Designing for Patient Safety and Efficiency: Simulation-Based Hospital Design Testing

2020 ◽  
Vol 13 (4) ◽  
pp. 68-80 ◽  
Author(s):  
Nora Colman ◽  
Mary Bond Edmond ◽  
Ashley Dalpiaz ◽  
Sarah Walter ◽  
David C. Miller ◽  
...  
Keyword(s):  
Bivariate Analysis ◽  
Effect Analysis ◽  
Healthcare Facilities ◽  
Children's Hospital ◽  
Hospital Design ◽  
Design Changes ◽  
Simulation Based ◽  
Children’S Hospital ◽  
Design Planning ◽  
Schematic Design

Objective: In the schematic design phase of a new freestanding children’s hospital, Simulation-based Hospital Design Testing (SbHDT) was used to evaluate the proposed design of 11 clinical areas. The purpose of this article is to describe the SbHDT process and how it can help identify and mitigate safety concerns during the facility design process. Background: In the design of new healthcare facilities, the ability to mitigate risk in the preconstruction period is imperative. SbHDT in a full-scale cardboard mock-up can be used to proactively test the complex interface between people and the built environment. Method: This study was a prospective investigation of SbHDT in the schematic design planning phase for a 400-bed freestanding children’s hospital where frontline staff simulated episodes of care. Latent conditions related to design were identified through structured debriefing. Failure mode and effect analysis was used to categorize and prioritize simulation findings and was used by the architect team to inform design solutions. A second round of testing was conducted in order to validate design changes. Results: A statistically significant reduction in criticality scores between Round 1 ( n = 201, median = 16.14, SD = 5.8) and Round 2 ( n = 201, median score of 7.68, SD = 5.26, p < .001) was identified. Bivariate analysis also demonstrated a statistically significant reduction in very high/high criticality scores between Round 1 and Round 2. Conclusions: SbHDT in the schematic phase of design planning was effective in mitigating risk related to design prototypes through effective identification of latent conditions and validation of design changes.

scholarly journals Designing interprofessional simulation based faculty development in a new women and children's hospital in the Middle East: A pilot study

2016 ◽  
Vol 11 (6) ◽  
pp. 594-600
Author(s):  
Elaine L. Sigalet ◽  
Joanne L. Davies ◽  
Ella A. Scott ◽  
Guy F. Brisseau ◽  
Joseph B. Shumway ◽  
...  
Keyword(s):  
Pilot Study ◽  
Middle East ◽  
Faculty Development ◽  
New Women ◽  
Children's Hospital ◽  
Simulation Based ◽  
Children’S Hospital

Ideal physical features of environmental design in children’s hospital

Facilities ◽  
2020 ◽  
Vol 38 (5/6) ◽  
pp. 445-466 ◽  
Author(s):  
Sara Nourmusavi Nasab ◽  
Amir Reza Karimi Azeri ◽  
Seyedjalal Mirbazel
Keyword(s):  
Environmental Design ◽  
Developed Countries ◽  
Design Guidelines ◽  
Hospital Environment ◽  
Content Type ◽  
Children's Hospital ◽  
Hospital Design ◽  
Children’S Hospital ◽  
Physical Disorders ◽  
Physical Features

Purpose During hospitalization, children are faced with physical disorders and many psychological challenges. One important factor affecting children is the environmental design of the hospital. The inappropriate design of hospitals may contribute to an increase in fear, anxiety and behavioral disorders. The purpose of this study is to use children’s perspectives to evaluate the importance and impact of effective environmental factors to generate children’s hospital design guidelines. Design/methodology/approach In this study, children’s desired atmosphere during treatment was examined via 16 drawings and 24 interviews from children at a children’s hospital in Iran. Findings The encoding of information extracted environmental components such as window view, color, hobby, playing, decorations, family presence, structure of hospital, presence of nurse, furniture, water features, light and green space. The results indicate that children prefer a hospital environment that provides entertainment facilities while also offering design features such as the presence of light, colorful decorations, the existence of green spaces and conditions suitable for their families to be present. Research limitations/implications Depending on the location and their living conditions, the children’s prioritization can be different in any society. In addition, the data of this research was descriptive; thus, the conclusions must be considered tentative. Originality/value A number of studies focus on the needs of populations in developed countries. This topic has not been investigated in a major way via professionals in non-western countries such as Iran. Thus, the context of this study and present findings can be deemed unique.

scholarly journals Analysis of the Design Process of Green Children's Hospitals: Focus on Process Modeling and Lessons Learned

2009 ◽  
Vol 4 (1) ◽  
pp. 121-134 ◽  
Author(s):  
M.M Bilec ◽  
R.J Ries ◽  
K.L Needy ◽  
M Gokhan ◽  
A.F Phelps ◽  
...  
Keyword(s):  
Design Process ◽  
Medical Center ◽  
Children's Hospitals ◽  
Healthcare Facilities ◽  
Children's Hospital ◽  
Children’S Hospitals ◽  
Complex Design ◽  
Children’S Hospital ◽  
Design Requirements ◽  
The Impact

Healthcare facilities are among the most complicated facilities to plan, design, construct and operate. A new breed of hospitals is considering the impact of the built environment on healthcare worker productivity and patient recovery in their design, construction, and operation. A crucial subset of healthcare facilities are children's hospitals where the consequences of poor building system design and performance have the potential to seriously impact young lives with compromised health. Green facilities are not always pursued: they are perceived as difficult to build and costing more than equivalent conventional hospitals. This study explored the design process of the Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center (UPMC) and Penn State's Hershey Medical Center Children's Hospital to understand the critical steps and processes for green children's hospital design. Producing a series of process maps that identify the key characteristics in the complex design requirements of a green children's hospital, this paper reveals the importance of design process to design quality. More broadly, this research will help future project teams meet the complex design requirements of green children's hospitals.

