Hospitals produce stress in a variety of ways: excessive noise from
paging systems, alarms, machines, and voices upset patients and distract
staff. Poorly designed hospitals where people can get lost easily,
or that force bedridden patients to stare directly at glaring ceiling
lights, can cause anxiety and a sense of
helplessness. Double-occupancy rooms that impinge on patients'
right to privacy and rest can impede their recovery. In addition,
hospitals offer few places where patients can talk quietly with their
families or with staff.
According to The Center for Health Design (CHD), to create a model
health care environment for the 21st century, hospitals need to be
improved on several levels: their physical design and construction; the
ways in which the staff does their work; and their institutional
culture. This new approach is known as evidence-based design.
Enhancing patient safety through a reduction in infections,
risks, injuries from falls, and medical errors;
Eliminating environmental stressors, such as noise, that
negatively affect outcomes and staff performance;
Reducing stress and promoting healing by making facilities more
pleasant, comfortable, and supportive for patients, staff and
To put this evidence into action, the CHD recommends that hospitals:
Eliminate double-occupancy rooms and provide patients with
single rooms that can be adjusted to their changing medical
Improve indoor air quality to prevent infection;
Use sound-absorbing materials to reduce noise;
Provide access to natural light to prevent depression,
agitation, sleep disorders and medication errors;
Offer pleasant environments to relieve stress and promote
satisfaction among patients, staff and their families;
Be easy to navigate;
And make it possible for staff to better perform their jobs.
A new analysis of more than 400 research studies conducted by the CHD
shows a direct link between hospital design, patient health and quality
of care. For example:
Patient falls declined by 75 percent in the Cardiac Critical
Care Unit at Methodist Hospital in Indianapolis, IN, which made
better use of nursing staff by spreading out their stations and
placing them near patients' rooms;
The rate of hospital-acquired infections decreased 11 percent in
new patient pavilions at Bronson Methodist Hospital in
Kalamazoo, MI, that feature private rooms and specially located
Medical errors fell 30 percent on two new inpatient units at The
Barbara Ann Karmanos Cancer Institute in Detroit, MI, that
allocated more space for their medication rooms, reorganized
medical supplies, and installed acoustical panels to decrease
This evidence overwhelmingly shows that the health care
environment—where care is actually provided and received—has substantial
effects on patient health and safety, care efficiency, staff
effectiveness and morale and patient satisfaction.
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