Poorly designed and operated healthcare built environments contribute to adverse events such as healthcare associated infections, medication errors and patient falls. Facility design and renovation projects provide an excellent opportunity to carefully examine and redesign healthcare processes so that the built environment latent conditions that impact patient safety might be eliminated. However, there is a lack of a strong knowledge base or well defined methodologies in the healthcare design field for incorporating patient safety concerns during the facility design process. Brief introductory language around a 'patient safety risk assessment'(PSRA) has been included in the appendix of the 2010 Guidelines for Design and Construction of Healthcare Facilities (a key information resource and guiding document in healthcare facility design) from the Facilities Guidelines Institute. This project proposes to bring together a multidisciplinary group of experts to help develop this section further so that a well defined process for incorporating patient safety concerns can be included in the 2014 version of the Guidelines.
Specific aims for this project include: """""""" Identify how safety concerns are identified and resolved during the design process in other fields """""""" Identify key methodologies and tools from other fields that can be adapted for use during the design of healthcare facilities """""""" Develop consensus around key issues that need to be considered in order to address patient safety concerns at different stages in the healthcare facility design process """""""" Develop a set of questions/issues for the facility CEO/design team to be addressed at different stages of the healthcare facility design process The project goals will be achieved through a two-day conference program organized at Virtua Health in Marlton, NJ in partnership with the Facilities Guidelines Institute. The conference will include presentations, interactive panel discussions, workgroups and facilitated consensus development involving a multidisciplinary group of experts. Virtua, which is in the process of constructing a new replacement hospital (opens in Spring 2011), has used a process driven approach incorporating LEAN principles at every step in the design process. This hospital project will serve as a case study as well as tour site during this conference. An advisory panel of experts with diverse backgrounds will help develop the conference agenda as well as deliverables. In the long term, this project will change healthcare design practice by facilitating a more deliberate approach to patient safety during the healthcare design process. This will be achieved by translating the findings from this conference into the Guidelines as well as the study guides for the Evidence-Based Design Accreditation and Certification Program (EDAC) of The Center for Health Design.

Public Health Relevance

Medication errors, patient falls and healthcare acquired infections are a serious problem in U.S. hospitals as well as worldwide. Research shows that healthcare physical environment factors such as noise, poor lighting, inadequate ventilation and building layout and design contribute to these negative outcomes in healthcare. The goal of this project is to create safer healthcare environments by developing methods to enable careful consideration of built environment factors during the design and construction of healthcare facilities.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Conference (R13)
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Special Emphasis Panel (ZHS1-HSR-T (03))
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Freeman, William
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Center for Health Design, Inc.
United States
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