Improving Healthcare Quality and Safety through Design
Research has demonstrated that the physical environment is an important contributor to one’s experience in healthcare settings and can be an important tool for improving patient, family, and staff wellbeing. Working with diverse collaborators, we have investigated staff perceptions regarding the benefits of single-family neonatal intensive care unit design, family presence and family-to-patient interactions in an intensive care unit designed to support patient and family-engaged care, the influence of visibility on other health-related outcomes, and how design can improve the care experience for Veterans with mental health needs.
Enhancing the Quality of Life for Older Adults through Design
Globally, the population of persons 65 and older is on the rise. As we age, we often experience declining physical and cognitive performance, but improving the design of the physical environment may support our ability to live safely and with dignity. Our research has challenged the use of the Americans with Disabilities Act (ADA) accessibility requirements in situations where older adults need assistance transferring on and off of the toilet, and we have identified wayfinding strategies that can improve the travel experience for older adults.
Design to Improve Teaching and Learning Outcomes
Early research investigated the relationships between the design of K-12 educational settings on teaching and learning outcomes. Current research, funded by the American Society of Interior Designers, is investigating how mixed-use learning environments in higher education settings can best support individual and collaborative activities, as well as structured classes, with a particular focus on the millennial generation.
Framework for Designing Person-centered Mental Health Interiors for Veterans.
The Veteran’s Administration (VA), recognizing the potential influence that nurturing interior environments may have on patient well-being, has been designing and constructing mental health settings intended to calm, restore, and revive. Unfortunately, limited research investigates the links between the interior environment and mental health outcomes that can be used for guiding the design for these facilities. This paper seeks to provide a framework for designing person-centered mental health interiors that would be supportive of human factors for a healthcare organization’s clinical and operational staff as well as Veterans. The framework is intended to assist healthcare providers in achieving mental health aims through thoughtful, evidence-based, person-centered design. Based on a review of the literature and case study investigations of three VA acute inpatient mental health units in the United States, the framework is comprised of six domains: Involve, Protect, Engage, Comfort, Personalize, and Sustain. These domains, informed by existing credible research and best practices, were vetted through post-hoc analysis of qualitative data gathered from interviews, focus groups, and/or listening sessions conducted with the three sites. The resultant Framework for Designing Person-Centered Mental Health Interiors for Veterans, developed based on the data and methodologies used in conducting this study, is meant as a complementary resource for informing future research, planning, design, and operation of acute inpatient mental health spaces. The research team’s aim was to develop an accessible set of evidence-based environmental planning considerations to aid in the prioritization and development of person-centered mental health environments.
Platt, L., Bosch, S. J. & Kim, D. (2017). Towards a framework for designing person-centered mental health interiors for Veterans. Journal of Interior Design, advance access publication on February 7, 2017. doi: 1111/joid.12095
Featured on the EBD Journal Club, October 19, 2017 (Center for Health Design)
Key spatial factors influencing the perceived privacy in nursing units: An exploration study with eight nursing units in Hong Kong
Aim: This study examined how the spatial characteristics of patient beds, which are influenced by patient room design and nursing unit configuration, affect patients’ perceptions about privacy. Background: In the hospital setting, most patients expect a certain degree of privacy but also understand that their caregivers need appropriate access to them in order to provide high-quality care. Even veteran healthcare designers may struggle to create just the right balance between privacy and accessibility. Methods: A paper-based survey was conducted with 159 participants in Hong Kong—72 (45.3%) participants had been hospitalized and 87 (54.7%) participants had not—to document their selection of high-privacy beds, given simplified plans of eight nursing units. Two types of information, comprised of six variables, were examined for each bed. These include (1) room-level variables, specifically the number of beds per room and area per bed and (2) relational variables, including walking distance, directional change, integration, and control. Results: The results demonstrate that when asked to identify high-privacy beds, participants selected beds in patient rooms with fewer beds per room, a larger area per bed, and a longer walking distance to the care team workstation. Interestingly, the participants having been hospitalized also chose beds with a visual connection to the care team workstation as being high in privacy. Conclusions: The participants with hospitalization experience may be willing to accept a bed with reduced visual privacy, perhaps out of a concern for safety.
Lu, Y., Cai, H., & Bosch, S. J. (2016). Key spatial factors influencing the perceived privacy in nursing units: An exploration study with eight nursing units in Hong Kong. Health Environments Research & Design Journal. doi: 1177/1937586716672857
When Seconds Count: Design for Disaster Preparedness
In a collaboration with the College of Emergency Medicine, Dr. Valipoor and Dr. Bosch are investigating the ways in which the physical environment contributes to more efficient operation of emergency departments during mass casualty incidents. The results are expected to contribute to developing a design guideline for hospital emergency departments and free-standing emergency facilities to improve the flow of patients and reduce overcrowding. The pilot study is reported in the Environmental Design Research Association (EDRA) annual conference in summer 2017.
Valipoor, S., Hakimjavadi, H., & Bosch, S. (Jun 2017). Emergency Departments at the Time of Disasters: What is the Impact of Physical Design? Paper presented at EDRA 48 International Conference, Madison, WI.
Photo retrieved from Google Images http://www.kyabae.com/wp-content/uploads/2017/04/Emergency-2.jpg
