Transcript The effect of family friendly environment on family

Team Lego: Project Proposals
Design of Pediatric Health Center of the Future
Team Lego:
Lavanavarjit
Youngseon Choi
Randeep
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Principle and Problem one
Principle Provide physical environment to foster social interaction and support for
patients and families
Problem Definition The current design of family area doesn’t encourage interactions
between other family members and leave out the important source of social
support for families
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Problem one – no interactions occurs between other family members
The family area in Pediatric
Intensive Care Unit at MCG
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The family area in 4th floor
at MCG
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The Patient room at MCG Children’s hospital
Chair
Private bathroom
Full body length sofa
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Private refrigerator
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Evidence one: Families comforting one another
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Presence of other family members soothes family members’ emotional suffering
by comforting one another in trauma resuscitation room (Morse and Pooler
2002).
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Family members who are familiar with surroundings gave the patient and other
family members
 reassurance of the care (“I’ve worked with these guys; they are good”)
 encouragement (“Don’t worry; she is heading in the right direction”),
 information (“The analgesic will be working soon”)
(Morse and Pooler 2002)
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Evidence two: family needs in ICU
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The considerable amount of studies identified
5 needs of families in the ICU settings:
information
assurance
support
proximity
comfort needs
(Molter, 1987; Bouman, 1984; Daley, 1984; Leske, 1986; Norris & Grove, 1986;
Price, Forrester, Murphy, & Monaghan, 1991)
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Evidence three: spatial needs for families
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The survey result collected from 155 nursing staff indicated needs of peaceful
place for discussion for interaction between family members and nurses (AstedtKurki et al, 2001)
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27% out of 48 family members commented on the need for improved physical
space to have family discussion and conference with physicians (Abbott, 2001)
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Two of parameters considered to be important for ICU settings were; 1) waiting
room availability’; 2) room availability for family information available (Azoulay,
2002)
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Evidence three: proximity
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A private family area with a patient room meets this proximity need but it is also
limiting the source of other needs such as informational, assurance, and support.
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Personal experience: “We did not want to be far from her, but to give her any
kind of privacy or quiet. There was no place nearby to go. So we sat in the
hallway outside her room.”
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Project idea one: Customized Pocket Family area
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To meet five needs of family members
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information
assurance
support
proximity
comfort needs
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To foster interaction between families of other patients
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Territoriality
Security
Personalization
Frequency of encounter
Interaction
Social support – informational and emotional
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Proximity
The children’s medical center of Dayton
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Proximity – always near their child
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Proximity + Territoriality, Security, Personalization
 Pocket family areas which are assigned to specific
patient rooms near by
 Territoriality – recognized as their spaces
 Security - easy to identify person who uses
the area & card access
 Personalization – possible to bring their child
own toys or belongings and to use as needed
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Proximity + Territoriality, Security, Personalization + social interaction
 Frequency of family encounter - easy to encounter
same family members and be familiar with each other
 Interaction between families
 Emotional and informational support from each
other
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Steps
1. Customize pocket family area
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acuity level of patients in units
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type of diseases in units
2. Introduce technologies to meet family needs
3. Come up with a proper size of pocket family area
4. Come up with the layout of customized pocket family area
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Principle and Problem two
Principle Provide caring, devoted, fast (reduced waiting time) service in the
emergency department
Problem Definition Design an Emergency Department that has
 Reduced waiting-time and congestion in ED
 Efficient patient hand-over from ambulance to ED
 Use technology and mobile telephony to reduce the time for diagnosis and
improve the turn around time.
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Why focus on this problem?
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50,000 + annual patient visits
Most of them are for non-urgent care
Uninsured families turn to the Emergency Department for primary care
Overwhelming rush during peak times
Congestion leading to overflowing check-in area and cramped hallway
Where is patient privacy in such chaotic environment?
“The current facility layout also impedes operational efficiency. In a pediatric
healthcare setting, every second counts. Yet minutes and hours are wasted
transporting children to areas that should be located side by side”
Source:http://www.choa.org/Menus/Documents/Aboutus/hsoc/about_hughesspaldin
g.pdf
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Focus Idea 1
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Reduce waiting time and create a healthy healing environment
Evidence based design for ED [R6]
Clinical practice guidelines for specialty care like asthma [R1]
Improving service at Triage (Bottleneck in ED is Triage!)
 Team consulting in Triage [R3]
 Hypothesis: A doctor and nurse team investigating patients can reduce
the number of patient redirections in the ED  Reduced waiting time
and congestion
 Mini Registration in Triage [R2]
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Focus Idea 2
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Improve the patient handover at different stages through:
Strategic location of ambulance bay based on traffic
Design of Ambulance bay to avoid congestion and bottle necks due to the
incoming patient flow.
Allocation of bed and preliminary setup of ED before arrival of patient based on
the initial diagnosis done on the patient during transit.
Efficient transfer of patients to Grady for advanced examination
 Use walkways like in airports
 Use some overhead vision glasses
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Focus Idea 3
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Improved technology enabled patient handover from ambulance to ED [R4, R5,
R7]
 Transmission of Electronic ambulance record including vital sign information
and ECG
 94s vs 7min (accomplished by using computers and mobile wireless
network available)
 We could try to transmit necessary info using cell phones
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References [1]
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R1: Studdert J., Ramsden C., 2004. Introduction of standardized emergency
department pediatric asthma clinical guidelines into a general metropolitan
hospital. Accident and Emergency Nursing
R2: Gorelick M., Yen K., Yun H., 2004. The Effect of In-Room Registration on
Emergency Department Length of Stay. Annals of Emergency Medicine
R3: F Subash, F Dunn, B McNicholl, J Marlow, 2004. Team triage improves
emergency department efficiency. Emergency Medicine Journal
R4: V. Anantharaman, L. Han, 2001. Hospital and emergency ambulance link:
using IT to enhance emergency pre-hospital care. International Journal of
Medical Informatics
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References [2]
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R5: A Jenkin, N. A. Mitchell, S Cooper, 2007. Patient handover: Time for a
change? Accident and Emergency Nursing
R6: W. B. Millard, 2007. The cost of KOI: Evidence-Based design in emergency
medical facilities. Annals of Emergency Medicine
R7: Sotiris Pavlopoulos, Efthyvoulos Kyriacou, Alexis Berler, Spyros
Dembeyiotis, and Dimitris Koutsouris : A Novel Emergency Telemedicine System
based on Wireless Communication Technology—AMBULANCE
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Interesting Resources
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http://www.statcom.com/flash/loader.html (Patient flow simulator; dashboard
s/w)
www.archnewsnow.com/features/Feature37.htm (River Region Medical Center
in Vicksburg, Mississippi)
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