Great article but I so wish Interior Designers would get the science of Ergonomics and Human Factors right. These designs are based on the science of the human factor both physical and cognitive. This is not wellness as this is called in this article. It is astounding how much Interior Designers and Architects do not refer to Ergonomic Design experts in their practices and undertake these designs saying they have this expertise (how does one possess working knowledge of the human body and brain when ID’s do not take physiology, anatomy, human factors design, motor learning, etc etc?)
Buyer beware; if your Interior Designer is not using the expertise of a qualified ergonomic and human factors design firm they are not providing your firm or hospital or hotel or store etc with expertise anymore than hiring Optimal Performance will provide Interior Design expertise.
We recommend 2 things for those of you who are looking at purchase, design, redesign, renovation projects; A. in your RFP’s ensure a certified Ergonomic/Human Factors firm is part of the Interior Designer/Architectural team and B. make sure the firm actually uses the Ergonomic/Human Factors firm or specialist versus just saying they are using their services (this is a very common experience where the Ergonomist does not sign off on the drawings and installation but the ID and architectural firms say this was vetted by the ergonomic experts.
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A Healing Space
By: Jean Lian OH&S Magazine
APRIL/MAY 2013
2013-04-11
As poor floor design, storage closet clutter and crowded corridors contribute to fatigue and cause distractions, the study offers a design tool to increase efficiency in acute care settings by matching spatial design with caregivers’ workflow.
Rethinking Efficiency in Acute Care Nursing Units: Analyzing Nursing Unit Layouts for Improved Spatial Flow looked at floor plans and work patterns of five medical-surgical units at hospitals in the United States. In some hospital wards, main clinical spaces, such as nourishment rooms, are located far away from a nurse’s typical path. Congested patient-care corridors create excessive noise while high foot-traffic increases the potential for interruptions.
Rana Zadeh, assistant professor of design and environmental analysis in the College of Human Ecology at Cornell University, likens a nurse hunting for supplies stocked in various rooms to a pilot scouring the entire cabin looking for the tools and controls needed to steer the flight. “New medical practices and technologies have emerged during the past decade and facility design should adapt to these changing practices so that caregivers can perform better on their critical tasks,” she says.
The Cornell study cites findings from an earlier research paper indicating that almost 24 per cent of nurses’ time was spent walking to various destinations — making it the second most time-consuming activity during patient care. “Hospital layout and built space contribute to operational efficiency and safety,” the study says, noting that many errors are built into routines, systems and settings.
Apart from hurting patient care, errors also cause escalating distress and burnout in caregivers, who are described by the study as “second victims.”
Jeff Pajot, regional consultant with the Public Services Health and Safety Association in Peterborough, Ontario, highlights the importance of recognizing the connection between employee health and safety and patient safety. “The two are not mutually exclusive but rather interconnected in an overall culture of safety.”
A slip, trip and fall hazard affects employees, patients and visitors alike while an infectious agent can cause harm to anyone in the facility. “Health care organizations that use proper design, such as workplace layout to improve worker health and safety, will have spin-off benefits of improving patient or visitor safety and improve health care outcomes,” adds Pajot, who is also a certified ergonomist with experience in hospital layout design.
A FIRST
Vicki McKenna, first vice-president with the Ontario Nurses’ Association and a registered nurse in Toronto, can relate to the challenges posed by less-than-optimal design in health care facilities. “When things are designed poorly and people cannot get to them, that is why they overextend themselves.”
She cites carts stacked with medical supplies negotiating through narrow corridors, linens sitting precariously on bedside tables and nurses reaching for sheets placed high and deep in shelving units. “We have falls in some of our workplaces because of poor design and poor storage planning,” McKenna adds.
That challenge is compounded by the physical constraints commonly found in older hospitals. In some cases, beds that are too big for the doorway have to be disassembled before a patient can be moved to another unit for a medical procedure, and then reassembled to get the bed back into the room. “I know of a hospital where the operating room’s doorway is too small and they could not get patients in and out of those operating rooms on a bigger bed,” McKenna says. “They had to redo all the doorways.”
Michael Keen, senior director of planning and development with St. Michael’s Hospital in Toronto, says the spatial challenge posed by older facilities is a tough one. “Corridors are smaller, spaces are smaller — they were not designed to incorporate this intense amount of equipment [use].”
Keen is also the chair of the Canadian Standard Association’s (CSA) technical committee for health care facilities, which developed the landmark CSA Z8000 Health Care Facilities Standard launched in November of 2011. It is the first comprehensive national standard to address the complex nature of planning, design and construction of hospitals and health care facilities.
Prior to that, each health care facility building project undertaken in Canada relied on the knowledge and resources available to the architects and consultants engaged. While there are technical standards on lighting, electrical and plumbing, “there was no real document to tie everything together,” Keen notes.
While the CSA Z8000 standard, which sets out requirements and addresses concerns specific to health care facilities beyond what is contained in building codes and guidelines, is voluntary until adopted by the code, Keen says it becomes recognized as the industry standard once published — even if it is not mandatory.
David Jensen, media relations co-ordinator with the Ontario Ministry of Health and Long-Term Care in Toronto, says it is the responsibility of hospitals to produce a plan that meets the design principles captured in the OASIS principles, which stand for operational efficiency and effectiveness, accessibility, safety and security, infection prevention and control, and sustainability. “The OASIS principles can also be found in the new CSA’s Z8000 Canadian Health Care Facilities [standard].”