Herd-Health Environments Research & Design Journal最新文献

ObjectivesThis study evaluated a standardized patient room designed for multiple acuity levels in a quaternary care academic medical center by actively engaging clinical teams through an iterative simulation-based evaluation process using physical mock-ups.BackgroundPatient rooms are replicated multiple times in hospitals, and their design impacts patient and staff outcomes. Balancing often-conflicting needs and designing for future flexibility can be challenging. Simulation-based mock-up evaluations can help engage clinicians to obtain feedback about healthcare facility design in the context of clinical work.MethodsFocus groups, surveys, and observations collected input on a patient room design in three phases. The first phase assessed the bathroom location (inboard versus outboard) and room layout. The second phase evaluated five critical areas of the patient room: the bathroom, family zone, handwashing sink, dry work surface, and headwall. The third phase evaluated whether an outboard bathroom on the headwall or footwall supported patient care delivery better.ResultsThe study found that an outboard bathroom provided a better connection to the corridor, more functional space in the room, better equipment flow, and dedicated family space. Through the simulations, the team identified spatial challenges in the context of clinical scenarios and provided recommendations for refining design features. Clinicians preferred the footwall bathroom configuration due to better workflow support during the enacted patient care scenarios.ConclusionOverall, an outboard footwall bathroom supported staff workflows and care activities. The iterative simulation-based evaluation process was highly effective for obtaining clinicians' design feedback within the context of their everyday work.

AimThis study aimed to examine the factors influencing leisure walking intention among older adults in urban residential areas, analyze their interrelationships, and propose strategies for promoting walking activities.BackgroundUnderstanding the factors influencing walking intentions among older adults is essential for developing interventions that enhance physical activity levels in an ageing society. A comprehensive approach that integrates psychological and environmental factors provides deeper insight into these influences.MethodsData were primarily obtained from older adults aged 60 years and older residing in five residential areas in Guilin, China, selected based on construction time, population density, available facilities, and aesthetic design. Participants were recruited through assistance from residential management. After excluding questionnaires with ineligible ages, excessively short completion times, or uniform responses, 527 valid questionnaires were retained. Data analysis was constructed using structural equation modeling, integrating the Theory of Planned Behavior and the Health Belief Model. Reliability and validity of the questionnaire were evaluated through Cronbach's alpha, composite reliability, factor loadings and average variance extracted.ResultsThe findings of this study revealed that among the factors influencing walking behavior intention, attitudes towards walking had the strongest positive effects. Perceived environmental barriers have a stronger negative impact on walking intention than perceived personal barriers.ConclusionsImproving residential walking facilities to reduce environmental barriers and enhancing community health education to reinforce health beliefs are effective strategies for promoting physical activity among older adults. These findings provide practical guidance for urban planning and public health initiatives.

AimThe study aims to explore and preliminarily address the needs of users in the diagnostic imaging departments. The identified needs have been translated into initial design concepts for a proposed layout of diagnostic imaging departments, informed by systematic literature review to address the requirements of patients, nurses, technologists, and radiologists. The research examines the potential influence of these design concepts on fulfilling users' needs.BackgroundThe imaging department is recognized as a main diagnostic unit in hospitals. Nearly all patient categories, including inpatients, outpatients, and emergency patients, utilize this department, as do its staff members.MethodsA proposed layout for the department has been designed to address the demands of patients and staff while simplifying the flow of various patient kinds. Fifty experts, including healthcare designers, technologists, and radiologists in Saudi Arabia, evaluated this proposal through a questionnaire survey.ResultsThe findings demonstrate that the proposal could fulfill patients' requirements for flow organization (88%), privacy (78%), and reduced travel distance (70%), while also addressing staff demands for patient observation in waiting rooms (88%), travel efficiency (82%), and confidentiality (94%). This layout additionally supports family presence (78%), can improve the acoustic environment (86%), and enables daylight (92%).ConclusionThis study presents a layout for the imaging department that would potentially address the requirements of patients and staff; hence, it can enhance the healthcare environment within these facilities.

AimThe present case study explores insights related to navigating biophilic design innovation in public healthcare using the Outdoor Care Retreat at Oslo University Hospital and the Hospital of Southern Norway as a case.BackgroundAvailable research from environmental psychology proposes an association between access to biophilic design, well-being, health, and hospitalization satisfaction. Still, integrating this research into public healthcare is challenging and there is a need for research that builds on innovative examples of biophilic design integration in this context.MethodsStudy findings are based on eight individual interviews with people involved in project initiation and development of the Outdoor Care Retreat, in addition to online public records and other digital documents related to the case study. The qualitative materials were analyzed according to reflexive thematic analysis and categorized into themes.ResultsFindings illustrate how moving beyond conventional healthcare practices can support the implementation of biophilic design. Specifically, the findings suggest that biophilic design in healthcare benefits from an appealing story, individual contributions, and an organizational and environmental context that challenges common conventions. Drawing from research from public healthcare innovation and biophilic design, the study outlines key insights for implementation.ConclusionsThis study contributes to bridging the gap between theory and practice in a public healthcare context. It offers key insights for implementing biophilic design in healthcare environments, with the potential to ensure valuable improvements in the hospitalization experience for patients and their families in future developments of public healthcare facilities.

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.

