Analysis of functional layout in emergency departments (ED). Shedding light on the free standing emergency department (FSED) model
2022
Applied Sciences
Journal Article
Issue 10
Volume 12
Pages 5099
Author(s): Brambilla, A., Mangili, S., Das, M., Lal, S., Capolongo, S.
Research shows that emergency departments (EDs) are facing overcrowding, increasing patient acuity, and short staffing, which all are impacting wait times to be seen and patient satisfaction scores.
Added December 2022
Implementation of a navigation system: Economic verification in a local hospital.
2022
PLoS ONE
Journal Article
Issue 10
Volume 17
Pages e0276996
Author(s): Majerova, I., Michna, P., Lebiedzik, M., Nevima, J., Tureckova, K.
Wayfinding is a long-standing challenge in healthcare facilities. Multiple studies have evaluated the cost-benefit of traditional wayfinding systems with respect to cost (e.g., staff time spent direction giving) and benefits (e.g., improved patient experience).
Added November 2022
Designing for efficiency: Examining the impact of centralized and decentralized nurse stations on interdisciplinary care processes
2020
JONA: The Journal of Nursing Administration
Journal Article
Issue 6
Volume 50
Pages 335–342
Author(s): Fay, L., Santiago, J. E., Real, K., Isaacs, K.
Between 1980 and 2008, adult inpatient units increased in size by 118%. Size increases on this scale may negatively impact operational efficiency, waste reduction efforts, and workplace safety.
Added June 2020
The effect of vertical split-flow patient management on emergency department throughput and efficiency
2018
The American Journal of Emergency Medicine
Journal Article
Issue 9
Volume 36
Pages 1581-1584
Author(s): Garrett, J. S., Berry, C., Wong, H., Qin, H., Kline, J. A.
In some emergency departments (EDs), the severity of a patient’s condition is rated on a 5-point scale during admission using the Emergency Service Index (ESI). Under the “split-flow” model of patient triaging, patients with less-severe conditions (rated an ESI 4 or 5) are “fast tracked” so that they can be separated from patients with higher ESI scores, allowing for more efficient resource allocation for all patient treatment procedures.
Added December 2018
Introduction of a horizontal and vertical split flow model of emergency department patients as a response to overcrowding
2018
Journal of Emergency Nursing
Journal Article
Issue 4
Volume 44
Pages 345-352
Author(s): Wallingford, G., Joshi, N., Callagy, P., Stone, J., Brown, I., Shen, S.
Hospital emergency departments (EDs) strive to optimally organize patient flow so that optimal care can be delivered while patient length of stay is minimized. The emergency severity index (ESI) is a 5-point scale used to help medical staff discern the severity of patient conditions; higher ESI scores indicate less-severe medical conditions.
Added December 2018
Deliberate Perioperative Systems Design Improves Operating Room Throughput
2005
Anesthesiology: The Journal of the American Society of Anesthesiologists
Journal Article
Issue 2
Volume 103
Pages 406-418
Author(s): Sandberg, W. S., Daily, B., Egan, M., Stahl, J. E., Goldman, J. M., Wiklund, R. A., Rattner, D.
Operating rooms (ORs) are complex and sensitive environments that are typically expensive to operate and maintain. Minimally invasive surgical procedures are becoming increasingly more prevalent in many OR environments, while the costs of operating and maintaining OR environments are simultaneously increasing.
Added November 2018
Separate Medication Preparation Rooms Reduce Interruptions and Medication Errors in the Hospital Setting: A Prospective Observational Study
2016
Journal of Patient Safety
Journal Article
Issue 3
Volume 17
Pages e161-e168
Author(s): Huckels-Baumgart, S., Baumgart, A., Buschmann, U., Schüpfer, G., Manser, T.
Errors and interruptions are commonplace during medication preparation procedures in healthcare environments. One study found that one interruption occurred for every 3.2 drugs administered during nurses’ medication rounds.
Added December 2016
Low stimulus environments: reducing noise levels in continuing care
2016
BMJ Quality Improvement Reports
Journal Article
Issue 1
Volume 5
Pages 1-4
Author(s): Brown, J., Fawzi, W., Shah, A., Joyce, M., Holt, G., McCarthy, C., Stevenson, C., Marange, R., Shakes, J., Solomon-Ayeh, K.
This article highlights a project that aimed to reduce levels of intrinsic background noise on an adult mental health ward. Following intervention, the ward was able to decrease the background noise decibel level from 60dB to 53dB (on average).
