Lessons In Inpatient Unit Design
Nurses at Cooper University Hospital felt the two centralized nursing stations on the med/surg inpatient floors at Roberts Pavilion kept them away from patients, so during the fit-out of two shell floors, designed by EwingCole, the hospital added decentralized stations near patient rooms to increase patient visibility.
Only a few years had passed between the opening of Cooper University Hospital’s Roberts Pavilion in Camden, N.J., and the need to fit out two shell floors to add med/surg inpatient beds. Still, the project team didn’t want to simply duplicate the same design without first looking for new ideas and areas for improvement.
For example, in-room computer stations weren’t popular at the time of the original design but had become an industry standard since the pavilion opened in 2008. During interviews with the staff, designers at EwingCole, which oversaw both projects, learned the centralized nurses’ stations on the inpatient floors were another point of dissatisfaction.
“They felt it kept them away from patients,” says Mary Frazier, a principal at EwingCole. Additionally, the two workstations were located on the edges of the unit near the entrance and rear. “Sometimes, the staff would break them down into one side where the nurses sat and the other would be where the clinicians sat,” she says.
The project team decided the best way to move forward and help increase staff visibility and facilitate team-based care was to employ a combination of centralized and decentralized units on the new floors, which opened in 2014. The decentralized stations are located outside each pair of rooms and feature a small window with integral blinds to provide views inside.
In-room computer stations were also added in the patient rooms, giving the staff options to chart in the room, at a decentralized desk, or at the centralized workstation. “The variety of spaces accommodates multiple work styles and preferences,” Frazier says.
A larger, more centralized collaboration station is designed as a hub for all staff, including pharmacy staff, social workers, residents, and physicians.
“The area includes seating for multiple disciplines to confer, promoting coordination of care, which is positive for good patient outcomes,” says Gina Marone, who was involved in the project before becoming vice president of operations at MD Anderson Cancer Center at Cooper.
A year after the eighth and ninth floors opened, 93 percent of the staff said they were very satisfied with the unit’s ability to support their efforts to spend time with the patient. Ninety percent reported that the new unit has improved productivity, and six out of 10 said the decentralized stations have changed or improved the way they care for patients.
Fueled by this success, Marone says that Cooper used the design approach at its new cancer unit, which opened in July.