Herd-Health Environments Research & Design Journal最新文献

Background: The work of Human Factors and Ergonomics (HFE) engineers and healthcare architects may overlap when it comes to designing the physical environments of healthcare facilities. Both disciplines are tasked with improving healthcare efficiency, promoting experience and safety, and reducing medical errors. Both disciplines adopt evidence-based and human-centered approaches in the design and evaluation of their work. However, it remains unclear to healthcare design professionals why, when, and how to incorporate HFE engineers' expertise into the architectural design project. Objectives: This opinion paper aims to reintroduce HFE to healthcare design by revisiting the core concepts, comparing essential approaches, and explaining the benefits of integrating HFE expertise into the evidence-based design (EBD) of healthcare projects. Methods: Literature review and case studies have demonstrated that simulation and mock-ups, as effective tools, should be integrated into the design and prototyping phases; therefore, they provide feedback to adjust the design concepts and inform design decisions with the engagement of HFE perspectives. Results: A conceptual framework for the HFE-integrated EBD process was proposed to facilitate the evaluation and improvement studies for healthcare design.

ObjectivesTo explore the time spent on nursing tasks and the extent of multitasking in a hospital with multi-bedded rooms compared to single-occupancy rooms.BackgroundSingle-occupancy patient rooms in hospitals have become popular because of the privacy they offer. However, little is known about the impact of different hospital designs on time spent performing on nursing tasks.MethodsA before-after time motion study was conducted in a former hospital which featured multi-bedded rooms and a new hospital with 100% single-occupancy rooms. Trained observers shadowed nurses during day and evening shifts using an online shadow application distinguishing eleven main categories of nursing tasks (e.g., direct patient care, indirect care, and professional communication). Data was analyzed using descriptive statistics. Tasks performed concurrently (multitasking) are described in terms of (overlapping) duration and frequency.ResultsIn total, 60 and 107 nurses were shadowed for 225 and 450 hours in the former and new hospital, respectively. The top three tasks on which nurses spent most the time in the former and new hospital concerned: direct care 40% versus 40%, training and supervision 27% versus 25%, communication 25% versus 25%, respectively. In the former hospital, nurses performed on average 32.8% of their time on multitasking versus 34.8% in the new hospital.ConclusionsContrary to our expectations, the 100% single-occupancy rooms hospital design hardly affected nursing time spent in nursing tasks and multi-tasking compared to a multi-bedded patient rooms setting.

Purpose: This study evaluates the relaxation effects of viewing a Chinese classical garden and a Chinese-style public park in reality and virtual reality (VR) environments by focusing on their psychological and physiological impacts. Background: The experiment examined two landscapes: the culturally rich and elaborately designed Humble Administrator's Garden and the Hefeng Pavilion. Methods: Twenty-eight participants participated in four sessions, each consisting of a 5-minute viewing session of the Humble Administrator's Garden and the Hefeng Pavilion under Conditions A (real) and B (VR). Each session was evaluated using the Profile of Mood States (POMS) questionnaire, the Semantic Differences Scale, the Supplemental Questionnaire, and eye tracking technology. Results: In Condition A, POMS scores, Semantic Differential Scale ratings, the Supplemental Questionnaire results, and eye movement patterns indicated that viewing the Humble Administrator's Garden resulted in greater relaxation compared to the Hefeng Pavilion. Similar findings were observed in Condition B, reinforcing the Humble Administrator's Garden's relaxing effect. However, there was a noticeable disparity in the relaxation effects between Conditions B and A, with real settings offering more pronounced benefits. Conclusions: This study demonstrated that the culturally rich Humble Administrator's Garden significantly improves mood more effectively than the Hefeng Pavilion, whether viewed in real or VR environments. This study suggests that although VR can offer an immersive experience, it may not fully capture the sensory richness and therapeutic benefits of actual garden environments. Real settings delivered more substantial relaxation effects compared to VR settings.

Purpose: This study examines the economic benefits of innovative design in a hospital ward with the capital and operational costs and societal and government benefits. Background: An economic view of health care delivery options considers both the costs and benefits of an intervention for the economy, funders, and patients. Previous studies have focused on the financial costs of capital as an asset class for hospital development. Methods: Four hypothetical stroke rehabilitation units were designed within a larger Living Labs program (the NOVELL project). A standard stroke rehabilitation hospital ward design was compared to three alternative designs. The alternative designs expanded areas for therapy, social engagement, communal activities, and staff wellbeing, included activated corridors and enabled access to outdoor and recreational areas based on clinical evidence and expert advice. Results: The alternative designs are predicted to achieve A$3.3 million in savings annually for rehabilitation ward operational costs (a saving of 26%). Economy-wide benefits from the alternative designs are estimated to be A$12 million plus savings to government of between A$3.93 million and A$5.4 million per ward per annum. Conclusions: Adoption of innovation in design, clinical practice and evidence identification has the capacity to improve clinical effectiveness and patient outcomes. Economy wide benefits and cost improvements for health funders from the adoption of innovative design have been identified through micro- and macro-economic evaluation.

Objective: A secondary analysis of community health needs assessment data was used to determine access and barriers to primary, specialty and hospital-based care in a rural, frontier-designated Montana critical access hospital (CAH) to establish alignment between the physical healthcare facility infrastructure design approach and community healthcare service needs. Background: The lack of physical infrastructure and integrated equipment/technological resources in CAHs can be a contributing factor in closures when means are absent to be responsive to the needs of an ageing population, updated technology, and heightened acuity level of care. Method: Inferential and predictive analyses of a cross-sectional survey was used to understand the care access based on the community members demographics as well as perceptions of their personal health, the community's health, knowledge of health services, and insurance coverage. Results: Important associations and predictors for the use of primary, hospital-based and specialty care among the rural residents were positive perceptions of health of themselves and their community (60%+) and good to excellent insurance coverage (70%+). Predictive decision tree modeling determined notable variation in access and use of specialty care and current employment status. These results indicate most respondents did not delay care due to transportation, distance, childcare or work. Insurance coverage and its cost were critical in accessing all types of care but especially specialty care. Conclusions: Community health needs assessments are conducted to retain tax status for CAHs, and as such are available sources of stakeholder perspectives that may expedite design approaches and strategic planning.

