When evidence-based design collides with conventional wisdom, the outcome will sometimes be disruptive.
Take, for example, the generally accepted advantages in patient care and observation related to decentralizing nurses’ stations in hospitals, which is becoming standard practice for healthcare clients and their AEC partners.
A recent evaluation of a renovated Missouri hospital, conducted by University of Kansas faculty members, raised questions about the impact of decentralization on patient satisfaction and the communication among nursing teams within the facility.
The St. Louis-based architectural firm Lawrence Group retained the Institute for Health + Wellness Design (IHWD) at KU’s School of Architecture, Design, and Planning to provide a third-party review of the firm’s 2014 remodeling of the orthopedic unit at SSM St. Mary’s Hospital in Jefferson City. That healthcare system was about to embark on an expansion of its St. Joseph Hospital West in Lake St. Louis.
Lawrence Group is an affiliate member of IHWD.
The Institute assessed the unit using an evidence-based design checklist developed by the nonprofit Center for Health Design in California. Its survey included a “space syntax” evaluation that generated a heat map, which showed how the unit’s layout might affect patient satisfaction.
“We wanted to see does moving into a new facility improve patient satisfaction scores, which is one of the most important things for hospital owners today,” said Hui Cai, Assistant Professor at KU, who with Professor Kent Spreckelmeyer and Frank Zilm, IHWD’s chairman, presented findings from the Institute’s nursing unit study at the Healthcare Design Conference 2016 in Houston last November.
The study found, perhaps not surprisingly, that the facility itself showed “statistically significant increase[s]” in scores after the renovation. But patient-quality scores mostly stayed the same, and one score—nurses’ responses to patient calls—actually dropped slightly.
The Institute hypothesizes that decentralization was the culprit, due to the physical distance and visual disconnection of decentralized nursing unit design, which necessitates that nurses must move farther to get from station to station. The Institute suggests these distances might be an impediment to interaction among nurses that might also delay responses to patients.
“This design trend needs to be further investigated before it is accepted as standard for every hospital,” said Cai. “We have to see how to modify the design to achieve balance between shorter walking distance, better patient surveillance and better staff communication and collaboration.”
This is one of the first research studies to link decentralized nurse station design with organizational performance and patient outcomes. The Institute has conducted a second phase of study to evaluate further the degree to which decentralized design affects nurses’ teamwork and patients’ perception of care. In late 2017, IHWD plans to present and publish the results of this study, which included a second hospital, the University Medical Center of Princeton at Plainsboro, N.J.
Related Stories
| Apr 27, 2012
GreenExpo365.com to offer webinars on EPA’s WaterSense Program
Architects and builders interested in developing water-efficient buildings invited to attend free sessions featuring experts discussing water-efficient building practices.
| Apr 25, 2012
McCarthy introduces high school students to a career in construction
High school students from the ACE Mentoring Program tour the new CHOC Children’s Patient Tower in Orange, Calif.
| Apr 20, 2012
McCarthy completes Santa Barbara Cottage Hospital Replacement Facility
The new hospital’s architectural design combines traditional Santa Barbara Spanish colonial architecture with 21st century medical conveniences highlighted by a therapeutic and sustainable atmosphere.
| Apr 18, 2012
Perkins+Will designs new complex for Johns Hopkins Hosptial
The Charlotte R. Bloomberg Children’s Center and the Sheikh Zayed Tower create transformative patient-centric care.
| Apr 17, 2012
Alberici receives 2012 ASA General Contractor of the Year award
Alberici has been honored by the ASA eight times in the award’s nineteen-year history--more than any other general contractor in its class.
| Apr 16, 2012
Freeland promoted to vice president at Heery International
Recently named to Building Design+Construction’s 40 Under 40 Class of 2012.
| Apr 16, 2012
Batson-Cook breaks ground on senior living center in Brunswick, Ga.
Marks the third Benton House project constructed by Batson-Cook.
| Apr 4, 2012
HDS designs Mount Auburn Hospital’s new healthcare center in Waltham, Mass.
HDS Architecture provided design services for all the Mount Auburn Healthcare suites including coordination of HVAC and FP engineering.
| Apr 3, 2012
Suffolk completes phase one of Baystate Medical Center expansion
Construction management firm awarded emergency department project for successful build of $296 million MassMutual Wing and Davis Family Heart and Vascular Center.