Designing the Perfect Patient Room

Welcome to Smart Healthcare Safety from a ECRI where we have real conversation about real safety issues in healthcare. I'm your host Paul Anderson. The Hmong architecture firms in the Boston area. It's a contest that didn't have a winner but really was still a resounding success got to start it. If you could introduce yourself Mark Mesa, risk management analyst here Daiquiri Institute. I'm probably best known here for playing patient. Number two in the opioid Deep dive last year. So if I'm recognized that's who I am to make sure we have a link to that video in the show notes today because it actually is a really cool show me some examples of respiratory distress or folks who have opioids in their body stage of little bit for what this contest was what it was intended to do who was participating that kind of thing. So the story of this contest actually begins years before the contest ever happened,

Administrator in Boston actually got sick while in the hospital and then he started seeing all the data about healthcare-associated infections and realizing this was a real problem that people were in addressing. So what he did was kind of convene this at first it was kind of a think tank with infection preventionist and environmental services people and Architects and they would learn and they would do research presentation. But then when all that happened to kind of created this contest and they were like seven of the best architecture firms in Boston came together and it was like, okay you guys are going to compete you can design the perfect patient room and the winner is going to get the patient room in a hospital Partners Healthcare, which should I believe runs a lot of hospitals in Boston Mass General Brigham and Women's Hospital specifically and the room that they were actually going to design was going to go in to Brigham and Women's Hospital. We call the article the contest that no one wants when we say that no one won.

What do we mean by that when we see the content that no one one that was really late for us to try to get people to read the article what really happened was everyone one specifically the hospital one and specifically the patient's one sees different Architects were talking about the top of their field the best architects in the city all came together the hospital quickly realized the best room would be if all seven of these rooms were combined into one room. So rather than saying, okay yours one and then ignoring the great hand hygiene stuff that was in the third-place room. They said you guys going to come together. We're going to reconvene this thing. You're all going to make the perfect room and that way everybody wins. So it must have been quite a thing to have these firms that are competing with each other now collaborating that was what all these Architects and I had them all on the same phone call at once if they came together in a way that they're almost friends now and they all kind of said, I only saw these people in the hospital. I'm leaving the room in the other person's coming and going at these pictures and you see them for once.

Turn the hallway and they're your enemies and you don't know them Architects, you know, it's not really a job. We have a really think about they don't get to collaborate with their peers. So for them to come together, they got to hear the thinking of their competitors in a way that is really groundbreaking is the word that one of the Architects use and it really was groundbreaking cuz we don't really do this in any industry. Let alone talk about with our partnership for Health it patient safety. We talked about EHR vendors agreeing not to compete on safety will compete on other features put on safety We're All in This Together, it sounds like an analogy here, right? We're not going to compete on safety in some sense. Exactly. It's the we're all on the same team. We're all I'm trying to make patients leave their home health ear infection control in their room design. So I wonder if maybe you could recap what some of those buckets are and maybe get some examples of interventions in each one. So this is kind of result of that thing tank thing at the beginning and then all the

Meetings at they had so they convened I believe it was for 6 hour or six for our meetings after the contest began and they were doing presentation. They will learn that homework everyday they're doing research and they came up that like to design the perfect room. It would be divided into these buckets one is that it facilitates room cleaning facilitates equipment cleaning one is that the adaptation to the room would minimize Splash or touch contamination one as I do encourage hand hygiene improve Waste Management every idea. They came up with what kind of fit into one of those boxes like you facilitate room cleaning. That's like a headboard that is smooth and not built into wall doesn't have these intrusive dust Gathering shells. He's ornate, you know, you're not going to build a room with a gargoyle above the bed because that can get dust on top of it facilitates equipment cleaning, you know that hands that can be cleaned without bringing them in and out of the room and getting another chance for contamination after you've already cleaned it.

Doors that you can open hand free or an example of like I was a big thing minimizing two light switches that go on automatically when you come into room call buttons that can be called without pressing hand hygiene monitoring stations and sinks at the room in providing opportunities for people to perform hand hygiene. So all these things fit into these buckets and they divided them up really just for simplicity's sake when they're analyzing everything even the folks who work directly in those meetings where he gives them a good framework this word to say yours how we've got to approach this here are as you say if I'm just this broad concept of reducing touch or reducing surfaces that dust can settle on I like it has a good framework this artist. Here's how we're going to approach a lot of these Solutions is easier than just saying, okay make the room clean it. Like what does that mean? Exactly you say the article that one of the big takeaways for the participants was don't believe the height height for we not believing marketing hype specifically at this is it take away that all of us can take I think not even

