patient experience empathy innovation

Transcription

1 patient experience empathy innovation summit

2 The Inpatient Unit: Design Strategies to Enhance the Patient Experience Sponsored by:

3 DISCUSSION OUTLINE Introduction Overall Patient Experience Patient Unit Design Patient Room Design Role of Technology Guest Experience

4 Introduction

5 Parkland Hospital Public Hospital for Dallas County (pop. 2.4M) Academic Medical Center, the primary teaching hospital for University of Texas Southwestern Medical School A system of 11 Community Oriented Primary Care (COPC) clinics throughout Dallas County 968 licensed bed hospital (operating 650 beds) Level 1 Trauma Center Only Burn Unit in North Texas Level 3 Neonatal Intensive Care Unit (NNICU) 27 languages are spoken at the hospital

6 About Our Organizations For 125 years, The Christ Hospital, Cincinnati, OH, has been a leader in medical excellence. Today, it is a vast network of physicians and staff, working in more than 100 locations, to make superior medicine convenient and accessible for the communities it serves. Skidmore, Owings & Merrill LLP

7 About Our Organizations Skidmore, Owings & Merrill is a multi-disciplinary architecture and engineering firm, established in Chicago in SOM began designing healthcare facilities in the 1950 s. We continue to be focused on the future of design, embracing new innovations and technologies, to deliver world-renowned projects. Skidmore, Owings & Merrill LLP

8 The Christ Hospital Joint and Spine Center Addition to comprehensive adult hospital Full service joint and spine center 90 beds 12 ORs Imaging (MRI, CT, Xray) Physical Medicine and Rehabilitation Pain Center Administrative and Support New Vehicular Approach and Entrance Physician Offices Parking Garage Skidmore, Owings & Merrill LLP

9 The Christ Hospital Joint and Spine Center Guiding Principles 01 Experience and Access Provides an exceptional patient/family/visitor experience Provides an extraordinary environment for physicians and staff to practice within Promotes a healing environment Creates ease of access, parking, wayfinding and circulation 02 Efficiency Accelerates expansion of strategic services (Musculoskeletal as first priority) Maximizes equipment, space, function and eliminates duplication Integrates with existing facilities, maximizing operational effectiveness 03 Flexibility Creates options for future growth and change Enhances safety and quality of multi-disciplinary care and services Creates synergies between patient care, education and research Develops a long term, coordinated real estate strategy 04 Innovation Integrates inpatient and outpatient planning and design Incorporates technology and state-of-the-art facilities 05 Brand Strengthens image and brand Preserves and builds upon the unique character of the campus Demonstrates strong commitment to sustainability Strengthens the Mt. Auburn neighborhood and other neighborhoods where our facilities are located Provides for a repeatable interior and exterior brand image

10 The Christ Hospital Joint and Spine Center Master Plan Reorganizing the campus, to grow and self-replace for the foreseeable future Skidmore, Owings & Merrill LLP

11 Skidmore, Owings & Merrill LLP

13 Overall Patient Experience

14 Defining the Patient Experience The sum of all interactions, shaped by an organization s culture, that influence patient perceptions across the continuum of care. The Beryl Institute

15 Patient Experience: What it s All About Patient experience/ satisfaction/ quality/ patient safety and cost reduction topped the list again Please rank your organization s top 3 priorities for the next three years 2011 Patient experience / satisfaction 70% 64% Quality / patient safety 63% 58% Cost management / reduction 37% 24% EMRs / meaningful use / IT 35% Employee engagement / satisfaction 22% ACO development / implementation Physician recruitment / retention 18% 17% Construction / capital improvements 11% 0% 10% 20% 30% 40% 50% 60% 70% 80% Source: The Beryl Institute Skidmore, Owings & Merrill LLP

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20 Before picture of entry sequence

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27 Design Principles Connectivity Flexibility Standardization On Stage / Off Stage Sustainability

28 ED WISH Acute Care Tower WISH Clinic Med/Surg Clinic DART Station Parking Garage

29 Connectivity

30 Linear Parks

31 WISH Clinic Entry

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33 Putting the Park back in Parkland

34 Patient Unit Design

35 Design Principles On Stage/Off Stage Access to Views/Daylight Simple Wayfinding

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38 On Stage/Off Stage On-Stage Elevators On-Stage Circulation

39 On Stage/Off Stage Off-Stage Elevators

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41 TYPICAL PATIENT FLOOR Two 36 Beds = 72 Beds 36 PATIENT BEDS 36 PATIENT BEDS

42 TYPICAL PATIENT FLOOR Two 18 Beds = 36 Beds

45 TYPICAL PATIENT FLOOR ON STAGE CIRCULATION 36 PATIENT BEDS 36 PATIENT BEDS WAITING FAMILY/ VISITORS ELEVATORS WAITING WAITING FAMILY/VISITOR ZONE PATIENT ZONE-BEDS PROVIDER/STAFF SUPPORT ZONE GREETER DESK

46 TYPICAL PATIENT FLOOR OFF STAGE CIRCULATION 36 PATIENT BEDS 36 PATIENT BEDS PATIENT UNIT SUMMARY Number of Beds 72 BGSF Nursing 72,911 DGSF Nursing 62,181 NSF Nursing 43,719 NSF Nursing Support 18,483 BGSF/BED 1,013 NSF to DGSF Grossing Factor 1.42 DGSF TO BGSF Grossing Factor 1.7 Nursing Support 42% STAFF/SUPPORT ELEVATORS PATIENT ELEVATORS PATIENT ZONE-BEDS PROVIDER/STAFF SUPPORT ZONE

