Using Family-Centered Design to Support Patient Outcomes, Part 1
There is a virtual vise applying significant pressure on hospitals today. On one side is the desire to improve patient outcomes, which supports evidence-based design and can be a key criterion in pay-for-performance compensation. On the other side there is increasing competition as users view everything from physicians to facilities through the eyes of the savvy consumer, requesting better care, more amenities, and the kind of customer service that has traditionally been associated more with hotels than hospitals.
One strategy that alleviates the pressure from both sides is that of incorporating family-friendly features into the patient room. Let’s look at some benefits, as well as some compatible design strategies, in the first installment of this two-part online exclusive series.
Improved patient care
Studies show that when a family member becomes part of the patient care team rather than a bystander to the process, there are several positive outcomes regarding patient recovery. Because patients are not always lucid, family members often are better able to remember and understand physician comments and instructions, as well as to advocate for a patient’s wishes. In addition, those who know the patient best often are able to see signs of stress or distress more quickly than the physicians, nurses, and others attending to that patient.
Because family members spend much of their time with the patient in the room, they are able to assist the nursing staff by helping the patient get in and out of bed, which will help to prevent falls, as well as assist the patient with personal grooming, eating meals, using the telephone, etc.
Having a family member as an integral part of the patient care team also reinforces the plan for care, both during the patient’s stay and after discharge. In fact, this kind of support may allow patients to go home sooner because someone will be with them who understands the level of care needed, and who has participated in that care during the patient’s hospital stay and can continue that care at home. By integrating the family member into the patient’s care, the family member becomes an invaluable caregiver after discharge, which goes a long way to reduce readmissions and improve outcomes.
Strategies to incorporate family members
Additional strategies a hospital can take to incorporate family into a patient’s care include the following:
• A clearly defined, in-room area for family and visitors will ensure they feel welcome and can observe medical staff without hindering their work. Visiting and sleeping space is important, as is storage for items families bring with them. A sleeper sofa or a sleeper chair ensures a measure of comfort for overnight stays. Other amenities that encourage families to feel at home include a reading light, separate TV controls, use of the toilet/shower room within the patient room, in-room refrigerator, microwave, a small table for meals, and perhaps a curtain to close off the family area so as not to disturb the patient or have night staff disturb family members.
• Provide opportunities for patients and family members to personalize the room. Patients may want to bring in their own music and movies, artwork, and home comforts, such as quilts, photo albums, games, etc. It also can be important to incorporate the patient’s faith into the room, especially for those who are devout. This can involve anything from traditional pastoral care to accommodating and supporting native cultural healing artifacts and practices. The in-room TV can be used for changing artwork, hobbies, and video games. Video conferencing with family and friends is beginning to be integrated into the patient room as well to reduce isolation and support positive distraction.
• Some hospitals incorporate various concierge services that are similar to those provided in hotels. For example, displaying information for patients and family about meal schedules and menus, the name and number of the patient’s nurse, and instructions on use of the Internet, TV, and other items allows family members to orient themselves to their surroundings.
• The patient room TV, which used to be an afterthought, is becoming the focal point for patient care, education, and entertainment. The in-room TV now allows the patient to order meals online, access the Internet to check email and Facebook, listen to music, and watch movies. More importantly, physicians can prescribe informational videos for the patient and family members to watch in their room, educating them on the illness, preventive measures, at-home care, signs to look for to indicate improving and/or declining condition of the patient, etc.
Education pinpointed to the patient’s specific illness goes a long way to prevent re-hospitalization. Another emerging technology for the patient-room TV is the ability to video conference with family members, friends, and/or healthcare specialists. This ability allows the patient and family member to stay in touch with remote family and friends, or to simply say goodnight to the children at home before they go to bed.
Check back to www.healthcaredesignmagazine.com for the second part of this online series.
Jeani Natwick, AIA, is a principal with NAC|Architecture. She can be reached at firstname.lastname@example.org .