Patient Room Design Research Articles

Preliminary Method for Prospective Analysis of the Circadian Efficacy of (Day)Light with Applications to Healthcare Architecture

Recent studies have attempted to link environmental cues, such as lighting, with human performance and health, and initial findings seem to indicate a positive correlation between the two. Light is the major environmental time cue that resets the human circadian pacemaker, an endogenous clock in the hypothalamus that controls the timing of many 24-hour rhythms in physiology and behavior. Insufficient or inappropriate light exposure can disrupt normal circadian rhythms which may result in adverse consequences for human performance, health and safety.This paper addresses the problem of prospective analysis of building architecture for circadian stimulus potential based on the state of the art in photobiology. Three variables were considered in this analysis: lighting intensity, timing, and spectrum. Intensity is a standard design tool frequently used in illuminating engineering. Timing and spectrum are not commonplace considerations, so the analysis that follows proposes tools to quantitatively address these additional requirements.Outcomes of photobiology research were used in this paper to define threshold values for illumination in terms of spectrum, intensity, and timing of light at the human eye, and were translated into goals for simulation – and ultimately for building design. In particular, the climate-based Daylight Autonomy (DA) metric was chosen to simulate the probabilistic and temporal potential of daylight for human health needs.The developed method was applied to study the impact of key architectural decisions on achieving prescribed stimulus of the circadian system in a hospital patient room design; studied variables included orientation, window size, and glazing material. A healthcare setting was specifically chosen with the intent of follow-on research to validate our findings with actual patient outcome data.

The architecture of safety: hospital design

This paper reviews recent research literature reporting the effects of hospital design on patient safety. Features of hospital design that are linked to patient safety in the literature include noise, air quality, lighting conditions, patient room design, unit layout, and several other interior design features. Some of these features act as latent conditions for adverse events, and impact safety outcomes directly and indirectly by impacting staff working conditions. Others act as barriers to adverse events by providing hospital staff with opportunities for preventing accidents before they occur. Although the evidence linking hospital design to patient safety is growing, much is left to be done in this area of research. Nevertheless, the evidence reported in the literature may already be sufficient to have a positive impact on hospital design.

Evidence-Based Design: Strong Support and Healthy Skepticism

I'm a staunch supporter of evidence-based design (EBD), but I'm also skeptical about it. That is why I'm delighted and excited about the publication of the Health Environments Research & Design Journal (HERD). This journal has the potential to make EBD a far more powerful tool, enabling healthcare architects to design better buildings than is now possible.Need for Evidence-Based DesignArchitects are famous for drawing-some might say leaping to- conclusions about the spaces they design. Healthcare architects are no exception. We have long been convinced that the healthcare environments we design can sometimes dramatically affect the outcomes of everything from patient safety to staff turnover to financial results.Our conclusions about the link between design and outcomes, however, have been largely intuitive and so obvious as to be beyond dispute. Provide attractive, single-patient rooms and you promote healing; make work space more functional and attractive and you reduce staff turnover; develop efficient wayfinding and you reduce the cost of staff required to give people directions. Though these conclusions seem obvious, they have not been supported by research until recently when EBD arrived on the scene.I first encountered this term a decade or so ago. The process it represents involves basing design decisions not only on sound design principles, designer knowledge, and client input, but most importantly on scientifically sound research.Properly applied, EBD can significantly impact patient, staff, and institutional outcomes. One example: An older medical center in Florida was replaced by a new facility designed to provide natural light, improve airflow, separate public and patient transport areas, and offer homelike patient room design. A year after the building opened, staff turnover was 13% compared to more than 20% in the old facility. Another example: An Oregon hospital installed ceiling lifts and booms in patient rooms in the intensive care unit. The result: fewer patient injuries and the virtual elimination of staff injuries caused by patient lifting.Evidence-Based Design and the Hospital Building BoomEBD's importance is greater today than ever, given the current hospital building boom, the largest in U.S. history. Fueled by aging baby boomers, new technologies, population shifts, and the need to replace or remodel aging facilities that were built in the 1960s and -70s, by the end of the decade this boom is expected to boost spending for hospital construction to more than $20 billion annually. Because these hospitals will be operating for decades, it is imperative that we design them in ways that yield the best possible outcomes. EBD is a valuable tool for ensuring that we meet this responsibility.As President of the American College of Healthcare Architects (ACHA), I can affirm that our organization understands the importance of EBD. ACHA members are leaders in the industry. Many serve as faculty for EBD seminars and initiate independent research projects with clients. Our membership leads the industry in the number of clients that have been part of the Center for Health Design Pebble projects.But not all healthcare architects have an equal understanding of EBD, so it is not used uniformly across our profession. However, the popularity and acceptance of EBD definitely are growing. As more architects gain sophistication about the impact of EBD on healing, workplace productivity, and safety, more of them will incorporate it into the design process. New simulation models have been developed that enable design hypotheses to be tested before a facility is built. The prestige associated with expertise in this area is rising as well. Architectural firms are hiring people skilled in conducting and interpreting EBD research.Since the term EBD first came into our lexicon, it is estimated that 1,000 articles about healthcare design research have been published. …

Environmental risk analysis of ultraviolet phototherapy centres in Ireland

Ultraviolet (UV) radiation is commonly used in the treatment of dermatological conditions such as psoriasis. It is known that high levels of exposure to UV radiation (UVR) will increase the risk of adverse biological effects. Exposure limit values for UVR have been developed by the International Commission on Non-Ionising Radiation Protection (ICNIRP) and occupational exposure to phototherapy staff should be kept within these limits. The use of environmental controls such as warning signs, good ventilation and UV-opaque curtains will significantly reduce the risks to staff, patients and members of the public. The aim of the study is to identify hazards in phototherapy centres and present recommendations for reducing risks. An environmental risk assessment has been carried out at eleven phototherapy centres in the Republic of Ireland. The study assessed a number of areas such as patient safety, staff safety, room design and UV leakage measurements. The majority of clinics are well designed and there is consistent use of protective equipment. The results show that on the whole there is a satisfactory level of risk management in phototherapy centres. Recommendations on maintaining good safety standards are presented.

Patient Room Design: Report on a panel discussion at the Western Hospitals meeting

Patient Room Design: <i>Report on a panel discussion at the Western Hospitals meeting</i>