Optimizing Walking Distances and Visibility in a Med-Surg Unit
Upali Nanda (PI), Sipra Pati, Ryan Gathmann, Adeleh Nejati, Steve Jacobsen, Camilla Moretti, and Tyler Schwede
Deana Sievert, Chief Nursing Officer, ProMedica Toledo Hospital, Toledo, Ohio
Alison Avendt, President ProMedica Transportation Network, ProMedica Toledo Hospital, Toledo, Ohio
ProMedica Healthcare System
WHAT WAS THE AIM
To study the workplace in a medical-surgical (med-surg) unit and to identify suboptimal environmental conditions that can be improved in the current unit and avoided in future design, through rapidly deployed field research and timely simulation.
Why is it important
Literature emphasizes the importance of the healthcare workplace and the effect on patient outcomes. What is lacking are studies conducted on-site and used for immediate application in design to assess and improve workplace conditions.
WHAT DID WE DO | HOW DID WE DO IT
A rapidly deployed field research and simulation study was conducted in a 40-bed med-surg unit of a large healthcare system as part of the process of designing a new medical tower. Online surveys, systematic behavioral observations, semi-structured interviews, sound studies, and advanced spatial analysis through parametric modeling were conducted.
WHAT DID WE FIND
The following created challenges for patient monitoring, care coordination, and management: (1) waste and variability in walking, (2) limited point-of-use access to supplies, (3) large distances traveled for minor tasks, and (4) low visibility and connectivity. The corridor is used as a workspace/communication hub. There is a distinct difference in beginning of day and night shift patterns and between walking "distance" and walking "sequence." There is a tendency for nurses to multitask, but a simulation exercise shows that for key tasks like medication delivery, multitasking may not always reduce walking distances.
What is next
Walking, visibility, and connectivity are issues that have been investigated extensively in med-surg units. However, each health system, each delivery system, and each organizational culture is unique and there is a need to do on-site field research, and a deeper analysis of the spatial context, to address solutions.