Just Environmental Services infection Real Housewives. Trying to clean my carpet right now and even I was in there the most expensive carpet cleaner must be the best one but that's really not the case. They found out and they had what the Architects what is abogada crash course in what it means to be evidence base. And then they were they were getting sucked in by the hype in some cases and like we all do and oh, this is the most expensive solution. This must be the right thing. This must be the correct solution and it's really not when you're cleaning a room bleach is just as effective in many cases as the latest antimicrobial a lot of these are buzzwords. I don't mean anything. Actually I talked to Carol Clark who's one of our patient safety analyst hear about this and and she made an excellent point that so much of the price of cleaning supplies is the marketing budget being brought in. So if a company is saying I hear this cleaner Cossacks, it's really no different than the bleach with no name on it. It's just they spent x amount of dollars marketing that product and now they're passing on that price to

The consumer that I can use that in any aspect of our life, but specifically when you trying to spend your money in the right ways, that's an easy way to make better choices hundreds of station room. I'm at you were talking about surface Cleaning Solutions and in floor cleaning and laundering got to clean out their Linens and everything so all of those and I did pick the most expensive carpet cleaner for my apartment. I want in my room to smell like Hawaii but paying a hospital maybe not the right choice or not the right choice. Are you close the article by emphasizing that the idea that room design matters and that there are lessons for hospitals. Not just for the architect. So what are some things may be that the folks in hospitals can take away that are over and above with the folks in the architecture and it stinks take away when I talk to all these people there was a hospital infection control specialist on the call too. And I think she said what was

The best thing that I heard someone say she like if I had my way I want the hospital room to be a stainless steel room with nothing else and I can go in there. I can host the room now between patient which is were really thinking from an infection perspective. That's what we should have you come in there and you can come in and it's easy you're going in there and you're wearing a hazmat suit and it comes out and says clean as I can possibly be and it's completely sterile, but you're making an inhospitable to germs be also making an inhospitable to patients and you have to remember that we're treating people and then the Architects kind of gave her this course on know the way a room looks you know, we've read studies here about even putting a plant in the room make such a difference in a window that faces the Sun and different types of art have different effect on patient recovery and they're the things that I think when you're just thinking let's get this room cleaned, but get this patient in and out I can get lost it. This is people we're dealing with that really surprised you

Work on this architect to me is like a job that they made up for romantic comedies when they need someone to follow. I never met an architect before so I never really thought about their day-to-day life even more. I never thought about a healthcare architect and the thing that really stood out to me was the healthcare architect said this isn't a job you grow up wanting to be a healthcare architect you fall into it and you stay because you want to make a difference you stay because you love it and you know, they're not designing skyscrapers and they're not designing tassels and they're designing their Limited in what they have to do and they're they're basically making these hotels that have to make you feel better and the fact what they said that I had never thought about what a healthcare architect does and what about you what they specifically said that they're part of the healthcare team and they consider themselves partners with the infection control people on the doctors and I don't think that whatever comes to mind and I wonder if that even crosses the mind of a lot of healthcare organization that the architect is a part of your team and really the first step.

If you're running a hospital and getting people to feel better is making sure that room, you know, it said it's an extra Safeguard if your room is healthier your patients are going to leave healthier. What's something our listeners whether they're running the hospital or they're just running the Environmental Services team or they're designing a new building. What's something they can do today to start to make a difference. The biggest takeaway was keep it simple. That was the answer that they found two really don't need to have a contest and invite every architect in your city to design the perfect room. You don't need to dig up and build a whole house with his guys a lot of their solutions. They came up with our simple and the biggest thing is just limiting touch areas. You know, I'm focusing on hand hygiene. That means having cues for hand hygiene in your room. It means having places for people to wash your hand but also means like take away those places where people are going to touch what germs are going to settle so I think about putting your TV, we have these flat screen TVs now, they can go flush against the wall and they won't have these two shelves and for other patients can't be used as a weapon as easily anything.

A lot of clutter in your apartment maybe a hospital room should not be up room for a hoarder. The least amount of things people can touch and you don't even have to think about it like oh, well, what's the big deal about me having this car in the corner of the room or after you wash your hands and you don't know who toucha before you so if you take away the opportunities for people touch you take away the opportunities to spread germs. I think that's the easiest way to redesign. The room is strip it down make it simple. Obviously don't make a stainless steel room. Like they want it but limit the places where germs can settle try to look and see if the room had actually been built because when I wrote the article they were still working on it and no word yet, but I'm intrigued and I hope that this is It's really I hope it changes or listen to his mind about what a room design mark macek. Thank you for joining us today and see if Mark is a risk management analyst with our patient safety risk and quality team here at a Career Institute. Make sure you see the show notes for today's episode to find a ling.

Article about the room design contest and More Design tips for putting patient safety first in room design layout.