Improving Stethoscope Disinfection at a Children's Hospital

2013 ◽  
Vol 34 (11) ◽  
pp. 1189-1193 ◽  
Author(s):  
Justin Zaghi ◽  
Jing Zhou ◽  
Dionne A. Graham ◽  
Gail Potter-Bynoe ◽  
Thomas J. Sandora
Keyword(s):  
Pathogenic Bacteria ◽  
Healthcare Providers ◽  
Future Research ◽  
Healthcare Facilities ◽  
Logistic Regression Models ◽  
Children's Hospital ◽  
Contact Precautions ◽  
Before And After ◽  
Children’S Hospital ◽  
The Impact

Objective.Stethoscopes are contaminated with pathogenic bacteria and pose a risk for transmission of infections, but few clinicians disinfect their stethoscope after every use. We sought to improve stethoscope disinfection rates among pediatric healthcare providers by providing access to disinfection materials and visual reminders to disinfect stethoscopes.Design.Prospective intervention study.Setting. Inpatient units and emergency department of a major pediatric hospital.Participants.Physicians and nurses with high anticipated stethoscope use.Methods.Baskets filled with alcohol prep pads and a sticker reminding providers to regularly disinfect stethoscopes were installed outside of patient rooms. Healthcare providers' stethoscope disinfection behaviors were directly observed before and after the intervention. Multivariable logistic regression models were created to identify independent predictors of stethoscope disinfection.Results.Two hundred twenty-six observations were made in the preintervention period and 261 in the postintervention period (83% were of physicians). Stethoscope disinfection compliance increased significantly from a baseline of 34% to 59% postintervention (P < .001). In adjusted analyses, the postintervention period was associated with improved disinfection among both physicians (odds ratio [OR], 2.3 [95% confidence interval (CI), 1.4-3.5]) and nurses (OR, 14.3 [95% CI, 4.6-44.6]). Additional factors independently associated with disinfection included subspecialty unit (vs general pediatrics; OR, 0.5 [95% CI, 0.3-0.8]) and contact precautions (OR, 2.3 [95% CI, 1.2-4.1]).Conclusions.Providing stethoscope disinfection supplies and visible reminders outside of patient rooms significantly increased stethoscope disinfection rates among physicians and nurses at a children's hospital. This simple intervention could be replicated at other healthcare facilities. Future research should assess the impact on patient infections.

Paediatric tracheostomy tubes: recent developments and our current practice

2018 ◽  
Vol 132 (11) ◽  
pp. 961-968 ◽  
Author(s):  
D J Tweedie ◽  
J Cooke ◽  
K A Stephenson ◽  
S L Gupta ◽  
C M Pepper ◽  
...  
Keyword(s):  
Tracheostomy Tube ◽  
Current Practice ◽  
Small Range ◽  
Street Hospital ◽  
Children's Hospital ◽  
Great Ormond Street Hospital ◽  
Design Changes ◽  
Children’S Hospital ◽  
Recent Developments ◽  
Tracheostomy Tubes

AbstractObjectiveA variety of paediatric tracheostomy tubes are available. This article reviews the tubes in current use at Great Ormond Street Hospital for Children and Evelina London Children's Hospital.MethodsThis paper outlines our current preferences, and the particular indications for different tracheostomy tubes, speaking valves and other attachments.ResultsOur preferred types of tubes have undergone significant design changes. This paper also reports further experience with certain tubes that may be useful in particular circumstances. An updated sizing chart is included for reference purposes.ConclusionThe choice of a paediatric tracheostomy tube remains largely determined by individual clinical requirements. Although we still favour a small range of tubes for use in the majority of our patients, there are circumstances in which other varieties are indicated.

scholarly journals Lessons Learned from a Collaborative to Develop a Sustainable Simulation-Based Training Program in Neonatal Resuscitation: Simulating Success

Children ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 39
Author(s):  
Nandini Arul ◽  
Irfan Ahmad ◽  
Justin Hamilton ◽  
Rachelle Sey ◽  
Patricia Tillson ◽  
...  
Keyword(s):  
Multidisciplinary Approach ◽  
Neonatal Resuscitation ◽  
Individual Performance ◽  
Lessons Learned ◽  
Hospital System ◽  
In Situ Simulation ◽  
Children's Hospital ◽  
Resuscitation Training ◽  
Simulation Based ◽  
Children’S Hospital

Newborn resuscitation requires a multidisciplinary team effort to deliver safe, effective and efficient care. California Perinatal Quality Care Collaborative’s Simulating Success program was designed to help hospitals implement on-site simulation-based neonatal resuscitation training programs. Partnering with the Center for Advanced Pediatric and Perinatal Education at Stanford, Simulating Success engaged hospitals over a 15 month period, including three months of preparatory training and 12 months of implementation. The experience of the first cohort (Children’s Hospital of Orange County (CHOC), Sharp Mary Birch Hospital for Women and Newborns (SMB) and Valley Children’s Hospital (VCH)), with their site-specific needs and aims, showed that a multidisciplinary approach with a sound understanding of simulation methodology can lead to a dynamic simulation program. All sites increased staff participation. CHOC reduced latent safety threats measured during team exercises from 4.5 to two per simulation while improving debriefing skills. SMB achieved 100% staff participation by identifying unit-specific hurdles within in situ simulation. VCH improved staff confidence level in responding to neonatal codes and proved feasibility of expanding simulation across their hospital system. A multidisciplinary approach to quality improvement in neonatal resuscitation fosters engagement, enables focus on patient safety rather than individual performance, and leads to identification of system issues.

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