From Fable to Reality at Parkland Hospital: The Impact of Evidence-Based Design Strategies on Patient Safety, Healing, and Satisfaction in an Adult Inpatient Environment, Health Environments Research & Design Journal
ARTICLE
Evidence-Based Design Journal Clubs are formatted for 15-minute presentations and 45-minutes of discussion to provide an opportunity for attendees to interact with authors who recently published EBD papers or articles in peer-reviewed journals such as HERD. Learn as they share ways to put their research into practice.
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Rich, R. K., Jimenez, F. E., Puumala, S. E., DePaola, S., Harper, K., Roy, L., Brittin, J. (2020). From Fable to Reality at Parkland Hospital: The Impact of Evidence-Based Design Strategies on Patient Safety, Healing, and Satisfaction in an Adult Inpatient Environment. Health Environments Research & Design Journal, pages in press.
Objective: This research aimed to evaluate the quantitative effects of new hospital design on adult inpatient outcomes.
Background: Tenets of evidence-based healthcare design, notably single-patient acuity-adaptable and same-handed rooms, decentralized nursing stations, onstage offstage layout, and access to nature were expected to promote patient healing and increase patient satisfaction, while decreasing adverse events.
Methods: Patient healing was operationalized through length of stay (LOS) and patient safety through three adverse events: falls, hospital-acquired infections (HAI), and medication-related events. Standard patient surveys captured patient satisfaction. Patient records from 2013 through 2017 allowed for equivalent time periods surrounding the move to the new hospital in August 2015. Stratified by hospital division where significant, pre/post comparisons utilized proportional hazards or logistic regression models as appropriate; interrupted time series analyses afforded longitudinal interpretations.
Results: Observed higher postmove LOS was due to previously increasing trends, not increases after the move. In surgical and trauma units, a constant increase in falls was unaffected by the move. Medication events decreased consistently over time; medication events with harm dropped significantly after the move. No change in HAI was found. Significant improvement on most relevant patient satisfaction items occurred after the move. Call button response decreased immediately after the move but subsequently improved.
Conclusion: Results did not clearly indicate a net change in adult inpatient outcomes of healing and safety due to the hospital design. There was evidence that the new hospital improved patient satisfaction outcomes related to the environment, including comfort, noise, temperature, and aesthetics.
Renae Rich, M.S., EDAC
Research Analyst, HDR
A research analyst at HDR, Renae Rich strives to connect the work we do with the strategic outcomes our clients care about. Renae plays an integral role in HDR’s research initiatives, especially through analyzing and interpreting data. With a background in advertising and marketing and a Master of Science in statistics, Renae combines her analytic mindset with her creative side to explore complex problems by diving into data. A recipient of the 2018-2019 Academy of Architecture for Health Foundation research grant, she enjoys working on diverse projects and is compelled by the opportunity to affect people’s lives by influencing change in building environments.
Francesqca Jimenez, M.S.
Research Strategist, HDR
As a researcher at HDR, Francesqca Jimenez thoughtfully investigates the ways in which the built environment impacts human health, performance, and well-being. Francesqca has a Master of Science in Applied Research in Human-Environment Relations from Cornell University’s Department of Design and Environmental Analysis with a minor in Organizational Behavior, and a Bachelor of Arts in Psychology, English and Women’s Studies from the University of California-Los Angeles. Ms. Jimenez’s primary research interests are in environmental psychology, and in linking environments to health. She is currently coordinating several HDR-led studies in healthcare and higher education.
Sheila DePaola, MSN, RN
Nursing Operations Specialist, Parkland Health and Hospital System
Sheila DePaola serves as a Nursing Operations Specialist at Parkland Health & Hospital System. Her clinical expertise is in Nursing Informatics and Cardiovascular Interventions. She has a Masters in Nursing with an emphasis on Health Care Informatics from Grand Canyon University, Phoenix, Arizona. Sheila is committed to ensuring that nursing workflows and the technology tools utilized are intuitive, value-added and serve to improve staff engagement, quality of care and the safety of hospitalized patients.
Host: Kati Peditto, PhD, EDAC, Assistant Professor - Human Factors, Dept. of Behavioral Sciences and Leadership, U.S. Air Force Academy
Kati Peditto, PhD, EDAC is an environmental psychologist and assistant professor in the Department of Behavioral Sciences and Leadership at the U.S. Air Force Academy. She received her PhD in Human Behavior and Design from Cornell University and completed postdoctoral training under Dr. Mardelle Shepley. Her research focuses on providing equitable health environments for adolescents and young adults, ranging from pediatric cancer facilities to college health centers. She is the recipient of the 2018 New Investigator Award from The Center for Health Design, and a 2018 AIA-AAH Tuttle Fellow in Health Facility Planning and Design.
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