Herd-Health Environments Research & Design Journal最新文献

Objective: To identify associations between inpatient hospital design features and empirical patient clinical outcomes as well as changes over time. Background: A growing body of literature has emerged evaluating the association of hospital design features with measurable clinical outcomes during inpatient hospital admissions. However, there has been limited effort to evaluate the scope and quality of studies examining individual, inpatient hospital design features on empirical patient clinical outcomes. Methods: Primary research articles published in English between 1980 and 2021 evaluating inpatient clinical outcomes were included. Key terms for hospital designs and clinical outcomes were used. Ovid Medline, Embase, CINAHL, Web of Science, Scopus, Cochrane Library, Elsevier Embase, and Google Scholar were searched on May 28, 2021. Data were independently extracted by two authors, with arbitration from the third author. Results: Forty-six research articles were included for analysis. Predominantly studied inpatient hospital design features included: single versus multibedded rooms/wards, windows, furnishings, installed lighting, ward size and spatial arrangement, noise level, air ventilation, and patient visibility. Although nearly half (43%) of the articles lack appropriate methods to account for residual confounding, a trend of improvement in the use of appropriate methods was identified with 68% of studies in the last decade having appropriate methods. Studies demonstrating positive associations were more likely to be cited than those with negative associations (average citation per article, 508 vs. 27). Conclusion: Our study demonstrates the use of empirical patient clinical outcomes as a feasible approach to evaluate hospital design features, and identified an incremental improvement in the methods being applied.

Objective: The aim of this study was to translate the Australian Environmental Assessment Tool (EAT) into Chinese and identify culturally specific characteristics in the Chinese context for adaptation. Background: In the context of dementia-specific care, the design of the environment is considered an influential factor in supporting and maintaining skills. However, despite the increasing number of individuals with dementia in China, there is currently no valid instrument available to systematically assess the quality of the physical environment in long-term care facilities (LTCFs). Methods: This study utilized a mixed-method procedure consisting of seven steps, including translation and adaptation. The study involved focus groups comprising an expert panel (n = 17) and potential users (n = 64) of the newly developed tool. Cross-cultural adaptation was performed through Chinese literature review and literature quality appraisal, field study, and expert committee review. Results: The final version of the China Environmental Assessment Tool (C-EAT) consisted of 10 key design principles and 64 items. The C-EAT was tested in four LTCFs in China and underwent two rounds of review by an expert panel. Conclusions: The C-EAT was deemed a suitable tool for assessing the environment and enhancing the living environments for individuals with dementia in LTCFs in China. In future research, field tests will be conducted to validate the C-EAT scale and modify the EAT-HC to enhance its applicability in China.

Objective: This review aims to assess the incorporation of patient and family input into intensive care unit (ICU) design processes. It aims to highlight the importance of prioritising patient and family perspectives in ICU design to improve patient experiences and clinical outcomes.

Background: Traditionally, ICU design has focused on clinical efficiency at the expense of patient-centered needs, leading to heavily sedated patients and neglected holistic care delivery. While architects historically dominated design decisions, there's no recognition of the necessity to integrate patient and family perspectives. However, such efforts remain rare despite professional guidelines advocating for multi-professional team involvement.

Methods: This review summarises the published literature on built ICUs that have incorporated patient and family input into the design process. It evaluates methodologies used and measures patient-centric outcomes to identify successful examples and areas for improvement in future initiatives.

Results: The limited published literature identifies only three projects successfully integrating patient and family input into ICU design. Additionally, one project was identified in a search of the gray literature. However, these projects often lack rigorous evaluation of patient-centric outcomes, with initiatives involving patients and families remaining uncommon. The review underscores the need for more comprehensive evaluation and greater emphasis on patient and family involvement in ICU design.

Conclusion: This review emphasizes the significance of integrating patient perspectives into ICU design to enhance outcomes and improve experiences. While progress has been made in recognizing their importance, more efforts are needed to prioritize patient and family involvement for creating conducive environments for healing and recovery.

Purpose: This study examined the augmented reality (AR) application in design evaluations through an immersive experience of medical task simulations in combination with a full-scale physical mock-up of a trauma room.

Background: Augmented reality technology is emerging in various fields including architectural design. Traditionally, building physical mock-ups has been the most effective tool to involve end-users in design evaluations. However, AR can eliminate cost- and labor-intensive components of a physical mock-up by replacing them with holograms.

Methods: Two simulation sessions with emergency department clinicians were conducted using AR. The research team collected user feedback through simulations and interviews. Clinicians' feedback was systematically categorized and summarized according to various design elements.

Result: The integration of mock-up and AR simulations enabled the evaluation of design elements that were previously unattainable. Examples include simulating color-coded floor boundaries and adjusting door widths, which enhanced clinicians' immersion and involvement in design changes. Interviews and analyses of video recordings captured from the clinicians' perspectives supported the design evaluations during simulations.

Conclusions: Augmented reality has great potential to be used widely in the evaluation of healthcare environment design. Augmented reality is an innovative approach that can benefit end-users in interacting with a mix of real spaces and virtual components. It also introduces new ways of data collection and analysis to architectural design evaluation methods.

