Herd-Health Environments Research & Design Journal最新文献

ObjectivesThis study quantified the total time required by staff to complete intrahospital transfers (IHTs) and identified key activities and facility attributes affecting efficiency.BackgroundIHTs, which involve moving patients between rooms or units, place significant demands on healthcare staff and facility resources. While previous studies have explored the impact of IHTs on patient safety and clinical efficiency, few have assessed the specific tasks and time demands on all staff members involved.MethodsFifty IHTs (39 between-unit, 11 within-unit) were observed at a 718-bed level-1 trauma hospital. Transfer tasks were categorized into 13 activity types. These included managing equipment, belongings, and supplies (EBS), handoff communication, and patient transport.ResultsIHTs required a mean of 77 min of staff time, 53 min (75%) of which was nursing time. EBS management accounted for the largest share of transfer time, followed by handoff communication. Transfers with an increase in acuity level required more staff and additional total time. Elevator use was associated with a significant increase in nursing time. Issues that added to transfer time included miscommunication about room readiness and the need to acquire or transport specialized equipment.ConclusionsStreamlining EBS processes, optimizing staffing for acuity-related transfers, and improving elevator availability could reduce IHT times and alleviate workload on nurses. Enhanced coordination during shift changes, better communication about room readiness, and support for non-clinical tasks offer further opportunities to improve efficiency. These findings underscore the role of facility design and operations management in enhancing hospital efficiency, reducing nursing burden, and improving patient care.

Aim: This systematic literature review, following the PRISMA statement, aims to review the knowledge of how the indoor lighting environment and color palettes impact individuals living with Autism Spectrum Disorders (ASD), particularly their behavior and lighting and/or color preferences. Background: A supportive built environment is crucial for persons with ASD. Lighting design (daylight and electrical lighting) and color schemes significantly impact their behavior, information processing, and overall well-being. Despite its importance, lighting design for autism has received limited attention in architecture and design research. Methods: A comprehensive search across seven electronic databases (PubMed, CINAHL, SveMed+, and four library databases including Oria, Regina, the British National Bibliography, and the Royal Danish Library), followed by a thorough review and critical appraisal, resulted in seven (7) high-quality studies with moderate to low risk of bias. Articles were assessed using three standardized checklists, for example, JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies, JBI Critical Appraisal Checklist for Qualitative Research, and Mixed Methods Appraisal Tool (MMAT). Conclusions: The findings are consistent with previous research and confirm that light and color influence ASD individuals' behavior and sensitivity. However, there is a substantial gap in understanding practical applications, as most studies are descriptive or exploratory rather than experimental. Future research should emphasize experimental approaches to develop evidence-based guidelines for designers.

ObjectivesOur study examines experiences of patients admitted to multibedded patient rooms in a former hospital building, compared to patients' experiences in single-occupancy patient rooms (SPRs) in a new hospital building, designed according to principles of a healing environment.BackgroundTo improve patients' privacy, comfort and infection control, newly built hospitals increasingly accommodate patients in SPRs.MethodsIn a single-center, before-after study, patients completed a questionnaire of 40 items in four domains: privacy, sanitary facilities, patient room and ward layout. This substudy was embedded within the WELCOME study.ResultsA total of 227 participants were involved in the before-measurement and 416 in the after-measurement. Patients considered the SPRs better in terms of privacy; more than 90% of participants (strongly) agreed with the privacy-related questionnaire items. Sanitary facilities, patient rooms and ward layout were also rated higher in the new hospital building. For most questionnaire items pertaining to these domains, more than 80% of patients in the new facility (strongly) agreed. 23.5% of respondents in the new building reported missing the companionship of fellow patients.ConclusionsPatients rated the 100% single-occupancy ward configuration more favorably than the former multi-occupancy layout, with enhanced privacy emerging as an important advantage. However, this same privacy can leave some patients feeling isolated. Future studies should explore targeted interventions-such as structured social activities or volunteer-led engagement-to mitigate loneliness and promote mobilization, while preserving the established benefits of SPRs.

