Rooms designed to reduce falls, standardize all gear
Palomar Pomerado Health (PPH) in San Diego, CA, is incorporating several strategies for improving patient and staff safety with the design of its new hospital. Tom Chessum, AIA, principal architect for PPH, notes that reducing patient falls was a major concern, and the risk manager explained that many patients fall when trying to get to the bathroom by themselves.
In the new design, the bathroom is placed about 6 feet from the patient bed, closer than in most hospital rooms, with a continuous path of travel along the wall that includes a handrail and no obstructions. With this design, the patient can move to the bathroom without venturing out across an open floor.
PPH also is designing patient care areas so that nurses are distributed among the patient rooms, with their work areas nestled between patient rooms with glass walls that allow continuous viewing. This is a different design from most nurse stations that are centralized on a unit without direct visual contact with many patient rooms, Chessum notes.
Standardization of the patient rooms is a fundamental part of improving safety in the new PPH facilities, says Michael Shanahan, AIA, director of facilities, planning, and development for PPH. Every patient room is designed to be nearly identical and "same-handed," meaning the suction is always on the right side of the bed, for instance, or the intercom is always on the left. Most hospitals have rooms that are mirror images of each other because the wall between the rooms contains all the support equipment and the locations for wall fixtures are reversed on either side of that wall.
At the new PPH facilities, "every room is exactly the same," Shanahan says. "The idea is that the staff need to know exactly where everything is without looking for it, making their response more intuitive. We're reducing the need for mental adjustments regarding equipment so that the caregiver can focus more on the patient, and it may help reduce errors."
In addition to wall fixtures, other items in the rooms, including sharps containers, hand-washing sinks, and family seating areas, always will be in identical locations.
Can do on a smaller scale
But can you include patient safety in facility design without increasing costs? Shanahan was skeptical at first. Standardizing the rooms, for instance, would require double the piping inside the walls instead of allowing fixtures off the same pipe in mirror image rooms. But a cost study revealed that PPH actually could save money with standardization by using modular units and by improving the ability to interchange parts and supplies. Repairs would no longer require several parts for different equipment, for example. Any part would work in any room.
Incorporating patient safety in a new design can be effective, but what if you're not building a new facility from scratch? Shanahan and Chessum suggest that some of the same strategies can be applied to existing facilities, especially the idea of standardizing the location of items such as hand sanitizers.
"You can place them by the door, in exactly the same place, in every patient room to encourage hand washing as the caregiver leaves the room," Shanahan says. "You may be able to accommodate other improvements without a whole scale remodel, things like adding a handrail and a clear path to the bathroom in every patient room."
Palomar Pomerado Health (PPH) in San Diego, CA, is incorporating several strategies for improving patient and staff safety with the design of its new hospital.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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