Certain characteristics of hospital rooms may influence patient outcomes after high-risk surgeries

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Certain characteristics of hospital rooms, such as: Other factors, such as the view from the window and the distance to a nursing station, can influence clinical outcomes after high-risk surgeries, according to research presented at the American College of Surgeons (ACS) Clinical Congress 2022 Scientific Forum. Each year, approximately $50 billion is spent on building healthcare facilities in the United States. Architecture and interior design can improve patient care and outcomes. A groundbreaking comparative study published in Science in 1984 found that a view from a window can affect recovery after surgery, and further research...

Bestimmte Merkmale von Krankenhauszimmern, wie z. B. die Aussicht aus dem Fenster und die Entfernung zu einer Pflegestation, können die klinischen Ergebnisse nach risikoreichen Operationen beeinflussen, so die Forschungsergebnisse, die auf dem Wissenschaftlichen Forum des Clinical Congress 2022 des American College of Surgeons (ACS) vorgestellt wurden . Jedes Jahr werden in den Vereinigten Staaten etwa 50 Milliarden US-Dollar für den Bau von Gesundheitseinrichtungen ausgegeben. Architektur und Innenarchitektur können die Patientenversorgung und die Ergebnisse verbessern. Eine bahnbrechende Vergleichsstudie, die 1984 in „Science“ veröffentlicht wurde, ergab, dass eine Aussicht aus dem Fenster die Genesung nach einer Operation beeinflussen kann, und weitere Untersuchungen …
Certain characteristics of hospital rooms, such as: Other factors, such as the view from the window and the distance to a nursing station, can influence clinical outcomes after high-risk surgeries, according to research presented at the American College of Surgeons (ACS) Clinical Congress 2022 Scientific Forum. Each year, approximately $50 billion is spent on building healthcare facilities in the United States. Architecture and interior design can improve patient care and outcomes. A groundbreaking comparative study published in Science in 1984 found that a view from a window can affect recovery after surgery, and further research...

Certain characteristics of hospital rooms may influence patient outcomes after high-risk surgeries

Certain characteristics of hospital rooms, such as: Other factors, such as the view from the window and the distance to a nursing station, can influence clinical outcomes after high-risk surgeries, according to research presented at the American College of Surgeons (ACS) Clinical Congress 2022 Scientific Forum.

Each year, approximately $50 billion is spent on building healthcare facilities in the United States. Architecture and interior design can improve patient care and outcomes. A groundbreaking comparative study published in Science in 1984 found that a view from a window can affect recovery after surgery, and further research has found that critically ill patients placed in intensive care units that are not well visualized by medical staff may have worse outcomes. However, little research has examined how room characteristics such as single or dual occupancy, distance to a nursing station, and window views may impact clinical outcomes. Researchers at the University of Michigan wanted to find out whether certain characteristics of hospital rooms affect mortality and length of stay after surgery.

We were intrigued to see in a previous study that mortality varied in rooms within sight of a nurse's station. Nursing staff would be able to better assess the patient's condition and intervene more quickly in the event of serious events. We wanted to see how this finding would impact our institution, particularly in a surgical population. One of the next big steps in healthcare design is to understand these causes, which can lead to different clinical outcomes in patients housed in hospital rooms with different characteristics.”

Mitchell J. Mead, study co-author, health and design scientist, University of Michigan

This single-site study's analysis included 3,964 patients who underwent 13 high-risk surgical procedures (including colectomy, pancreatectomy, and kidney transplant) at the University of Michigan Hospital between 2016 and 2019. The patients were housed in rooms on two hospital floors.

Patient rooms were coded based on their characteristics: window or no window, single occupancy, double occupancy, distance from nursing station, and line of sight to clinical staff. Patient encounters were linked by room number to determine clinical outcomes, including mortality and length of stay, associated with room design.

Key findings

  • Mortality rates for high-risk procedures varied by room design and room type.

  • Room characteristics that influenced clinical outcomes after surgery included distance to a nursing station, single room occupancy, and direct line of sight through which physicians could see into the room.

  • Adjusted for patient comorbidities and surgical complexity, mortality rates were 20% higher (odds ratio 1.2) when patients were admitted to a hospital room without a window than when they were admitted to a room with a window.

  • Patients placed in a room without a window had a 10% higher 30-day mortality rate (odds ratio 1.1).

  • Although mortality rates varied by room design, after accounting for length of stay, mortality rates did not vary by room type, suggesting that length of stay does not influence differences in mortality.

"This research provided evidence that when clinical risk was taken into account, patients had different outcomes depending on room design and warrants further research into how hospital design might influence outcomes," Mr Mead said.

When the authors examined different rooms based on advantageous design features, it became clear that the sicker patients were more likely to receive single rooms that were closer to a nursing station and in direct line of sight and with window views, added study co-author Andrew M. Ibrahim, MD, MSc, assistant professor of surgery, architecture and urban planning at the University of Michigan and co-director of the Center for Outcomes and Policy.

Dr. Ibrahim noted that this study is just one example that illustrates the often overlooked connection between hospital design and patient care. Investing in research to find out which design features work best can be a key factor in improving patient outcomes. “I think we can get a much better return on investment from what we’re building and hopefully design safer, healthier hospitals,” he said.

Future studies should examine these results at multiple hospitals to determine whether the results are generalizable, the authors suggest. They are in the process of replicating a similar study across Michigan Medicine and hope to recruit employees from other hospital systems.

In addition, the researchers hope to expand their study to include other metrics such as pain medication use and patient satisfaction in these room types.

"The most common question we get is: Do you want us to rebuild our hospitals? Of course that's not practical. But we're seeing clear patterns where certain types of rooms have better outcomes after surgery," said Dr. Ibrahim. "We can start by prioritizing the sickest patients. Just as we have developed precise healthcare models to provide the right care to the patient, there can also be a consequence for the right space for the right patient and the right procedure to optimize overall outcomes."

The study was funded by the Department of Surgery at the University of Michigan.

Source:

American College of Surgeons

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