Insights & Solutions

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.  

This webinar will share research and case studies that explore how design can be used as a tool complementing therapeutic protocols to reduce patient stress and aggression on pediatric mental health units.   

Taking advantage of the collective knowledge and expertise in attendance, this webinar will offer interdisciplinary perspectives to evaluate current cutting edge design solutions, help attendees to develop solutions of their own, and inspire further research with the aspiration to transform the future of the care team station in inpatient behavioral health settings.  

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?  

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.

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.

Don’t miss this, high-return day to problem-solve with experts, idea-share with colleagues and obtain new strategies and resources to address behavioral health challenges not only in specialized units, but in emergency departments, outpatient clinics and throughout acute care settings. 

The 12,500 SF unit was designed and constructed in just 120 days and incorporates all of the planned care and documentation practices to support the Western Maryland community during the COVID-19 pandemic and future events as they may occur. The negative-pressure and ventilator-capable environment was designed adjacent to outpatient facilities and increases the overall capacity of available beds, while limiting the exposure of the infected patients. The unit features two operating modes: “normal,” where the rooms function as typical medical/surgical beds; and “infectious,” where all 20 rooms operate under negative pressure to care for infected patients and provide clinical safety.

King, B., Bodden, J., Steege, L., & Brown, C. J. (2020). Older adults experiences with ambulation during a hospital stay: A qualitative study. Geriatric Nursing

The inability to independently ambulate during an admission frequently results in “hospital associated disability” for older adults. Understanding and addressing ambulatory barriers from their point of view is essential to facilitate better outcomes. Focus groups were conducted to solicit and categorize responses. Researchers uncovered a new place-based concept that they referred to as “Danger Zones.” Unwelcoming environments, inadequate care planning, and interpersonal biases all contribute to challenges with older patient’s lack of ambulation. This study provides a prototype for identifying barriers to ambulation in healthcare settings from the perspective of older adults as well as a broader range of inpatients.

The challenges created by today’s growing mental health and substance abuse crises, especially in light of the recent pandemic, reach far beyond the behavioral health unit into emergency departments, outpatient clinics and throughout acute and ambulatory care settings.

To support improved care and enhance staff safety, today’s design, facility and care professionals have to advance their understanding of the environment’s impact on behavioral health care and learn how to incorporate the best and latest design solutions throughout all healthcare setting.