Herd-Health Environments Research & Design Journal最新文献

Objectives: To explore how evidence-based design is transforming healthcare environments into transforming spaces that improve patient outcomes and staff experiences.

Background: Traditional hospital designs often prioritize functionality over patient and staff well-being. This editorial examines the shift toward evidence-based design in healthcare facilities.

Methods: We review recent studies and case examples demonstrating the impact of thoughtful healthcare design on infection rates, patient recovery, and staff performance.

Results: Evidence shows that elements such as private rooms, access to nature, and improved lighting can significantly reduce infections, accelerate healing, and enhance staff satisfaction.

Conclusions: Implementing evidence-based design principles in healthcare environments can lead to measurable improvements in patient outcomes, staff performance, and overall healthcare quality.

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.

Aim: This study aims to shift views away from negative perceptions towards aging by exploring the following research question: How are the multiple levels of the gerotranscendence theory influenced by the sustainable behavior and attitude toward the biophilic design of older adults? Background: Improving perceptions of aging is vital for positively impacting both the biological and societal aspects of the global aging phenomenon. Methods: The study utilized a mixed-method design. Initially, 300 older Turkish adults completed self-reported measures including the Gerotranscendence Scale (GS), Pro-environmental Behavior (PB), Environmental Identity Scale (EID), Biophilic Design Importance Level (BDI), and Inclusion of Nature in the Self Scale (INS). Subsequently, the second phase involved diary logs from 30 participants who volunteered during the initial phase. Results: Results indicated that a higher importance level placed on biophilic design was linked to a greater inclusion of nature in the self. Moreover, a stronger interest in nature correlated positively with the gerotranscendence experience. Conclusions: The results bring significant attention to biophilic design, especially its relevance in supporting sustainable environmental behaviors and positive aging.

Background: The end-of-life experience is significantly influenced by the surrounding environment, emphasizing the importance of exploring built environmental factors in palliative care, especially for pediatric patients. As the majority of end-of-life individuals are elderly or adults, most studies have focused on the environment for this demographic. However, it is essential to recognize that children and adolescents may have distinct needs in this regard. Aim: This narrative review aims to explore the impact of the built environment on pediatric end-of-life patients in inpatient units within palliative care settings. Method: A comprehensive search was conducted across four key databases (PubMed, MEDLINE, PsycINFO, and CINAHL) to identify relevant articles. The screening process commenced with an initial assessment of article titles and abstracts, followed by a thorough examination of full-text studies that met the inclusion criteria. Data synthesis involved thematic analysis facilitated by NVIVO software and informed by the findings extracted from selected literature. Results: The review identified 22 studies meeting inclusion criteria, revealing key insights into environmental considerations in pediatric palliative care. Four themes emerged, highlighting the significance of activities and play environments, accommodation spaces for patients, supportive spaces for families, and outdoor and green spaces. Conclusions: Acknowledging limited research on architectural aspects and reliance on family and staff perspectives, future studies should prioritize understanding pediatric patients' perspectives, particularly adolescents. The study underscores the importance of enhancing environmental design in pediatric palliative care to meet the unique needs of patients and their families.

Objectives: The study aimed to fill the knowledge gap about how operating room (OR) design could reduce orthopedic surgery duration and contribute to surgical care safety and efficiency.

Background: Long surgery duration may lead to delays and cancellations of surgeries, deteriorated patient experiences, postoperative complications, and waste of healthcare resources. The OR physical environment may contribute to the reduction of surgery duration by minimizing workflow disruptions and personnel movements during surgeries.

Methods: Unobtrusive observations were conducted of 70 unilateral total knee or hip replacement surgeries in two differently designed ORs at a community hospital in the United States. A set of computer-based forms adapted from recent research was used to measure the surgery duration, environment-related disruptions, and ambulatory movements involving circulators. Potential confounding factors like surgery type were controlled in statistical analyses.

Results: Significantly shorter surgery durations were recorded in the larger OR with more clearances on both sides of the operating table, a wider door located on the sidewall, more cabinets, and more clearance between the circulator workstation and the sterile field (p =.019). The better-designed OR was also associated with less frequent disruptions and fewer movements per case (p < .001). Significant correlations existed between surgery duration, the number of disruptions, and the number of movements (rs = .576-.700, ps < .001).

Conclusions: The study demonstrated the important role of OR physical environment in supporting the safe and efficient delivery of surgical care, which should be further enhanced through research and design innovations.

Objective: To identify, examine, and map the characteristics of knowledge of nature-based design in stroke rehabilitation facilities, examine how research in this field has been conducted and identify gaps in knowledge.

Background: Many stroke survivors have wide ranging impacts, resulting in long hospital stays to undertake rehabilitation. The physical environment can influence brain recovery; however, there is limited evidence to support the design of effective rehabilitation environments. Conversely, the health benefits available from connection with nature are well established. A nature-based design approach may have benefits and implications for the physical environment of inpatient stroke rehabilitation facilities; however, it is unclear what evidence exists in this field.

Method: This scoping review followed the JBI methodological guidance for the conduct of scoping reviews, with systematic searches of six databases.

Results: Twenty-eight studies were included in the review. Aims and research methods varied widely. Investigations in 19 studies related to gardens and other designed outdoor nature-based environments. Other studies explored natural analogues, nature inside, inside/outside connections, and the natural environment. Findings from the studies were spread across the fields of design, use, exposure to, and engagement in nature-based environments.

Conclusion: The characteristics of knowledge underpinning nature-based design in stroke rehabilitation environments are highly diverse, and significant gaps exist in the evidence base. A framework developed during this review for mapping knowledge on the intentions and impacts for spaces and services in this field assisted to identify these gaps and may be applied to other areas of healthcare design research.

Background: This study addresses the challenges in hospital navigation, particularly focusing on the sequence of arrival experiences through foot traffic or driving within a medical campus. While previous research has emphasized wayfinding in interiors, this study recognizes the importance of transition from outdoor to indoor spaces in the hospital arrival zone.

Objectives: Twofold research efforts include: (1) Exploring vehicular and pedestrian behaviors in a hospital arrival zone using Space Syntax Analyses (SSA), and (2) Validating the SSA results using empirical data collected from onsite observations and behavior mapping.

Methods: A series of axial map analyses were conducted on the hospital campus and building arrival zone regarding spatial connectivity and integration, depth of spaces, and wayfinding intelligibility based on vehicular and pedestrian movement paths. Systematic behavioral data collection includes vehicle shadowing (10 h) and pedestrian mapping (20 h) in the building arrival zone.

Results: Space Syntax Analyses indicates high intelligibility scores for vehicles (R = .91) and pedestrian (R = .78) circulation patterns; traffic situations were visualized via axial maps. A dataset of 219 vehicles and 2,096 pedestrian behaviors was analyzed and visualized using diagrams and heatmaps, identifying different occupancy patterns within the space. Correlational analyses indicated strong correlations between the results: connectivity and integration scores are significantly correlated with both vehicular and pedestrian traffic volumes.

Conclusion: Preliminary findings of the study validated an integrated protocol to evaluate the impacts of campus configuration and building approach design on patient arrival and spatial navigation at large hospitals, serving as a POE protocol involving SSA.