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Healthcare Facilities

Evidence-Based Design Interventions: Operating Rooms and Intensive Care Units
Tuesday, July 21, 2009

Using evidence-based design to promote better healthcare, the Institute for Healthcare Improvement (IHI) identified six specific areas within a healthcare facility needing critical design interventions for improved safety and quality care. This blog encompasses two of those areas: Operating Rooms and Intensive Care Units. Our proceeding blog series will dive into other areas addressed by IHI: Emergency Departments, Medical-Surgical Nursing Unit, Medical Office Settings and Neonatal Intensive Care Unit.

Operating Rooms
Studies show that design characteristics of the operating rooms impact staff functioning and communication and ultimately impact patient care and safety.

  • Optimal ventilation and filtration within operating rooms impact surgical site infections. Discussions and research is underway to determine the best system to implement.
  • Designing for OR functions will assist in relieving the pressure felt by staff. Adding to the stressful nature of the job, for long periods of time, physicians and nurses are in the operating rooms with excessive noise, no access to natural light and are crowed by people and equipment. While most sound-absorbing materials are hard to clean, thus unsuitable for the OR, IHI suggests implementing:


o Adjustable -height footstools
o Better monitor placement
o Ergonomically designed instrument tables to help reduce neck   and back tension experienced by surgical nurses trying to obtain an unobstructed view of the operating field while reaching for instruments.

Intensive Care Unit
Communication and collaboration are key factors in the effective treatment of high-risk and critically-ill patients.

  • Acuity-adaptable rooms are basic features of evidence-based healthcare design as well are critical for Intensive Care Units. The rooms provide different levels of care without having to move patients from room to room as their acuity improves. The implementation of this design concept reduces patient handoffs, potential for patient slips and falls, incidences of staff injuries related to patient lifting and medication errors.
  • Larger rooms which allow patients' families to be involved in care have shown to improve outcomes and perceptions of both patients and families. In fact, having family members present during cardiopulmonary resuscitation is becoming a practice in pediatrics.
  • Sound-absorbing ceiling tiles, in studies where they replaced sound-reflective ceiling tiles, have showed to improve patients' sleep patterns.

In our next blog of the evidence-based healthcare design intervention series we will visit Emergency Departments and discover ways proven design tactics benefit both patients and staff.

 

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