Photo Courtesy of HKS Inc.

Photo Courtesy of HKS Inc.

Environmental Correlates of Efficiency and Safety in Emergency Departments

Read the journal paper here


Debajyoti Pati (PI), Tom Harvey, Jennie Evans, Dave Vincent, and Sipra Pati

Doug Bazuin, Researcher, Herman Miller, Zeeland, Michigan
Mary Ann Derr, President, Synurgy Healthcare Soutions, Zionsville, Pennsylvania

Academy of Architecture for Health Foundation (AAHF) Research Grant and Herman Miller Grant

What was the aim

The objective of this study was to explore and identify physical design correlates of safety and efficiency in emergency department (ED) operations.  

Why is it important

Increased quantity, timeliness, and intensity of care have created many challenges for the operation of EDs today. Interventions have been typically operational, although there is an implicit and growing recognition of the role of the physical environment. However, elaborate/ adequate scientific literatures on ED physical design are not available. 

What did we do | how did we do it

This study adopted an exploratory, multi-measure approach to: (1) examine the interactions between ED operations and physical design at 4 sites, and (2) identify domains of physical design decision-making that potentially influence efficiency and safety in ED operations. Multi-disciplinary gaming and semi-structured interviews were conducted with stakeholders from seven departments at each site. Data were collected in 2011. Gaming sessions were videotaped and interviews were audio taped, which were subsequently professionally transcribed. Transcribed data were analyzed using commonly accepted content analysis procedures.  

What did we find

Study data suggest that 16 domains of physical design decisions influence safety, efficiency, or both. These include (1) entrance and patient waiting, (2) traffic management, (3) sub-waiting or internal waiting areas, (4) triage, (5) exam/treatment area configuration, (6) exam/treatment area centralization versus decentralization, (7) exam/treatment room standardization. (8) adequate space, (9) nurse work space, (10) physician work space, (11) adjacencies and access, (12) equipment room, (13) psych room, (14) staff de-stressing room, (15) hallway width, and (16) results waiting area. 

What is next

This study was exploratory and qualitative in design, with the objective to support more detailed and quantitative examinations of physical design correlates and associated operational phenomenon identified in this study. The findings from this study should, as a result, be treated as preliminary, with future studies expected to provide greater and more robust recommendations for design practice.