Insights & Solutions

Masclee, G. M. C., Masclee, A. A. M., Kruimel, J. W., Conchillo, J. M., van Vliet, J., Keszthelyi, D. (2022). Using a patient hotel: Perceptions of the quality of care by patients undergoing analysis for gastrointestinal motility disorders in the Netherlands

Spending the night in the hospital before a procedure, or testing can be stressful. These hospital stays are also costly for patients and for the healthcare organization. Recently, a hospital in the Netherlands began putting gastrointestinal (GI) patients up in a hotel instead of having them stay in the hospital. This appears to be the first study to look at the impact of the outpatient hotel experience on the patient experience. Results show that when generally healthy patients can spend the night in outpatient hotels, their outpatient stay is more comfortable, and the overall perceptions around quality of care may be more positive. Some of you may remember the Motel 6 commercials and Tom Bodet promising to leave the light on for you? Well maybe we need to consider an option for patients where they don’t have to worry about the lights being left on, so they can get a good night’s rest.

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.

Tseung, V., Verweel, L., Harvey, M., Pauley, T., Walker, J. (2022). Hospital outdoor spaces: User experience and implications for design

While outdoor views and spaces can positively impact patient and hospital staff outcomes, research is needed to understand how outdoor design might contribute to patient therapy in post-acute and rehabilitation care. Researchers used a pre-occupancy evaluation to interview patients, family, and staff involved with rehabilitation activities in the outdoor areas of an existing hospital to inform the design of a new facility. Researchers identified three overarching themes: outdoor spaces and views help patients focus on life beyond their illness, specific design elements should be considered when planning outdoor views and spaces, and deliberate design of outdoor spaces can promote rehabilitation. Design elements identified in this single-site study include: year-round visual access to the outdoors, a variety of plants, water, and wildlife; challenging grades that support therapy but do not create barriers for patients with mobility issues; safety stations and clear signage for trails or paths; and separate spaces for patients/families and staff.

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.

Keys, Y., Stichler, J. F. (2018). Safety and Security Concerns of Nurses Working in the Intensive Care Unit: A Qualitative Study

Safety and security are top priorities for healthcare organizations, and are especially important in areas where patients are at their most vulnerable, such as the intensive care unit (ICU). ICU nurses and providers have intense responsibilities when caring for complex patients and a safe and secure environment of care is necessary. There is very little research on how design of the ICU environment affects nurse perceptions of safety – safety for themselves and for other patients. In addition, the research that does exist is largely based on an assumption that ICUs are safe and secure places. The current study begins to test this assumption, and results suggest the following recommendations for ICU design: smaller unit sizes, the need for improved visibility, the ability to access alternate exits, including security controls for emergencies or threats, and providing adequate staffing.

Jiang, S., Allison, D., Duchowski, A. T. (2022). Hospital greenspaces and the impacts on wayfinding and spatial experience: An explorative experiment through immersive virtual environment (IVE) techniques

Healthcare facilities are notoriously complex spaces, and wayfinding is a common challenge. There is evidence from previous studies that certain design interventions can improve wayfinding, such as environmental cues and clear signage. But people from different backgrounds interpret signage differently, and so we need to think about other ways design can support navigation. Results from this 2022 study by Jiang and colleagues show that visual access to the exterior natural environment seems to help support recognition, orientation, and mood – all of which can set visitors up for better wayfinding, and ultimately – for a better healthcare experience.