5 Space Planning Events You’ll Want to Attend at HCD 2018

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This years  Healthcare Design Expo + Conference is taking place at the Phoenix Convention Centre in Arizona.

We’re already underway and you’ll find us at booth #1244 showing off our KwickScreens.

 

If you are at the conference, you’ll also want to catch one of these 5 sessions focused on space planning:

E42: Research Matters: 10 Picks for the Year

  • Room: North 229AB

  • Session Number:E42

Monday, November 12, 2018: 9:45 AM - 10:45 AM

To apply evidence-based design, you have to know what the best available evidence is. But research is published faster than anyone can read it. How can researchers and practitioners keep up with the most important work? In this rapid-fire session, experts from The Center for Health Design will present their version of visual abstracts for 10 articles of the past year, discussing what we’ve learned and what we still need to know. This session will help participants ride the waves in an ocean of evidence, without drowning in it. But more: It will provide a shared body of knowledge for the health design community.

E47: Reality Check: The Continuing Collision of Health, Technology, and Design

  • Room: North 232AB

  • Session Number:E47

Monday, November 12, 2018: 9:45 AM - 10:45 AM

Explore how the continuing relationship of medicine and health technology has changed the world of healthcare design and where it has not. Consider how good previous predictions and visions were and the likelihood of a predictable future. This presentation looks inside and outside of medicine to multiple forces of change that can potentially influence future health facilities’ planning and design. Presenters have proposed what-if scenarios and have taken a further step to extrapolate these trends and formulate possible visions of a not-too-distant future with cutting-edge scenarios considering people and place. They will share research focused on solutions that meld health, technology, and design.

E62: The Big 5: Healthcare Planning and Design Strategies for an Adaptable Future

  • Room: North 229AB

  • Session Number:E62

Monday, November 12, 2018: 4:45 PM - 5:45 PM

Healthcare buildings of today must be malleable in order to remain relevant tomorrow. How can we design healthcare buildings to be flexible in the face of uncertainty? This session addresses trends in patient-centered care, population health, and technology that drive the need for flexibility. Presenters will dive into “The Big 5” design decisions that provide adaptability in an ever-changing healthcare landscape. Specific examples from award-winning healthcare projects peel away design layers to reveal a variety of ways these often unseen yet fundamental decisions are applied. Examples include a candid look at renovation regrets, renovation successes, and new construction.

E77: Becoming a High Reliability Hospital: Digital Transformation of Experience, Care and Operations

  • Room: North 232AB

  • Session Number:E77

Tuesday, November 13, 2018: 8:15 AM - 9:15 AM

When the new 656-bed Humber River Hospital opened in October 2015, it implemented technologies to improve operations; transform care delivery; and create a paperless, seamless, connected experience for patients, staff, and clinicians. Leadership was intent during planning and design of the facility that it would meet the needs of its rapidly expanding community for decades to come. The project team utilized digital twins to evaluate the impact of design and technology decisions, developed a robust digital strategy, and more recently, implemented a state-of-the-art command center for real-time management of hospital operations. The speakers describe Humber’s journey, approaches used, and results achieved.

E102: Challenging One Size Fits All: The Joe DiMaggio Pediatric Cardio Vascular Center

  • Room: North 229AB

  • Session Number:E102

Tuesday, November 13, 2018: 2:30 PM - 3:30 PM

Standard OR planning processes cannot address the patient safety or family anxiety concerns for children undergoing pediatric heart surgery. Using the research of Clemson's MUSC RIPCHD OR research, this project team set an EBD process to challenge preconceived design solutions for a special cohort in a vertical expansion. The addition incorporates an outpatient heart center, imaging, acute care, step down, CVICU, and a dedicated cardiovascular surgical suite. The design required hyper-specialized spaces with a need for extreme flexibility, clinical integration, case management, and a better patient experience. See how the team challenged convention to meet the medical and experience needs of patients and families.

We’ve only selected 5 here but there are plenty more to visit this week! If you want to view the full schedule click HERE. And if you are on the conference floor, we will be at Booth #1244. Hope we see you there!

Creating Realistic Ambulance Simulation for Tulane’s Future Healthcare Professionals

Tulane Medical School is built on a rich history. Many important advances in medicine over the last century were born in Tulane, thanks to distinguished alumni and faculty members like Dr. Michael E. DeBakey, Dr. George E. Burch, Dr. Louis J. Ignarro, and more.

In Healthcare, Your Biggest Asset is also Your Biggest Liability: Your Environment

People do not go to a hospital because they want to—they go because they are referred for treatment. Many of them are afraid, unsure of what to expect, feel out of their comfort zone—experiencing a lack of control, and could be incredibly uncomfortable as a result of their condition. So it is vital to do whatever you can as a healthcare professional to help make their environment and the overall care package as safe, supportive, clear, and inviting as possible.

