Design Of Healthcare Facilities Research Articles

User-Centred Design Approaches for Planning Inpatient Room of Geriatric Long-Term Care Hospitals: Design Factors with Practical Suggestions

Evidence-based design (EBD) has traditionally guided health care facility design to improve functional workflow from health care professionals’ perspectives. However, it is hard to apply EBD concepts in a specific hospital, such as a geriatric long-term care hospital in South Korea where there is a need to provide services based on geriatric patients’ characteristics. This study aims to suggest design factors with practical suggestions for inpatient rooms in a geriatric long-term care hospital in South Korea from the user-centred design (UCD) perspective which covers a wider range than EBD by including the patients’ perspective. In order to accomplish the goal, we conducted the following steps using qualitative research methods because geriatric patients have a limited capability to adequately respond to questions. First, evaluation criteria from a UCD perspective were optimized after analysing literature. Second, a field study was conducted, which proposed a case study, expert interviews and user-centred research. Finally, the design factors with practical suggestions were provided after the evaluation.

Interdisciplinary User Groups and the Design of Healthcare Facilities.

This Australian research explores how "user group" participants from diverse professional discipline backgrounds understand, define, perform their roles, and assess the outcomes of the healthcare design process. Part of the design process in Australia and New Zealand, the purpose of interdisciplinary user group consultation is to design the best healthcare facilities possible within the parameters set by project clients and funding bodies. An online survey was used to explore how user group participants viewed the process, including how well informed they felt they were about their role/s in it, its success in achieving specific outcomes for their project, and how they felt their project client, owner, or funding body assessed these same issues. It included both closed and open-ended questions, and data were then analyzed using an interpretative methodology by an architect researcher based in practice. Emergent issues identified include governance of the process, knowledge asymmetries between participants, missed opportunities for innovation, composition and workloads of user groups, and the quality of resources available to guide the process. The interdisciplinary user group process could be improved, and future research will look at how drawing on participatory design methods used in sectors such as urban planning may support the development of new techniques for conducting user groups.

Decentralized Nurse Stations: A Methodology for Using Research to Guide Design Decisions.

The purpose of this methodology is to define a process for facility planning teams to use to ensure research findings are used to guide decision making in the design process. Over the past decade and a half, research in health facility design has developed and the body of knowledge has grown significantly, but at the same time, the process for incorporating these findings into the design process has been less defined. This methodology evolved out of the desire to develop a structured process to integrate recent research findings into the planning and programming process at the user group and planning team level. This two-phase methodology consists of, first, reviewing recent, relevant research on the topic, classifying the findings into positive and negative attributes and, then, summarizing the attributes by category on a summary table and in a brief narrative. The second phase consists of reviewing the research to identify operational and facility strategies that can be used to mitigate the inconsistent and negative attributes identified. In the case study, as a result of this process, one inconsistent attribute and three negative attributes were identified. In the second phase, potential research-based operational and facility strategies were identified to mitigate the inconsistent and negative attributes identified. This information served as the basis for making design decisions. This methodology presents an organized, efficient process for organizing and providing relevant research findings to a facility planning team to use in evaluating a new healthcare design concept and making research-based design decisions.

Cost-Effectiveness of Multifaceted Built Environment Interventions for Reducing Transmission of Pathogenic Bacteria in Healthcare Facilities.

