ARTICLE
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.
Abstract
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
Experts
Dr. Debajyoti Pati is Professor and Rockwell Endowment Chair in the Department of Design, Texas Tech University, Lubbock, TX. He has researched, published and presented extensively on healthcare design, internationally. He was twice voted among the 25 most influential people in healthcare design, by the Healthcare Design Magazine. He has received over ten research awards, including three-time recipient of the best international research award by the International Academy of Design and Health. He serves on the board of directors of the AIA-NIBS BRIK program, is on the editorial board of the HERD journal, and is a Fellow of the Indian Institute of Architects.
Tom has invested his career of 35+ years as an architect, operations consultant, educator and researcher in design for healthcare facilities. He is a Fellow of the American Institute of Architect a Fellow of the American College of Healthcare Architects and is EDAC certified. His leadership and ideas have influenced an extensive array of environments for healthcare-related missions within settings ranging from rural to urban academic teaching enterprises. He holds the distinct honor, among these accomplishments, of leading the naval design team design for our nation’s two hospital ships, the USS Mercy and Comfort.
His passion focuses on optimal performance of the buildings that emerge from his practice. He organized and is a member of the HKS’ Knox Advisors (business consulting), and is the President and Managing Principal of HKS’ Center for Advanced Design Research & Evaluation (CADRE), a non-profit organization dedicated to rigorously distilling and disseminating quality research evidence relevant to the improvement of design. This focus has led to an innovative design approach intent upon informing design by operational discoveries and evidence from rigorous research in practice.
Sipra Pati is a Human Geographer who has been conducting research in Healthcare Design for the last six years. She has worked with HKS Architects, CADRE, and CHD. She has several publications in peer-reviewed and other journals and has been part of research projects that have been awarded by EDRA CORE and IIDA. Her past research interests examined the spatial attributes of inhabited spaces, the conceptualization of space as a physical entity on domestic violence, and inhabitants’ perceptions of space and employee behavior in industrial workplaces. Her work in the context of healthcare design draws on her understanding of these critical relationships.