Question

Write a 700- to 1,050-word paper. Your paper should:

• Analyze the impact of federal, state, and local legal and regulatory requirements on your selected facility.
  • Consider and discuss assets and equipment you will need to add to your floor plan.
  • Consider and discuss any modification you made to your floor plan with respect to structure and area.
• Analyze accountability and liability implications for individuals and organizations for your selected facility.
• Analyze legal versus ethical considerations for your selected facility.

Include a print screen of your facility below. Use the instructions provided if you need help adding

Answer 1

The design of a facility/structure with its fixed and moveable components can have a significant impact on human performance, especially on the health and safety of employees, patients, and families. In a review of more than 600 articles, researchers found that there was a link between the physical environment (i.e., single-bed or multiple-bed patient rooms) and patient (e.g., fewer adverse events and better health care quality) and staff outcomes (e.g., reduced stress and fatigue and increased effectiveness in delivering care). Efforts to improve patient and staff outcomes can target latent conditions for clinicians by using evidence-based designs to decrease distractions, standardize locations of equipment and supplies, and ensure adequate space for documentation and work areas.

In a review of the literature by Henriksen and colleagues, the following design elements were identified as critical in ensuring patient safety and quality care, based on the six quality aims of the Institute of Medicine’s report, Crossing the Quality Chasm: A New Health System for the 21^st Century:

• Patient-centeredness, including

*using variable-acuity rooms and single-bed rooms

*ensuring sufficient space to accommodate family members

*enabling access to health care information

*having clearly marked signs to navigate the hospital

• Safety, including

*applying the design and improving the availability of assistive devices to avert patient falls

*using ventilation and filtration systems to control and prevent the spread of infections

*using surfaces that can be easily decontaminated

*facilitating hand washing with the availability of sinks and alcohol hand rubs

*preventing patient and provider injury

*addressing the sensitivities associated with the interdependencies of care, including workspaces and work processes

There have been five other significant reviews of the literature relating to the physical environment and patient outcomes. Nelson and colleagues identified the need to reduce noise pollution and enhance factors that can shorten a patient’s length of stay (e.g., natural lighting, care in new/remodeled units, and access to music and views of nature); according to their study, patients can benefit from the skillful utilization of music and artwork. Ulrich and colleagues found research that demonstrated that the design of a hospital can significantly improve patient safety by decreasing healthcare-associated infections and medical errors. They also found that facility design can have a direct impact on patient and staff satisfaction, a patient’s stress experience, and organization performance metrics. Three other reviews found that hospital design, particularly when single-bed rooms are employed, can enhance patient safety and create environments that are healthier for patients, families, and staff by preventing injury from falls, infections, and medical errors; minimizing environmental stressors associated with noise and inefficient room and unit layout; and using nature, color, light, and sound to control potential stressors.

The walls between rooms are separated and insulated with airspace, minimizing transfer noise. This was designed into the structure early in the building design. In addition, vibration noise between floors and within a floor was minimized through design. The mechanical, electrical, and plumbing systems were designed to use the optimum materials for minimizing noise. This included using vibration isolation/dampening devices wherever vibration could be a factor.

The flooring in the patient room is rubber, second to the carpet in sound reduction qualities. The reason carpet was not chosen (it was mocked up and tested) is because spills and mishaps needed to be cleaned up immediately. Carpet requires housekeeping to bring a carpet cleaner, which could take time and also could be embarrassing for the patient. The carpet was chosen, however, for the alcoves and hallways, with a low-nap, special carpet for hospital application. Special ceiling tiles that absorb noise better than regular ceiling tiles were chosen. Triple glazed windows were specified to minimize outside noises. No overhead paging system is used (except for public emergencies such as a tornado warning), and nurse call systems use minimal tone with vibrating features. As specific equipment and technologies were needed, manufacturers of that piece of equipment or technology were contacted and asked how they reduced noise in their products. That became one important criterion for selecting which company’s equipment to use.