August 4, 2010
My recent job shadow of a med/surg nurse proved enlightening. It reinforced my belief that there should be a space available either directly inside or outside of every patient room to store supplies and equipment. Decentralizing important items to these areas would enable nurses to work more efficiently. And it would cut their travel time to supply areas and equipment rooms.
Storing supplies in or near patient rooms will require those spaces to be maintained, but this responsibility should not be shouldered by nurses. Their job is to care for patients, not to hunt and gather supplies.
There also should be a place in every patient room to store select pieces of equipment, such as IV poles and pumps. Patients now are sicker and the equipment storage needs for them has increased. The equipment might vary depending on the specialty of the unit, but this step would make it immediately accessible for use.
We architects already allocate and plan space for supplies and equipment in labor delivery recovery/postpartum rooms. If we use this same approach and reallocate the square footage that typically would go into an equipment room, that space could be used to provide storage in or near the patient room. This would eliminate wasted motion, give nurses what they need–where and when they need it–and allow them to focus on giving care.
July 28, 2010
During my recent job shadow of a nurse working on the med/surg floor at a nearby hospital, it felt like we walked for miles during his shift. I was probably right. According to a 2008 study, nurses walk between one and five miles per 10-hour daytime shift.
This amount of walking is caused mainly by central workstations and longer, inefficient circulation paths to single patient rooms. This was the case during my shadow experience. Not only was our travel route inefficient, it also resulted in greater activity at the workstation where concentration and limited interruptions are so important.
Single patient rooms are advantageous and preferable for a number of reasons, but the resultant unit configurations have created even longer travel distances for nurses. These rooms are larger and when located side by side, the distance increases from one patient to the next.
This activity could be remedied by decentralizing supplies, equipment, and medications to the patient room. Or, another strategy would be to design narrower support cores with more cross circulation. Designing more circulation paths through the support core would enable nurses to work cross corridor and reduce their travel distances.
Decentralizing supplies, equipment and medications, and designing narrower support cores with cross circulation are key to reducing travel distances and promoting safe and efficient nurse environments. Plus, the additional time they save could be spent with patients—a win-win situation for all.
Top photo via: Flickr.com
July 21, 2010
Editor’s note: This is the first post in a six-part series that will focus on improving caregiver work environments.
It’s been more than 20 years since I went from a career as a nurse to being an architect. So when I recently had the chance to shadow a nurse for eight hours, a number of things about his work environment surprised me.
I was sure that advances in technology and equipment would make work for nurses less demanding. That would give them more time with patients. I was wrong. Nurses are working harder than ever for longer hours and with sicker patients. And the number of patients they treat is increasing because of a nursing shortage.
Considerable attention has been given to patient-focused and family-centered environments. But only limited focus has been given to creating sustainable environments for nurses. Their environments remain stressful and inefficient, which unfortunately can lead to medical errors.
I wasn’t surprised when I saw a survey indicating that more than one-third of nurses would not recommend their profession to young people. The physical demands are great—six hours went by before we sat down for the first time—and the emotional stress can be exhausting.
As a nurse, I understand the demands faced by caregivers. As an architect, I believe my profession can respond to those demands by designing safe and efficient nurse environments that also provide respite and rejuvenation.
In part two of her series, Cardon will focus on decentralizing the nursing unit.
Photo via: WorkingNurse.com
Design, Healthcare, Products
July 14, 2010
When Herman Miller Healthcare decided it was going to design the Compass system, a modular furnishings solution for the patient room, it went right to the source: the people who work in healthcare every day.
According to Doug Bazuin, senior researcher for Herman Miller Healthcare, the Compass design team interviewed more than 550 clinicians, administrators, facility managers, and healthcare architects and interior designers to determine what healthcare issues are most important to them. Four key concerns kept rising to the top:
1. Support changing technology
2. Improve nurse efficiency
3. Improve the family experience
4. Be healthcare appropriate
In this video, Bazuin discusses how this research was applied to the final product design.
Launched in June at NeoCon, the award-winning Compass system is ready to help healthcare professionals navigate change. That’s the benefit of going the source.
July 7, 2010
Imagine being required by a hospital or insurance company to be present at all times in a family member’s patient room?
I’ve heard about this happening in some U.S. hospitals and in healthcare facilities abroad. Evidence suggests social support from family helps patients heal emotionally and physically. The presence of family also can reduce the risk of a patient fall. So, it’s likely that teaching family to be caregivers inside and outside of the hospital will increase as hospitals face the need to reduce 30-day hospital re-admissions and deal with staff shortages.
This prompts the need for a family zone in the patient room, which is referenced in a research summary titled, “Patient Rooms: A Changing Scene of Healing,” but what features create the best family zone? You might see a work surface, a place to sleep, access to power, or Wi-Fi. Some hospitals already are including a second television or refrigerator. Going forward, patient rooms will have to adapt to support the needs of families as caregivers.
June 23, 2010
Remember Frasier’s father on the TV show Frasier? He was very attached to an overstuffed recliner, “Just like my dad,” says Larry Fischer, principal at Perspectus Architecture in Cleveland.
When Fischer’s 89-year-old dad had hip replacement surgery a few years ago, Fischer started looking for a chair that would offer more than familiarity. At the Healthcare Design Conference in Florida that year, he found it. The Nala chair was not yet in production; however, Fischer was among the first to place an order.