Objective: The aim of this systematic review was to identify which aspects of evidence-based design (EBD) and sustainable design principles overlap based on evidence in the peer reviewed academic literature. By doing so, the study enables hospital infrastructure design decisions that prioritize both sustainability outcomes (sustainable hospital infrastructure design) and therapeutic (EBD) outcomes. Background: Healthcare facilities need to adapt to the future demands from a changing climate, demographic shifts, and economic restraints. Facilities need to be designed in ways that better support patients, staff, and the environment to ensure their long-term success. Methods: A systematic literature search was conducted through searches in SCOPUS and Web of Science. All studies in acute care settings were included in the review except those investigating EBD in the context of specific health conditions, which were excluded. Themes that overlap were identified to form a conceptual framework for sustainable EBD. Results: Sixty-five articles were included in the final analysis. Identified sustainability features were related to: Sociocultural and functional, Indoor environmental quality and wellbeing, Energy and atmosphere, Water, Materials and resources, Waste, Sustainable sites, and Facility design. EBD thematic analyses were categorized into Indoor environmental quality, Design, Sociocultural, and Functional performance and safety. Conclusions: Key areas of synergy include Indoor environmental quality and wellbeing and Energy and atmosphere. The development of the conceptual framework enables scholars and practitioners to identify design features that align both priorities and through future research, refine the framework.

Purpose: The current study performed a post-occupancy evaluation on a new cancer infusion center with pod-like layout and compared results to a pre-occupancy evaluation to investigate the impact of different cancer infusion center designs on staff efficiency and patient and staff satisfaction.

Background: The new cancer infusion center opened in October 2020 and replaced two previously existing infusion centers, in the same healthcare system.

Methods: The study used a similar mixed-method approach as the pre-occupancy research, which included staff shadowing, medication delivery shadowing, and staff and patient questionnaires.

Results: The new infusion center improved staff efficiencies by reducing nurse travel time compared to pre-occupancy infusion centers. Results also showed an increase in satisfaction with different aspects of the new infusion center including patient privacy, by both patients and nurses. The pod design allowed for better audio and visual privacy for patients, provided a higher amount of worksurface and availability of workstations, reduced noise levels, and enhanced nurse concentration at workstations. Findings indicated that nurses who had prior experience working in the pre-occupancy infusion centers expressed significantly lower levels of satisfaction in the new infusion center, especially in the ability to connect with nurses in other pods.

Conclusions: Although the new pod design had limitations in terms of collaborative opportunities across pods, it showed to provide a more efficient work environment for the staff and increase staff and patient satisfactions. The results also highlight the importance of effective change management strategies when nurses transition to a new work environment.

Purpose: We explored the literature on the use of design in dementia care and the relationships with inclusion, accessibility, and equity in the past decade. Background: A body of research indicates the importance of studies that focus on a person-centered approach, with a direct potential to impact the quality of life of people with dementia through inclusion, accessibility, and equity. Although there is a growing presence of the literature on design approaches in dementia care settings, there is a need to integrate these findings for a better understanding of the progress in this field. Methods: We conducted a scoping review of the literature in seven databases, covering a period of ten years in May 2023. Results: Twenty-nine papers were included and analyzed with a focus on person-centered design and its relationship with inclusion, accessibility, and equity. Based on the identification and analysis of these studies, we discuss the significance of person-centered design, emphasizing its impacts on inclusion, accessibility, and equity. We present a summary of findings and offer recommendations for future research. Conclusions: By exploring and presenting existing practices, resources, and tools tailored to specific needs in dementia care, this research provides information for researchers, designers, and policymakers in developing interventions that prioritize the well-being and dignity of those affected by this condition.

Background: The objective of an operating room (OR) ultra-clean ventilation system is to eliminate or reduce the quantity of dust particles and colony-forming units per cubic meter of air (CFU/m³). To achieve this, ultra-clean goal high air change rates per hour are required to reduce the particle load and number of CFU/m³. Aim: To determine the air quality in an ultra-clean OR during surgery, in terms of the number and type of microorganism and quantity of dust particles in order to establish a benchmark. Methods: Number of CFUs and the quantity of dust particles were measured. For measuring the CFUs, sterile extraction hoses were positioned at the incision, the furthest away positioned instrument table, and the periphery. At these locations, air was extracted to determine the quantity of dust particles. Findings: The number of CFU/m³ and particles was on average at wound level ≤1 CFU/m³ resp. 852.679 particles, at instrument table ≤1 CFU/m³ resp. 3.797 particles and in the periphery ≤8 CFU/m³, resp. 4.355 particles. Conclusion: The number of CFUs in the ultra-clean area is below the defined ultra-clean level of ≤10 CFU/m³ for ultra-clean surgery. The quantity of dust particles measured during surgery was higher than the defined ISO 5.

Purpose: To present the social network analysis-based approach used to create a new workspace layout for three hospital services as part of a campus expansion at a large tertiary care public hospital. Objective: To analyze the relationships among service members across four healthcare resilience abilities (monitor, anticipate, respond, and learn) and utilize network metrics to indicate the suitability of a shared workspace layout for the services. Background: The hospital expanded by 70%, providing space for relocating key services-the rapid response team, medical on-call team, and nursing supervision. Initial observations suggested a shared workspace layout based on anecdotal evidence. Method: Stakeholders have reached a consensus on a three-stage process to assess the suitability of a shared workspace layout for these services: first, collecting data on social interactions with a focus on resilience abilities; second, presenting layout alternatives based on sociograms; and third, evaluating these alternatives and devising a strategy for allocating personnel to shifts based on a resilience score derived from social network metrics. Case Study: The examination of social network metrics allowed identifying key individuals contributing to the overall resilience of the three services. Sociograms provided visual representations of how these individuals were spatially distributed within the shared layout. Discussion: The process was designed to shape a resilient layout and incorporated initial data, preferences, and constraints into layout proposals. Additionally, it utilized a resilience score from existing literature to formulate a strategy for staff allocation to shifts, ensuring consistent collective resilience ability across all shifts.