The objective of this study is to determine the optimal allocation of budgets for pairs of alterations that reduce pathogenic bacterial transmission. Three alterations of the built environment are examined: handwashing stations (HW), relative humidity control (RH), and negatively pressured treatment rooms (NP). These interventions were evaluated to minimize total cost of healthcare-associated infections (HAIs), including medical and litigation costs. HAIs are largely preventable but are difficult to control because of their multiple mechanisms of transmission. Moreover, the costs of HAIs and resulting mortality are increasing with the latest estimates at US$9.8 billion annually. Using 6 years of longitudinal multidrug-resistant infection data, we simulated the transmission of pathogenic bacteria and the infection control efforts of the three alterations using Chamchod and Ruan's model. We determined the optimal budget allocations among the alterations by representing them under Karush-Kuhn-Tucker conditions for this nonlinear optimization problem. We examined 24 scenarios using three virulence levels across three facility sizes with varying budget levels. We found that in general, most of the budget is allocated to the NP or RH alterations in each intervention. At lower budgets, however, it was necessary to use the lower cost alterations, HW or RH. Mathematical optimization offers healthcare enterprise executives and engineers a tool to assist with the design of safer healthcare facilities within a fiscally constrained environment. Herein, models were developed for the optimal allocation of funds between HW, RH, and negatively pressured treatment rooms (NP) to best reduce HAIs. Specific strategies vary by facility size and virulence.

ПРИНЦИПЫ ПРИРОДОИНТЕГРАЦИИ В ФОРМИРОВАНИИ АРХИТЕКТУРНОЙ СРЕДЫ СОВРЕМЕННЫХ ОБЪЕКТОВ ЗДРАВООХРАНЕНИЯ


 
 
 The relevance of health facilities formation taking into account principles of nature integration is substantiated in the article. It is shown that the concept of harmonious interaction with nature gives the best results for treatment and rehabilitation of patients; it gains more popularity and attracts attention of specialists in the field of medicine, architecture and design around the world. On the basis of the research work, several principles of nature integration in formation of architectural environment of health facilities can be distinguished. They depend on functional purpose of architectural objects, compositional structure, climatic conditions, ecosystem and location. It is proved that architectural formation of health facilities harmoniously associated with natural environment directly affects health of patients. In the process of architectural environment formation it is very important to take into account interests of environment users and nature itself, in order to obtain a favorable result of interaction of natural environment and man. Taking into account principles of nature integration in the design of health facilities contributes to improving the quality of medical and rehabilitation institutions environment, raising the level of services provided and harmonizing the environment.
 
 

Hospital design features related to patient experience

Noise can be problematic in hospitals due to concerns over impacts on patients and staff members. Noise in particular is problematic and consistently rated low on patient experience surveys nationwide. Furthermore, previous studies have linked hospital noise to negative reactions for patients including reduced sleep and increased incidence of re-hospitalization. These safety risks—coupled with reduced Hospital Value-Based Purchasing program reimbursements due to low patient experience ratings—result in strong incentives for healthcare providers to provide quieter, safer environments. In this talk, we will explore what is known about hospital design features and patient experience, including a particular focus on noise. Results from ongoing and previous studies reveal new insights into how various features of the built environment are related to patient experience and therefore should be considered in the design and renovation of healthcare facilities.

The Future of Healthcare Facilities: How Technology and Medical Advances May Shape Hospitals of the Future

In this review article, we aim to depict how healthcare facilities may look in the near future from an architectural design point of view. For this purpose, we review newly introduced technology and medical advances in the field of healthcare, such as artificial intelligence (AI), robotic surgery, 3D printing, and information technology (IT), and suggest how those advances may affect the architectural design of future healthcare facilities. In future hospitals, less space will be required; there will be no need for waiting areas. Most care will be given far from the hospital. Every human might have a computer chip attached to his body, with all his medical data ready and monitored by AI. In the future, all processes may be done by robots and AI, from reception to detection (radiology, scans, etc.). Nearly all surgery will be done by robots, so the architectural design of operation departments will need to be changed accordingly. AI is faster and better in disease detection than man; thus, there will be no need for laboratories or detection departments as we know them now. 3D printers are able to print almost everything from medical equipment to parts of the human body; thus, space will be needed for scanning and 3D printing in future hospitals. 3D printers might change the pharmaceutical industries, and drugs will be produced for any human individually.

Isolation or interaction: healthcare provider experience of design change.