Objective: There is a need for a more theoretical understanding of human behavior to inform the decision-making related to how technology should be integrated into healthcare environments. Background: Healthcare systems are transforming with more technology embedded within the built environment of healthcare facilities. The placement of these technologies, however, only sometimes considers the needs or workflow of patients, visitors or staff. Despite similarities, evidence-based design, smart building design and human-building interaction research rarely intersect. However, each relies on multi-disciplinary insights to enhance these fields. In this paper, we contextualize human-building interaction with building technology through an analytical framework inspired by mediation theory. Methods: Based on five case examples from previous studies and site visits, we present the interaction and explain how mediation theory provides insight into the interaction. Results and Conclusions: Looking at human-building technology interaction from the lens of mediation theory, it is apparent that the specific decisions taken in spatial and technological design impact the behaviors of building occupants. This paper provides examples of how technology in healthcare environments is used unintendedly, resulting in adapting the use to meet the user's needs. Mediation theory provides a framework to contextualize such encounters which will allow researchers to anticipate user needs and avoid disruptive building technologies in the future.

Window views, indoor plants, and room décor can potentially improve restoration and healing in a hospital room environment. Preferences for these attributes and their individual effect on physiological and cognitive outcomes remain understudied. This study investigated the extent to which visible green nature in window views, plantscapes, and green colored decor in virtual reality hospital rooms, affected restoration outcomes of simulated acute care patients. First, 12 room environments were developed in virtual reality where window views, plants, and green-colored room decor variables relevant to Stress Recovery Theory were systematically manipulated. Next, participants in a simulated patient acute-injury scenario (N = 188), which induced an external stress process, rated the environments on how much they perceived the room contributed to their sense of feeling relaxed and ability to clear their mind of stressful thoughts. Ratings for each environment were aggregated and used in full-profile and moderated conjoint analyses. Indoor plants produced the highest utility score on physical relaxation, while nature window views had the highest utility score for mental clarity. Utility scores for indoor plants were significantly higher on physical relaxation and mental clarity for the respondents with higher scores of acute cognitive stress, induced from the external stressor process. The verdant elements (e.g., green nature views, indoor plants, and green room décor) were associated with the highest restorative utility. Buildings obstructing nature views were associated with negative utility scores on the restoration outcomes. Findings highlight the individual and combined effects of: (1) indoor plants; (2) unobstructed views from the window of green nature; and, (3) green-colored décor in hospital room design.

Purpose: This article assesses the magnitude and impact of wayfinding problems in US hospitals as perceived by staff. Background: Problematic wayfinding in healthcare facilities is a persistent issue, leading to frustration, stress, fatigue, physical aggression, wasted time, and a negative organizational image. Despite anecdotal evidence, few studies have quantified the impacts of wayfinding problems. Methods: This descriptive cross-sectional study used an online questionnaire to gather data from hospital staff in the United States. The questionnaire targeted (1) wayfinding for hospital staff, (2) wayfinding for hospital visitors, (3) the impact of wayfinding problems on staff, and (4) the importance of addressing wayfinding problems. Data from 301 questionnaires were analyzed using descriptive and nonparametric statistics. Results: Staff found it easy to navigate their own departments but more difficult to navigate other departments. Staff's responses indicated that wayfinding was relatively difficult for visitors. Each staff member spent about 30 min per week on helping others with wayfinding. The five locations in which users needed the most assistance were the cafeteria, restrooms, elevators, exits, and main lobby. Staff commonly escorted people to a point from which they could independently reach their destination. Wayfinding difficulties could distract staff from their main duties and cause frustration. Nearly 44% of the participants experienced incivility from users who had become frustrated by wayfinding problems. Participants rated addressing wayfinding problems as very important. Conclusions: Despite the extensive literature on the environmental factors that influence wayfinding, this study finds that hospital visitors in the United States still struggle with wayfinding, which indicates a potential gap between design research and practice.

Background: Despite a lot of studies that have been conducted on the effects of the built environment on the health of the elderly and environmental salutogenic factors, a limited number of studies have investigated the architectural physical factors clearly. Purpose and Aim: This paper investigated the architectural elements in the non-therapeutic built environment that can achieve salutogenic goals for the elderly. It also aimed to provide an answer to the question of how architectural design might be used to physically bring salutogenic theory to life. Method: In this review study, data were collected systematically using the PRISMA checklist. The three lists of keywords used for the initial search were "built environment" or "architecture," "elderly," and "health," and were supplemented with synonyms for a second search in four databases: Scopus, Science Direct, Web of Science, and PubMed, in the period from 2000 to 2024. By applying inclusion and exclusion criteria, 26 articles were selected for review and data extraction. The data were then qualitatively analyzed, and two reviewers independently verified the analysis. Conclusions: This study found that architectural elements can be salutogenic by supporting the comprehensibility, manageability, and meaningfulness. Porches, Stoop, above-grade entrances, and balconies are key elements in the home that support the sense of coherence. In assisted living facilities, walls were recognized as the only physical factor supporting the sense of coherence due to the creation of a personal, distinct, meaningful, comprehensible, and manageable space.