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EDRA_2008_Inboard Outboard Study
- 1. Justice GovernmentVeracruz, MexicoEDRA 39 Impacts of different patient fi tiroom configurations on patient care activities in adult medical-surgical unitsadult medical-surgical units Debajyoti Pati PhD AIIA Director of Research HKS Architects May 31, 2008
- 2. Study Team
- 3. Agenda The configuration rating criteriaThe configuration rating criteria Study methodology D i d iDesigners vs non-designers Configuration assessments
- 4. The symposium Objectives:Objectives: Assess relative importance of 23 criteria Identify key room configuration issues: Inboard, outboard and nested toilet/shower locations, “Same-handed” rooms vs “back-to-back” mirrored room arrangement.
- 5. Participants Integris Health (Clinician + Patient +Integris Health (Clinician + Patient + Patient advocate) MD Anderson (Clinician)MD Anderson (Clinician) U T Arlington School of Nursing (Ed t )(Educator) HKS (Design Professionals)
- 6. Six configurations: Layout A @Layout A: Mirrored Inboard Toilet @ Headwall
- 7. Six configurations: Layout B L B Mi d O b d T il @ F llLayout B: Mirrored Outboard Toilet @ Footwall
- 8. Six configurations: Layout C L C Mi d N d T il @ F llLayout C: Mirrored Nested Toilet @ Footwall
- 9. Six configurations: Layout D L D S H d I b d T il @ H d llLayout D: Same Hand Inboard Toilet @ Headwall
- 10. Six configurations: Layout E L E S H d O b d T il @ H d llLayout E: Same Hand Outboard Toilet @ Headwall
- 11. Six configurations: Layout F L F S H d O b d T il @ F llLayout F: Same Hand Outboard Toilet @ Footwall
- 12. Rating Criteria: Patient safety Visibility of patientVisibility of patient Access to toilet C iCaregiver access Toilet room configuration Auditory pathway StandardizationStandardization
- 13. Rating criteria: staff efficiency Clearance around bedClearance around bed Access to supplies A t d tAccess to data
- 14. Rating criteria: circulation Access to patient headAccess to patient head Access around patient
- 15. Rating criteria: patient consideration Transport in/out of roomTransport in/out of room Visibility to corridor Vi l i f idVisual privacy from corridor View of exterior Daylighting Patient storagePatient storage Privacy
- 16. Rating criteria: infection control Handwash location/separationHandwash location/separation Handwashing and work surface
- 17. Rating criteria: family amenities/space View of TVView of TV Proximity to patient F il d tiFamily accommodation
- 18. Study methodology Criteria ranking round 1Criteria ranking round 1 Layout assessment C it i ki d 2Criteria ranking round 2 Overall assessment
- 19. Criteria ranking Round One Non-designers (Top 10) Designers (Top 10) Clearance around bed Access to patient head A d ti t Visibility of Patient Caregiver access Cl d b d Non designers (Top 10) Designers (Top 10) Access around patient Visibility of Patient Privacy (auditory) A t t il t Clearance around bed Access around patient Hand wash location/separationAccess to toilet Proximity to patient Caregiver access location/separation Access to patient head View of Exterior Access to toiletHand washing and work surface Family accommodation Access to toilet Day lighting Access to supplies
- 20. Criteria ranking: Round One Non-designers (Last 5) Designers (Last 5) View of Exterior Access to data Proximity to patient Toilet Room configuration Non-designers (Last 5) Designers (Last 5) View of TV Standardization Patient Storage View of TV Patient Storage StandardizationPatient Storage Standardization
- 21. Criteria ranking: Round One Major disagreements Privacy (auditory) Proximity to patient Major disagreements Proximity to patient Caregiver access Family accommodation Hand wash location/ separation Vi f t iView of exterior Access to data
- 22. Criteria ranking: Round Two Non-designers (Top 10) Designers (Top 10) Clearance around bed Access to patient head A d ti t Visibility of Patient Clearance around bed C i Non designers (Top 10) Designers (Top 10) Access around patient Access to toilet Caregiver access Vi ibilit f P ti t Caregiver access Access around patient Access to toilet A t ti t h dVisibility of Patient Privacy Hand washing and work surface Access to patient head Hand wash location/separation Transport in/ out of roomsurface Family accommodation Transport in/ out of room Transport in/ out of room Toilet Room configuration Privacy
- 23. Criteria ranking: Round Two Non-designers (Last 5) Designers (Last 5) View of Exterior Access to data Day lighting Visual privacy from corridor Non designers (Last 5) Designers (Last 5) View of TV Patient Storage Standardization Patient Storage View of TV StandardizationStandardization Standardization
- 24. Criteria ranking: Round Two Major disagreements Day lighting Hand wash location/ Major disagreements Hand wash location/ separation Toilet room configuration Access to data
- 25. Round One vs Round Two Round One Round Two Total difference in ranking between non-designers Total difference in ranking between non-designers Round One Round Two g and designers = 32.57% C l ti b t th g and designers = 25.75% C l ti b tCorrelation between the two ratings: Spearman’s Rho = 0.691, significant Correlation between rankings: Spearman’s Rho= 0.843, significant at, g at 0.001 level , g 0.001 level
