Where Operations And Design Meet
During a meeting the other day, I was asked to define evidence-based design (EBD). Of course, there are a few different ways to illustrate the benefits of having research available to support design interventions, such as improving outcomes, increasing patient satisfaction, or reducing healthcare-associated infections (HAIs).
But for the sake of this particular conversation, I turned to the bottom line. While there are a number of positives tied to any one of those benefits listed above, one major one is avoiding the costs tied to not achieving them (poor outcomes, decreasing patient satisfaction, increasing incidence of HAIs).
I used the example of fall prevention. If having empirical data to back up how the right flooring, grab bars, or room layout might actually reduce very expensive patient falls, it’s a win for providers and their patients.
It’s this conversation that reminded me of a recent report I saw on the Joint Commission Center for Transforming Healthcare’s Preventing Falls with Injury project. The group partnered with seven healthcare institutions—including Baylor Health System, Kaiser Permanente, and Memorial Hermann Healthcare System—to use a robust problem-solving methodology to identify causes and develop solutions to prevent falls.
At the end of the day, the effort targeted initiatives like creating awareness among staff, empowering patients to take a role in their own safety, utilizing a validated fall risk assessment tool, and providing hourly rounding and toileting assistance. Together, 21 solutions were identified that resulted in a 35 percent reduction in falls and a 62 percent reduction in injuries from falls at the participating locations.
“If the center’s approach is translated to a typical 200-bed hospital, the number of patients injured in a fall could be reduced from 117 to 45, and save approximately $1 million annually through fall prevention efforts. Similarly, a 400-bed hospital could reduce the number of patient falls with injury by 133 and expect to save $1.9 million annually,” a press release states.
This type of data is exciting. However, I can’t help but look at the center’s solutions and notice that they’re largely operational. By all means, there’s huge potential for change there—but just think of the additional impact that could be made if these recommendations were implemented in unison with EBD-proven solutions.
What if an environmental assessment was done, as well, looking at things like lighting, flooring types, furniture heights, etc., to determine if even simple tweaks could be made to make that patient room—specifically the path from bedside to toilet room—even safer?
At the end of the day, operations take place within the built environment. And we know that the right environment can better support even the best operations.