Optimizing Patient Flow in Design and Construction

Transcription

1 Optimizing Patient Flow in Design and Construction Christine Guzzo Vickery, CID, EDAC Vice President Interior Design Research Dennis J Vonasek, AIA, NCARB, ACHA, CID Vice President

2 All life is an experience Ralph Waldo Emerson

3 Describe the primary objectives of optimal patient flow. Convenience Facilitates low stress Provide High Quality Care Create Affordable Solutions

4 Convenience factors Location Factors Entry Sequence Customer service reception check in Wayfinding Comfort Safety / Privacy Adjacencies

5 Facilitates Low Stress Positive Distraction View of Nature Calming color pallet

6 Facilitates Reducing Stress Wellness: Top 10 Places and Values Associated with Feeling Well Places Nature Home Places for Physical Activity Bodies of Water Art Urban Spaces Mountain, Desert, Forest Balance Rural Spaces Openness Values Fun Peace Friendship / Human Contact Spirituality Privacy Competition / Challenge Soothing Beauty Escape Exhilaration

7 Provide High Quality Care Interior environment and design of an exam room contributes to the overall satisfaction and success of patient care. overall efficiency of space utilization accommodation for patient comfort privacy and accessibility and integration and adaptation for the advancement of new technologies.

8 Create Affordable Solutions HealthEast Retail Clinics Market availability Low initial investment 10 year lease with cost of $70 $90 SF for build out

9 Explain how facility design can be used to improve patient movement and care delivery

10 Need to consider all of care delivery. Not just the patient 1. The flow of patients 2. The flow of clinicians 3. The flow of medications 4. The flow of supplies 5. The flow of equipment 6. The flow of information 7. The flow of process

11 What is LEAN Lean is a relentless pursuit, identification and elimination of waste to produce value for the customers Muda (waste) is any human activity which absorbs resources but creates no value

12 Lean Principles Types of waste Over production Waiting Unnecessary transport Over processing Excess inventory Unnecessary movement Defects and errors Value Assessment Step by step, time and effort investment Value Chain

13 LEAN Core Principles Start with the customer what value does the customer want from the process Respect for people Principles to achieve value for the customer One piece flow First in / first out Mistake proofing Standard work Unified layout Visual management control

14 Identify ways in which architecture impacts patient flow at your healthcare facility. Concept of On Stage / Off Stage Safety Considerations Maximizing Provider time with Patient

15 Architect or Record TKA

16 Travel distance average for patient Travel distance shortest for physician Travel distance shortest for nursing

17 The majority of falls are related to intrinsic causes. Fewer than 10% to 15% caused by the environment Location of Bathroom a factor Ability to have the bathroom door remain open Having the toilet located on a sidewall was associated with fewer falls than when the toilet was across from the entrance Half as many falls in patient rooms that have a designated family area as rooms that have no designated family area

18 Maximizing Provider time with Patient SSM St Claire's Decentralized unit design effect nurses delivery of care and time spent in specific areas. Examine nurses work process, such as frequency of visits to and average time spent pre visit in specific areas of the unit. Compare nurses distance traveled with results from other similar studies. Discuss how the decentralized design impacts the frequency of activities performed in specific areas of the unit.

19 SSM

20 SSM

21 SSM Nurse Shadowing

22 SSM Post Occupancy Findings Nurse spent more than half their day in patient rooms (18 23% increase compared to other studies). Waiting rooms received minimal usage because patient rooms are single, private, and accommodate visitors Not all charting stations may be needed, on average each received 41 minutes of usage by nurses daily. Lack of a central nurses station was confusing for visitors and patients Provide more specialized storage in patient rooms for medical equipment, such as commodes, so they are out ofsight and reach of patients.

23 Describe the role that simulation Modeling can play in helping to meet competing needs in design and construction. Space Race Physical Mockups Virtual Reality Mockups

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25 Active Learning Lab Major Med.

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27 Virtual Reality

28 Mockups Virtual Spectrum of IVR experience levels Currently VRDL is at the exploratory level and moving towards interactive Passive Interactive Exploratory

29 Mockups Virtual State of VR UMN College of Design & CSE VR lab since 2006 Applications were limited due to technological limitations With advances in computing and graphics technology, Immersive Virtual Reality is rapidly evolving to cost effective and powerful 3D visualization tool

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31 Mockups Virtual Future Developments (informed by pilot project and LPCH simulation outcomes): Interactive and real time virtual model effects Dynamic components show object movement Real-time lighting and reflections Hand and arm avatar and controller for interactive Animated simulations of simple to complex scenarios

32 Mockup Tools Summary and Comparison Physical Mockups Virtual Reality Mockups Room Size Complex Room-Based Simulations Movable / Interactive Equipment and Objects Construction Details Lighting General Room Impressions Sightlines Between Corridors / Rooms Finishes Accessory Locations Large, Multi-Story Spaces Department Layouts Department-Based Simulations / Travel Distances Connections to Exterior

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