Added November 2016
"Let's Sit Forward": Investigating Interprofessional Communication, Collaboration, Professional Roles, and Physical Space at EmergiCare
2016
Health Communication
Journal Article
Issue 12
Volume 31
Pages 1506-1516
Author(s): Dean, M., Gill, R., Barbour, J. B.
Due to the fact that emergency department (ED) caregivers are constantly involved in interprofessional, knowledge-intensive conversations, effective modes of communication necessarily play a key role in promoting patient health and safety. Previous studies have explored how the physical environment directly affects modes of communication, and how these two dimensions of the healthcare environment constantly intersect with each other.
Added August 2016
A Recovery-Oriented Care Approach: Weighing the Pros and Cons of a Newly Built Mental Health Facility
2016
Journal of Psychosocial Nursing and Mental Health Services
Journal Article
Issue 2
Volume 54
Pages 39–48
Author(s): Ahern, C. C., Bieling, P., McKinnon, M. C., McNeely, H. E., Langstaff, K.
An inpatient mental health hospital was renovated with a newly built environment that incorporated patient-centered, clinically informed designs in an attempt to improve overall safety and quality of care. The new designs were considerably expensive and had extensive design implications for other parts of the hospital outside of the mental health facility.
Added June 2016
Ebola Holding Units at government hospitals in Sierra Leone: evidence for a flexible and effective model for safe isolation, early treatment initiation, hospital safety and health system functioning
2016
BMJ Global Health
Journal Article
Issue 1
Volume 1
Pages 1-8
Author(s): Johnson, O., Youkee, D., Brown, C. S., Lado, M., Wurie, A., Bash-Taqi, D., Hall, A., Hanciles, E., Kamara, I., Kamara, C., Kamboz, A., Seedat, A., Thomas, S., Kamara, T. B., Leather, A. J. M., Kargbo, B.
The outbreak of Ebola Virus Disease (EVD) in West Africa during 2014-2015 was an unprecedented modern crisis that required novel approaches to outbreak containment and management. In response, the Ministry of Health and Sanitation (MOHS) and the King’s Sierra Leone Partnership (KSLP) in Freetown, Sierra Leone, worked to develop and implement five new Ebola Holding Units (EHUs) in government hospitals, which successfully isolated 37% of the 3,097 confirmed EVD cases within the country’s Western Urban and Rural district.
Added June 2016
Healthcare Staffs’ Experiences and Perceptions of Caring for People with Dementia in the Acute Setting: Qualitative Evidence Synthesis
2016
International Journal of Nursing Studies
Journal Article
Author(s): Houghton, C., Murphy, K., Brooker, D., Casey, D.
Dementia is an international health issue that greatly impacts healthcare delivery systems. Individuals with dementia have specific needs when it comes to healthcare, and it seems that, generally, acute care environments aren’t suitable for these individuals. Considering how previous studies have shown that as much as a quarter of individuals utilizing acute hospital services are likely to have dementia, the authors posit that there needs to be a shift in ethos, organization, and environment in which more appropriate care is provided to patients with dementia in acute care settings.
Added June 2016
Performance Evaluation of 32 LEED Hospitals on Operation Costs
Volume 145
Pages 1234-1241
Author(s): Sadatsafavi, H., Shepley, M. M.
As healthcare needs increase, providers strive to reduce operational costs while simultaneously increasing healthcare facility construction and renovation efforts. At the same time, certification programs such as Leadership in Energy and Environmental Design (LEED) are examples of the emerging concerns regarding the environmental impact of healthcare facilities. The authors note that the number of studies documenting the benefits of more “green” facilities is limited; however, they hypothesize that upon comparing LEED-certified hospitals with uncertified ones, the LEED facilities will prove to have lower-than-average maintenance costs.
Added June 2016
Analysis of Credits Earned by LEED Healthcare Certified Facilities
Author(s): Golbazi, M., Aktas, C. B.
Green buildings have garnered widespread public support due to the positive impacts they are perceived to have on the environment, the economy, and society as a whole. The concept of green building design appeals to institutions because of its potential benefit for the indoor and outdoor environment as well as its potential for improving public image. As a result, there may be hospitals that become certified by the Leadership in Energy and Environmental Design (LEED) rating system but aren’t actually providing a green healthcare environment that positively influences patients and their periods of recovery. This is an important distinction since the core purpose of healthcare facilities is to improve the conditions of the sick and vulnerable, as well as society overall.