BackgroundPediatric patients increasingly seek care for mental and behavioral health (MBH) conditions in Emergency Departments (EDs). Yet, ED environments are poorly designed, organized, and equipped to deliver safe, effective care to these patients. There is an urgent need for solutions that improve safety and care quality and support provider wellbeing. To address this need, our team brought together experts from across the United States to identify and prioritize the most urgent challenges for further study and design intervention.MethodsA workshop held in September 2023 brought together 61 multidisciplinary experts and clinical stakeholders to identify, prioritize, and brainstorm solutions for the most urgent challenges facing EDs in providing care to pediatric MBH patients. Breakout groups built upon presentations from leaders in pediatric emergency healthcare and the research team's study findings to identify the six most critical challenges and brainstorm possible systems-based interventions to solve them.ResultsKey challenges included accommodating families, supporting flexibility and adaptability, respecting patient dignity and humanity, optimizing communication, minimizing the psychological effects of boarding, and safely supporting coping. The ideas generated in this workshop indicate that built environment interventions that facilitate flexible caregiving, support sensory environment control, and balance patient privacy with staff monitoring and ED policy and process interventions that clarify care team roles and standardize processes may support pediatric MBH care better.ConclusionsThe ideas generated in this serve as a framework and catalyst for researchers and health systems interested in developing systems-based solutions to the complex challenges of pediatric emergency mental healthcare.

AimThis study explores how future-proofing is understood and applied in hospital building design, focusing on the perspectives of experienced architects. It aims to examine the practical implications of future-proofing and to identify key barriers to its implementation within contemporary healthcare infrastructure projects.BackgroundExisting literature often focuses on the general benefits, such as cost savings and sustainability, but lacks detailed analysis of the multifaceted implications and obstacles encountered in real-world projects. This study addresses this gap by directly examining architects' perspectives, offering critical insights into the practical realities and complexities of future-proofing hospital buildings, thereby contributing to a more nuanced understanding and informed decision-making in this field.MethodsSixteen semistructured interviews were conducted with experienced hospital architects based in Australia. Data were analyzed using a combination of deductive and inductive thematic analysis.ResultsThe results of thematic analysis have been categorized under three overarching categories: perceived benefits, perceived drawbacks, and implementation challenges. The findings highlight that future-proofing is neither inherently beneficial nor burdensome, but rather a context-sensitive strategy that must be tailored to each project's evolving operational, economic, and policy.ConclusionsThe study underscores the need for more systematic, longitudinal evaluation of future-proofing strategies, as well as greater integration of advanced futures methodologies into healthcare planning and design processes. A more structured and evidence-based approach to future-proofing can support the development of hospital infrastructure that is both resilient and responsive to the long-term evolution of healthcare systems.

ObjectivesChildren scheduled for surgery and anesthesia often experience fear and anxiety before the procedure, as well as pain afterward. While medical treatments are essential for managing these challenges, design strategies that positively influence environmental and psychological factors can significantly improve children's experiences and their overall subjective well-being. This narrative literature review examines "design for well-being" strategies that support the subjective well-being of children undergoing surgical procedures.BackgroundAccording to the World Health Organization, health is defined not merely as the absence of disease but as a state of complete physical and mental well-being. Achieving such well-being requires not only medical care but also the optimization of environmental and psychological conditions that impact emotional states. Today, evidence-based, multidisciplinary approaches are recommended to promote well-being. In health-related design, one focus is on improving the quality of medical care, while another addresses non-medical factors that influence subjective well-being.MethodsThis research employs a non-systematic literature review methodology, utilizing existing literature and evidence-based approaches to synthesize relevant strategies.ResultsEnhancing subjective well-being-through evidence-based design strategies such as age-appropriate environmental modifications, sensory-friendly elements, and interactive distraction tools-alongside optimized medical practices in pediatric surgeries contributes to improved clinical outcomes and reduced perioperative stress. The review highlights "design for well-being" strategies, which effectively support the subjective well-being of children undergoing surgical procedures.ConclusionsEmphasizing "design for well-being" strategies is crucial for enhancing the overall experiences and well-being of children undergoing surgery. Future research should focus on the implementation and long-term impact of these design interventions to further validate their effectiveness and scalability.

Objectives, Purpose, or AimThis study investigates how physical environmental features influence balance loss and falls among women in their third trimester of pregnancy. It aims to identify environmental affordances that contribute to or mitigate fall risks.BackgroundFalls during pregnancy pose significant risks to maternal and fetal health. Understanding interactions between pregnant women and home environments is essential for effective fall prevention. This study employs ecological and dynamic systems theories to explore these interactions.MethodsWeekly interviews were conducted with 13 pregnant women in their third trimester. Participants documented real-world incidents of falls and near-falls within home environments. Data were analyzed to identify patterns in environmental affordances and behaviors linked to balance loss and fall prevention.ResultsFindings identified three types of affordances: Functional affordances supporting behavior (e.g., sufficient lighting levels to navigate spaces). Dysfunctional affordances increasing risks, such as low furniture, slippery surfaces, and inadequate supports. Preventive affordances used to avoid falls. Behaviors linked to falls included rising from low furniture, descending stairs, navigating cluttered spaces, and entering bathtubs. Environmental factors like slippery surfaces and open furniture layouts were key contributors.ConclusionsFalls during late pregnancy result from complex interactions between environmental and behavioral constraints. This study offers insights into designing safer environments tailored to pregnant women's needs. Limitations include recall bias and limited generalizability due to the small sample size. Despite these, the study provides a strong foundation for future research and fall prevention strategies.