How to help improve patient safety via design

Are there specific tactics that architects and engineers can use to possibly improve conditions in healthcare environments? Experts believe the key lies in organized "pre-design" plans and metrics.

How does the layout of a hospital room affect the health of a patient? Are there ways to re-fashion the architectural details found in current residential care establishments to cut down on patient-care errors made by caregivers? Can designers improve the ways that they approach creating new inpatient facilities? A recent article posted on Healthcare Design magazine's web site offers specific design recommendations that address these ideas--and may affect building codes across the United States in coming years.

"A growing body of research shows that features in the built environment—such as light, noise, air quality, room layout, and others—contribute to adverse patient safety outcomes, like healthcare-associated infections, medication errors, and falls in healthcare settings," the article's authors, Anjali Joseph, Ellen Taylor, and Xiaobo Quan, wrote. Pointing to the 1.5 million medical errors per year estimated to cost Americans $19.5 billion dollars annually (based on a 2010 medical claims study by The Society of Actuaries), the authors suggest that design guidelines could perhaps have a positive economic impact, too.

Joseph, Taylor, and Quan attended a two-day seminar funded by the Agency for Healthcare Research and Quality and the Facility Guidelines Institute (FGI) held in fall 2011. The goal of the event was to build consensus on issues to address in the 2014 Guidelines for Design and Construction of Health Care Facilities from the FGI, a publication that lays out the minimum standards required for architectural and engineering design details for hospitals and other patient-care environments. It's used by numerous federal agencies, often as a reference for building and accreditation codes. The key takeaway from the seminar? Intensive "pre-design" research and strategy should be in place to help architects and engineers create safer environments for patients.

Here is a summary of the report on the seminar and its findings.

The top five suggested activities to be prioritized for the pre-design phase of healthcare facilities:

  • Have a clear mission/vision around patient safety. This offers a "tone" for the project that can be referenced throughout the various design stages.
  • Define planning processes and future states. In other words, plan how the design project will be planned. It sounds redundant, but can help as a guideline. And then anticipate how the planning process itself may evolve.
  • Use simulations even before the actual design of an environment takes place: Mock ups can work well to pinpoint current challenges and to visualize key early design ideas.
  • Design patient-care processes while designing a building: Designers should help figure out how patients are best attended to by caregivers, and not just concentrate on improving where they are cared for.
  • Set specific, measurable goals: Designers should gather baseline statistics around important patient safety goals, such as infections and medical errors.

The top four priorities to consider during the design and construction phases:

  • Keep using simulations: Mocking up and mapping out designs can be helpful during the actual design stage.
  • Schedule check-in meetings to follow up on goals: Given that the goal is patient safety, it's important to regularly make sure the design is meeting safety expectations set in the pre-design stage.
  • Conduct post-occupancy evaluations: Keep gathering data after the design is done.
  • Schedule regular safety reviews: Keep measuring how safety has been improved, against baseline data, and also gather patient insights--which could help, obviously, in the planning and design of future healthcare facilities, too.

Image: HikingArtist.com/Flickr

This post was originally published on Smartplanet.com

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