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Providing care quality by design: a new measure to assess hospital ward layouts
The Journal of Architecture ( IF 0.6 ) Pub Date : 2020-02-17 , DOI: 10.1080/13602365.2020.1733802
Rosica Pachilova 1 , Kerstin Sailer 1
Affiliation  

Which hospital ward layout works best? In the past, one response to this question has been to design layouts that minimise walking distances of healthcare workers, and increase the time spent with their patients. However, new research suggests that good face-to-face communication between doctors and nurses crucially impacts the health and safety of patients. Taking this into account, this research proposes a new single measure called Spaces for Communication Index (SCI). It assesses communication opportunities arising from the layout, and shows that a high index is associated with the provision of good healthcare. Six NHS wards were first studied in depth by collecting detailed information about movement and communication patterns of healthcare workers. The index was developed on this basis. Thirty-one NHS wards were then selected, based on their quality of care rating. These were used to test the index. Each ward was analysed with the Space Syntax method, which investigated the size of visual fields of healthcare workers on everyday movement paths through the ward. Large viewsheds provide good visibility and awareness of the environment. As a result, they accrue more communication opportunities by virtue of the layout. Statistical analysis was also used to test if the index can predict care quality. Other factors such as distances between key areas, number of patient beds or ward size were tested, too. Results showed that the higher the index, the better the quality of care. The other factors were not related to healthcare quality. In terms of design, these results highlight the importance of the openness of spaces that healthcare workers traverse to get from one key area to another. This research contributes to the development of an objective method that designers can use to compare different nursing unit designs, and anticipate the care quality that would be provided to patients.

中文翻译:

通过设计提供护理质量:评估医院病房布局的新方法

哪种医院病房布局效果最好?过去,对这个问题的一种回应是设计布局以最大限度地减少医护人员的步行距离,并增加与患者相处的时间。然而,新的研究表明,医生和护士之间良好的面对面交流对患者的健康和安全至关重要。考虑到这一点,本研究提出了一种新的单一衡量指标,称为传播空间指数 (SCI)。它评估了布局带来的沟通机会,并表明高指数与提供良好的医疗保健相关。通过收集有关医护人员的运动和交流模式的详细信息,首先对六个 NHS 病房进行了深入研究。该指数是在此基础上制定的。然后选择了 31 个 NHS 病房,根据他们的护理质量评级。这些用于测试索引。每个病房都使用空间句法方法进行分析,该方法调查了医护人员在穿过病房的日常移动路径上的视野大小。大视域提供了良好的可见性和环境意识。结果,他们凭借布局积累了更多的交流机会。还使用统计分析来测试该指数是否可以预测护理质量。还测试了其他因素,例如关键区域之间的距离、病床数量或病房大小。结果表明,该指数越高,护理质量越好。其他因素与医疗保健质量无关。在设计方面,这些结果突显了医护人员从一个关键区域到另一个关键区域的空间开放性的重要性。这项研究有助于开发一种客观方法,设计人员可以使用该方法来比较不同的护理单元设计,并预测将为患者提供的护理质量。
更新日期:2020-02-17
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