When it arrived a few months later, Fischer replaced the recliner with the Nala–without consulting his father, who thought his low, cushy recliner was just fine. “At first, he was skeptical that it wouldn’t be comfortable because it looked kind of skeletal and he was used to overstuffed,” says Fischer. “He’s lived in that house for more than 60 years, and [stylistically] it’s definitely a typical grandpa’s house. And the chair looks pretty radical in that kind of home.”
Over time, however, he bonded with the Nala, which stops at any point along the recline range and provides correct body support. The arms that flip up all the way, allowing him to turn 90 degrees and get to his walker more easily, have been a boon. “At his age, you lose a lot of your upper body strength and that makes it hard to get out of a chair,” says Fischer, who couldn’t be more pleased that the executive decision he made to replace the chair has paid off.
“In terms of getting in and out of the chair and the comfort it offers, Nala has absolutely changed his life.”
Photo via: Larry Fischer
June 16, 2010
This week at NeoCon, Herman Miller Healthcare celebrated the opening of its new showroom in Chicago’s Merchandise Mart and its recognition as a Large Showroom Winner in the International Interior Design Association (IIDA) Showroom and Booth Design Competition.
The prestigious award honors originality of design, visual impact, effective use of materials, and the outstanding use of space, color, texture, lighting, and graphics.
NeoCon showrooms typically consider the convergence of a company’s employees, products, environmental sensibilities, and graphic expressions. Our new space particularly was designed to convey our knowledge about healthcare facility design and practices, and comprehensive product portfolio.
With the recent acquisitions of Brandrud and Nemschoff, Herman Miller Healthcare possesses the most comprehensive healthcare furnishings portfolio in the industry. We chose to demonstrate this portfolio through a broad range of applications that feature a variety of products, including our award-winning Compass system.
Together, Herman Miller Healthcare, Brandrud, and Nemschoff have a tremendous portfolio of innovative, high performance products designed to improve the healing environment.
Design, Healthcare, Products, What's Up
June 14, 2010
Say what you will about NeoCon—for example, “My feet are killing me,” or “These elevators make me crazy,” or “Where am I?”
The truth is, NeoCon provides a great opportunity to see who Herman Miller is, what they stand for, and what they offer.
These videos let you share Herman Miller’s NeoCon experience from wherever you are. They give you a brisk overview of the space, showcasing how we support people at work. The thing is, with mobile technology, people can work almost anywhere now. And they will go to the places where they are best able to get their work done, which often means collaborating with others. Work has become much more complex, so meeting people’s needs is much more complex. In the showroom, you’ll see how Herman Miller handles it:
• Putting people first
We listen to our customers to understand how and where their people work.
• Understanding the ways work is changing
We research factors that impact people at work: technology, speed, mobility, collaboration, health, and multiple generations.
• Making great workplaces
We offer a continuum of integrated, optimized solutions for the entire office landscape that support the full spectrum of work needs.
Plus the showroom looks great. Take a look, and see what they’re up to.
NeoCon overview with Cindy Donn: “Today’s office landscape actually has to support three different areas—individual, group and community.”
Herman Miller Healthcare with Gianfranco Zaccai: “Compass is designed to accommodate itself to any space and to the specific interaction between patient and caregivers.”
Thrive portfolio with Matt Tedesco: “Our job is to make sure that your people can do their job, and that’s what Thrive is all about—making sure you feel better so you work better – simple as that!”
Education with Jeff Vredevoogd: “It comes down to the word ‘change.”’
New Geiger guest chairs:
• David Ritch: “There is sort of this serendipity that takes place between the curved hoop and the rectilinear base of the Saya chair.”
• Khodi Feiz: “I will be happy if somebody walks by and looks at the A-line and Deft chairs and has a little smile just because of the way it looks and then sits on the chair and has another smile because of the way it feels.”
June 9, 2010
Many individuals are in good health and can independently perform their activities of daily living. Unfortunately, this is not the case for over 14 million Americans who receive some form of long-term care. From 2000-2025, the 65-plus demographic will double and increase the demand for long-term care by 100 percent. The current elder care system leaves many elders’ needs unmet and as the demand for long-term care increases the problem will get worse.
Innovators already tackling this problem include the Business Innovation Factory and its Elder Experience Lab, a platform for creating partnerships and prototyping solutions to improve the elder experience, and The Green House Project, a nationwide project rethinking skilled nursing care environments.
This is a complex problem without a right answer, but we can become part of the solution. Ultimately, the goal is to increase elder well-being, which for elders means staying engaged, being connected, and having a sense of purpose. Contact your local AARP chapter to see how you can start improving the lives of elders in your community or think about the elders in your family and how you could improve their experience. A quick phone call telling them how much they mean to you is a good place to start!
Photo via: Business Innovation Factory
June 2, 2010
As a healthcare architect in private practice, I remember redoing the same space for a healthcare customer three times in three years. And it’s not because it was bad design! Initially, the need in the space was a doctor’s lounge; then medical records; finally, the space was converted into a cardiac care unit for the Emergency Department. Each time, the space was gutted and rebuilt!
Functional needs just change too fast for healthcare providers to effectively predict their future needs. As architects and designers, we must own this problem for our customers, not be a part of the problem. Designs must be planned to accommodate continuous change with minimal downtime and capital costs. We can no longer believe that our design statement is the perfect solution to a program since the program will likely change at some level—even prior to occupancy.
A five-year usage of a space is a long time; imagining 50 years is only wishful thinking. How we plan, design, and construct spaces that can change gracefully is the new basic requirement for sustainable design.