Although largely a product of organizational culture, family-centered care is also influenced by the physical design of the healthcare facility. An academic medical center recently opened a free-standing Children's Hospital that was designed on the theme of family-centered care.
The hospital's Performance Management and Improvement (PM&I) team developed and administered an Environment of Work (EoW) survey to measure providers' initial impressions of the effects of family-centered design on job function, patient safety, and personal well-being.
The PM&I team collected surveys from 270 clinical faculty and staff. Eighty-seven percent of respondents rated the new family-centered hospital better than the former Children's hospital. Respondents rated the new hospital efficient for information flow (81%), patient flow (88%), and overall efficiency (80%). Over 70% of respondents gave high ratings to the organization of charting, availability of computers and equipment, and lighting levels in the units.
However, a majority of providers representing the neonatal intensive care unit (NICU) and pediatric critical care unit (PCCU), respectively, believed the facility design makes team communication and patient monitoring difficult and limits social interaction among staff. High rates of interruptions, elevated noise levels, and excessive walking were also cited by ICU providers.
Initial results show that providers rank the patient-centered design as an improvement to the former facility, and believe it facilitates safe and efficient care. Design changes have had the biggest impact on ICU providers who have been required to make substantial changes in their work processes. The results underscore the need to include human factors expertise on the design team and to evaluate these factors early in the design process.