Private Rooms are New Standard in Updated Guidelines
With mounting evidence that shared hospital rooms contribute to medical errors, higher infection rates, privacy violations, and harmful stress for patients, the updated Guidelines for Design and Construction of Health Care Facilities calls for single-patient rooms in medical/surgical and postpartum units to become standard for all newly constructed hospitals. This is the first such recommendation since these guidelines were originally published by the federal government in 1947. Updated every four years by the Facility Guidelines Institute (FGI) and published by The American Institute of Architects (AIA), the guidelines are currently used by more than 40 state governments to regulate hospital licensing and construction.

2006 Guidelines for Design and Construction of Health Care Facilities highlights:

• Private rooms for acute medical/ surgical and postpartum patients in new hospital construction.Ý
  
  
• New sections on intermediate care units, observation units in emergency departments, and skilled nursing units in general hospitals.Ý
  
  
• Strengthened information on the Infection Control Risk Assessment process.Ý
  
  
• New chapters on urgent care facilities, gastrointestinal endoscopy facilities, psychiatric outpatient centers, renal dialysis centers, office surgical facilities, and small primary care hospitals.Ý
  
  
• New language on assisted living facilities, hospice facilities, and adult day health care facilities.Ý
  
  
• New appendix language on green architecture and surge capacity in emergency departments.

"These Guidelines are focused on patient safety. The committee, where possible, used an evidence-based approach to conceive the best possible environment for patients to heal in," said Joseph G. Sprague, FAIA, chairman of the Health Guidelines Revision Committee. "Our thorough review concluded that private rooms lead to considerably less potential for disease transmission, greatly reduce medical errors, help prevent falls, and certainly allow for patients to sleep better. Patients will not only heal better, but they won't end up spending as much time in the hospital."

Scot Latimer, president of the AIA Academy of Architecture for Health, said, "Initial costs for all private rooms in hospitals will pay for themselves very quickly, and nursing units with private rooms are far less costly to operate. Hospitals will actually be able to run at a higher occupancy rate, as well as reduce the costs and safety risks that are associated with patient transfers."

"These recommendations must be adopted by every state in order to achieve measurable improvements in recovery time from illness and injury, and to provide a safer, healthier environment for patients," said Paul Mendelsohn, senior director of AIA State & Local Affairs. "We will work towards achieving uniformity in state health facility codes so that hospitals can offer a far more conducive healing environment and additional economic benefits."

About the Guidelines
The Guidelines are updated on a four-year cycle by the 124-member, multidisciplinary Health Guidelines Revision Committee (HGRC). Individuals knowledgeable about health care practices and health facility design (doctors, nurses, facility managers, architects, and engineers) and those who apply the document in the field (state and federal authorities having jurisdiction, or AHJs) serve on the committee. (AHJs reviewing and approving plans and construction for health facilities are often architects or engineers.) Adopted as regulatory baseline in more than forty states, the 2006 changes in the guidelines will require adoption by regulators and legislators in individual states.

Source: American Institute of Architects

Universal Bed Model Proven Successful in Cardiac Expansions
As hospitals and healthcare organizations look for new ways to outdistance the competition in appearance, efficiency, and convenience, progressive design is fast becoming strategically more important. The Universal Bed (UB) model is designed to manage hospital patients in one setting from procedure through discharge, while flexing staff coverage, equipment, and expertise to match patient acuity. The UB concept offers an innovative way for organizations to differentiate their services from the competition and more effectively compete in the current marketplace.

The use of a 'one-stop' care delivery model was first introduced to healthcare when obstetrical patients were cared for in one room throughout their hospital stay using the labor, delivery, recovery, post-partum (LDRP) model.

Corazon has pioneered its innovative application to cardiac surgery and interventional patients, and has applied this progressive model to a number of cardiovascular expansion projects, resulting in the CUB, or Cardiac Universal Bed. Corazon advocates the CUB model as a means to improve clinical outcomes, reduce operating costs, and enhance patient, family, staff, and physician satisfaction.

Programs across the country have begun to realize the benefits of a one-stop model for cardiovascular patients, and as a result, many hospitals have successfully adapted this model to the CV service line, typically including open-heart surgery and interventional cardiology patients. More recently, this model has extended to other patient populations such as neurology or neurosurgery; thoracic, vascular, and general surgery; medical cardiology; and general medicine.

