Decentralized nurses stations could improve patient satisfaction

Hospitals seeking to improve patient satisfaction scores must depart from the straight and narrow--as in long hallways fanning out from central nurses stations--and rethink the way they lay out patient floors, according to an article in Healthcare Design Magazine.

Decentralized work areas that locate staff and supplies closer to clusters of patient rooms give nurses better sightlines to rooms and allow them to respond more quickly to call buttons or alarms while reducing the largest source of customer complaints: noise, design experts told the publication.

A series of "perches," each with two nurses supporting a cluster of rooms, is one form of decentralization. Glass-walled collaboration areas off hallways can reduce noise while maintaining sightlines. And smaller storage areas closer to rooms provide easy access to caregivers and eliminate the need to restock in-room storage areas and disrupt patients.

As for the rooms themselves, the move is toward private rooms, Cyndi McCullough, evidence-based design director for HDR in Omaha, Nebraska, said in another Healthcare Design article. Patients prefer private rooms, which also reduce the incidence of hospital-acquired infections.

Rooms must have separate zones for patients, family and staff to make it easier for patients to sleep, protect them from "pathogens and medical error," and to allow families to help care for the patient, said Carolyn BaRoss, principal and healthcare interior design director for Perkins+Will in New York.

Hospitals that made those changes already see results. For example, patients in new rooms featuring outdoor views, a sofabed for guests and an in-room drug dispensary at University Medical Center of Princeton ask for 30 percent less pain medication. The single-occupancy rooms have sinks in the patient's line of sight so they can observe caregivers wash their hands as well as handrails that lead from the bed to the bathroom to reduce patient falls.

In some cases, nurses, doctors, staff and patients participate in the design process, such as at the Texas Children's Pavilion for Women. Designers created life-size mockups of suggested designs and solicited feedback, which continued even after the pavilion opened in March 2012.

For more information:
- here's the article on patient floor layouts
- check out the article on room design
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