Evidence Based Design for ECIB Using evidence to innovate and - - PowerPoint PPT Presentation

▶
evidence based design for ecib
SMART_READER_LITE
LIVE PREVIEW

Evidence Based Design for ECIB Using evidence to innovate and - - PowerPoint PPT Presentation

Sep 21, 2023 451 likes •940 views

Evidence Based Design for ECIB Using evidence to innovate and elevate WDHB facilities and improve patient experience and outcomes 1 9 O C T O B E R 2 0 1 7 D R K A T H E R I N E T S E H E A L T H C A R E D E S I G N F E L L O W Aim

slide-1
SLIDE 1

Using evidence to innovate and elevate WDHB facilities and improve patient experience and outcomes

Evidence Based Design for ECIB

1 9 O C T O B E R 2 0 1 7 D R K A T H E R I N E T S E – H E A L T H C A R E D E S I G N F E L L O W

slide-2
SLIDE 2

Aim

  • Explain the concept of evidence based design
  • Update on the Elective Capacity Inpatient Bed (ECIB)

project

  • Identify areas of the ECIB project – particularly the

ward which needs investment in evidence based decision making with the aim of improving

  • utcomes
  • Gain support from W2025 design group for a

evidence based approach to the ECIB project

slide-3
SLIDE 3

P h i l i p p i n e s R u r a l H o s p i t a l , C A Z A a r c h i t e c t s

How can design influence health, patient outcomes and experience? Who decides?

slide-4
SLIDE 4

How can design influence health, patient outcomes and experience? Who decides? Publicly funded health facilities don’t have the flexibility (or resources) to iteratively refine and redefine in a timely manner. We need to be smart about how we design for the short term, but also long term

slide-5
SLIDE 5

Evidence Based Design

  • Concept derived from Evidence Based Medicine
  • Process in which a designer, together with an informed

client, makes decisions based on best information available from research and project evaluations

slide-6
SLIDE 6

Evidence Based Design

  • 1. Evaluate evidence from scientific literature and the link

between physical environment and health outcomes

  • 2. Create a theory based on evidence
  • 3. Implement a design + Measure the results
  • 4. Publicly share results
slide-7
SLIDE 7

Evidence Based Medicine

  • 1. Evaluate evidence from scientific literature
  • 2. Create a theory based on evidence
  • 3. Implement a treatment + Measure the results
  • 4. Publicly share results
slide-8
SLIDE 8

Why use EBD in design?

Links between Environment + Health

slide-9
SLIDE 9

Links between Environment + Health

slide-10
SLIDE 10

Links between Environment + Health

slide-11
SLIDE 11

ECIB Elective Capacity Inpatient Beds

slide-12
SLIDE 12

Background

  • Extension of ESC building

eastward on grass area

  • Number of levels has

changed since last consultation with W2025 group

  • Business case submitted to

CIC (Capital Investment Committee) in August 2017

  • Positive direction towards

sustainability

envelope design and energy modelling analysis conducted to help the design team reduce

  • perational energy consumption. This work was

fully subsided by EECA (Energy Efficiency and Conservation Authority)

slide-13
SLIDE 13

Carpark

slide-14
SLIDE 14
slide-15
SLIDE 15
slide-16
SLIDE 16
slide-17
SLIDE 17
slide-18
SLIDE 18

Cullen Ward roof 82m long 18m wide

slide-19
SLIDE 19
slide-20
SLIDE 20
slide-21
SLIDE 21
slide-22
SLIDE 22

Areas for Evidence Based Design

  • 1. Noise + Sleep
  • 2. Nature + View
  • 3. Line of site + Distance walked
  • 4. Flexi Rooms
  • 5. Mechanical Plant
  • 6. Welcoming Environment
slide-23
SLIDE 23
  • 1. Noise + Sleep

