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August 25, 2014

Redesigning hospital rooms to help patients heal

Daily Briefing

    The University Medical Center of Princeton has developed a new type of hospital patient room that brought patient experience scores to the 99th percentile, reduced falls, and decreased infection rates, Michael Kimmelman reports in the New York Times.

    As it prepared to design a new hospital, staff at the Princeton hospital created a mock patient room with an outdoor view, a new drug dispensary, a fold-out sofa for guests, and a newly positioned bathroom.

    Details of the room

    The features of the room include:

    • Going solo. All patient rooms are singles, because research suggests that patients are less likely to divulge relevant health information to clinicians when another patient is in the room. The rooms also have ample space for family and friends; research shows visitors hasten recovery.

    • More daylight. The rooms have big windows that bring in plenty of sunlight and outdoor views. Research has long supported the theory that viewing nature has curative powers.

    Hospitals take design cues from malls, airports

    • Bathroom positioning. The bathroom is positioned close to the patient's bed and is connected by a handrail to prevent falls. There is a sink in the bathroom and one in the main room so staff will be encouraged to wash their hands in front of patients.

    • Mirrored floor plans. Patient rooms are mirrored from a shared wall behind the head of patient beds. The positioning of the equipment and attachments makes the room less expensive and more space conscious. However, having everything reversed in each room could increase the chance of clinicians making mistakes when they use equipment.

    • Secure prescription drugs. Each room boasts a lock box—that opens in both the patient's room and in the hallway—for safely storing drugs. The design reduces the risk of pharmacists or other clinicians making mistakes, since drugs can be delivered directly to specific patient rooms.

    How new facilities make nursing units more efficient

    How the room improve satisfaction, care quality

    To test the "pilot room," the hospital placed real patients in it for months and surveyed their satisfaction levels.

    Patients in the "pilot" room rated food and nursing care higher than patients in the older rooms—even though it was the same. They also asked for 30% less pain medication, which led to faster recoveries, shorter hospital stays, and reduced overall costs.

    Inspired by the findings, the hospital designed its new $523 million, 636,000-square-foot facility to include the new rooms. And after moving to the new facility with the new rooms, patient satisfaction increased from the 61st percentile to the 99th. And infections and accident rates dropped to new lows.

    Major facility investments can be tricky

    Hospital CEO Barry Rabner acknowledges it is difficult to know where to invest in facility design, since there is little research available on the amenities that most improve health outcomes. For example, antibacterial floor coating costs an extra $1 per square foot—or an extra $700,000 for the entire facility. But "where's the evidence that it works?" he asks.

    Principal architect on the project, Christopher Korsh of HOK, says, "We employ researchers to study outcomes of what we do. But it's still not like doing drug development. Pharmaceutical companies can have control groups, placebos."

    Building a 'hospital without beds'

    But overall, Korsh says "good design really can make you better faster… Patients now say they won't come to a facility because they don't like it, and if there's a building that can save 2% on the cost of delivering health care, that's huge" (Kimmelman, New York Times, 8/21).

    More from today's Daily Briefing
    1. Current ArticleRedesigning hospital rooms to help patients heal

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