Improve care? Save money? Can standards do both?

Hospital professionals are always looking to improve the care they deliver and do so more efficiently. Many think standards are the answer, especially in patient room design. But a question quickly arises: Which approach—same-handed or mirror-image design—is better for patient safety and staff efficiency?

Why the debate? Mirror-image rooms like the one below share plumbing chases and medical gas and electrical lines. That’s efficient from an architectural point of view.

On the other hand, same-handed rooms like the one below don’t share chases and lines. That adds about $3,000 to $5,000 to the cost of each patient room.

Even with this added cost, an increasing number of hospitals are choosing same-handed design. They’re doing because they believe that standardized same-handed design contributes to better process and workflow. Trouble is, there’s very little evidence to support this belief.

So the debate goes on. We think it’s a healthy debate because it focuses attention on the important role design plays in patient-room settings. It’s generating new research into the merits of same-handed versus mirror-image design, too.

This is all good, but in all the research and all the talk, let’s not lose sight of the people who deliver care. Too much standardizing in the name of efficiency—prescribing, for example, their approach (either left or right) to patients—may backfire if we don’t involve them in the discussion.

Photos 2 & 3 credit: HKS Architects

Coordinating Care in an Age of Chronic Illness

If the current methods of healthcare delivery remain unchanged, treating chronic diseases will elevate healthcare spending and insurance costs to unforeseen levels. Chronic illness currently accounts for 75 percent of our global healthcare spending and is the leading cause of death and disability. By 2030, two out of three Americans will be living with a chronic condition.

Our current system of healthcare delivery is not organized to treat those with chronic conditions holistically. More efficient and cost-effective healthcare management calls for new approaches to our current model of siloed and fragmented care delivery.

Improving patient self-care, building teams of care providers that are accountable as a team, and introducing tools of technology to better communicate and share information, all guided by clinical leadership that wants to change, are required in order to shift from a siloed, fragmented system to an integrated, cooperative—and sustainable—one.

‘Core’ Issues in Healthcare Design

Anyone over the age of 45 knows that things happen as we age. Reading glasses sometimes make an appearance, as do sore knees after exercise or a stiff back in the morning.

Nurses are particularly aware of the effects of aging. The average age of U.S. nurses happens to be 46.8–the highest of all occupations in the world. Years of lifting and moving patients, and walking several miles during every shift, take a toll. Nursing also ranks among the top occupations for work-related back injuries—more than coal mining and manufacturing.

It is possible, however, to make nurse environments safer and more efficient. For example, the design of the central core unit—an area where nurses gather supplies, medications, check patient records, and consult with coworkers—is a good place to start.

Providing better lighting for reading prescriptions and locating medications, supplies, and equipment, and placing these items within arms length will reduce strenuous bending and reaching. Smart floor layouts also will reduce the amount of walking and give nurses more time to be with patients.

These steps will have a positive impact on the satisfaction and performance of nurses and address the particular realities of an aging workforce.