ObjectiveThe purpose of this study was to investigate how environmental affordances in the behavioral health inpatient milieu affect a patient's sense of autonomy.BackgroundPatients who feel empowered are more likely to participate in their care, which can, in turn, improve the quality of care (Ippolito et al. 2020). However, the lack of patient empowerment can have negative consequences in behavioral health facilities such as intensified physical violence, aggression, and loneliness in the milieu (Bellman et al., 2022; Dell et al., 2019; Hickmann et al. 2022). Research has also demonstrated that patient empowerment is closely linked to patient autonomy (Gagné, 2003; Hodgins et al., 2006). However, there is little insight as to how milieu spaces can foster patient autonomy.MethodsThis study utilizes a triangulated methodology to conduct a post occupancy evaluation through an on-site environmental assessment and behavioral observations within key milieu spaces.ResultsThe results demonstrated that access to scenic views, tactile features, patient's ability to move freely throughout the unit, and access to immediate provider care were significant indicators that differentiated patient autonomy between facilities. The behavioral observations showed that negative behaviors occurred around the edges of the milieu as well as when external stressors were involved. The autonomy score findings encapsulated by the designer evaluation were also closely associated with the frequency of positive behaviors observed by staff.ConclusionOutcomes include responsive design recommendations for design implementation.

Objective: This article provides a conceptual exploration of research and creativity within the profession of architecture, including a proposed theoretical framework exemplifying research as a catalyst in the creative process in practice. Background: There is a growing recognition among thought leaders in the profession of architecture that both intuition and research have a rightful place in the creative process. However, there remains a pervasive concern in practice that research can threaten or detract from creativity. There is an opportunity for conceptual integration of these approaches. Methodology: Inspired by Reflective Equilibrium, this work is an analysis of the potential synergies between research and creativity in architecture. The dichotomy between normative assumptions of the two concepts is reassessed. Results: A conceptual model called The Supportive Model of Research is proposed, showing how research is more likely suited as a catalyst within the creative process in the profession of architecture. This model explores three ways research can benefit the creative process: (a) fortification; (b) protection; and (c) elevation. Three narratives are presented to illustrate the three components of the model. Conclusions: The apparent dichotomy between intuition and research may be false; after all, there is rarely a one-size-fits-all approach to every problem. There is a need to construct a new paradigm with clarity around the benefits of an expansive view and an integrated approach, with research as a support for the virtues of creativity. The work in this paper is an attempt to "break ground" on this conceptual construction project.

AimTo investigate evidence for the effectiveness of physical design interventions to reduce patient and bystander violence in emergency departments.BackgroundWorkplace violence in emergency departments can cause financial, emotional and physical harm for health care staff and organizations. Violence may be impacted by the physical design of the department.MethodA scoping review was undertaken of CINAHL, Medline, Scopus, and PsycINFO. The search utilized Boolean operators with key words, major search terms and subject headings. Inclusion criteria were physical design, violence and emergency departments. Studies on mental health or pediatric emergency departments, or non-research papers were excluded. AS review was used to sort and filter. Data was extracted into Covidence. Studies were reviewed for physical design elements used to manage aggression and outcomes. Content analysis of extracted data identified four themes.ResultsTen papers were identified. The majority of studies provided staff perceptions on the effectiveness of physical design on violence. Data revealed four main areas where physical design interventions could impact on violence from patients and bystanders. These were preventing harm from weapons, controlling physical access, observation and awareness and patient comfort.ConclusionThere is little evidence for the effectiveness of physical design interventions to reduce patient and bystander violence in hospital emergency departments. Despite a lack of empirical evidence, staff perceive that the physical design of the emergency department impacts on their safety. Further research is needed to better understand the effect of physical design on violence and determine which interventions are effective in impacting on aggressive behavior.

