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Key Considerations in Patient Room Design, Part 1
Sheila F. Cahnman, AIA, ACHA
Healthcare Design, April 2006

A source of general design information regarding:
Level of Acuity
Model of Clinical Care
Supply Distribution Model
Visibility versus Privacy
Patient/Family Amenities

Lecture, 02/11/2009, part 1, part 2
Sheila F. Cahnman, AIA, ACHA

General design Information regarding:
Nursing Model

Effects of Acuity-Adaptable Rooms on Flow of Patients and Delivery of Care

by Ann L. Hendrich, Joy Fay and Amy K. Sorrells

This study tested whether use of acuity-adaptable rooms helps solve problems with transfers of patients, satisfaction levels, and medical errors. It is a pre/post study. Significant improvements in quality and operational cost occurred after the move, including a large reduction in clinician handoffs and transfers; reductions in medication error and patient fall indexes; improvements in predictive indicators of patients’ satisfaction; decrease in budgeted nursing hours per patient day and increased available nursing time for direct care without added cost; increase in patient days per bed, with a smaller bed base (number of beds per patient days). Some staff turnover occurred during the first year; turnover stabilized thereafter.

Creating a Healthcare Design and Practice That Lasts
by J. William Miller, AIA, ACHA, NCARB

This article discusses the history and transition to a "universal" solution. It also goes into general details concerning flexibility and patient safety.

The Use of Single Patient Rooms vs. Multiple Occupancy Rooms in Acute Care Environments
by Habib Chaudhury, Atiya Mahmood and Maria Valente

A literature review of 222 article and journal entries. The study breaks the research into empirical and non-empirical and sub-categories within each of "first and operating costs, design and therapeutic impacts, and disease control and falls prevention."

The Role of the Physical Environment in the Hospital of the 21st Century: A Once-in-a-Lifetime Opportunity
Roger Ulrich, Xiaobo Quan, Craig Zimring, Anjali Joseph, Ruchi Choudhary,

A literature review of 600 studies that link the physical environment to patient and staff outcomes in four areas:
1. Reduce staff stress and fatigue and increase effectiveness in delivering care
2. Improve patient safety
3. Reduce stress and improve outcomes
4. Improve overall healthcare quality

Nurses’ perception of single-occupancy versus multioccupancy rooms in acute care environments: An exploratory comparative assessment
Habib Chaudhury, PhD, Atiya Mahmood, PhD, Maria Valente

A review of the literature revealed that operating costs are reduced in singlepatient rooms compared with multioccupancy rooms due to reduction in transfer cost, higher bed occupancy rates, and reduction in labor cost. In addition, single rooms can positively impact patients’ hospital experience through increased privacy, better interaction between family and staff, and reduced noise and anxiety. This pilot study focused on nurses’ perception of the advantages and disadvantages of single-occupancy versus multioccupancy patient rooms in medical–surgical units in four hospitals in the northwest. A majority of respondents in the four hospitals favored single rooms over double-occupancy rooms for the majority of the 15 categories, including the following: appropriateness for patient examination, interaction with or accommodation of family members, and lower probability of dietary mix-ups.

Do patients in hospitals benefit from single rooms?
Irene van de Glind, Stanny de Roodeb, Anne Goossensen

A literature review that shows that single rooms have a moderate effect on patient satisfaction with care, noise and quality of sleep, and the experience of privacy and dignity. Conflicting results have been found on hospital infection rates. Some studies did not show significant differences, while others concluded that single rooms decrease the risk of hospital infections. Evidence on recovery rates and patient safety was lacking.

Advantages and Disadvantages of Single-Versus Multiple-Occupancy Rooms in Acute Care Environments
Habib Chaudhury, Atiya Mahmood and Maria Valente

The objective of this article is to reviewand analyze the existing literature to identify the empirical evidence related to the advantages and disadvantages of single- versus multiple-occupancy patient rooms in hospitals. Three substantive areas were identified for synthesis of the review: (a) first and operating cost of hospitals, (b) infection control, and (c) health care facility management and hospital design and therapeutic impacts. The analysis reveals that private patient rooms reduce the risk of hospital-acquired infections, allow for greater flexibility in operation and management, and have positive therapeutic impacts on patients. This review highlights the need to consider room occupancy issues along with other patient care issues and environmental and management policies.

A view on the Room

Diana Anderson, MD, MArch

A response to Detsky’s article “Single-Patient Rooms for Safe Patient-Centered Hospitals.” A point is made that some patients may prefer a roommate and as such may require a certain number of double occupancy rooms as well.

Single-Patient Rooms for Safe Patient-Centered Hospitals
Michael E. Detsky; Edward Etchells

An article that describes the “considerable quasi-experimental and descriptive evidence of the benefits of single-patient rooms on safety, utilization, and satisfaction is available.”

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