@article{7147, author = {D. J. Birnbach and I. Nevo and S. R. Scheinman and M. Fitzpatrick and I. Shekhter and J. L. Lombard}, title = {Patient safety begins with proper planning: a quantitative method to improve hospital design.}, abstract = {

BACKGROUND: A quantitative methodology that enhances design of patient-safe healthcare facilities is presented. The prevailing paradigm of evaluating the design of healthcare facilities relies mainly on postconstruction criticism of design flaws; by then, design flaws may have already negatively affected patient safety. The methodology presented here utilises simulation-based testing in real-size replicas of proposed hospital designs. Other simulations to assess design solutions generated mainly qualitative data about user experience. To assess the methodology, we evaluated one patient safety variable in a proposed hospital patient room.

METHOD: Fifty-two physicians who volunteered to participate were randomly assigned to examine a standardised patient in two hospital room settings using a replica of the proposed architectural plan; the two settings differed only by the placement of the alcohol-based hand-rub dispenser. The primary outcome was the hand hygiene compliance rate.

RESULTS: When the dispenser was in clear view of the physicians as they observed the patient, 53.8% sanitised their hands. When the dispenser was not in their field of view (as in the original architectural plan), 11.5% sanitised their hands (p=0.0011). Based on these results, the final architectural plans were adjusted accordingly.

CONCLUSION: The methodology is an effective and relatively inexpensive means to quantitatively evaluate proposed solutions, which can then be implemented to build patient-safe healthcare facilities. It enables actual users to proactively identify patient safety hazards before construction begins.

}, year = {2010}, journal = {Qual Saf Health Care}, volume = {19}, pages = {462-5}, month = {10/2010}, issn = {1475-3901}, doi = {10.1136/qshc.2008.031013}, language = {eng}, }