3 rd Annual Patient & Family Centered Care Conference

1. Redefining Relationships in Health Care 3rd Annual Patient & Family Centered Care Conference Concurrents II – Room Redesign: Patient and Family Involvement in Design Projects Christopher Schlaps, RA, NCARB, LEED AP Senior Architect Facilities Planning & Development

2. Discussion Objective Discuss strategies for patient and family involvement in hospital design and construction projects, and how patient and family resources have been utilized in the University Hospital Inpatient Room Facelift Project.

3. The Process of a Design and Construction Project Design & Construction Move Day Project Inception Operations & Activation

4. Project Inception Projects begin as an idea. They can be as simple as renovating an exam room to as complex as building a complete replacement hospital. Regardless of the size, a design & construction project… • Solves problems • Needs a champion and decision makers • Has guiding principals • Requires financial support

5. 1. Identification of Problems University Hospital opened in 1986. The patient tower includes 475 adult general care (non-ICU) beds, with a mix of private and semi-private rooms. After 25 years, the rooms are showing their age and are due for a facelift.

6. 2. Decision Makers One of the most difficult questions to answer is Who needs to be at the table? Nursing Faculty Architects Engineers Interior Designers Equipment Planners Administrators IT Network Engineering IT Desktop Support Maintenance Infection Control Safety Management Security Services Biomed Patients and Families

7. 3. Guiding Principals Improve the aesthetics, comfort, and healing environment for the patient Develop a standard footwall that will meet the interests and needs of patients, families, clinical staff and support staff as well as support staff workflow Standardize project related items in patient rooms where clinically appropriate Ensure that regulatory and safety standards and requirements are met

8. 4. Financial Support –and Moving Forward Project Kickoff: January 2010 Information Gathering & Predesign: Early 2010 Budget Scenario Development: Late 2010 Project Approval: March 2011 Design Development: Spring 2011 Room Mock-ups: Fall 2011 Construction: 2011 – 2013

9. Further Defining the Problem Press Ganey survey data used as a discussion starter to identify project scope Common Complaints: • Rooms need updating, dull colors, cluttered, too small • Room too hot or cold, too dry, dirty vents, T-stats had no effect on temp, supply air directed at patient • Too noisy when door open; lack of soundproofing between rooms • Bed operation problems Not-as-Common Complaints: • “Flimsy” curtains • Two clocks or one in the middle • Lack of card display space • Carts with noisy wheels • Toilet height too low

10. Brainstorming and Analyzing Brainstorming sessions with staff, and a survey sent to PFCC e-Advisor group to generate ideas and priorities Top Priorities: • Provide a second clock in semi-private rooms • Modify the wardrobe cabinet to improve storage capacity • Replace doors (staff) • Install a handrail on the footwall • Reduce the bathroom threshold • Improve acoustic privacy • Provide hanging folding chairs • Replace TV with a flat screen • Add a nurse call response button near the door • Provide an in-room cleaning wipes dispenser (patients) • Upgrade lighting and additional lighting controls at the bedside • Organize the patient view of the footwall (staff)

11. Developing Solutions The “wish list” is whittled down… Top Priorities: • Provide a second clock in semi-private rooms • Modify the wardrobe cabinet to improve storage capacity • Replace doors (staff) • Install a handrail on the footwall • Reduce the bathroom threshold • Improve acoustic privacy • Provide hanging folding chairs • Replace TV with a flat screen • Add a nurse call response button near the door • Provide an in-room cleaning wipes dispenser (patients) • Upgrade lighting and additional lighting controls at the bedside • Organize the patient view of the footwall (staff) …and other items including new paint, accent colors, new ceilings, new corner guards, new furniture, new sinks, new lighting and ballasts, and other maintenance items…

12. Refining the Design Electronic Surveys: PDF survey sent by email to the PFAC e-Advisor group • 28 total responses • Windows in the doors are preferred • Whiteboards with more information are preferred • Folding chairs are ok for additional flexible seating

13. Refining the Design Furniture Evaluations: • 3 day public evaluation • Located in a prominent walking path between buildings • Advertised in the global email the week prior • 8 chairs to compare • Over 200 responses from families, patients, clinicians, and support staff

14. Refining the Design Mock-up Rooms: • Staff and patient evaluation period • 2 side by side patient rooms • Opportunity to compare different design approaches between rooms, such as furniture layouts, sinks, televisions, doors, and other items

15. Closing Thoughts • Surprises, and differences of opinion • Patients want doors with windows into the rooms • Patients want sleep chairs for family members • Flat screen TV’s are more important to staff than patients • Challenges and barriers • Obtaining information from patients and families without an established PFAC • Larger committees make consensus more difficult • The “I Know Better” attitude (ie. EGO) • Going forward • Design staff to attend PFAC meeting • Design staff to join appropriate PFAC subgroups