Decentralized Nursing ModelHybrid Nursing ModelHow does a building layout better support caregiver collaboration?  Not so long ago, there was a trend to decentralize  nursing units to place the caregiver closer to the patient. I can recall even a few years ago it was thought that the nurse station would become a relic of the past.  While not too many did away with the nurse station, they did take aim at providing a decentralized layout where several smaller nurse stations were in place.  While decentralization of the nurse work areas  had many benefits (such as spending more time with the patient for one) there has also been some debate on the impact it has had on care collaboration.  Those lesser experienced were missing out on the invaluable knowledge of casual interaction in the workplace. What to do? The latest thinking now suggests that having both nursing alcoves and a larger centralized hub will result in the best of both worlds.  Given the level of mutlidiscliplinary care that goes on within most nursing units, it has become neccessary to provide a larger shared work environment (ideally adjacent to the nurse station but behind closed doors or glass.) Allowing these private areas for staff also decreases noise the patient may overhearand protects patient privacy.  TAYLOR has most recently partnered with St. Joseph Health System and St. Jude Medical Center to provide such a care environment. This project will be featured as part of the Healthcare Design 09 in Orlando, Florida in November.  Please plan to attend the session titled  “Improving Care Delivery through Care Collaboration and Healing Environments.”  We look forward to seeing you there!

As Washington continues to debate on just how a plan for healthcare reform would work, there are specific areas related to women’s health that are being analyzed.  As part of a recent report published by the Department of Health and Human Services (HHS), their findings indicate that  twenty-one million women and girls went without health insurance in 2007.  HHS goes on to say women are less likely to have health insurance as they may not be employed full-time, work only part-time (making them ineligible for benefits in some cases) or simply be unable to afford the high premiums associated with individual coverage.  In a recent national survey, more than half of women reported delaying or avoiding needed care because of cost. If  reform legislation is passed by the end of this year, healthcare organizations may be dealing with significant increases in their volumes down the road due to the dramatic increase  of women and girls that may then be covered.  If dealing with a remodel or planning effort for your women’s service lines, think of ways to allow for significant volume increases in the near future. Some of this might include designing soft space areas such as storage rooms or offices with future utilities that  allows for conversion to treatment space  later or converting to digital technologies sooner to allow for increased volumes with less equipment.  It is still too early to tell where things are headed with the reform agenda, but these issues are important to consider in order to be better prepared for what may come.

If our healthcare system is going to have to change drastically in the next couple of years, then why shouldn’t the design of healthcare facilities change along with it?

Let’s take our regulatory agencies, for example, a system that is designed to insure the safety of the design of facilities. What if a part of the regulatory code was to include items that helped the patient recover?  Take for instance sinks. Hand washing sinks are required. What if design elements that help children learn and partake in healthy activities while they recover were required as well?  What if patient floors were designed to look onto activity centers where children could go to and partake in different kinds of physical and educational activities vs. nurse stations or hallways?  Nurses are everywhere and the nurse station as we know it is changing everyday as technology changes.  If children had a line of site to an activity center, this would then help stimulate emotion and physical healing which could then extend to the recovery at home.

Sixteen percent of children 6-19 years old are overweight or obese.  This number has tripled since 1980; another 15 are considered at risk of becoming overweight according to the Centers for Disease Control and Prevention. Tripled since 1980, change is necessary here. Childhood obesity has been linked to several chronic conditions such as heart disease, stroke, asthma, and some forms of cancer (don’t forget the cost associated with these, an upwards of 14 billion dollars a year)….to the children who are at risk or are already dealing with this health problem, how can we help?  What if school systems, parents and healthcare facilities partnered?  I see great things happening in children’s healthcare facilities when parents and the hospital collaborate. They become a powerful force to bring about change, and just think how powerful it could be if schools partnered in the effort to raise the bar of preventative medicine for children.

If the reform is already in effect, we should be taking it upon ourselves to do our part as well. Our children are our future, we need to be bold, and make it our duty to bring about positive change in their future.