The healthcare system, which includes the built environment, clinical guidelines and policies, technology and tools, people and organizational culture are all designed with the intent of preventing harm to patients and staff. However, holes or weaknesses (referred to as latent conditions) that adversely impact patient safety are unnecessarily built into the physical environment during the planning, design and construction of healthcare facilities. These problems are difficult and expensive to address once a facility has been built and occupied. Facility replacement and renovation projects provide an excellent opportunity to proactively identify and eliminate building-related latent conditions that may lead to harm for patients and staff. The proposed project builds upon an excel-based Safety Risk Assessment (SRA) Toolkit developed through an existing AHRQ grant (# 1R13HS021824-01). The primary goal of this project is to develop a versatile, web/app based, proactive and systematic Safety Risk Assessment toolkit that can be easily used by multidisciplinary stakeholders to address safety issues while designing a healthcare facility. A usable tool that uses a systematic approach will help the healthcare design industry focus on safety issues and result in safer environments for patients and staff. Moreover, this project will help in translatin evidence around designing for safety into an actionable tool and will specifically support AHRQ's priority area of 'making health care safer'. The proposed project to develop an online SRA tool will utilize a human factors approach to ensure that the needs of the users and of the industry (including regulatory requirements) are met and that the end result is flexible, reliable and easy to use. The key phases of the proposed project include: 1. Problem analysis will focus on understanding in detail the problem of conducting a proactive and systematic safety risk assessment during a healthcare facility design process including identifying users, user needs and workflows This will be followed by three iterative cycles including the following steps: 2. Design development 3. Implementation 4. Evaluation

Public Health Relevance

Medication errors, patient falls and healthcare associated infections are a serious problem in U.S. hospitals as well as worldwide. Research shows that healthcare physical environment factors including noise, poor lighting, inadequate ventilation and building layout and design contribute to these negative outcomes in healthcare. The purpose of the proposed project is to develop a highly usable web-based Safety Risk Assessment toolkit for healthcare facility design that teams across the United States can use to design safer healthcare facilities.

National Institute of Health (NIH)
Agency for Healthcare Research and Quality (AHRQ)
Research Demonstration and Dissemination Projects (R18)
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Healthcare Information Technology Research (HITR)
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Henriksen, Kerm
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Center for Health Design, Inc.
United States
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