PurposeThis study examines the impact of facility design on patient experiences in substance abuse treatment centers.BackgroundTherapeutic architecture enhances rehabilitation environments by incorporating sound, light, color, privacy, and views to promote healing. Thoughtful design can reduce stress, improve wellbeing, and support recovery and reintegration.MethodA survey was conducted between October 2022 and May 2023, comprising 25 questions focused on privacy, safety, autonomy, social interaction, and technology. The survey included 67 participants, made up of healthcare designers and individuals with substance abuse histories, with data analyzed using Qualtrics XM and NVivo 12.ResultsKey themes of privacy, safety, autonomy, social interaction, and technology emerged. Participants emphasized the need for private spaces for communication, uncluttered environments, and staff monitoring for safety. Designs allowing patients control over lighting and temperature increased autonomy. Supportive environments, including art, enhanced social interaction. While opinions on virtual reality's usefulness varied, designers viewed it as a valuable distraction tool.DiscussionThe findings highlight the significant influence of environmental design on patient engagement and healing. Essential elements include privacy, safe layouts, home-like settings, and social support areas. Both patients and designers valued autonomy over environmental controls, such as lighting and temperature. Although virtual reality showed potential benefits, concerns were raised about its effects on safety and stigma.ConclusionEffective environmental design is crucial to improving patient experiences and engagement in substance abuse treatment. Key factors include privacy, safety, autonomy, home-like environments, and supportive social spaces, with virtual reality offering additional but debated benefits.

BackgroundExisting literature highlights the crucial role of Healthcare Built Environments (HBEs) in generating value and shaping service experiences. HBEs must fulfil their intended purpose during the operational phase of construction projects to generate value. Additionally, many design requirements for facilities are shaped by the needs of clinical and support services, as well as those of users. Therefore, understanding value generation requires considering the dynamic interdependence between physical space and service needs. However, previous studies have not thoroughly explored these relationships, leaving a critical research gap.ObjectiveIt aims to propose a method to understand value generation in HBEs by examining the relationships between built environment attributes and healthcare service delivery, from the perspectives of multiple user groups.MethodDesign Science Research was the methodological approach adopted in this investigation. Two empirical studies were undertaken in different hospitals.ResultsThe primary output is the i3 method, a novel approach for understanding value generation in HBEs. It integrates the laddering technique, which is based on the means-end chain conceptual model, with additional sources of data, such as design documents, interviews with stakeholders, and direct observations of the HBEs.ConclusionsFindings highlight the importance of analyzing the interactions between the HBE and services, revealing opportunities to enhance value generation. The hierarchical value maps generated through the i3 method offer a structured approach to support design decision-making. The i3 method helps identify overlooked constructs and relationships, such as the need for HBE adaptability to address service changes or respond to unforeseen service demands.

ObjectivesThis study investigates the interplay between energy efficiency, lighting control, and window design in hospital settings, emphasizing their collective impact on sustainable healthcare operations.BackgroundDespite growing attention to energy conservation in healthcare, limited research comprehensively addresses how lighting strategies, window designs, glazing solutions, and occupant behavior interact to optimize energy use while enhancing patient environments.MethodsA systematic review of 43 rigorously selected studies was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, analyzing research across architecture, engineering, environmental science, and healthcare disciplines to explore these relationships.ResultsThe findings highlight that adaptive lighting, high-performance glazing, and optimized window design play a crucial role in enhancing energy efficiency, lowering operational costs, and improving patient comfort.ConclusionThis study provides actionable insights for healthcare professionals, facility managers, and policymakers to promote sustainable hospital design by integrating energy-efficient strategies.

Aim: To assess staff satisfaction with the physical work environment (PWE) and its relationship with work engagement and turnover intention through a new hospital's postoccupancy evaluation (POE). Background: The healthcare workforce shortage has intensified globally. POE is a well-established method for collecting information on the success of the PWE. While strong work engagement is associated with lower turnover intention, research on their relationship with satisfaction in PWE in hospitals is limited. Methods: The study used a cross-sectional survey design. Data were collected at a public hospital in Finland from January to February 2024, using a POE questionnaire, the Utrecht Work Engagement Scale-3, and the Turnover Intention Scale. A total of 510 hospital staff members participated. The data were analyzed using correlations and multifactor analysis of variance. Results: Overall satisfaction with the physical work environment was relatively high. Satisfaction in security and safety, comfort, and architecture was strongly correlated with most other PWE categories. Physicians and hospital support and logistics staff were more satisfied with the PWE than nurses. A moderate relationship was found between satisfaction with the PWE and work engagement. The perception of comfort with the PWE and satisfaction with security and safety were moderately associated with work engagement. The relationship between satisfaction with the PWE and turnover intention was weak. Conclusion: The results suggest that when planning new hospitals, attention should be paid to developing the PWE, especially in terms of safety and security and comfort, since it may impact staff work engagement.