Evan Zasoski

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7/28 - Created my blog page before class. I'll have more to say tonight.

7/28 - In class we discussed evidence based medicine/design, which is essentially the process of using empirical data gathered gathered from surveys, studies, etc. as the primary guiding factor in your design process. One thing I did find really interesting was the degree to which a hospital designed in this way will pay for the extra costs within a year and generally help the bottom line. Typically one thinks of the payoff for higher quality design to be more intangible and, from a bottom line perspective, almost a complete loss. The fact that it can make the money back and even help turn a profit long-term was a bit surprising.

7/30 - Today we took a trip to Hugh Spalding. It was an interesting trip that gave many insights into how hospitals, especially children's hospitals work, but it could have been longer. A lot of things, particularly the prepared presentation, felt rushed. It may be wise to, in the future, push the visit back further so that it can be better coordinated and allow students to stay longer. Also, pushing it back allows for participation to be optional so long as at least one representative of each group is present (assuming you wait until the groups are reasonably well crystallized).

7/30 - Hugh Spalding Report: Observations

1. Hand sanitizers next to elevators and scattered around. 2. Big purple comfy chairs for the kids gettings transfusions/dialysis 3. Drab waiting rooms full of people that look a lot like they're running out the clock in purgatory 4. A lot of the 'kiddie stuff' seemed tacked on after the fact. 5. Nurses' station with screens facing towards where patients would be, requiring the use of polarizing screen covers that make it hard to see. 6. Supply closet with thumb scanner 7. LCD screens and DVD player for kids to watch.

Conversations: 1) CHOA doesn't like the hand sanitizers but hasn't seemed to notice them yet. 2) TVs are a bad idea in waiting rooms 3) In the new building, emergency/primary/walk-in care will be co-located to allow for better use of space. 4) The new building is designed with growth in mind. Currently unassigned space has been built into the design to allow for painless growth. 5) HIPAA does not allow for nurse's computer screens to be visible to patients

Suggestions. 1) For increasing donor awareness: Epcot Center has quite a scam going on these days. They have these walls which, from a distance, look like they've been painted with abstract patterns, but when you get closer, you see it's all little tiny squares that are composed of a) pictures of donors b) donor's names c) short sayings that the donors requested put there. It's good because a) it's aesthetically pleasing b) it engages the viewer since it's not just a lisit of names

2) Have a small library for patients and families to use while they're waiting so they don't have to just reread the same month old issue of Time over and over again.

3) Give people waiting for something a beeper like at restaurants so they don't have to stay in the waiting room.

7/4 - One thing that I think is interesting about patient and family centered care is that there is a definite balancing act to it all. Doctors are authorities in their fields, and patients, well, aren't. It's one thing to, say, respect the wishes of Jehova's Witnesses to not have a transfusion or to work to accommodate the personal needs and wishes of the patient and his or her family, but there's a lot to be said for maintaining the doctor's ability to say, in no uncertain terms, "This is what you need."

7/6 - I think it's an interesting idea that you can't necessarily count on things like surveys and interviews to really tell you all the needs of a client or of the staff of a medical center. In fact, you have to worry about the surveys or interviews being skewed the wrong way, because the subjects may think they want one thing, but really need another. It's important to really go and look at how the existing facilities are being used to get a really good idea about how to best improve them.