Herd-Health Environments Research & Design Journal最新文献

Objective: This study aimed to identify latent conditions in a pediatric intensive care unit (PICU) by analyzing characteristics of flow disruptions (FD) during a simulation of a three-phased scenario.

Background: The built environment of healthcare facilities contributes to FD that can lead to clinical errors and patient harm. In the facility design process, there is an opportunity to identify built environment features that cause FD and pose safety risks. Simulation-based evaluation of proposed designs may help in identifying and mitigating safety concerns before construction and occupancy.

Methodology: During design development for a new 400-bed children's hospital, a series of simulations were conducted using physical mock-ups in a large warehouse. A three-phased scenario, (1) admission and intubation, (2) cardiac arrest, and (3) bedside surgery involving a cannulation to extracorporeal membrane oxygenation, was conducted in a PICU room mock-up. Each scenario was video recorded from four angles. The videos were systematically coded to identify FD.

Results: Analysis identified FDs in three ICU zones: respiratory therapists (RT) zone, nurse zone, and head of the patient. Challenges in these zones were related to spatial constraints in the RT zone and head of the bed, equipment positioning in the RT zone and nurse zone, and impeded visibility related to the location of the boom monitor in the nurse zone.

Conclusion: Simulation-based evaluation of prototypes of patient care spaces can help identify characteristics of minor and major FD related to the built environment and can provide valuable information to inform the iterative design process.

Objective: This study examines the impact of ambulatory waiting room characteristics on patients' emotional states and investigates whether these states are universally experienced or influenced by social and cultural factors among women aged 18-35 from the three largest demographic groups in the United States: Black, Hispanic/Latina, and White.

Background: Patients typically spend more time waiting for routine medical appointments than receiving care, and evidence suggests that waiting can reinforces power dynamics that benefit privileged groups, leading to different experiences for minority women seeking preventative care. Still, literature addressing the impact of waiting areas is largely limited to universal measures, and little is known about how different ethnic/race groups respond to waiting spaces.

Methods: This inquiry used a questionnaire assessing 15 waiting room characteristics and testing four variables (furniture arrangement, room-scale, color saturation, and quantity of positive distractions) in a 2 × 3 quasiexperiment using a fractional randomized block design with 24 waiting room images.

Findings: Responses from 1,114 participants revealed mutual preferences for sociopetal seating, positive distractions, neutral colors, and welcoming and calming environments. Yet, Black participants indicated significantly greater importance in seeing ethnically/racially similar patients and healthcare providers and strategies that promote transparency, including image-based provider directories and views into the clinic.

Conclusion: By investigating the impact of the waiting room environment on patient affect and comparing perceptions across three demographic groups of women, this study offers insights into potential strategies for improving access to preventative care services by creating more welcoming ambulatory care waiting environments.

Introduction: When a seriously ill and dying parent is hospitalized, the families are at risk of developing problems. Only sparse evidence is available on the effects of creating family-friendly rooms in hospitals.

Aim: This study investigates how a seriously ill parent to children aged 0-18 experiences staying in a hospital room with family-friendly furnishing.

Methods: From September 2012 to September 2015, seriously ill and dying patients with children ages 0-18 were offered the opportunity to stay in a family-friendly room at the North Denmark Regional Hospital. The sick parents were interviewed about how the changed room impacted themselves, their children, and their family.

Results: The analysis led to three themes: (1) The ability to visit a sick parent, (2) maintaining family functions and relationships, and (3) room for children and adults.

Conclusion: By offering the families a hospital room with cozy furniture and a big TV screen, seriously ill parents see that their children are more comfortable when visiting the hospital. A family-friendly hospital is not just an idealistic thought, it is a real opportunity to improve the final period of a dying parent's life.

Objectives: This article examines a novel theoretical framework, which we term Home Triad, for research and practice involving people living with dementia (PLWD).

Background: Most of the existing home-related research on PLWD focuses on interior modifications, home care interventions and models, place attachment, and/or institutional homelike environments. However, limited studies have examined the meaning of home from PLWD's perspective, and even fewer have simultaneously considered the individual experience of PLWD, the external power (e.g., the role of design), and their interaction dynamics in the meaning-making process.

Methods: We developed home triad based on Lefebvre's spatial triad. Inspired by Chaudhury's home story structure, we conducted a life story analysis of a person living with dementia, "Kai," under four contexts-childhood home, neighborhood and city, daily routine, and attachment-within home triad.

Results: Home triad abstracts "home" with a dialectically interconnected relationship of the conceived, perceived, and lived home. Through PLWD's everyday life, the essence of home is primarily shaped by the interaction between their lived and perceived homes. However, a person's experiences of and participation in home living activities are also planned and/or regulated by different groups of people (caregivers, designers, and policymakers), who play important roles in the conceived home. Critically examining how PLWD's lived and perceived home is constrained or enabled through the conceived home deserves greater future research efforts.

Conclusion: A systematic examination of the essence of home for PLWD using home triad can facilitate subsequent research and practice that promote PLWD's health, well-being, and quality of life.

