Use of Single Patient Rooms versus Multiple Occupancy Rooms in Acute Care Environments

by Habib Chaudhury, Atiya Mahmood, and Maria Valente

Published by The Coalition for Health Environments Research (CHER) and funded by The Facility Guidelines Institute

EXECUTIVE SUMMARY

An extensive review of literature in the areas of healthcare design, construction and operating cost, hospital management, staff efficiency, infection control and patient outcomes was conducted in order to identify advantages and disadvantages of single versus multiple occupancy patient rooms. The literature search revealed that many articles on the relationship of design to healing and innovations in hospital design are dated 1980 and later, so this timeframe was chosen for the systematic journal searches. However, relevant articles dealing with room occupancy and patient care issues, and dated earlier than 1980 were also included in the review.

The research questions that guided the literature review were:

1. What are the differences in first cost, operating cost, energy costs and efficiency of management and care delivery in single and double occupancy patient rooms in acute care settings?

2. What are the advantages and disadvantages in disease control and falls prevention in single versus double occupancy rooms in acute care settings?

3. What are the therapeutic impacts (socio-behavioral issues of patient privacy, social interaction and daily functioning) of single versus double occupancy hospital rooms?

The articles, book chapters and reports reviewed were initially divided into four categories: a) First and operating cost of hospitals; b) Health care facility management and hospital design; c) Disease control and falls prevention; and d) Relationship between healing and environment. An in-depth review of the literature revealed that articles in the “Healthcare facility management and hospital design” and the “Therapeutic impacts: Relationship between healing and environment” categories had a significant overlap of foci and issues.

Consequently, findings in these two categories were combined. The final three categories [i.e., a) cost, b) infection control and falls, and c) hospital design and therapeutic impacts] were utilized as a framework to analyze the literature, which is presented in the integrated summary document, “A Review and
Analysis of the Literature.” The findings from the literature review are also presented in a chart format in order to provide information in a concise manner. In addition, an annotated bibliography providing a summary of key issues from each article or chapter was developed. Based on the feedback from CHER Research Council on the interim report, several additional pertinent articles have been included in this review and analysis since the time of submission of the interim report. Moreover, sections of the document have been reorganized and/or fine-tuned based on the council’s comments.

Key Findings:
Private rooms are the trend in hospital planning and design. The advantages of single-occupancy rooms are cited as improvements in patient care, a reduction in the risk of cross infection, and greater flexibility in operation. However, it is important to view and interpret the benefits of single-occupancy rooms within the context of patient care issues, other environmental changes and management policy changes in order to bring about desired and sustainable outcomes.