Hospital safety is a big deal, and your patients are starting to take notice. From consumer reports to Yelp reviews, the concept of safety in hospitals and long-term care facilities is vital to the patients and families that trust you with their care.
It’s not just your patients though. Organizations ranging from CMS to Leapfrog are tracking, ranking, and publishing safety records of healthcare facilities. Facility leaders around the country are responding in many different ways but one of the most common, and most effective, is incorporating evidence-based design (EBD) in hospital safety initiatives.
Evidence-Based Design Gives Safety a Boost
EBD is a complex, evolving field, but it doesn’t take years of study to understand the safety benefits healthcare facilities can see from evidence-based design plans.
AHRQ analysis reveals that hospitals have the opportunity to tackle some of the most stubborn challenges in patient safety with the used of evidence-based design. Some of the most common safety improvements hospitals stand to see include,
- Preventing patient falls: AHRQ predicts that annual cost of patient falls will cross $30 billion by 2020, and that’s among the elderly population alone.
- Reducing Medical Errors: Adverse drug events, many of which are caused by human error, cost facilities up to$5.6 million per hospital each year. That doesn’t even count the blows to reputation through negative word of mouth and online reviews.
- Cutting down hospital-acquired infections: HAIs are expensive, especially when you look at them case-by-case. Central line-associated bloodstream infections average over $45K per case and the costs of the common catheter-associated urinary tract infection can crack $1k each case.
Your facility has its risk profile, so it’s worth examining what your safety challenges look like to understand the potential for improvement you can see through evidence-based design.
An Example: Patient Falls
To get a better look at what EBD initiatives look like for a specific and common safety issue, let’s take a look at patient falls.
A few years ago, Debajyoti Pati, professor of environmental design in the College of Human Sciences at Texas Tech University, Lubbock, began studying physical design elements to understand how they contribute to patient falls.
His team created a space that represented a typical hospital room and bathroom and had patients over 70 years of age navigate the room while connected to motion-capture technology. The subjects were attached to harnesses to prevent falls and injury and directed to interact with the room as patients. The results revealed that four postures were most likely to blame for falls: pushing, pulling, grabbing, and turning.
Evidence-Based Safety on the Ground
The Texas Tech study results include insights into what safety-focused design can look like in real life.
In the bathroom, in particular, the study highlighted opportunities to improve bathroom configuration and design including toilet seats and grab bars, bathroom doors, toilet flush handles, and obstructions along the path to the bathroom. IV poles, chairs, overbed tables, and even trash cans were also design challenges for patients to maneuver around. The study recommended configuring bathrooms to reduce turning and designing other spaces to avoid involving two or more of the high-risk postures.
Healthcare designer, Jain Malkin highlights potential design elements such as faucets that prevent the growth of pathogens by not allowing water to collect inside the rim and bathroom layout. For example, when a toilet is flushed, fecal matter is aerosolized and spread to other surfaces around the room. The patient and other caregivers then touch those surfaces – so toilet placement is an important design consideration.
She also points to noisy and visually distracting environments (i.e., with poor lighting) and how these types of nurse stations can contribute to medical errors that threaten patient safety.
Other evidence-based design elements include private rooms to reduce noise and disease transmission, as well as personalized medication cabinets, which when properly locked, can help reduce medication errors.
Patient safety has become such a fundamental concern that it’s now a valuable part of a provider’s brand. If you want to improve outcomes for your patients, avoid being named as an F hospital on a public list, and get the most out of your safety investment, it’s time to introduce yourself to evidence-based design. We’ve put these posts together to help you get started.