Creating Immersive Medical Training for a Fraction of the Cost

I was only eleven when I decided that a career in healthcare was for me. I really wanted to be part of the team that exists primarily to help people feel better, live better, and—where possible—to get better as well.

Preparing the Next Generation of Medical Professionals with KwickScreen

We aim to simulate real-life clinical situations that facilitate learning opportunities within a safe environment allowing for mistakes to be made, reflected upon and the knowledge gained to be applied to their work with real patients. Creating believable simulations is critical to the future success of these students and soon-to-be Healthcare professionals.

Creating Unforgettable Experiences at Boston Children's Hospital for Those Who Need it Most

As an eternal optimist, I always like to say that if your child is at Boston Children's Hospital, it's definitely not a good thing—but it's also the best thing, given the circumstances. You're unlikely to find the same level of care, commitment, and quality anywhere else in the country.

Beautifying Hospital Environments for Children: KwickScreen and Vistamatic

Childhood isn't always easy—especially when kids get sick. Children want to play. They want magic and adventure in their lives. Kids love colour and they need it when they get ill. Unfortunately, hospitals are often drab. They are built to heal the body, not to inspire creativity and feed the imagination. But this is all changing.

Building More Than Biceps: Leveraging KwickScreen for Strong Customer Relationships

Fitness has the incredible ability to transform peoples' lives. Not only can they become healthier, but also more confident. Unfortunately, most fitness facilities just don’t make the average person feel welcome.

Smart Ideas and Clean Hands: How Environments Impact Disease Control

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Infection control is the effort to stop infections from transmitting from person to person. My long-term research interest has looked at ways to prevent antimicrobial resistant bacteria spreading, either through use of devices, new practices, or different uses of antibiotics.

In the United Kingdom, microbiologists spend a lot of time liaising with doctors who care for infected patients. We provide a bridge between the microbiology laboratory and the hospital wards. We see patients ourselves, as well as advise on antibiotic treatment, prevention of infection transmission, and how to keep our antibiotics active by preventing development of resistance. We are on the front lines of combatting infection transmission. We see the problems while seeking the solutions.

Amongst the chief issues is that only about 25% of UK hospital beds are in single rooms. The rest of the beds are located in shared, open accommodations like bays or wards. This is in contrast to the private sector, where essentially all beds are in single rooms, and it is much easier to stop an organism from spreading.  

The reason for the difference in the risk of spread between bays and single rooms is threefold: First, staff are reminded to wash their hands in these environments. Second, they do not simply walk near patients on their way to somewhere else. Lastly, doctors and nurses must make a particular effort to go into the single room.

‘A temporary solution can offer permanent benefits’
 
 


Conversely, people constantly walk through wards that accommodate up to five patients at a time. If even one of them has an infection, or the person walking through did not wash their hands and has touched a contaminated surface, the chances for transmission are greater. We believe environmental contact is how most infection is transmitted. It’s also easy to forget to wash your hands when walking from one bed to the next bed, and unwashed hands account for two thirds of transmission. The remaining one-third is airborne. But a physical barrier between beds reminds people to wash their hands and reduces air transmission as well.

We identified a need to either temporarily increase the number of single rooms or to discover ways to encourage people to wash their hands as they move between patients within these bays. However, the public health system simply lacks the funds to convert all hospitals into single rooms. The vast majority are mixed.

On top of the limited funding, we now see increasing antibiotic resistance. We need new antibiotics, but there are far fewer being developed as we would like. It’s critical that we do everything in our power to stop these resistant organisms from spreading without relying on antibiotics. Naturally, we need to be both scientific and creative in our approach to this problem. 


Quantifying Innovation: Testing Smart Ideas   

There have been many proposed solutions. It is common for most infection control departments to introduce bundled approaches, a series of five or six evidence-based measures used together to encourage infection prevention. Education programmes have been reasonably successful. The average hand hygiene compliance has improved from approximately 25% to 60–80% over the last decade. 

Much of our investigation has focused on optimising surfaces in an effort to make them less hospitable to the survival of the organisms. For example, a rough surface easily allows the bacteria to stick to them and they do not stay long on a smooth surface. So adapting physical surroundings have been a top priority. While it is too expensive to build more hospitals with more single rooms, it is less so to introduce barriers between beds. 

The Department of Health instituted a program called SmartIdeas Project in 2010 to bring about different solutions to be implemented at the hospitals and studied for future application. We identified three notable innovations. In an effort to innovate novel ideas to reduce infection transmission, they provided a fund and invited inventors to take on the challenge. A panel—including myself—judged the wide variety of ideas and inventions, which included temporary side rooms, glass LCD privacy screens, and retractable room dividers. The successful inventions got a bit of help along the way. We would test them in our hospital, allowing the companies direct access to front-line healthcare workers so they could observe and utilise their feedback to adapt their product accordingly. 