EVIDENCE Poor sleep within top 5 of all hospital complaints Noise among the causes for poor sleep -staff, equipment, multi-bedded rooms, other patients and visitors, alarms Sleep important for recovery, CVS, healing, mental health and wellbeing UoA study Ward 7 NSH WDHB priority to improve inpatient sleep and enhance patient experience – Sleep Program

slide-24
SLIDE 24
  • 1. Noise + Sleep

HYPOTHESIS we can reduce hospital noise with design? METHODS

slide-25
SLIDE 25
  • 1. Noise + Sleep

METHOD MEASURE dB readings patient experience patient reported sleep Teaming up: Academic institutions R&D Companies Acoustic Engineers

slide-26
SLIDE 26
  • 2. Nature + View

View from ECIB wards is towards carpark and Cullen Ward EVIDENCE Post op cholecystectomy recovery – shorter length of stay, lower analgesic requirement, less negative comments for patients in room with a view vs. a brick wall (1984 Urlich) Proximity to green space reduces anxiety, improved perceived health status

slide-27
SLIDE 27
  • 2. Nature + View

HYPOTHESIS can we improve patient experience and patient outcomes with a view of nature and privacy? METHODS

slide-28
SLIDE 28
  • 2. Nature + View
slide-29
SLIDE 29
  • 2. Nature + View
slide-30
SLIDE 30
  • 2. Nature + View
slide-31
SLIDE 31
  • 2. Nature + View

Natural lighting in central atrium + smart lighting Solar power Heat recovery AC Waste reduction Built in energy optimising building management system

slide-32
SLIDE 32
  • 2. Nature + View

MEASURE Patient experience Physiological measurements – UoC study Comparison study pre and post implementation PROMs Post Occupancy Evaluation Green Star

slide-33
SLIDE 33
  • 3. Line of Site +

Distance Walked

Long, narrow corridor Patients rooms spread along footprint EVIDENCE ? Distance trackers Operational research – floorplanning, master planning

slide-34
SLIDE 34
  • 3. Line of Site + Distance Walked

HYPOTHESIS Will glass improve line of site and visibility in a long ward footprint? How can technology improve visibility?

slide-35
SLIDE 35
  • 3. Line of Site + Distance Walked

MEASURE staff walking distances investigate relationship falls vs distance comparison study between Cullen ward + ECIB

slide-36
SLIDE 36
  • 4. Flexi Rooms

EVIDENCE ?? – hasn’t been done in NZ HYPOTHESIS Do flexible rooms improve patient outcomes for THJR, TKJR How do flexi rooms affect sleep? Cost analysis flexi vs non flexi? Mock ups?

slide-37
SLIDE 37
  • 5. Mechanical

Plant

?Where will this be placed? Previously decided to place partially on the ward – taking up clinical space, reducing single bed numbers

slide-38
SLIDE 38
  • 6. Welcoming

Environment

Wayfinding – reducing patients and whanau getting lost Promoting independence and post operative recovery – ending PJ paralysis Inviting space, providing privacy

slide-39
SLIDE 39
  • 6. Welcoming Environment

EVIDENCE people getting lost – CB5 building qualitative data

slide-40
SLIDE 40
  • 6. Welcoming Environment
slide-41
SLIDE 41
  • 6. Welcoming Environment

EVIDENCE home environments improves patient experience + social engagement eg. dementia residences, EDARS

slide-42
SLIDE 42
  • 6. Welcoming Environment
slide-43
SLIDE 43
  • 6. Welcoming Environment

MEASURE utilisation of public spaces patient experience LOS staff satisfaction Friends + Family test

slide-44
SLIDE 44

EBD: Short term outcomes

  • Ensure that patient safety, experience and positive

health outcomes remain at the forefront of this project

  • Real world demonstration of Core Design Principles,

Ideal Ward at WDHB facilities development, providing an exemplar ward for innovative hospital design

  • An innovative structured research based ward

design approach

slide-45
SLIDE 45
  • Allowing for flexibility when refurbishment is required for

changing demographics and models of care

  • Evidence based design providing recommendations and

information to guide future design at Waitemata DHB

EBD: Long term outcomes

slide-46
SLIDE 46

Waitemata 2025 Design Group

Endorse

  • i3, Leapfrog, Facilities and Patient Experience groups to be

involved in an EBD approach to the ECIB project

  • use of external parties in this field academic institutions,

researchers, New Zealand Health Design Council, Jasmax in investigations

  • work with Well Foundation and other external supporters for

funding on extra costs in trialling, evaluating and implementing

  • ptions
  • trials and testing of various solutions as appropriate, running

pilots/simulations/evaluations of products and solutions

  • share information with other DHB’s and contribute to EBD
slide-47
SLIDE 47