CUB room designs vary widely, but most are intended to minimize the stark, sterile, high-tech appearance of a typical ICU setting. Some rooms resemble attractive hotel suites with high-quality wood paneling to conceal medical equipment and monitors, along with the use of sconce lighting and even framed artwork — all to decrease patient anxiety and promote recovery in a comfortable, homey setting. Equally important, however, is the ability to address the needs of patient acuity, while accommodating the preference for privacy during stages of recovery. Private bathrooms and windows are also typical elements of CUB room design.

Several factors compel hospitals to consider this new model of care delivery. First, market pressures to reduce costs demand a streamlined approach to the patient care process by eliminating costly transfers and hand-offs. Second, technology and practice have advanced to shorten hospital stays, but require a higher clinical caliber and more intensive specialized care from admission through discharge. Third, patients prefer a more humanistic approach with a greater customer orientation and appreciate the benefits of private rooms and a consistent expert nursing staff. And finally, physicians and staff have commented on the intense level of collaboration that readily occurs between doctors and nurses working in a CUB unit. Physician trust and confidence in the nursing staff are heightened with this new model of cardiac care, since the staff's broad range of skills (critical care and telemetry) allows them to deal with any emergency. Because the nurse cares for the patient for a longer period of time, there is a better understanding of the clinical and psychosocial issues unique to each patient and a greater ability to rapidly respond to unexpected setbacks at any point in the recovery continuum.

Source: Corazon Consulting

"Physicians in Their Own Voices" DVD Available Free of Charge
As part of its ongoing program to foster the use of measurement and quality improvement processes by physicians to improve care, the American Board of Internal Medicine (ABIM) Foundation has developed a DVD that explains the attitudes of physicians who were early adopters of quality improvement (QI) and what impact QI has had on their practices. Copies of the DVD, "Putting Quality Into Practice: Physicians in Their Own Voices," are available free of charge.

The ABIM Foundation, in collaboration with the National Committee for Quality Assurance (NCQA) and the Commonwealth Fund, interviewed 39 physicians in solo and small group practices who have successfully introduced systematic quality improvements in their practices. Physicians describe how they have been able to improve patient care and increase efficiency by implementing quality measures, many of which are relatively simple and easy to put into place.

Putting Quality into Practice (PQIP) is a collaborative project with the Commonwealth Fund and NCQA to improve the clinical performance of physicians. Twenty organizations, including certifying boards, medical societies and accreditation organizations, are members of the PQIP Consortium.

To order a copy of "Putting Quality Into Practice: Physicians in Their Own Voices," complete the order form at http://www.abimfoundation.org/quality/pqip.shtm or call Helen Egner at 215-446-3530. Excerpts of the video can be viewed online through the Foundation's web site.

Source: ABIM

New Online Calculator for Injury Prevention Savings
A new online calculator has been launched for risk managers and safety officials at hospitals and healthcare facilities. The calculator provides an estimate of potential return on investment (ROI) from the implementation of a safe lifting program and to help justify the investment of time, training, and capital equipment. It is available at www.SafeLiftingPortal.com/calculator.

The ROI Calculator is part of the Safe Lifting Environment injury prevention campaign that is sponsored by Liko, Inc. and designed to promote the use of safe lifting and patient handling practices at healthcare and hospital facilities.

Entering basic facility data such as the number of beds at the facility and the number of full time employees produces a customizable report that provides basic savings information. The report can then be used to support the creation of a facility-wide safe patient handling program. The ROI Calculator utilizes industry-average cost and injury rates to provide an accurate representation of potential cost savings. Formal, more detailed ROI estimates, including life-cycle cost savings, are also available by request through the Safe Lifting Portal site.

The Safe Lifting Portal serves as a clearinghouse for injury prevention information with presentation aids, educational resources, and links to related websites. With recent legislation in many states aimed at reducing caregiver injuries, information availability is key for the communication of successful strategies between lift committees, risk managers, safety directors, and occupational health professionals.

Free Safe Lifting Environment starter kits, which include healthcare injury statistics, Safe Lifting Environment decals, and graphic elements are also available at the portal. For more information, visit http://www.SafeLiftingPortal.com or call 888-545-6671.

Source: Liko, Inc.

Please send items for possible inclusion in Trends, to: Susan Carr Editor Patient Safety and Quality Healthcare susancarr@psqh.com Information for this section has been compiled from industry press releases.

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