- 27. Layout A Layout 'A' Mean Rating Visibility of Patient Access to toilet Caregiver access Toilet Room configuration Auditory Pathway Standardization Rating Scale Layout 'A' Mean Rating Clearance around bed Access to supplies Access to data Access to patient head Access around patient Transport in/ out of room Transport to toilet Visibility to corridor Vi l i f id ssessment Criteria Visual privacy from corridor View of Exterior Daylighting Patient Storage Privacy Handwash location/separation Handwashing and work surface View of TV Proximity to patient Family accomodation Room As ‐3.00 ‐2.00 ‐1.00 0.00 1.00 2.00 3.00 Family accomodation L A Mi d I b d T il @ H d llLayout A: Mirrored Inboard Toilet @ Headwall
- 28. Layout B Layout 'B' Mean Rating Visibility of Patient Access to toilet Caregiver access Toilet Room configuration Auditory Pathway Standardization Rating Scale Layout B Mean Rating Clearance around bed Access to supplies Access to data Access to patient head Access around patient Transport in/ out of room Transport to toilet Visibility to corridor Visual privacy from corridor Vi f E t i Assessment Criteria View of Exterior Daylighting Patient Storage Privacy Handwash location/separation Handwashing and work surface View of TV Proximity to patient Family accomodation Room A ‐3.00 ‐2.00 ‐1.00 0.00 1.00 2.00 3.00 L B Mi d O b d T il @ F llLayout B: Mirrored Outboard Toilet @ Footwall
- 29. Layout C Layout'C' Mean Rating Visibility of Patient Access to toilet Caregiver access Toilet Room configuration Auditory Pathway Standardization Rating Scale Layout C Mean Rating Clearance around bed Access to supplies Access to data Access to patient head Access around patient Transport in/ out of room Transport to toilet Visibility to corridor Visual privacy from corridor Assessment Criteria View of Exterior Daylighting Patient Storage Privacy Handwash location/separation Handwashing and work surface View of TV Proximity to patient Family accomodation Room A ‐3.00 ‐2.00 ‐1.00 0.00 1.00 2.00 3.00 L C Mi d N d T il @ F llLayout C: Mirrored Nested Toilet @ Footwall
- 30. Layout D Layout'D' Mean Rating Visibility of Patient Access to toilet Caregiver access Toilet Room configuration Auditory Pathway Standardization Rating Scale Layout D Mean Rating Clearance around bed Access to supplies Access to data Access to patient head Access around patient Transport in/ out of room Transport to toilet Visibility to corridor Visual privacy from corridor f Assessment Criteria View of Exterior Daylighting Patient Storage Privacy Handwash location/separation Handwashing and work surface View of TV Proximity to patient Family accomodation Room A ‐3.00 ‐2.00 ‐1.00 0.00 1.00 2.00 3.00 L D S H d I b d T il @ H d llLayout D: Same Hand Inboard Toilet @ Headwall
- 31. Layout E Layout 'E' Mean Rating Visibility of Patient Access to toilet Caregiver access Toilet Room configuration Auditory Pathway Standardization Clearance aroundbed Rating Scale a Clearance around bed Access to supplies Access to data Access to patient head Access around patient Transport in/ out of room Transport to toilet Visibility to corridor Visual privacy from corridor View of Exterior m Assessment Criteria Daylighting Patient Storage Privacy Handwash location/separation Handwashing and work surface View of TV Proximity to patient Family accomodation Room ‐3.00 ‐2.00 ‐1.00 0.00 1.00 2.00 3.00 L E S H d O b d T il @ H d llLayout E: Same Hand Outboard Toilet @ Headwall
- 32. Layout F Layout'F' Mean Rating Visibility of Patient Access to toilet Caregiver access Toilet Room configuration Auditory Pathway Standardization Rating Scale Layout F Mean Rating Clearance around bed Access to supplies Access to data Access to patient head Access around patient Transport in/ out of room Transport to toilet Visibility to corridor Visual privacy from corridor Assessment Criteria View of Exterior Daylighting Patient Storage Privacy Handwash location/separation Handwashing and work surface View of TV Proximity to patient Family accomodation Room A ‐3.00 ‐2.00 ‐1.00 0.00 1.00 2.00 3.00 L F S H d O b d T il @ F llLayout F: Same Hand Outboard Toilet @ Footwall
- 33. Key findings Clinicians vs Design professionalsClinicians vs Design professionals Layout assessment through a multi- dimensional performance approachdimensional performance approach The process structuring decision-making
- 34. So which layout is optimum? Suitability scores Broad conclusions Order of suitability: B, F, E, C, A, D y B, F, E, C, A, D Both negative rated layouts have inboard t il t A Weighted B Weighted C Weighted D Weighted E Weighted F Weighted 0 86 18 90 5 05 2 78 10 93 16 04 toilets-0.86 18.90 5.05 -2.78 10.93 16.04
- 35. Concluding remarks Questions on reliability and validity ofQuestions on reliability and validity of findings How and where could the findings beHow and where could the findings be used The power of performance thinking in programming and designThe power of performance thinking in programming and design Traditional decision-making process and the suggested framework Potential phases for application
- 36. Q U E S T I O N S