings,
Built environment = Healing environment
A Healing Environment
is the result of a design that hasdemonstrated measurable improvements in the physical and/or psychological , social and spiritual states of patients and/or staff, physicians, and visitors
- complementary treatment modality
- makes a therapeutic contribution to the course of care
EBD Research Initiatives1. Centre for Health Design
& Robert Wood Johnson Foundation, Chicago
2. Georgia Institute of Technology
3. Rubensi & Golden meta-analysis on 84 studies (1998)
4. Ulrich & Zimring meta-analysis on 600+ studies (2004)
Centre for Health Design
Literature Search 2004by Ulrich & Zimring
• Organizes the substantial research knowledge base on the effects of the environment to various outcomes.
• Findings :Rigorous studies link the environment to outcome in 4 areas :1. Reduce patient stress & improve outcome2. Reduce staff stress & fatigue3. Improve safety4. Improve quality
Literature Search 2004Literature Search 2004by Ulrich & Zimringby Ulrich & Zimring
Research Conclusion / Recommendations
• Provide single bed room• Hospital should be much more quieter to reduce
stress and improve sleep• Provides stress reducing views of nature• Develop efficient way finding systems• Improve ventilation• Improve lighting• Design to reduce staff walking and fatigue
Saint Alphonsus Saint Alphonsus Centre for Advanced HealingCentre for Advanced Healing
Identify evidence based design elements with positive outcomes (in order of the strength of evidence):
1. Single patient rooms2. Installing HEPA filters3. Providing access to nature4. Installing ceiling lifts5. Installing sound-absorbing ceiling tiles6. Family areas within patient care spaces7. Providing access to sunlight8. Promoting the use of visible and accessible hand washing facilities/dispensers9. Promote visual access and accessibility to patient10.Providing areas of respite for staff
Single Patient Rooms
-High HAI-More medical error-Increase patient transfers-Privacy violation-Lack family involvement-Stress-Reduced quality of care-Reduced satisfaction-Reduced staff productivity
-Faster recovery-Lower HAI & medical error-Better privacy-Less noise-Better communication between staff and patient-High satisfaction
Installing HEPA filters
-Control indoor air pollution
-Filter harmful pathogens
-Reduce impact of infections
-Isolation of patient
-During construction and renovation (portable HEPA) to filter m. organism eg. aspergillus from soil
Providing access to nature• View to Nature
-large window
• Healing Garden-visibility, accessibility, familiarity, quiet environment
•Positive Distraction-ARTS, music etc
-Increase satisfaction
-Positive escape & recuperation from stress
-Opportunity for patient-visitors interactions
-Positive mood change
Comforting/Healing
Artwork - ExampleStress Induced
Installing Patient Lifters
- 44% of injuries to nurses that result in lost workdays
- patients becoming heavier & nursesageing( 40% US nurses aged >50 by 2020 )
- integrated with staff education, ergonomic program,& no manual-lifting policy
- reduce staff injuries-reduce staff MCs-reduce medical claims
Installing sound absorbing ceiling tiles
- Acoustic environments - Reduced sound reverberation times & sound propagation-Reduce noise- Reduce stress- Improve sleep- Improve communication
- Reduces perceived work pressure
-High ambient noise levels
- Staff emotional exhaustion and burnout
-Threat to patient confidentiality and safety
- Impeding effective communication
Family areas within patient care spaces
- Space within patient’s room - Family lounge &-Family counseling room
-Encourage active family participation
-Patient-family interaction privacy
-Unfriendly facilities for family
-Intermittent contact with patient
-Unable to participate actively in patient care
-Reduce family involvement & satisfaction in care
Providing access to sunlight
-Reduce depression & stress
- Less pain
-Decrease LOS
-Improve sleep & circadian rhythm
-Less agitation among dementia patients
-Vitamin D intake
- -Patient & staff rooms, family lounge
-Large windows
-No glare
-Able to control light level
Visible and accessible hand washing facilities
Scrub troughs, clinical sinks or hand sanitizers
-Easy access
-Good visibility
-Within easy reach
-Unobstructed access
-Placed at comfortable height
-Minimal effort to use
-All patient rooms
Hand washing frequency among healthcare staffs generally still low
Promote visual access and accessible to patient
-Decentralized nurse stations-Alcoves outside patient rooms-Locating frequent used supplies in / near patient room
-Reduce staff walking distance-More time on direct patient care-Reduce staff fatigue-Reduce patient fall rate
-Centralized nurse base
-1/3 nurse time walking
-Walks 6 miles/shift
-No direct visibility of patients
-Time wasted in hunting & gathering supplies
Providing area for respite for staff
-”non revenue generating space”
-very cramp/compact
-contribute to staff stress
-poor staff satisfaction
-poor staff retention
-Large staff lounge-Windows with view-Respite area-Staff toilets and shower
-Staff satisfaction & retention-Increase staff effectiveness
Nowhere to Rest………
• Environmentally preventable hospital acquired conditions can no longer be tolerated eg. -infections and falls
-injuries to staff, -unnecessary intra hospital transfers
that can increase errors, -increase patient and family anxiety,
stress, -LOS caused by noisy, confusing care environments
• Clear connections between constructing well-designed healing environment and improved health care safety and quality for patients, families and staff as well as long run cost saving
Conclusion
Conclusion
• Cost-effective, evidence based environmental design interventions should be included in all hospital improvement programs
• Evidence-based environmental design intervention should be implemented together with other process improvements for them to be effective
We can show empathy through EBD…..
THANK YOUTHANK YOU