47 PROVIDER/STAFF CIRCULATION PATTERN STAFF CONFERENCE CAREGIVER ZONE MEDICAL/EQUIPMENT/CLEAN MEDICAL/EQUIPMENT/CLEAN CAREGIVER ZONE PATIENT ZONE-BEDS PATIENT ELEVATORS PROVIDER CAREGIVER TEAM COLLABORATION ZONE STAFF/SUPPORT ELEVATORS PROVIDER/STAFF SUPPORT ZONE

48 Decentralized Nurse Station

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50 On-Stage

54 Concepts for Supporting Patient Dignity Decentralized caregiving relationship to patient Single patient rooms for privacy Off-stage staff areas Patient unit floor plan Skidmore, Owings & Merrill LLP

55 Concepts for Supporting Patients and Caregivers Narrow center core Strategically placed services (in core and outboard) Family Support Core Support Reception Support Family Patient unit floor plan Skidmore, Owings & Merrill LLP

56 Concepts for Staff Responsiveness Support spaces distributed for quick access Caregiver supplies at point of use Primary caregiver support Secondary caregiver support Patient unit floor plan Skidmore, Owings & Merrill LLP

57 Separation of Vertical Circulation Public, bedded patients and service traffic are all separate Public elevators Patient elevators Service elevators Patient unit floor plan Skidmore, Owings & Merrill LLP

58 Concepts Supporting Patient Privacy Caregiver team consulting takes place in a huddle room Staff huddle room Skidmore, Owings & Merrill LLP

61 Patient Room Design

63 Concepts for Engaging Patients Decentralized nursing: Nurses are closer to patients Caregiver supplies at point of use Nested toilets provide visual order, as well as flexibility for acuity adaptability Staff charting stations Caregiver area Nurse server Early nurse server schemes Skidmore, Owings & Merrill LLP

64 Experiencing the Patient Room Features Patient, Caregiver and Family Zones Flexible Lighting Shelves for Cards and Flowers Elegant yet Maintainable Finishes Characteristics Daylight Acoustically and Visually Quiet Patient Control Mock-up of patient room Skidmore, Owings & Merrill LLP

65 Concept for Increasing Bedside Presence Patient room side - Patient room nurse server, med pass and PPE Corridor side - Patient room nurse server, med pass and PPE Skidmore, Owings & Merrill LLP

66 Concepts for Effective Caregiving Adequate caregiver space and supplies at bedside Specific computer orientation within the patient room Dedicated family/ caregiver zones Skidmore, Owings & Merrill LLP Mock-up of patient room

67 Concepts for a Quiet Environment Dimmed corridor lighting at night Heavy privacy drape, patient controlled No central nurse station Remote family waiting Strategic location of patient room doors reduces sound reflection Skidmore, Owings & Merrill LLP Mock-up of patient room

68 Concept for Easing Personal Care Larger patient bathroom Wide and/ or double doors Commode chair and bedpan storage Lifts in bariatric bathrooms Prefabricated pods Skidmore, Owings & Merrill LLP Mock-up of patient bathroom

69 Concept for Hygiene: Patient Bathroom Deinstitutionalized appearance Tile with matt finish does not show water marking Grout colors darker in floor Integral sink bowls Thoughtful storage reduces visual clutter Keeping shower water contained Occupancy sensors (hands free) Skidmore, Owings & Merrill LLP Mock-up of patient bathroom

70 TYPICAL PATIENT ROOMS Family Zone Hygiene Zone 50 nsf Patient Zone Clinical Zone 273 nsf Monitoring Zone

71 TYPICAL PATIENT ROOMS Family Zone Patient Zone Clinical Zone Hygiene Zone 50 nsf 273 nsf PATIENT ROOM ATTRIBUTES Universal room design Outboard toilet Decentralized nursing Same-handed rooms Functional zones Encourages hand washing protocolsink adjacent to room entry Educational/teaching multimedia footwall Monitoring Zone

72 EVIDENCE-BASED DESIGN Creating the Healing Environment POSITIVE DISTRACTIONS WINDOWS WAYFINDING LIGHT BUILDING LAYOUT ACCESS TO NATURE HEALING ENVIRONMENT AIR QUALITY FLOORING MATERIALS SINGLE PATIENT ROOMS FURNITURE ARRANGEMENTS ERGONOMICS NOISE CONTROL

73 Patient Mockup Rooms

74 Patient Room

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76 Patient Toilet

77 LDR

78 Role of Technology

79 City of the Future Frank R. Paul, 1942

80 Planning the Future

81 Planning the Future

82 Tech challenges Sufficient for IT connection density Antenna distribution Mobility Integrated systems and devices Include robust rough-in space for future tech Conduit Server/data room/rack expansion

83 Concepts for Reducing Readmissions and Increasing Communication Skidmore, Owings & Merrill LLP Patient room with patient education/ entertainment system and patient information/ clinical monitor

84 Concepts for Enhancing Patient Safety and Communications Patient precautions monitor - Fed from medical record Mock-up of patient precautions monitor Skidmore, Owings & Merrill LLP

85 The Caregiver Tool Belt -- Then Skidmore, Owings & Merrill LLP

86 The Caregiver Tool Belt -- Now Voice, Alarms, Text, Bar Code Reader Skidmore, Owings & Merrill LLP

87 Enhancing patient control Lights Temperature Privacy Curtain and Blackout Shade Skidmore, Owings & Merrill LLP

88 Guest Experience

89 Concepts for Engaging Family in Caregiving Family gathering spaces Family accommodation in the patient room Family space in patient room - mockup Skidmore, Owings & Merrill LLP

92 Roof garden

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95 Sub Waiting Rooms

96 Cafeteria

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101 patient experience empathy innovation summit

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