Herd-Health Environments Research & Design Journal最新文献

PurposeA pilot mixed methods facility environmental evaluation of a rural critical access hospital in Montana coupled with qualitative community interviews to identify areas of convergence and divergence of meaningful design changes to enhance hospital operations, service line offerings, and access.BackgroundMontana is the fourth largest state with a population of approximately one million residents. Most Montana residents live in geographically isolated rural or frontier communities with chronic healthcare provider shortages and critical access hospitals closing or at risk of closure. As many rural hospitals undergo renovations, there is a need for a holistic approach to align facility and community needs in an interpretable manner to both design teams and hospital leadership.MethodsEnvironmental evaluation was conducted using checklists for seven indicators of facility health: lighting; air quality; noise; infection control/prevention; information security; travel and wayfinding; and supply management. In tandem, qualitative semi-structured community resident interviews were conducted. Findings were synergistically interpreted in partnership with a community advisory board and hospital leadership.ResultsOf the seven environmental indicators, noise and lighting were most significant to local resident perspectives and attitudes to accessing care at the hospital. Residents noted the need for heightened safeguards to support privacy and confidentiality when individuals and family groups are familiar with one another in small towns.ConclusionsFindings in this study suggest rural healthcare facility design teams may benefit from a mixed methods approach and use of a rural culture-specific guiding conceptual framework to align decision-making with meaningful changes to enhance community engagement.

BackgroundThe Nursing Institute of Healthcare Design conducted an interdisciplinary design professional workshop surrounding evidence-based research inclusion throughout the continuum of healthcare projects. A mnemonic was developed to guide learners through steps of research integration: Rethink; Appraise; Inquire; Study; and Empower (RAISE).PurposeThe purpose of developing the RAISE heuristic model was to create a common approach to evidence-based design integration in healthcare projects through easily interpretable, guided steps and adaptable use across multiple stakeholder groups/settings.MethodGuided by situational learning theory, RAISE was introduced to over 49 design professionals via a keynote presentation, panel session, and interactive virtual escape room activity. Workshop attendees used the mnemonic to find clues, solve puzzles, and complete a quiz to 'escape' one of four project scenarios: operating room; pediatric in-patient behavioral health; community clinic; and emergency department.ResultsA total of 34 attendees completed an evaluation survey, which included Likert-scale quantitative questions and qualitative open-ended questions. Over 80% of respondents rated the knowledge of subject, presentation skills, content, and overall session as 'Excellent.' Qualitative findings noted areas of opportunity to refine the RAISE model to smaller scale project applications.ConclusionThe RAISE model has been adopted by an interprofessional graduate healthcare systems design course at Montana State University and by industry partners of the Nursing Institute of Healthcare Design to make research approachable to new generations of designers. Future work will include further testing and iterative refinement of the model as part of an online toolkit developed by the Institute.

Objectives: This scoping review aims to investigate the role of the physical environment on intrahospital transport (IHT) for intensive care unit (ICU) patients and to understand how it interacts with various work system factors. Background: ICU patients often require IHT for diagnostic or therapeutic procedures, which is associated with increased risks of adverse events, morbidity, and mortality. However, the literature on healthcare architecture rarely considers how the physical environment may contribute to these outcomes. Methods: This review systematically searched five databases, including PubMed, CINAHL Plus with Full Text, MEDLINE, PsycInfo, and Web of Science. Population, Concept, and Context (PCC) framework guided the keywords selection. Results: The review included 15 articles. The role of the physical environment on IHTs for ICU patients was grouped into categories including ICU patient rooms, corridors, elevators, receiving departments, unit layouts, and overall hospital layouts. Conclusions: The findings suggest that optimizing environmental design can significantly enhance patient and staff safety, and transport efficiency. Future research should focus on addressing the identified gaps, employing more robust methodologies, and exploring innovative design solutions to improve IHT outcomes in ICU settings.

Purpose: This study aimed to better understand how the design of the pediatric outpatient waiting room impacts the experiences of autistic children. Background: Outpatient waiting rooms are frequented by autistic children for a variety of healthcare services. Often, these settings consist of unpredictable, uncontrollable, and intense stimuli that may be difficult for children to tolerate. Due to the increased prevalence of autism and significant differences in sensory and self-regulation needs, it is essential to design waiting rooms that are more supportive and inclusive. Methods: Data collection included participant observations, semistructured interviews with the participant and their family, and administration of parent surveys. The Person-Environment-Occupation Model was used to guide data collection and analysis. Once all data was collected, a six-step thematic analysis process was used. Results: Three children and their families participated in this study. Three themes emerged: waiting room triggers, facilitating regulation, and supported inclusion. Each theme identified specific barriers and facilitators of the current waiting room design. Conclusions: This study contributes important perspectives to the literature when designing outpatient therapy waiting rooms. More research is needed to fully tailor healthcare design to be supportive of autistic children.

Aim: This study aims to evaluate the physical and architectural features of nursing homes in Türkiye to establish a foundational understanding of their current conditions and recommend improvements that can enhance residents' quality of life. Background: This study represents the first comprehensive assessment of nursing home environments in Türkiye, focusing on facilities in Ankara, Izmir, and Istanbul. The research addresses a gap in understanding the physical environments of these facilities by examining how well their design and amenities are represented or overlooked within the scope of the assessment tool. Method: The study uses the Physical and Architectural Features (PAF) checklist from the Multiphasic Environmental Assessment Procedure (MEAP) to conduct a detailed evaluation of seven nursing home facilities. This checklist allows for a structured analysis of various environmental factors critical to the design and function of care settings for older adults. Result: Findings indicate that while Community Accessibility and Safety Features were within the acceptable norms, Staff Facilities and Social-Recreational Aids scored moderately low. Moreover, Physical Amenities, Prosthetic Aids, and Orientation Aids scored significantly below the average, showing significant deficiencies across the evaluated facilities. Conclusion: The assessment provides foundational knowledge for understanding the physical conditions in Turkish nursing homes and offers insights for policymakers and designers. The study's recommendations aim to inform future interventions that can enhance the physical environment of care settings, thereby supporting older adults' well-being and quality of life.