Added June 2016
Understanding Green Building Design and Healthcare Outcomes: Evidence-Based Design Analysis of an Oncology Unit
2016
Journal of Architectural Engineering
Journal Article
Author(s): Campion, N., Thiel, C. L., Focareta, J., Bilec, M. M.
The United States healthcare industry is a major part of the economy as well as a significant contributor to carbon dioxide emissions and other environmental issues. Green building design (GBD) attempts to offset environmental impacts of buildings, and recently designers have been combining GBD with evidence-based design (EBD) in order to create facilities that positively impact both the external and internal environment.
Added June 2016
Route complexity and simulated physical ageing negatively influence wayfinding
2016
Applied Ergonomics
Journal Article
Author(s): Zijlstra, E., Hagedoorn, M., Krijnen, W. P., van der Schans, C. P., Mobach, M. P.
In this study, “wayfinding” is defined as determining and following a path or route between an origin and a destination. Wayfinding can be particularly difficult in complex and sometimes stressful environments like hospitals, and as hospitals continue to expand to meet increasing healthcare demands, their layouts face the possibility of becoming more difficult to navigate. Wayfinding is particularly difficult for the elderly, who may have memory issues and weakened physical abilities. Support from the environment is necessary to help elderly people function at their best, so it is important to understand what elements of the designed environment either benefit or confuse them.
Added May 2016
Effect of hand sanitizer location on hand hygiene compliance
2015
American Journal of Infection Control
Journal Article
Issue 9
Volume 43
Pages 917-921
Author(s): Cure, L., Van Enk, R.
Hand hygiene is the most important intervention to prevent infection in hospitals. Health care workers should clean their hands at least before and after contact with patients. Hand sanitizer dispensers are important to support hand hygiene because they can be made available throughout hospital units. The aim of this study was to determine whether the usability of sanitizer dispensers correlates...
Added May 2016
Impact of the Physical Environment of Residential Health, Care, and Support Facilities (RHCSF) on Staff and Residents A Systematic Review of the Literature
2015
Environment and Behavior
Journal Article
Issue 10
Volume 48
Pages 1203-1241
Author(s): Joseph, A., Choi, Y.-S., Quan, X.
Strategies related to the design of the built environment should be considered within the context of the culture of the organization and the resident population. This study of the physical environment of residential health, care, and support facilities addresses the range of settings and population, where other studies have been lacking. The literature review strongly suggests that the built environment is an important component of care provided in residential care settings.
Added May 2016
The Creation of a Biocontainment Unit at a Tertiary Care Hospital: The Johns Hopkins Medicine Experience
2016
Annals of the American Thoracic Society
Journal Article
Issue 5
Volume 13
Pages 600-608
Author(s): Garibaldi, B. T., Kelen, G. D., Brower, R. G., Bova, G., Ernst, N., Reimers, M., Langlotz, R., Gimburg, A., Iati, M., Smith, C., MacConnell, S., James, H., Lewin, J. J., Trexler, P., Black, M. A., Lynch, C., Clarke, W., Marzinke, M. A., Sokoll, L. J., Carroll, K. C., Parish, N. M., Dionne, K., Biddison, E. L. D., Gwon, H. S., Sauer, L., Hill, P., Newton, S. M., Garrett, M. R., Miller, R. G., Perl, T. M., Maragakis, L. L.
Prior to the 2014 Ebola virus disease (EVD) outbreak in West Africa, the United States had only one to three specialized biocontainment units. Once the EVD crisis began, a group of reputable American healthcare institutions worked together to renovate a deactivated clinical space into a functioning biocontainment unit (BCU).
Added April 2016
Making the Case for Evidence-Based Design in Healthcare: A Descriptive Case Study of Organizational Decision Making
2010
Health Environments Research & Design Journal
Journal Article
Issue 1
Volume 4
Pages 56-88
Author(s): Shoemaker, L.K., Kazley, A.S., White, A.
It is reported that an approximately 98,000 people die each year in the United States as a result of medical errors (IOM, 1999). This is unacceptable in a country that prides itself on the best medical institutions and access to the highest-end technology. It is believed that the need to renew currently standing hospitals is due to a combination of aging buildings, aging populations, and introduction of new technologies (Ulrich, 2004). This has led to a large patient safety movement and the largest hospital construction boom in U.S. history (Jones, 2004).
Added January 2016
