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Healthcare Facilities

Five Design Strategies to Increase Staff Retention
Tuesday, July 28, 2009

Many hospitals face significant nurse turnover rates, which can be very costly. Recent studies conclude that the costs of single nurse turnover can range from about $22,000 to more than $64,000 dollars. According the Agency for Healthcare Research and Quality (AHRQ), the average annual turnover rate for healthcare workers is 20 percent due primarily to stress and the physically demanding nature of the job. In addition to instituting a supportive work culture, healthcare design should support ways of working that ensure health, safety and effectiveness for all in healthcare.

  1. Reduce Patient transfers to increase productivity and reduce errors: According to the Center for Healthcare Design a typical nursing unit transfers or discharges 40 to 70 percent of its patients every day. Acuity-adaptable rooms are rooms that are designed to care for patients as the demands of their health changes from admittance to discharge. This patient room design decreases the amount of time staff spends transferring patients and the chances of patient information getting lost leading to errors. Clarian Methodist Hospital in Indianapolis, IN, under the leadership of Ann Hendrich, equipped single-patient rooms of the cardiac wing with acuity adaptable headwalls that included gases and equipment needed to provide care as patient acuity changed. Patient transfers were reduced by 90 percent and medication errors were reduced by 70 percent.
  2. Reduce caretaker walking: One study reported by the Center for Healthcare Design found that 28.9 percent of nursing staff time was spent walking. Research suggests that bringing staff and supplies closer to the patient helps reduce the time spent walking and increases the amount of time caregivers spend with patients. Hendrich's project at Clarian included decentralized nurse stations and supply areas. The design reduced walking and supply trips which increased nursing time allowing for a reduction in budgeted staffing care hours, while at the same time increasing time spent in direct-care activities.
  3. Reduce excessive stressful noise: The World Health Organization recommends noise levels within hospitals to not exceed 35 dB. High sound levels are directly correlated with work interference and noise-induced stress. Reducing noise through the use of sound-absorbing ceiling tiles have been found to improve speech intelligibility, reduced perceived work demands and lessened perceived pressure and strain.
  4. Reduce staff sickness: In addition to having better ventilation to reduce air-borne infections, poor hand washing compliance among staff is the primary cause of contact transmission of infections. Design aspects to increase hand washing include: visible and conveniently located sinks, handwashing liquid dispensers and alcohol rubs.
  5. Reduce staff injuries: strains and sprains account for 44 percent of nursing injuries that result in lost days while more than 10 percent of back injuries are associated with moving and assisting patients. Ceiling lifts to eliminate the need to lift patients. PeaceHealth in Oregon installed ceiling lifts in most patient rooms in its intensive-care unit and neurology unit to realize the annual cost of patient-handling injuries in these units reduced by 83 percent.

 

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