Hospitals' physical environment can threaten patient safety

Hospitals may overlook patient safety threats linked to facility design and environment. Things like walls, floors and even decorations can all affect patients.

"Facility-related issues can adversely affect patient safety just as much as medical errors," Mark Bruley, vice president of ECRI Institute's Accident and Forensic Investigation Group, told Infection Control Today.

According to Healthcare Design, water walls and decorative fountains have been linked to Legionnaires disease, even with proper maintenance. Although attractive, decorative water fountains are risky for patients, linked to a chain of infection.

In a separate report last week, The Center for Health Design asked participating hospitals, including Cleveland Clinic, Advocate Health Care and Iowa Health System Allen Hospital, about risks associated with their designed environment.

They found that in-patient falls are the largest single category of reported incidents in hospitals, according to a statement. One reason for patient falls is the layout of the bathroom.

Researchers concluded that flooring, placement of rail bars and even the number of people using the bathroom affected patient falls. Patients fell less if they had one bathroom per patient room, compared to shared bathrooms or no bathroom in the room, and if the bathroom had two grab bars instead of one. Fall rates were 10 times higher in bathrooms with linoleum flooring than with vinyl or ceramic tile, study authors noted.

"With reimbursement tied increasingly to these hospital-acquired conditions and patient satisfaction, hospital owners and administrators are paying a lot of attention to the factors that impact these outcomes, including the design of the built environment and the design of patient rooms," said senior research scientist Margaret Calkins at the IDEAS Institute, a behavioral research center.

According to Infection Control Today, organizational leadership can take a greater role in facility-related safety by participating in environment-of-care rounds and encouraging staff to report hazardous conditions.

For more information:
- here's the Infection Control Today article
- see the Healthcare Design article on infections
- read the Center for Health Design statement and report summary on patient falls

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