Background: The COVID-19 pandemic placed healthcare design at the heart of the crisis. Hospitals faced challenges such as rapidly increasing their intensive care unit capacity, enabling physical distancing measures, quickly converting to telehealth and telework practices, and above all, keeping patients and staff safe. Improving flexibility in hospital facility design and adaptability of hospital operations to function in "crisis mode" can be seen as ways of future-proofing for pandemics. In a design brief, flexibility is typically mentioned as an important target. Meanwhile, robustness of technical infrastructure is called for, and standardization at unit level with single-occupancy inpatient accommodation may be considered a way to enhance flexibility and adaptability in dealing with a surge in infectious patients.

Aim: To future-proof facility design with pandemic preparedness and resilience in mind, this study evaluated what kinds of interventions were taken in Dutch hospital facilities and what perspectives need to be considered when hospitals operate in crisis mode.

Methods: We have collected data from facility and estate professionals from 30 Dutch hospitals. Using a practice-based approach, in-depth interviewing helped uncover and compare successful operational strategies and design elements that provided the flexibility needed in the early stages of the recent crisis.

Results: As we looked at existing facilities and alterations made to allow hospitals to operate during the COVID-19 pandemic, we discovered that staff availability and adaptability were deemed crucial.

Conclusion: We add the perspective of staff as an essential factor to be considered when future-proofing hospital facility desigr crisis mode operation.

Objectives: In this study, it was aimed to evaluate the landscape plants used in the design of hospital gardens in terms of toxicity.

Background: Although plants have positive effects on humans, some plants can be toxic due to the compounds found in their bodies. The toxicity of plants is an issue that needs to be addressed in design, and it is important to investigate the toxic properties of plants in designs to be made in hospital gardens, which have a large user population and especially where people come to heal.

Methods: Observation technique and document analysis were used in the study. Species were identified by taking samples from landscape plants in the gardens of state hospitals in Bursa. The distribution of the identified plant taxa according to toxic groups and their relations with each other were analyzed.

Results: Taxa used in hospital gardens were mostly nontoxic (54.43%). It has been determined that there is a linear relationship between the number of taxa and toxic groups, and the increase in the number of taxa also increases the number of toxic taxa.

Conclusion: It is seen that toxic plants are used in the design of hospital gardens, but they are included in toxic taxa. It will be an important approach to raise awareness by placing labels showing the toxicity status of taxa together with the collection of toxic taxa at points far from users.

Objective: This exploratory study examines a rural critical access hospital (CAH) staff's perception of current obstacles and needs concerning the physical environment.

Background: CAH intends to improve access to healthcare, coordinate with experts and providers, and serve as the rural population's healthcare hub. It is imperative to understand environmental qualities that impact the quality of care to develop effective policies and design guidelines for rural healthcare. Nevertheless, a limited number of studies have focused on user or organizational outcomes related to the physical environment of rural healthcare settings.

Methods: This cross-sectional exploratory qualitative case study was conducted as part of the facility planning process for a CAH in rural North Carolina. Hospital staff participated in a survey exploring their satisfaction with the overall physical environment privacy, space allocation, and department adjacency. An open-ended question asked staff to elaborate on needed improvements and changes in their department.

Results: Findings show low satisfaction levels for space allocations for emergency department, lab, surgery, and wound care. Safety and quality were the two emerging outcomes of the physical environment's shortcomings. Two clusters emerged from the content analysis, representing facility needs (rightly sized spaces, functional needs, COVID-19 needs, and improved access) and ambient conditions (clutter, visibility, flooring quality, noise, privacy, cleanliness, aesthetics, and temperature).

Conclusion: The findings from this study suggest that the interior and exterior facility and ambient conditions of the CAH play a key role in quality and safety outcomes.

Aims: The study aimed to (1) discover workers' attitudes toward the use of novel video screens to improve hand sanitization in the workplace and (2) discover what workers' preferences are for hand hygiene (HH) messaging style and tone and reasons for their preferences.

Background: Practicing good HH in non-medical office settings is vital to curb the spread of a range of common and infectious diseases. Despite this, workers are rarely consulting in the construction of HH messages. The qualitative views of users can provide us with the "why" rather than the "what" and can highlight areas of cynicism, concern and overall attitudes to HH.

Methods: A survey was completed by 520 UK workers concerning attitudes and views toward HH messaging and the use of a video-based hand sanitizer unit. Analysis consisted of both qualitative and quantitative methods.

Results: Workers were skeptical toward the use of digital technologies within HH interventions, and there were misgivings about the role that video could play. Results demonstrated a strong preference for positive and supportive messages. Educational and trustworthy qualities were well rated. Messages that emphasized surveillance, previously successful in a clinical setting, or guilt, were not well received. Visual approaches that utilized serious illustration were valued.

Conclusion: This study highlights how consulting workers before the design of HH initiatives is important in guiding the design process. The resultant user-centered criteria promotes the use of positive, motivational, thought-provoking, surprising, and visual approaches to HH messaging.