Recent studies have drawn attention to the relationship between healthcare environments and patient outcomes. Yet, it remains unclear how changes in the design of healthcare facilities are experienced by providers. To understand this relationship, this study employs an inhabited institutionalist theoretical frame to assess longitudinal ethnographic and interview data collected at a neonatal intensive care unit (NICU) as it transformed from an open-bay unit, to one with single-patient rooms. Findings show that changing the structure of the NICU interfered with the original local organisational culture of collaboration. While providers actively worked to maintain the original culture, their success in doing so was mediated by the built environment. Responding to the new space, practitioners developed new practices. Some of the practices (such as doorway discussions and increased individual assessments) directly undermined the original organisational culture, whereas others (hallway hangouts and calling out) worked to transpose the original culture into the new space. These findings call for greater attention to the effect of physical space on organisational culture.

Palliative Design Meets Palliative Medicine: A Strategic Approach to the Design, Construction, and Operation of Healthcare Facilities to Improve Quality of Life and Reduce Suffering for Patients, Families, and Caregivers.

A built environment designed to be appropriate for palliative care can make a profound difference for people with life-limiting illnesses. The built environment affects a patient's quality of life, the management of physical and psychological symptoms, and the quality of social interactions with loved ones and caregivers. This article is informed by the emerging trends in the research and practice in the disciplines of architecture, design, medicine, and nursing. The article is intended to provide a definition of palliative design and invite discussion of its potential impact on patients, families, and caregivers. Our goal is to initiate conversation about palliative design, foster sharing of experiences and feedback among building professionals, and discuss future paths for formal adoption into practice.

Lean-Oriented Layout Design of a Health Care Facility.

In this article, we propose a method that integrates systematic layout planning techniques to lean health care practices aided by multicriteria decision analysis that could be applied to reformulate the layout of health care facilities. We analyze a high-variety sterilization unit of a large public hospital located in Brazil. The unit is currently implementing lean practices, and layout changes are required to provide more efficient materials and information flows. Traditional design of health care facilities is not aligned with lean implementation and its underlying practices and principles. We propose the integration of such approaches to enhance their benefits. To rank and select the best layout alternative, a multicriteria decision analysis method (analytic hierarchy process) is adopted. There are 3 contributions here: the integration of lean principles into traditional health care facility design practices, the use of multicriteria decision analysis to refine the determination of the best layout solution, and the application of our propositions in a real case study.

Key stakeholders\u2019 views on the quality of care and services available to frail seniors in Canada

BackgroundFrail seniors often receive ineffective care, which does not meet their needs. It is still unclear how healthcare systems should be redesigned to be more sensitive to the needs and values of frail seniors and their caregivers. We thus aimed to describe key stakeholders’ perspectives on the current healthcare and services available to frail seniors.MethodsIn this qualitative descriptive study, we conducted semi-structured interviews with a convenience sample of 42 frail seniors, caregivers, clinicians, or healthcare administrators/decision makers involved in frail senior care from five Canadian provinces. We explored participants’ perspectives on the quality of care and services for frail seniors. We used an inductive/deductive thematic data analysis approach based on the Square-of-Care model, including emerging themes using the constant comparison method.ResultsWe grouped participants’ perspectives into strengths, weaknesses and opportunities for improvement, and then into nine themes: care processes, continuity of care, social frailty, access to healthcare and services, models of healthcare delivery, cost of care, healthcare staff management and professional development of healthcare providers, material resources and environmental design of healthcare facilities, and coordination of care. Our findings suggest redesigning assessment, communication with frail seniors and their caregivers, targeting care and services to the needs, and integrating care better across settings and in time.ConclusionsA systematic identification of frail older people is the first step to adapt healthcare systems to this population’s needs. Participation of frail older people and their caregivers to decision making would also allow choosing care plans meeting their care goals. The integration of care and services across settings, over time, and with various providers, is also needed to meet frail senior needs.

The Architecture Of Safety: An Emerging Priority For Improving Patient Safety.

