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
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
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
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
Adapting to Family-Centered Hospital Design: Changes in Providers’ Attitudes over a Two-Year Period
2009
Health Environments Research & Design Journal
Journal Article
Issue 1
Volume 3
Pages 79-96
Author(s): France, D., Throop, P., Joers, B., Allen, L., Parekh, A., Rickard, D., Deshpande, J.
Although hospitals are being designed based on evidence-based design principles, it’s unclear how working in such an environment influences providers’ attitudes and professional performance.
Added January 2016
Making acuity-adaptable units work: lessons from the field
2012
Health Environments Research & Design Journal
Journal Article
Issue 3
Volume 5
Pages 115-128
Author(s): Zimring, C., Seo, H.
Acuity-Adaptable Units (AAUs) are rooms with a treatment model that allows all stages of patient care to come to the patient’s unit from the time of admission to discharge. Minimizing the amount of patient transfers helps decrease medication errors, infection rates, and medical complications. This helps avoid injuries and infections connected with patient transfers from unit to unit through transitions in stages of care.
Added January 2016
Leading Change During an Inpatient Critical Care Unit Expansion
2008
Journal of Nursing Administration
Journal Article
Issue 11
Volume 38
Pages 461-467
Author(s): Braungardt, T. & Fought, S. G.
Acute care hospitals are changing rapidly to address economic and technologic advancements and meet community needs. The authors describe one medical center’s use of Kotter’s work on leading change to expand the neuroscience intensive care unit from 10 to 30 beds to meet community needs, improve hospital efficiencies, and increase bed capacity.
Added January 2016
A Conceptual Model for Healthcare Facility Design
2014
Journal of Nursing Administration
Journal Article
Issue 6
Volume 44
Pages 321-325
Author(s): Stichler, J. F.
This study article presents a conceptual model to explain the interrelationships among healthcare design elements.
Added January 2016
Measuring the Use of Examination Room Time in Oncology Clinics: A Novel Approach to Assessing Clinic Efficiency and Patient Flow
2014
Journal of Oncology Practice
Journal Article
Author(s): Hamel, L. M., Chapman, R., Eggly, S., Penner, L. A., Tkatch, R., Vichich, J., Albrecht, T. L.
Inefficient use of time can drain resources and impede effective clinic flow. Long wait times in oncology units often result in higher costs for both caregivers and patients, while patients also tend to experience increased stress and reduced overall satisfaction with their treatment. Long wait times have also been shown to directly and indirectly reduce patient adherence to recommended treatments.
Added December 2015
The Impact of a Flexible Care Area on Throughput Measures in an Academic Emergency Department
2015
Journal of Emergency Nursing
Journal Article
Issue 6
Volume 41
Pages 503-509
Author(s): McGrath, J., LeGare, A., Hermanson, L., Repplinger, M. D.
This paper explores the implementation of a novel strategy which involved the creation of a “flexible care area” (FCA), a space designed for initiating patient evaluations and treatments at the beginning of a patient’s visit.
Added December 2015
Does an ED Flow Coordinator Improve Patient Throughput?
2014
Journal of Emergency Nursing
Journal Article
Issue 6
Volume 40
Pages 605-612
Author(s): Murphy, S. O., Barth, B. E., Carlton, E. F., Gleason, M., Cannon, C. M.
Added December 2015
Initiatives to reduce overcrowding and access block in Australian emergency departments: A literature review
2014
Collegian
Journal Article
Issue 4
Volume 21
Pages 359-366
Author(s): Crawford, K., Morphet, J., Jones, T., Innes, K., Griffiths, D., Williams, Allison
Australian emergency departments are experiencing an increasing demand for their services. Patient throughput continues to expand resulting in overcrowding and access block where patients cannot gain entry to appropriate hospital beds. This is despite both state and federal governments implementing numerous schemes to address the complex causes of stress on emergency departments. This paper...
Added December 2015
Using Lean-Based Systems Engineering to Increase Capacity in the Emergency Department
2014
Western Journal of Emergency Medicine
Journal Article
Issue 7
Volume 15
Pages 770-776
Author(s): White, B., Chang, Y., Grabowski, B., Brown, D.
Emergency department (ED) crowding is a widespread issue that causes a multitude of negative effects on patient care quality, safety, and efficiency. Lean-based systems engineering, which is often used for industrial manufacturing, is a method for eliminating all forms of waste (including wasted time and other resources) to optimize productivity. Recent studies have begun to demonstrate the use of systems engineering and improvement science on streamlining processes and improving throughput in different medical capacities, but an opportunity remains to refine the application of these tools within EDs in particular.
Added December 2015