Case Study: SynergyHealth St. Joseph’s Hospital, West Bend, WI

In 2002 St. Joseph’s Community Hospital of West Bend, Wisconsin brought together with SynergyHealth a number of leaders in healthcare and engineers to outline a set of safety-driven design standards to guide the design process of a new hospital. With a team approach, the new facility includes standardized patient rooms, new technologies, and a new approach to an alcove in each patient room for care. With flexibility in mind during the design process, the architects coined the design “The Synergy Model,” describing the idea of molding the building and all its’ interior spaces to work efficiently as a whole.

The model challenge was to incorporate traditional hospital design and the new safety-driven recommendations. The design was approached from a patients’ perspective in order to identify the areas of care that needed to be developed. Overall, there were several entities that required development.
- Visibility of patients to staff: Windows between patient rooms and charting alcoves enhance visibility. Each room is wired for cameras and has proper lighting.
- Standardization: Patient rooms are standardized for maximum efficiency and level of care.
- Automate where possible: New technologies have been proven to promote safety in the patient room. Bar-coding of medications, electronic records, and physician order entry will keep inventory and delivery of materials efficient.
- Adaptability: The facility has the ability to expand and adjust to changes in technology and processes. This flexibility will eliminate unsafe conditions (ceiling height, hall and door width, lighting, etc.) - Access to information at point of service: Easy access and the accommodation of an integral information system are essential for at-the-moment decision making.
- Noise Reduction: Distractions can be hazardous and stressful to patients. No overhead paging and the use of carpet and sound-absorbing ceiling tiles help with noise reduction.
- Patients involved with care: The design encourages patients and their families to be involved. Empowering them with the knowledge and encouragement to ask questions regarding treatment will promote safety and teamwork among staff.
- Design for Vulnerable Patients: Patient interaction is the focal point of the design. This allows the facility to manage and provide opportunities to change organizational processes. These design choices will be adaptable for the most vulnerable patient.
- Use of FMEA at each stage of the design process: FMEA (Failure Mode and Effects Analysis) was used to identify and prevent problems associated with product design. The design team modified a typical FMEA spreadsheet where scores were low, medium, or high. Through the analysis done, the team identified that the more frequently a patient must be moved, the greater the likelihood that errors would occur or equipment would fail. Often times, this resulted in harm to the patient. This was solved through adjacencies of rooms and treatment and full standardization of all patient rooms. In creating a safer environment for patients, the patient room was very carefully considered. Mockups were presented to the physicians, staff, patients, and their families.

Suggestion forms were placed in each mockup and feedback was carefully considered. Among these suggestions were desk heights, visibility of patients, and the configuration of the bathroom. These mockups were also used for staff efficiency. Processes were documented and caregivers commented on the new design. All rooms are fully standardized in layout, including the locale of the medications and supplies. This enhances safety and efficiency within the room.

The safety features that were added to the traditional patient room include:
- Standardization in room size and layout
- In-room sink to allow physician to disinfect upon entering
- Charting alcove with a window to increase patient visibility for nurses to patients
- Private rooms to ensure maximum privacy and comfort
- Close proximity between bed and bathroom to reduce patient falls
- Bedside computers are used to
o 1. Allow patients access to their records and increase involvement
o 2. Allow nurses to double-check medication or other treatment before administration
- Oversized window to increase natural light and therefore promote healing within design
- Ceiling heights adjusted to allow adaptability
- Family zone with a sleeper sofa to encourage family support
- Improved technology with an advanced nurse call system and computerized order entry
- Use of infrared technology reduces the potential for patient falls.
- Noise reduction through low-vibration construction

Case Study: SynergyHealth St. Joseph’s Hospital, West Bend, WI - Health Architecture

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