There's been a growing adoption of electronic medical records in the past several years and today more than 44 percent of hospitals use electronic over paper medical records, says Jessica Ellison, principal consultant, NorCal operations manager, Environmental and Occupations Risk Management (EORM,San Jose, Calif.),
 
In the rush to accommodate this new way of gathering and recording medical data and patient information, designers and owners may also be creating unnecessary risks with quick-fix retrofits in patient rooms and nursing stations.
 
During the session "I Chart Ergo I Am--Ergonomic Design in an Era of Electronic Medical Records," on the opening day of the Healthcare Design Conference in Orlando, the speaker illustrated how some facilities have made the transition with a slide show of "worst-in-class" examples: nurses and doctors sitting at desks either too tall or too short, mouse pads piled atop books, and monitors positioned so that employees must crane their necks to work or maintain eye contact with patients.
 
"How can we design so people can work in proper postures?" Ellison asks. 
 
To start, she says designers and owners should think about how a space is going to be used and then the type of equipment that will be in the hands of the staff, whether it's computers, mobile devices, or laptops.
 
For computer-based work stations, for example, the spaces should be flexible and able to adapt to new technologies as well as expanding staff sizes. "Think about where you want people to sit," she says.
 
Issues regarding work surface heights, monitor location, and chair heights must  also be factored in to ergonomically smart design discussion. Ellison says there's a lack of guideline standards to assist designers but pointed to the Australasian Health Facility Guidelines, which suggest a maximum thickness of 2 inches for work surfaces, while work benches for computers should have a depth of 24-30 inches and a height of 28-38 inches. 
 
The speaker also offered a few additional suggestions for design considerations, including:
  • Using height-adjustable work surfaces for sitting and standing ("Pick things that are quick and easy to adjust," she says)
  • Utilizing keyboard trays, adjustable legs (for retrofits), and carts
  • Considering placement of computer in relationship to patients so you can eliminate awkward postures for the staff
  • Keeping work surfaces or small carts available in patient rooms, even where mobile devices are in use since employees will still need places to put their devices down to make notes or observe patients
  • Utilizing devices that can be docked so the staff isn't always having to hold the units while working