One of the promising solutions in the program was KwickScreen, the retractable room divider that fits into a mobile, cylindrical container. The end of the screen is on a small pair of wheels and can easily be pulled out. When we had a patient who needed source isolation in a bay and we did not have a single room to put them in, we would use a KwickScreen as a means to provide physical separation. Another option was the temporary single room, but it could only be assembled if there was enough space.

  KwickScreen installed at Bradford Royal Infirmary

KwickScreen installed at Bradford Royal Infirmary

‘Strong visual aids can improve doctor hand hygiene’.
 
 


A Study in Hygiene Psychology

Interestingly, like the other inventions, KwickScreen did improve hand hygiene. The simple presence of a screen reminded individuals, particularly the doctors, that they needed to wash their hands when approaching a particular patient and upon leaving. KwickScreen also mounted alcohol hand gel on the leading edge as a second cue to encourage staff to wash their hands. Hand hygiene compliance increased from 50% to approximately 75%. When we watched doctors coming toward the patient, none of them washed their hands if there was no visual reminder, like the screens or the room. When we put in one of the three solutions, doctor hand hygiene increased to 70%, overall. Clearly, doctors were not necessarily aware that they were approaching a patient with a potentially infectious pathogen and that they needed to wash their hands. 

Doctors should wash their hands with every patient, but they need to be reminded of the requirement. The large physical presence in the form of a barrier is effective in a way that notices on the end of the bed are not. You can't miss this visual reminder. We published a paper (ref 1) reflecting the outcomes of the SmartIdeas Project and conducted trials with a number of patients who did need source isolation. We distributed questionnaires for both patient and staff feedback so we could gauge whether they could be used in practice in addition to our hand hygiene study component.

We also analysed whether people would decline to have them around their beds. No patient objected to having KwickScreen. A few patients objected to the temporary side room. Staff would not put patients with diarrhoea into the KwickScreen because it was not an all-around solution. They would only put patients into the KwickScreen who had illnesses spread by contact, like Methicillin-resistant Staphylococcus aureus (MRSA), for example. We took all feedback into account.

Another area of focus was the material used for the screens. We did a great deal of sampling from the units themselves to see what organisms would grow on each surface. It was expected that we would find a bacterial presence on the KwickScreen near infectious patients. We had to be mindful of ease of cleaning and diligence in decontamination protocols so as not to spread infection. If you adjust what the screen is made of, that material can make a big difference. The tendency is often to use a rough plastic because they are easier to grip. Your hand does not slip off, but rough plastic can store 10 times as many MRSA as a smooth metal, for example. The best option is to have the smoothest possible surface. Of course, the designers have to judge that against having something that's so slippery you cannot even pull it. There was some compromise to consider.

One of the greatest aspects of a program like SmartIdeas is that products are tested in real-life scenarios. All of these challenges identified were opportunities for the inventions to improve their offering based on real-world experiences. 

The Move to Modernise and Protect

KwickScreen has taken that feedback and now has a more robust offering. They've produced artwork on the formerly blank screen, which helps to make it more acceptable to the patients who were split on whether they preferred a clear screen versus those who wanted additional privacy. We also scrapped the addition of disposal sinks that were attached to the KwickScreen, as individuals would rather use the plumbed ones. 

KwickScreen has gone for a smooth, easy to clean plastic for the screen material. It is always a tradeoff, however, since rough surfaces are less likely to transfer bacteria onto hands, with the opposite being true for smooth surfaces. 

Retractable room dividers can be used for infection control purposes in certain cases and can also be useful for privacy. A working group followed up on other KwickScreen applications such as privacy and gender separation issues after the SmartIdeas Project. 

The SmartIdea project was a wonderful representation of the innovation that can take place in the NHS. There is a need for a SmartIdeas Project to run again. It has been almost nine years since the last program. Technology has moved on. There are many extremely bright designers out there and I think they need to be encouraged to try and help the staff in the wards with prevention of infection

It's sometimes quite difficult for companies in the UK to get a foothold because products must have a scientific basis in order to become widely accepted. Programs like SmartIdeas Project not only help companies come up with new ideas, but it helps them discuss with active working professional members what is useful. Companies like KwickScreen have been able to utilise the program to test their product, gather feedback, and improve their offering. It’s exciting to think what the future will hold. 

Ref 1: ‘Ward assessment of SmartIdeas Project: bringing source isolation to the patient’. Moore G, AliS, FitzGerald G, Muzslay M, Atkinson S, Smith S, Cryer P, Gush C; SmartIdeas Research Group, Wilson AP. 

Removing Limitations, Not Moving Patients. Founder Micheal Korn on the Birth of KwickScreen

I didn’t plan to be an entrepreneur. I started off as an engineer studying at Cambridge where I assumed I would graduate and work for someone else. But at some point, I realised that life wasn't for me. I wanted to do something more significant, something of my own. I was looking for the freedom to explore what I could do. I was better as a disruptor than I was at following someone else's lead.