Advancing evidence-based design
Many of Ann &
Robert H. Lurie Children's Hospital of Chicago’s key design decisions
reflect evidence-based design features intended to improve care for children.
Our team reviewed the growing body of evidence that shows that hospital design
impacts patient stress, patient and staff safety, staff effectiveness and care
quality in order to determine which
features to incorporate into the design of Lurie Children’s. Some examples
include:
- All
private inpatient rooms to reduce infection
- Acuity
adaptable rooms in the Regenstein Cardiac Care Unit to eliminate transfers
to another unit when a patient’s condition changes
- Decentralized
nursing stations to increase staff time spent in direct patient care
- Access
to sunlight and views of nature to reduce stress
We are also conducting our own studies to add to the latest
findings. We’re working with the Center
for Health Design’s Pebble Project, an international collaboration of
hospitals that have built new facilities and share their pre-to-post occupancy
research in order to advance evidence-based design. In addition to Children’s Memorial,
only three other pediatric hospitals are participating in the project.
Facility design impact on trauma of hospitalization in children
The stress of hospitalization can lead to symptoms of
psychological trauma, such as sleep disruption and separation anxiety, for
months after the child goes home. Jenifer Cartland, PhD, Director of the Child
Health Data Lab (CHDL) at Children’s Memorial
Research Center,
is conducting a pilot study to determine if elements of hospital design can add
to a supportive child-centered toolkit children’s hospitals can use to make the
experience less traumatic for children.
Examples of design elements that will be included at Lurie
Children’s that are hypothesized to reduce child and parent stress include:
- Private rooms with control over light and
artwork
- Respite spaces such as the Crown Sky Garden
- Child-friendly creative features on each floor
offered through partnerships with the city’s cultural institutions
Dr. Cartland received funding for this pilot study from the
Center for Health Design. In future studies, she hopes to evaluate in greater
depth the stress-reducing impact of designs for the Emergency Department and
the Psychiatric Unit at Lurie Children’s.
Centralized vs. decentralized nursing stations: the effect on nursing staff
A study comparing caregiver communication, teamwork, stress
and quality of care on units with a centralized nursing station at the current
hospital versus a decentralized design at Lurie Children’s is being led by
Associate Chief Nurse Executive Sherri Ewing, MSN, RN, NEA-BC, and Karen
Richey, MBA, RN, Administrator of Acute Care Services.
Centralized unit designs typically include a large nursing
station that concentrates all patient charts, computers, medications and staff
that need access to this information together in one location. A decentralized
unit design brings nursing staff and supplies closer to patients. At Lurie Children’s,
the units will have one nursing workstation with a chair and computer for every
two patient rooms and four care team stations distributed at different ends of
the unit.
Previous hospital design research has primarily focused on
benefits to patients, with few studies looking into unit design improvements
from the caregiver perspective. Funding by the Shaw Faculty Collaborative
Research Grant will provide support for Phase I data collection of nurse
perceptions of the care environment within the current hospital’s unit design,
as well as data on quality outcomes. Phase II of the study will evaluate the
same measures at Lurie Children’s six months after the move, and then again one
year later.
The results of this study will provide valuable evidence on
how patient care unit design impacts nursing staff performance and quality of
care.
More studies to
evaluate outcomes related to the design of Lurie Children’s are in development.