Environmental design in palliative care settings receives increasing attention, yet methodologies for studying such environments often lack interdisciplinary integration. Traditional research designs may overlook the lived expertise of clinicians and designers. Objectives: This article describes a collaborative, cross-disciplinary communities-of-practice model developed as a methodological framework to enable effective environmental evaluation and design processes in healthcare settings. Its application is illustrated through a case study in a palliative care unit. Methods: A co-designed, multi-methods approach was developed by a team of clinicians, facility managers, and academic researchers. The methodology included a scoping review, site-specific environmental data logging (sound, temperature, lighting), and co-created survey tools for staff and patients or proxies. Data were collected over two phases, following ethically approved protocols to protect privacy and support data validity. Results: The communities-of-practice model successfully integrated cross-sector expertise, improved the contextual relevance of study instruments, and enabled real-time, context-sensitive data collection in a high-acuity clinical setting. The method supported context-aware adaptations that would not have emerged from conventional top-down research approaches, effectively bridging academic inquiry and practical clinical application. Conclusion: The communities-of-practice model offers a replicable, interdisciplinary method for researching complex healthcare environments. Its case study in a palliative care unit demonstrates its capacity to generate actionable insights aligned with patient-centred outcomes. As health architecture increasingly intersects with evidence-based care delivery, such methodological approaches are vital for aligning design decisions with clinical and human-centred goals.

Background: The rising demand for outpatient care, fueled by improved efficiency, technology, and patient-centered models, necessitates reevaluating clinic design and healthcare delivery. This reassessment should align with evolving patient expectations to enhance care continuity and outcomes. Objective: This research explores how targeted design features affect patient behaviors, movement dynamics, and staff perceptions in outpatient clinics. The goal is to enhance patient experience, improve operational efficiency, and elevate care quality by identifying strategies to boost clinic performance and patient outcomes. Methods: This study utilizes behavior mapping, shadowing observations, surveys, and Gemba walk-throughs across four outpatient clinics to examine how design affects patient experiences and operational workflows. Behavior mapping collected 1179 data points, revealing that waiting for appointments and making phone calls were the most common activities. Shadowing 13 patients identified navigation inefficiencies, particularly the lengthy route from exam rooms to exits and the frequent movement between the scale and waiting area. Surveys and Gemba walk-throughs with 95 staff members highlighted critical design elements that enhance experiences, including aesthetics, acoustics, and room sizes. Feedback indicated a demand for improvements in accessibility, privacy, wayfinding, reduced staff travel distances, and child-friendly features to boost clinic efficiency and patient satisfaction. Conclusion: This study highlights the importance of patient-centered design in outpatient clinics. It shows that improving waiting areas, clinic navigation, privacy measures, and technology integration can enhance patient experience and operational efficiency.

Nature-based interventions (NBIs) in healthcare settings have the potential to enhance physical and mental wellbeing of patients, healthcare staff, and visitors but are often underutilized. Knowledge about factors influencing effective implementation of NBIs in healthcare settings is scarce. This study aimed to develop a framework for identifying implementation factors relevant to NBIs in hospitals, long-term care facilities for elderly, and rehabilitation centers. A two-round Delphi study was conducted. In the first round, potential implementation factors were identified based on input from 33 experts from the following groups: healthcare managers, landscape designers, nature and health consultants, and healthcare staff. These factors were then supplemented with additional factors identified from previous studies and the Consolidated Framework for Implementation Research (CFIR). In the second round, 21 experts rated the importance of these factors. The items that reached expert consensus were included in the new implementation framework. In the first round, an initial set of 99 implementation factors was identified. Most factors derived from experts and literature were design related. These factors were complemented with factors derived from the CFIR. In the subsequent round, 98 implementation factors were considered important by experts and retained. These factors were incorporated into a new framework, the Green Implementation Framework (GreenIF). The GreenIF provides an overview of factors that contribute to the successful design and implementation of NBIs in healthcare settings and can be used to enhance their usage and maximize their benefits.

ObjectivesThis study aims to identify key factors influencing residential satisfaction and sense of belonging among residents in Shanghai's "moving-merging" rural-urban resettlement communities, with a particular focus on variations across different age groups.BackgroundUrban expansion globally impacts rural populations, with China experiencing rapid urbanization. Shanghai's unique "moving-merging" strategy consolidates villagers into new sites near their original locations, preserving social ties while improving physical environments. This study examines how this strategy influences residents' place attachment, focusing on person, place, and process dimensions.MethodA mixed-methods approach was adopted, integrating quantitative surveys with qualitative data collection. A structured questionnaire was administered to 245 residents (133 younger individuals <60 years, 112 older individuals ≥60 years) in the DX Community, Shanghai. The survey assessed residential satisfaction, sense of belonging, and perceived changes before and after relocation. Factor analysis with oblique rotation and binary logistic regression were employed for data analysis.ResultThe study revealed that while living conditions improved, overall resident satisfaction did not significantly increase, especially among younger residents. Older residents perceived greater benefits but encountered adaptation challenges. Social ties and belongingness were strengthened in higher-density settings,ConclusionThe "moving-merging" strategy enhances residential satisfaction and fosters a sense of belonging, particularly benefiting older adults by preserving social networks. However, challenges persist in improving physical environments. Findings highlight the necessity of differentiated policies addressing specific needs and preferences of different age groups.