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Security Implications Of Physical Design Attributes In The Emergency Department

May 2017
EBD Journal Club


Pati, D., Pati, S., & Harvey Jr, T. E. (2016). Security implications of physical design attributes in the emergency department. HERD: Health Environments Research & Design Journal, 9(4), 50-63.


Objective: The objective of this study was to identify physical design attributes that potentially influence safety and efficiency of ED operations.

Methods: An exploratory, qualitative research design was adopted to examine the efficiency and safety correlates of ED physical design attributes. The study comprised a multimeasure approach involving multidisciplinary gaming, semistructured interviews, and touring interviews of frontline staff in four EDs at three hospital systems across three states.

Results: Five macro physical design attributes (issues that need to be addressed at the design stage and expensive to rectify once built) emerged from the data as factors substantially associated with security issues. They are design issues pertaining to (a) the entry zone, (b) traffic management, (c) patient room clustering, (d) centralization versus decentralization, and (e) provisions for special populations.

Conclusion: Data from this study suggest that ED security concerns are generally associated with three sources: (a) gang-related violence, (b) dissatisfied patients, and (c) behavioral health patients. Study data show that physical design has an important role in addressing the above-mentioned concerns. Implications for ED design are outlined in the article.

Keywords: ED security, physical design, emergency departments, evidence-based design