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Insights & Solutions

    Member Project
    February 2021 Member Project
    ESa provided master planning and design services to transform the Monument Health Rapid City Hospital campus into a campus equipped to accommodate more patients and to offer more advanced services in an updated environment with efficient patient through-put. Phased improvements include a 260,000 square feet of additions and renovations and a new integrated 80,000-square-foot, four-story hospital office building. Improvements include a newly relocated, expanded Emergency Department, new bed tower with the addition of 32 critical care beds and shell space, and a Central Utility Plant expansion. The additions have also been designed for future interior buildout, vertical and horizontal expansion.    
    Slidecast
    February 2021 Slidecast

    Hopkins, S., Morgan, P. L., Schlangen, L. J. M., Williams, P., Skene, D. J., & Middleton, B. (2017). Blue-enriched lighting for older people living in care homes: Effect on activity, actigraphic sleep, mood and alertness. Current Alzheimer Research

    As we get older, sleep quality suffers, and poor sleep can lead to poor overall health. Our circadian function plays a major role in the quality of our sleep, and research suggests that the physical environment can support better circadian function. Some research shows that residents with dementia in care homes experienced better sleep when exposed to increased light levels. The authors believe this to be the first study to look at the effect on a general population of older people not diagnosed with dementia.

    Slidecast
    February 2021 Slidecast

    Altizer, Z., Canar, W. J., Redemske, D., Fullam, F., & Lamont, M. (2019). Utilization of a Standardized Post-Occupancy Evaluation to Assess the Guiding Principles of a Major Academic Medical Center. HERD: Health Environments Research & Design Journal

    “Let’s do a POE.” Seems simple, right? Design professionals get the potential value of post-occupancy evaluation, but they often find that there is zero time after construction is complete to create a POE tool and go through the evaluation process. Can standardized tools that have customizable features provide a balanced solution to this evaluation conundrum?  

    EBD Journal Club
    January 2021 EBD Journal Club
    Lim, L., Kanfer, R., Stroebel R.J., Zimring, C. (2020). Health Environments Research & Design Journal. DOI: 10.1177/1937586719888903
    Podcast
    January 2021 Podcast
    Holly Harris,  at age 28, shares her perspective on healthcare architecture and design in today’s world.  When asked “Many interior design and interior architect students have been known to shy away from specializing in healthcare because they see it as unsexy and boring. What do you say to that and what would you say to them?” Holly’s answer was inspiring. She quickly responded with, “If you don’t like what you’ve experienced or have seen in the world, then you could be the one to change it.”
    The Lede
    January 2021 The Lede
    With debate about SARS-CoV-2 transmission, Italian researchers studied whether the virus’ RNA was on surfaces where COVID-19 patients were receiving care. Two of 26 samples tested positive, suggesting “real life” surface contamination is a lower risk factor than previously reported.
    The Lede
    January 2021 The Lede
    Under controlled lab conditions, NIH and CDC researchers found two SARS viruses survived in the air, and on plastic, stainless steel, copper, and cardboard up to several days. Precautions against infections originating in hospitals and super-spreader events are needed.  
    Slidecast
    January 2021 Slidecast

    Dhala, A., Sasangohar, F., Kash, B., Ahmadi, N., & Masud, F. (2020). Rapid implementation and innovative applications of a virtual ICU during the COVID-19 pandemic: A case study. Journal of Medical Internet Research

    The novelty of the coronavirus, combined with the complexity of treating COVID-19 patients, forced many organizations to redirect their critical care staff to the COVID-19 units for 24-hour bedside coverage. The hospital accelerated and expanded their tele-critical care program that connected ICU patient rooms to remote caregivers - virtual ICU (vICU). This technology ended up augmenting their critical care capacity during the COVID-19 surge. The program was expedited with COVID, and over the weeks, multiple ICUs implemented the vICU and became COVID-19 units.  While the program was not intended for virtual visits, the virtual setup became a welcomed communication tool during the pandemic. The Ops Center collaborated with bedside staff to coordinate virtual family visits, which improved emotional well-being for patients and families. Anxiety about PPE shortages were alleviated, and medical staff and specialists felt more protected with a reduced number of times they had to go into the room.

    Slidecast
    January 2021 Slidecast

    Lednicky, J. A., Lauzardo, M., Hugh Fan, Z., Jutla, A., Tilly, T. B., Gangwar, M., Usmani, M., Shankar, S. N., Mohamed, K., Eiguren-Fernandez, A., Stephenson, C. J., Alam, M. M., Elbadry, M. A., Loeb, J. C., Subramaniam, K., Waltzek, T. B., Cherabuddi, K., Glenn Morris, J., & Wu, C. Y. (2020). Viable SARS-CoV-2 in the air of a hospital room with COVID-19 patients. International Journal of Infectious Diseases

    There has been ongoing debate about how SARS-CoV-2 is transmitted – is it just droplets? Or does it also transmit by air? Lednicky and colleagues developed a sampling method to test air in a shared patient room with COVID19-positive patients. The air samplers were located at a distance greater than 6’ from the patients. The results showed a complete sequence of SARS-CoV-2 collected from an air sample was an exact match with the virus isolated from patient 1. This study does clearly suggest there is an inhalation risk for acquiring COVID-19 beyond the 6’ practice of physical or social distancing. For designers, aerosolization raises questions about HVAC systems and air changes, but since HVAC design wasn’t the purpose of this study, we know we need to continue to work with engineering professional to establish how to best mitigate transmission by air.

    Slidecast
    January 2021 Slidecast

    Mills, P. D., C. Soncrant, J. Bender, and W. Gunnar. “Impact of Over-the-Door Alarms: Root Cause Analysis Review of Suicide Attempts and Deaths on Veterans Health Administration Mental Health Units.” General Hospital Psychiatry 64

    In order to reduce inpatient suicide, ligature resistance has been a focus of CMS and accrediting organizations for the past several years, but questions remain as to how far we go and where the real risks lie. In this study based in the Veterans Administration, researchers conducted a retrospective review and analysis of system-wide data of suicide deaths and attempts. As with other studies, the majority of suicides or attempts involved hanging, most of which used doors as the anchor point. Of events where the patient was using a door, more than a third involved an over-the-door alarm (OTD), and none of those events included a death. While correlation does not prove causation, the results suggest that OTD alarms prevented death. Knowing the alarm might alert staff became part of the deterrent. Quite simply, in mental health units where the risk of patients committing suicide is high, OTD alarms may help save lives, as part of a comprehensive strategy that includes sight lines, rounding, ongoing maintenance, and even ligature resistant bedding.