There is a lack of awareness regarding the pervasive influence of the built environment on caregiving activities, and how its design could reduce risks for patients and providers. This article presents a narrative review summarizing key findings that link health care facility design to key targeted safety outcomes: health care-associated infections, falls, and medication errors. It describes how facility design should be considered in conjunction with quality improvement legislation; projects under way in health systems; and the work of guideline-setting organizations, funding agencies, industry, and educational institutions. The article also charts a path forward that consolidates existing challenges and suggests what can be done about them to create safe and high-quality health care environments.

Modeling the Impacts of Local Factors for Healthcare Building Energy Performance Improvement in Thailand

This research aims to perform, compare, and evaluate Integrated Building Design (IBD) processes, collaborating the Building Information Modeling (BIM) with Building Performance Simulation (BPS) applications to perform energy analysis and to improve the building energy performance of a Generalizable Building Design (GBD), a universal application on health care facilities design in Thailand. The IBD processes produce the simulation results in a harmonious direction. Slight variation in building orientation could alter the extent of energy consumption. The integration of the three measures could minimize energy consumption greatly. The study addresses the limitations of the IBDs in the software integration processes.

P064: Characteristics of physical space that optimize clinical learning in the emergency department: implications for design

Introduction: Over the last few decades, health care facility design has been studied to look at its effect on many patient-centred outcomes. However, limited data exists on the impact that specific physical features of a clinical space may have on learning and the educational experience. The aim of this study is to develop a set of characteristics which clinicians, clinical teachers and residents believe should be present in a clinical space to maximize trainees learning, using an emergency department (ED) as a context. Methods: A qualitative methodology used semi- structured interviews with a purposive sample of twelve attending physicians and residents who work in EDs of varying age and design at several sites of a quaternary university hospital. We explored their perceptions of the physical features in the clinical and learning environment that supported or impeded teaching and learning. The interviews were transcribed and thematically analyzed. Results: Preliminary results show that many physical characteristics of the clinical space are perceived to have an impact on trainees learning experience. A design with separation between clinician-learner dyads and the patients, with a visual access; shared clinical space among different health care professionals within a reasonable distance; availability of enough clinical space for specific emergency presentations; features such as adequate size, appropriate light, and control of sound were all perceived to enhance and augment clinical learning. Not surprisingly, non-design factors such as the presence of a functioning team and the availability of adequate equipment and technology was considered as important as the characteristics of physical space to optimize learning. Conclusion: This study demonstrates the importance and the impact of physical space design on trainees learning in a dynamic clinical environment. It provides teachers and policy-makers with a basis for developing criteria of the physical characteristics of a healthcare facility to maximize learning.

Using an integrative mock-up simulation approach for evidence-based evaluation of operating room design prototypes

This paper describes the process and tools developed as part of a multidisciplinary collaborative simulation-based approach for iterative design and evaluation of operating room (OR) prototypes. Full-scale physical mock-ups of healthcare spaces offer an opportunity to actively communicate with and to engage multidisciplinary stakeholders in the design process. While mock-ups are increasingly being used in healthcare facility design projects, they are rarely evaluated in a manner to support active user feedback and engagement. Researchers and architecture students worked closely with clinicians and architects to develop OR design prototypes and engaged clinical end-users in simulated scenarios. An evaluation toolkit was developed to compare design prototypes. The mock-up evaluation helped the team make key decisions about room size, location of OR table, intra-room zoning, and doors location. Structured simulation based mock-up evaluations conducted in the design process can help stakeholders visualize their future workspace and provide active feedback.

Users' Assessment on Interior Environment of a Hospital Outpatient Unit in Malaysia

Assessment on the physical design of healthcare facilities from the perspective of the patient and their family members (user) is the method to understand their expectation, preferences and experiences. This paper reports the study conducted on an outpatient unit in Malaysia, focusing particularly on the interior design characteristics. The study adopted post occupancy evaluation technique that combines baseline analysis, occupancy survey and walkthrough observation methods. The study findings indicate that the case study, which has served the public for more than 20 years, is performing moderately on all interior design aspects. Users' assessments did not score any of the facility "good" in terms of their interior quality, suggesting the desire for improvement to the current facility.

