Technology-ready workstations between patient rooms are expected to increase nurses' productivity, reduce errors and improve customer satisfaction.
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| Linda B. Spivack | Lee Galuska | Chris Bormann |
Leaders at MidState Medical Center (Meriden, Conn.), looking to reduce medical errors, increase nurses' productivity and improve patient and staff satisfaction, believe they have found the answer--a patient care station in an alcove between each inpatient room.
Nurses, physicians, pharmacists, social workers and other providers collaborated with the medical center's architects to design a workstation that would function well for everyone who uses it. Each workstation houses a computer, the patient record, medications and other supplies needed for the two patients it serves.
MidState Medical Center is an acute care, nonprofit community hospital that has been licensed for 130 beds. Private inpatient rooms are arrayed along the perimeter of each of the four D-shaped inpatient pavilions. Patient care stations are located in a 4-by-3-1/2-foot alcove between two inpatient rooms. In the first three inpatient pavilions, opened in 1998, the stations included a shelf with a standard computer monitor, a pull-out counter below that and two locked cabinets, one for the CPU and another for medications.
In September 2003, the medical center opened a fourth inpatient pavilion--a 47,800-square-foot building with 28 beds, two additional operating suites and recovery bays, wound and hyperbaric care, and a dedicated digestive health center. An evolving, collaborative process between staff and the medical center's architects had already proven effective in the design of the original building, so medical center leaders employed it in the design of the fourth pavilion.
MidState leaders gathered a team of nurses, physicians, pharmacy technicians, pharmacists, social workers, physical therapists, housekeepers, information systems staff, engineers and an ergonomics specialist to improve the design of the workstations. The architect met with team members in a series of focus groups and work sessions, as well as in the work setting, to discuss improvements for the alcoves. They also conducted a workflow and space analysis.
The health care team first responded to design drawings, then
tested a full-scale mock-up of the alcove. Letting the team members
experience the size, scale, positioning and shape of the workstation
was a tremendous advantage for the design process, as the architect
was able to make numerous refinements before finalizing the design.
The team considered everything from door swings and waste containers
to the high-tech needs of team members.
The improvements to the new patient care stations included:
Leaders at MidState expect the new patient care stations will increase the productivity of the nursing staff. Because patient information, medications and supplies are located in one place and within 3 feet of each patient's room, nurses are able to work more efficiently. In addition, because it's adjacent to the patient room, the alcove lets the nurse remain in closer contact with the patient while providing care. In turn, it is expected that patients' perception of greater accessibility to clinicians will enhance communication and an overall sense of confidence and satisfaction with their hospital stay.
The new alcove is expected to reduce medication errors by providing nurses with a dedicated location for each patient's medication orders and medication administration record (MAR), as well as for prescribed medications. The nurse carries out the critical tasks of medication verification and preparation at a single location, right outside the patient's door.
The alcove was also designed to accommodate a computerized physician order entry system and an electronic MAR. The flat-screen monitor, on its movable arm, will enable the nurse to see the MAR while preparing the patient's medications.
Patient and staff satisfaction, measured by Press Ganey scores and informal measurements, have improved since the new pavilion opened. The medical center plans to monitor its recruitment of nursing staff to measure the success of a collaborative environment in which nurses are involved in improving the design of their workspace. The medical center continues to implement best practices in patient safety and to track the results.
The leaders and staff of MidState Medical Center believe that the multidisciplinary alcove, in fostering a collaborative approach at the point of care, will be one of the keys to achieving its goals for productivity, patient safety, and patient and staff satisfaction.
Linda Berger Spivack is vice president, patient care services, and Lee Galuska, R.N., M.S.N., is director, women's and inpatient medical services, MidState Medical Center, Meriden, Conn. Chris Bormann, A.I.A., is associate principal, Perkins and Will, New York, N.Y.
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New Patient Care Station at MidState Medical Center
Nurses, physicians, pharmacists, social workers
and other providers collaborated with the medical
center's architects to design a work station that
would function well for everyone who uses it.
Each work station houses a computer, the patient
record, medications and other supplies needed
for the two patients it serves.
The size and configuration enable more than
one member of the health care team to work
simultaneously at three sides of the alcove.
This article 1st appeared on June 15, 2004 in HHN Magazine online site.
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