Insights & Solutions

Kevdzija, M., & Marquardt, G. (2021). Impact of distance on stroke inpatients’ mobility in rehabilitation clinics: A shadowing study

Failure to rehabilitate after experiencing a stroke typically results in admission to long-term care. While the stakes are high, understanding how size and spatial configuration of rehabilitation settings can support wayfinding and help patients overcome mobility barriers is unclear. This study was undertaken to evaluate the how distances between spaces in rehabilitation clinics impact patients’ mobility. Longer distances increased the number of encountered mobility barriers within five identified categories for all patients, with no significant difference between patients’ mobility levels. This study demonstrates that the spatial needs and independent mobility of stroke patients can also be improved through building layouts with short distances and carefully planned routes between destinations.

Xuan, X., Duan, X., Feng, Z. (2022). The demand for specialization and its influence on the design of inpatient nursing units: Can standardized design be done once and for all?

General medical-surgical units within a single facility have a similar design, but often provide specialized care. Options to create work efficiencies for nurses who may engage in unique tasks depending on the patient populations served, might improve patient care. Researchers developed a survey to collect demographic data and information on caregiving activities which was distributed to nurses on several types of general units. Additionally, ten nurses from different units were interviewed. Survey results demonstrated statistically significant differences in nurse perceptions of walking distance, clinical space, communication privacy, visibility, facilities and storage, acoustics, lighting, and thermal comfort. Interview data indicated that although nurses felt there was enough work similarity to justify a uniform unit layout across general nursing units, there were differences in terms of specialized caregiving activities required for unique patient populations, differences in spatial requirements for caregiving activities, and differences in allocation of space for equipment.

Fay, L., Real, K., Haynes, S. (2022). The healthcare workspace: Understanding the role of decentralized nursing stations, corridors, and huddle spaces as locations for teamwork in a neonatal intensive care unit

Decentralization of nurses to corridor alcoves has placed them closer to the patient bedside, but has also resulted in unintended, negative consequences including reduced collaboration and teamwork. Researchers in this single-site study conducted a multi-phased pre-and post-occupancy evaluation of multidisciplinary care in a NICU transitioning from an open-bay to a single-family room layout. They looked for differences in collaboration among caregivers between the two layouts, and evaluated the use of nursing stations, corridors, and huddle stations on the new unit. Generally, survey respondents from a variety of disciplines demonstrated statistically significant improvements in perceptions of job satisfaction, well-being, and design satisfaction in the new unit but they had lower perceptions of teamwork although not statistically significant. Observations indicated that within professions the majority of communication occurred at the decentralized nursing stations, but when more than two professions were communicating, the huddle stations were most frequently used.

Lim, L., Kanfer, R., Stroebel, R. J., Zimring, C. M. (2020). Backstage staff communication: The effects of different levels of visual exposure to patients

Good communication and teamwork among healthcare staff is essential to quality healthcare. “Backstage areas” – or the areas away from patients – can provide privacy for staff discuss patient information, build relationships, and provide training. Conversations often include sensitive information about patients’ health, as well as specific patient needs or circumstances (for instance, letting each other know about a patient who is upset, or a patient who is hard-of-hearing). While there is a great deal of research around visibility in the workplace and team interaction, not many of these studies have focused on the healthcare workplace, and even fewer have looked at visual privacy from patients. The results of this study show that staff have a strong preference for the option of visually private backstage areas, but that more open areas can also support comfortable communication – especially when the design provides clear delineation to support adequate visual privacy from patients.

Stroebel, R. J., Obeidat, B., Lim, L., Mitchell, J. D., Jasperson, D. B., & Zimring, C. (2021). The impact of clinic design on teamwork development in primary care. Health Care Management Review.

This study by Stroebel and colleagues looked at the relationship of clinic design, specifically co-location of staff, and teamwork in outpatient settings.

This webinar offers a case study of IU Health Bloomington Hospital. One of the main challenges of this project was creating a flexible space that was safe and secure, but highly focused on hospitality and positive patient environments. This team discussed the ideal vision for the unit with the client and through intentional communication and focused listening, a plan was developed by the staff which Guidon implemented into a program space and floor plan. Using 3D modeling and mock-up, the team developed a thorough understanding of the integrated case work.

Penn Medicine Radnor, designed by Ballinger, transforms a derelict suburban office park into a community-focused, sustainable, mixed-use development rooted in nature. The 250,000 SF ambulatory care center is designed for regeneration of both the site and human health. The building and its attached garage form a U-shape around a courtyard, integrating it into the surrounding landscape and blurring the distinction between indoors and outdoors.

A letter from a patient to the CEO of one of New England’s premier hospitals saying how great the care she received was, but the physical environment, especially the art, was a true disservice to the patients. The CEO made it his mission to implement a fully donor funded art program hospital wide to create a calming space.

In Great American Art's initial walk-thru, we noted the walls were filled with things that didn't aid in the healing process. Using EBD for art to guide selections, we enhanced the physical environment providing points of connection with meaningful works of art that help all deal with the challenging circumstances they face.

Degl' Innocenti, A., Wijk, H., Kullgren, A., Alexiou, E. (2020) The influence of evidence-based design on staff perceptions of a supportive environment for person-centered care in forensic psychiatry. Journal of Forensic Nursing

Staff satisfaction is an essential return on the investment being made to improve the provision and efficiency of care. Getting their detailed feedback on the design of the built environment makes good heart and business sense.

To transform a traditional episodic outpatient care model into a team-based integrated setting, while enhancing the operational bottom-line and patient care delivery.