- I am from New Jersey and I'm not so great at pumping my own gas.
- I live on campus in the GLC.
- I am currently working for Children's Healthcare of Atlanta on a Revenue Cycle project.
- I worked for a year as a business analyst for JPMorgan Chase in Manhattan.
IRB Training Certificate
Apparently I'm not very good at oragami!
Julia Jones's Interesting points:
- A certificate of need is required for a regulatory review process of the state to build a hospital.
- Evidence based design to impact experience
- Center for healthcare design - designing for efficiency - patient focused - philanthropic - "universal room" - Flexible for future expansion - Centers of Excellence
- Most doctors not employed by the hospitals, and have poor handwriting!
- self propelled beds
- COW - Computer on Wheels
- Abulatory = outpatient treatment
- General Inpatient = diagnostic
For more clarification: What are we doing for Hughes Spaulding? What have they not planned yet?
Craig Zimring - Environments of Healing
Evidence based medicine -> evidence based practive -> EVIDENCE BASED DESIGN physical design variables that support decision making www.healthdesign.org/research/reports Principles:
- Improve quality and saftey
- Patient and Family centered
Hospitals are too noisy!
3 zones in a room: 1. family zone 2. patient zone 3. care giver zone
hospital contruction costs ~ $300 per sq. ft
- incorporate nature, art, music
- moving control from the institution to the individual
- decentralized nurses stations
- sound absorbing ceiling tiles
- acuity adaptable rooms
- flexible spaces
- oversized, windowed single rooms
- computerized order entry
- HAND WASHING
= fewer falls, fewer patient transferes, less infections, reduced nurse turnover, reduced drug costs
8/28/07 Hughes Spaulding Visit
- Low ceilings feel oppresive
- Entrance area is small and not welcoming
- Poor way finding. Nothing in addition to the signs
- ED is extremely cramped and a sheet is used to divide one large room- no privacy! It is also L shaped which makes visibility and communication difficult from one side to the other.
- Patient bracelets activate alarms and lock doors - Infant Protection System is a great idea.
- More lighting, preferably natural, to make smaller areas appear larger
- New paint and updated artwork including elements of nature to appeal to the children
- Color coding pathways to make it easier for way finding
- Motorized golf cart to transport patients through the tunnel
- Stored comfort preferences for repeat patients
- Leslie the HKS Clinical design architect - One of the biggest challenges he is facing is keeping the hospital 100% operational while building the new areas, moving, and destroying the older parts.
- Roscoe Simmons the security manager - There is no morgue in Hughes Spaulding. So the deceased patients are transported through the tunnel to the basement of Grady while other patients and staff are going through the tunnel as well. This demonstrates the importance of front of house vs back of house areas, processes in keeping the patients more comfortable and lower stress.
- A woman who works as an orderly at Hughes Spaulding - She said that even though the hospital is in really bad shape and the transition will make her job challenging, she loves working there because Children's treats their employees great. A true testament to employee satisfaction and loyalty. This is necessary in periods of major change.
Gerri gave the patient's point of view of healthcare. This discussion will be valuable when writing my paper for HS 6000 on patient-centered care. I really liked the demonstration she did with the students. It made me think about how I'd do it differently, and how I'd want a doctor to treat me. After the class I had a discussion with a friend of mine in PA school about the lack of classes teaching how to talk to the patients. The PA students think that this type of education is takes away from their serious studies. I feel that patient centered care needs to begin in the education of everyone working in a healthcare setting. Shared decision making is not a part of med or pa school, why is this? How can we change it?
Perkins + Will
- It is interesting to me that often the hospital won't allow the patients and community to take part in the design of the hospitals.
- Adopt-A-Room is a remarkable undertaking and would be great in any children's hospital
- "Sometimes perfect is the enemy of good"
- Workaround = a way around a current process that doesn't work well
- Common ED process problems
- Surgeon capacity - space - lack of flexibility - Problems downstream - nurse to patient ratio - slow to expand room for clients
- Important to redefine operations in the beginning of the design process
- Universal layout of floors
- Single handed vs mirrored rooms
- neumatic tube system for labs, records, meds etc?
- pod vs modules
- Acuity flexible ED rooms
Professor Ellen Do - Computational Environments
- Digital Fingerprinting
- Flex M
- Navigational Blocks
- Espresso Blocks - window, door, bench
- Energy Cube
- Body responsive furniture
- Smart kitchen counter
- Music under pressure couch
- Window seat
- Smell wall
- Analog hypertext
- Jungle room
- Alphabet paint space
- plant tiles
DJ Feather, CHOA - Clinical Involvement in Hospital Design
DJ had very interesting insight into involving front line staff such as nurses and physicians when designing a hospital. Nurses know design issue and work arounds. Care Teams created include:
- Clinical Care
- Family Support
- Bus. Ops
- Staff Management
Innovation needs to take place when setting the budget, not when designing. Look at other hospitals Identify unique design elements and describe the goal - then prioritize them. Full sized mockups for testing by bedside. Documet all decisions.
Principles of design
- Growth/future expansion
- Improve/ creat adjacencies
- Improve efficiencies
Programming - listing the space out Block Programming - block out budgeted money for the space
Strive for 70% bed capacity.
Systems - procedures, flows, processes - systems of systems
- measurements, collect data, statistical analysis - structure, process, outcome
- make sense? will it work? - project management
Use organizational process for our project: role assignment, time estimate, recognize talents and draw them out TEAMWORK!
Brainstorming - nominal group technique Structured decisions - weighted decisions Honor the decision made
Many groups presented their ideas including ours. Dr. Lamb suggested we look at TeleMedicine to compare some of the technologies making their way out there already.
Suggestions for all:
- Be cost and value concious!
- Smaller targeted problem
- Be more innovative
- Stay away from entertainment
- Use existing technologies in a new way, ex. Bluetooth
- Push it to another level
Today the rest of the groups presented their ideas. There are many recurring themes, so we need broader problem statements that the solutions can fall under. We spent the end of the class coming up with specific problem statements that we are looking to solve.
Our group came up with 3:
- Waiting room is not condusive to different users and uses
- Unnecessary visits to the hospital for chronic care
- Patients/Families feel a loss of control which causes stress and anxiety
This will put us on the right path of creating a specific solution. We will need to keep researching the problems in order to come up with some great solutions.
Our group will be visiting Scottish Rite on October 5th.