Virginia Children’s Center Represents New Wave in Facility Design

Virginia Children’s Center Represents New Wave in Facility Design

The Role of Space in Patients’ Experience of an Emergency Department: A Qualitative Study

Nurses are increasingly involved in the design of health care facilities. Although their experience differs from that of patients, they are often expected to represent patients in design processes. Especially in the context of an emergency department, patients' states of mind alter their experiences. Knowledge about the role of space in ED patients' experience is limited. Our study aims to gain insight into this role and thus provide ED nurses with information to better represent ED patients' perspectives in design. We conducted qualitative interviews with 22 patients. The interviews were supported by visual material collected through ethnographic methods to facilitate participants' reflections on the role of space in their experience. Participants were selected during their stays at the emergency department by convenience sampling. Interviews were audio-recorded, transcribed, and analyzed in combination with the visual material through open and axial coding. We found that the role of space in ED patients' experiences is affected by their altered sensory awareness and shaped by material, social, and time-related aspects. These aspects are intertwined and influenced by the transient character of the emergency department. The study indicates that paying attention to the role of space yields a nuanced understanding of ED patients' experiences. The challenge for hospital designers and staff lies in taking into account patients' altered sensory awareness and in designing interventions that support staff in emphasizing a human approach without counteracting the medical-technical aspect of emergency care.

Patients’ Perspectives on the Design of Hospital Outpatient Areas

There is a growing interest among healthcare managers and designers in moving towards a ‘patient-centred’ design of health and care facilities by integrating patient perceptions and expectations of the physical environment where care takes place. Increased interests in physical environments can mostly be attributed to our improved understanding of their role in patients’ health outcomes and staff productivity. There is a gap in the literature on users’ perspectives on physical settings in the context of healthcare. Moreover, the connection of care services with the design of the facility is often overlooked partly due to the lack of evidence. This research was aimed at filling the gap by exploring outpatients’ perspectives on design factors related to the areas frequented by them, e.g., hospital waiting areas. A 16-item questionnaire was conducted among randomly selected outpatients in two hospitals in Qingdao, China, with a response rate of 84.3%. Five principal factors were identified: sensory; lighting and thermal; facilities; spatial; and seating design, which agreed with the literature. Non-parametric tests were applied to assess variances in constructed principal dimensions concerning demographic variables. Female outpatients were found to be more perceptive of the ‘sensory design’ factors than males. The number of previous visits to the hospital was found to be associated with ‘spatial’ and ‘seating design’ factors, while respondents’ age had an association with ‘sensory’ and ‘seating design’ factors. Respondents ranked ‘noise’ and ‘air freshness’ and ‘cleanliness’ as highly important.

Microgrid Modular Design for Tribal Healthcare Facilities: Kayenta Health Center PV System Case Study

This paper describes an experimental process and detailed information related to a 100-KW photovoltaic (PV) system case study at the Kayenta Health Center, which is located in the Navajo Nation. Information about the solar irradiance on site, the PV system performance, the power quality at the facility, and observation of the related equipment is gathered. Experimental data validate the theoretical data available for the zone, the facility, the systems, and the equipment. Detailed study of an existing PV system at the Navajo Nation combined with modeling and simulation will lead to a good industrial pilot project from implementation and practical perspective of the microgrid in existing tribal health care facilities. A modified configuration of the existing power system is presented. The configuration provides guidance for the redesign of existing healthcare facilities around the microgrid concept. Since the Kayenta Health Center is representative of the average healthcare facility in the Navajo Nation, this guidance will be useful for the improvement of the power system of many tribal healthcare facilities. This in turn will improve the quality of the healthcare service and will benefit the living conditions of a significant tribal population.